Are referrals to occupational therapy for developmental coordination disorder appropriate?

Area of Science:

• Pediatrics
• Occupational Therapy
• Developmental Psychology

Background:

• Developmental Coordination Disorder (DCD) is a common neurodevelopmental condition affecting motor skills.
• Accurate diagnosis is crucial for timely intervention and support.
• Referral appropriateness to specialized services like Occupational Therapy (OT) requires careful consideration of diagnostic criteria.

Purpose of the Study:

• To evaluate the accuracy of referrals for suspected DCD to an Occupational Therapy service.
• To determine the proportion of referred children who meet the diagnostic criteria for DCD.
• To identify potential areas for improving the referral process.

Main Methods:

• A retrospective study of non-urgent referrals for coordination difficulties in children aged 5-10 years.
• Referrals were assessed against the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria for DCD.
• The Movement Assessment Battery for Children (Movement ABC) was used to evaluate motor skills.

Main Results:

• Out of 89 initially identified children, 76 were considered for analysis after excluding those not meeting DCD criteria.
• Using the 15th centile of Movement ABC, 38% of assessed children met DCD criteria; using the 5th centile, 31% met criteria.
• Referral success rates varied by referrer type, with school nurses having the highest (48%) and educational psychologists/teachers the lowest (20%).

Conclusions:

• A significant proportion of referrals to OT for DCD do not meet diagnostic criteria, suggesting a need for enhanced referrer education.
• Improved understanding and application of DSM-IV criteria are necessary to reduce inappropriate referrals.
• Implementing a triage system with a checklist could assist referrers and optimize service utilization.