Multidisciplinairy Implementation
of Task Oriented approaches for
children with DCD
Practical suggestions for the work
environment based on a Dutch
Objective presentation
Effective treatment for children with DCD,
inspiration and suggestions on
• Process
Thematic outline presentation
•
Implementation:
Process of Change,
(Neufeld,1995)
•
Effective cooperation and learning:
Community of Practice
,
(Simons, Germans et al. 2003)
•
Practical examples:
Task-oriented / Occupation based
approaches
• Practice of task performance,
interaction of
child, task
and
environment
• Based on contemporary theorie
• Child’s problem solving skills
• Child (
&
significant others) centred
• Transfer and generalisation
(Smits-6th Dutch Policy Conference, 2006
Treatment approaches,
actual situation
Is change needed?
Treatment approaches for children with
DCD,
2006
(Reinders,2006):
– Unclear clinical decision making
– the NL: 8 treatment approaches
– General support ! for task-oriented
approaches
(Wilson 2005)
Desired situation
Underlining
the Leeds Consensus Statement (LCS)
Intervention approaches:
1. Functional and meaningful activities
2.
Child’s wishes
3. Significant others
4. Contextual (family)life
5. Evidence-based, grounded in theories
Process of change
(Neufeld,1995)
5 major activities
1. Motivating Change
* Create involvement and communication
* Create readiness: show the
discrepancy between actual and
desired situation
2. Managing transition:
* Create the right group of people
3. Sustain momentum:
Ad 2&3:
Community of practice
(Simons, Germans et al. 2003)
Create the right group of people related to your
work situation:
– Bounded by collective practice
– Learning activities create:
•
a shared body of knowledge
•
development of knowledge
•
consensus
– Quality improvement
Multidisciplinairy
community of practice,
started: 10-11-2006
Example on a National level:
Collective practice representatives:
Dutch health care situation
– OT / PT / SpT (22) pediatric rehab centres
– New: Outpatient clinics (4)
– OT and PT community practices (2 x 2)
– Steering group (3)
Leading figures
(Grol et al,2005)
– Engagement other leading figures : External
school services, scientists
Process of change:
4.
Political support
• International Scientific Committee
(Polatajko et al)
• International DCD conferences
DCD I: 1995 – DCD VIII: 2009
• Dutch DCD policy conferences
• Dutch National Steering group
Process of change:
4.
Political support
Pediatric Rehabilitation Centres
Rehabilitation
specialists
Psychologists /
remedial
educationalists
ParaMedical:
OT, PT, Sp T
National DCD steering group
Community
practices
Process of change 5:
Dutch multidisciplinairy
Community of Practice
5. Create a
vision
- State a
mission
- State the
outcomes
- State the
conditions
• Application of task-oriented
approaches, evidence based
• Consensus methodological
process
• Evaluation of related
instruments and treatment
Development of consensus
related to assessment and
treatment of children with
DCD related to evidence and
experiences
5: Outcomes, April 2007
1. Starting point
LCS
: study and discuss
task-oriented approaches
– CO-OP
(Mandich&Polatajko)
– NTT
(Smits-Engelsman)
– Ecological approach
(Sugden)
2. Evaluation methodology: treatment and
assessment
5: Conditions
5:
Conditions
•
Twice a year
•
Agenda in time
•
Written report within 2 weeks
including action points
•
Shared responsibilities
•
Maintenance knowledge
–
Responsibility as representative
of DCD team
Activities
Dutch multidisciplinairy
Community of Practice
• Learning activities
:
– Information exchange and record
– Thematic discussions
– Practice
– Presentations
• Homework
:
Information exchange
research and new developments,
record:lists with information
Thematic discussions
sensory profile related to task oriented approach,
working with ‘significant others’
Practice:
•
DCD ‘Track’
to be used in
schools
•
Analysing and discussion
task performance
Video clip:
(Wong Chung, 2008)
a child with DCD performing a whole task
Question:
Write down 6 factors that play an important role
in the child’s performance and put on post it’s
Practice:
An Example
Video clip:
Write down 6 factors that play
an important role in the
child’s performance.
Post its: Write and glue
Environment
Task
Child
Homework:
Idem with case from own
practice
Presentations:
Motor learning,
School Amps, CO-OP ……
Motor learning:
•Theoretical models
•Learning stages
•Differentiation in
activity and support
•Role of feedback
Effective groupwork has
brought us so far…..
• Learning, teamwork and focus on the child and
significant others !
(Ferlie, 2001)
• Consciousness on level of implementation
task-oriented treatment:
– Intervention focus mainly on child
• Developing active (learning) network:
– Communication and exchange
Is this model useful for the Norwegian
situation?
• (Inter)National developments on DCD
• Frame of references: Process of change,
Implementation strategies
• Adjustment to the
own
and
Norwegian
situation:
– Leading figures / Representatives
– (Tele)Conferencing
Thank you!
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