Aim

Nationally, 5 % of children who have no identified neurological impairment and are within the average range of cognitive abilities present with motor coordination difficulties. The combination of many problems often leads to poor academic achievement and emotional, social and behavioural problems. Increasing numbers of children were being referred to consultants and therapists resulting in long waiting times.

Therefore, the overall aim was to develop a child focused pathway to manage these problems experienced during school years and reduce waiting times for assessment and treatment.

Methodology

Responding to evidence suggesting that intervention during early years could provide unique opportunities for influencing the development of motor skills, a pilot study, approved by the local ethics committee, tested the hypothesis that specific motor learning programmes could be easily incorporated into primary schools curriculum with subsequent improvement of motor skills.

Based on the positive results from this study, a DCD Partners Group of children, parents and health and education professional was established to redesign the whole system in order to develop and then support the Pathway process and team working.

The Pathway was developed and launched jointly by Swansea NHS Trust and LEA entitled, The Graduated Response.

Stakeholder satisfaction is monitored through interview and questionnaire.

Results

Pathway is now official LEA Policy and acknowledged as best practice by Consultant Paediatricians and Therapists in the Trust for Children with DCD.

Three bilingual (Welsh/English) brochures that offer practical help and strategies together with structured training in their use are provided for teachers and assistants.

Children with more specific or un-resolving problems can be referred via the Community Paediatrician for in depth assessment and appropriate intervention to the Multi disciplinary DCD Clinic.

Referrals to this clinic have decreased and waiting times have reduced from 2 plus years to less than 12 weeks.

Referrals are not now made to the Consultant Paediatric Neurologists and this has resulted in significant reductions in waiting lists.

Evidence is beginning to emerge of improved academic performance and increased confidence and social skills for these children.

Evaluation

There is a clear pathway for children with DCD that is used by all agencies involved so that children benefit through the provision of focused intervention at optimal times.

Feedback through audit and interview is ongoing and continues to show high levels of stakeholder satisfaction.

Children no longer have long waits for appointments with Consultant Paediatric Neurologist and then wait again for appropriate intervention by therapists.

Services are streamlined, facilitating improved service planning and more reliable performance indicators.

Reflection

 Learning opportunities have been invaluable and occurred in many areas including facilitation of future inter agency and multi disciplinary working.

The importance of involving parents and children at an early stage and maintaining this input throughout the process and beyond was critical to the success of the project.

This subsequently proved of particular value as there has been increasing pressure from parents and teachers for a pathway for Secondary Schools and views and suggestions from children have been key to developing this.

Further action

Continue to evaluate and audit the pathway.

Assess research possibilities to establish a standardised method of measuring improvement in motor skills.

Launch the continuation of the Pathway, together with an interactive DVD, for Secondary Schools in the Spring of 2008.