Management of children with disorders of motor control and coordination

Clumsy or impaired performance of motor skills can result from a number of neurodevelopmental disorders, either as a primary or secondary consequence of the condition (Dewey & Tupper, 2004) (see Table 16.1). Altered motor control and coordination stem from a variety of causes, manifest at different levels of severity, affect functioning in other neuropsychological domains, and take various forms. Problems in controlling one’s actions represent visible physical characteristics that often cause significant disability for children, and may continue to impact persons into adulthood unless managed effectively (Farmer & Deidrick, 2006; Keogh, Bernheimer & Guthrie, 2004; Mudrick, 2002). This chapter will review the identification and assessment of pediatric motor disorders from a developmental neuropsychological perspective, with a focus on disorders that affect primary aspects of motor control and coordination, rather than as secondary symptoms or manifestations of the developmental condition. After a discussion of motor control theory and assessment issues, two major neurodevelopmental conditions will be presented, and current management methods for amelioration of the motor impairments associated with those conditions will be discussed. Reviewed in turn will be two common types of cerebral palsy and representative treatment methods, and the neuropsychological entity known as developmental coordination disorder, which is yet to be clearly defined and may not represent a homogeneous condition. These disorders were chosen to represent several of the common neuromotor impairments seen in pediatric neuropsychology practice and will provide examples of conditions where controversial treatment methods have been used in the past, but where current scientific understanding is likely to lead to more efficacious intervention methods in the future.