How Occupational Therapists May Work With Kids With DCD

If your child has developmental coordination disorder (DCD), one way the school might help is by providing occupational therapy (OT). But what exactly does OT mean for kids with DCD (which some people refer to as dyspraxia)? How will the therapist work on building motor skills?

The answer depends on what your child’s weaknesses are. Most kids with DCD struggle with fine motor skills, motor planning and coordination. Trouble with these skills can impact both learning and everyday life.

Therapy at school might focus on school-related tasks like writing. Private OT might focus more on self-care routines. In either case, here are some of the strategies OTs may use to help kids improve skills and learn key tasks.

Strategies for Teaching Handwriting

To help kids form and place letters correctly and make them the right size, OTs might:

• Use sensory feedback to help kids practice letter formation. The therapist might have them trace the letter in sandpaper or form letters with a finger in shaving cream. Kids might also use a tracing app on a tablet with a stylus. (See more multisensory techniques for teaching handwriting.)
• Try various types of specialty paper to help kids position letters on the line. Some paper has raised, bumpy baselines. There’s also paper that has the bottom half of the writing space highlighted.
• Use handwriting instruction that goes from the easiest task to the hardest. Kids start by forming capital letters with straight lines. Later, they move on to more complicated lowercase letters.

Strategies for Cutting With Scissors

To help kids cut shapes accurately, OTs might:

• Try using different kinds of scissors. These include loop scissors, hinge scissors and smaller scissors that can help increase control for kids who struggle with coordination or hand strength.
• Trim and remove excess paper around the shape. That helps kids more easily approach the line and cut with accuracy while their other hand supports and turns the page.
• Place the scissors in kids’ hands at first, then work up to suggesting how kids can position the scissors on their own (with their “thumbs up”).
• Use different colored paper, as well as paper with varying thicknesses. Those “cues” can help kids who rush to slow down and cut with accuracy on the line.
• Teach in order of difficulty. Start with cutting straight lines. Then move on to more complicated tasks like cutting curved lines, jagged lines, circles and other shapes.

Strategies for Fastening Clothing

To help kids learn to manipulate buttons, zippers and snaps, OTs might:

• Use dressing vests or dressing boards to practice skills step-by-step. Kids work with these tools on a table, rather than working with actual clothing on their body.
• Use verbal cues like “put the train in the station then pull it up the tracks” to help kids remember how to hook and position the zipper.
• Use resistive putty to improve kids’ hand strength and coordination for working with snaps. Kids pinch the putty with their thumb, index and middle finger, in the same position they’d use for snapping.
• Align the buttons and holes on the vest, and push the buttons partway through the holes. Kids complete the final step of pulling each button through.

Watch as an OT explains how to teach kids with motor skills issues to button clothes.

Strategies for Tying Shoes

To help kids work on the complicated task of tying their shoes, OTs might:

• Use a lacing board with two different colored laces to teach the steps. That way kids can clearly see how the laces connect and intertwine.
• Use a shoe positioned on the table first because it’s easier to see the steps, rather than tying with the shoe on the child’s foot.
• Lace a shoe with long laces that will increase success of the bows staying intact, rather than shorter laces that quickly come undone and require more precision.

OTs can also work with kids to improve gross motor skills, balance and coordination in general. For instance, OTs might have kids practice jumping jacks, catch balls of different sizes and weights, or run obstacle courses. Some activities like this can also be helpful for kids with sensory processing issues who struggle with motor skills.

There are many ways you can help your child build skills, too. Ask the therapist if there are exercises you can do with your child at home. Discover fun ways to help your child build fine motor skills and gross motor skills.