Childhood Locomotor Disorders

Locomotor Disability

• Disability of the bones, joints or muscles leading to substantial restriction of the movement of the limbs. ( Problem in moving from one place to another).
• Common conditions
• Poliomyelitis
• Cerebral palsy
• Injuries of spine and head
• Soft tissue fractures
• Muscular dystrophies

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Prevalence

Causes

• Heredity
• Birth defects
• Lack of care during pregnancy and during childbirth
• Mal-nutrition
• Traumas

Characteristics

• Delayed motor development
• Delayed speech development
• Behavioural issues
• Feeding problems
• Balance and co-ordination problems

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The most commonly seen locomotor disability in children now a days is the Cerebral Palsy.

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Normal Motor Development

Motor milestones : 2

Gross Motor Skills : 3 to 5 years

Gross Motor Skills : 3 to 5 years

• Skills that use large muscles ( legs, arms, trunk and neck )
• Pedal a tricycle
• Catch an 8 inch ball thrown from 5 feet.
• Alternate feet going up and down stairs
• Jump forward 8 to 12 inches
• Walk across a 4 inch balance beam
• Kick a ball rolling him/her.

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Fine motor development – 2 years

• Towers 1 inch blocks
• Imitates a train of 2 to 4 blocks
• Holds a thick crayon in the palm
• Imitates or copies a vertical line
• Imitates a horizontal line
• Hand preference usually obvious
• Undresses mostly independently
• Unbutton large buttons
• Turns pages
• Opens a door

Fine motor development : 3 years

• Towers nine 1 inch blocks
• Grasps marker with thumb, middle and index fingers
• Copies horizontal line and circle
• Colours picture in general area
• Draws a simple design with some recognizable features
• Completes 4 to 5 piece puzzles
• Enjoys finger paint
• Does finger play
• Finger play with singing little songs

4 years

• Towers ten 1 inch blocks
• Builds various 5 to 6 block structures
• Holds a pen in adult fashion
• Copies a ladder
• Draws a recognizable person
• Completes larger puzzles with logical division
• Powers water or milk from small glass
• Traces own hand
• Manages fastners with occasional help

5 years

• Towers thirteen 1 inch blocks
• Copies triangle and various shapes
• Wants to write
• Print own name, some words and numbers upto 5
• Reversals common
• May write right to left
• Little awareness or control over spacing
• Draws a person with 6 parts
• Imitates six block design
• Completes 6 to 12 piece puzzles
• Manages clothing fasteners independently
• Cuts well with scissors
• Paper manipulated with fingers and wrists of assisting hand to cut complex shapes

Problem list

Learning Disability

• Dyspraxia/Developmental Co-ordination Disorder
• Common disorder that affects movement and co-ordination
• Does not affect intelligence
• Can affect your co-ordination skills such as
• Task requiring balance
• Playing sports
• Learning to drive a car
• Poor eye-hand co-ordination

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Difficulties

According to the National Centre for LD, individuals with dyspraxia have difficulties in :

• Movement
• Co-ordination
• Judgement
• Processing
• Memory
• Some other cognitive skills
• Planning and completing fine and gross motor task
• It can range from simple motor movements such as waving goodbye to more complex ones like sequencing steps to brush one’s teeth

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Dyspraxia often have :

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• Language problems
• Sometimes a degree of difficulty with thought and perception
• Does not affect the person’s intelligence
• Finds it difficult to plan what to do and how to do it.
• Inability to perform multiple tasks simultaneously
• Short attention span
• Hyper activity
• Poor lifestyle orientation
• Poor self esteem
• Inability to handle a situation

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Symptoms of Dyspraxia

• Poor balance
• Poor posture
• Fatigue
• Clumsiness
• Difference in speech
• Perception problems
• Poor hand-eye co-ordination

• Daniele Radcliffe ( lead actor, Harry Potter movies ) has a mild form of dyspraxia

Gold standard test for Dyspraxia

• Sensory Integration and Praxis Test (SIPT) : Jean Ayres in 1980 – 4 to 8 years
• Motorskill Assessment Tools
• Parent Questionnaires (sensory processing measure)
• New Tool (EASI-2021) : [ Not yet published ]
• Handwriting Assessment

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Diagnosis

• When carrying out an assessment, details required regarding the child’s developmental history, intellectual ability, gross and fine-motor skills
• Gross motor skills : use of large muscles – jumping, throwing, walking, running, maintaining balance
• Fine motor skills : use of small muscles – tying shoe-laces, doing up buttons, cutting out shapes with a pair of scissors and writing

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Dyspraxia in children ( very early childhood) : Child may take longer than other children : sit, crawl, walk, speak, stand, become potty trained, building up vocabulary

Dyspraxia in children ( early childhood ) :

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Pre-school Age

Later childhood

In Adults

Treatments for Dyspraxia

• Physical therapy
• Occupational therapy
• Speech and language therapy
• Perceptual motor training
• Active play
• Equaine therapy

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• Thank you ……

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• Smitha.T [BPT, MPT (paediatrics)]

Physical therapist,

ICCONS. ( mob: 9446131749)