Islington Community Paediatrics: Pathway for children referred for assessment of developmental coordination disorder (DCD)

Who is this care pathway for?

This care pathway has been written primarily for families and carers of a child who have possible developmental coordination disorder.
 
This information in this page is also likely to be of interest and helpful for professionals as well.

Who do we see?

We see children over 5 years of age for an assessment to determine if they meet the diagnostic criteria for DCD or dyspraxia, who have an Islington GP or attend a school in Islington.

How to use this tool

When you scroll down you will see the information provided in this care pathway is set out in the following sections:
  • Who we see?
  • Who can refer and how?
  • Care Pathway: gives a flow-diagram type overview of the pathway
  • Detailed actions: sets out in more detail what is involved in the different parts of pathway
  • Associated documents: more for use by professionals
  • Resources: these are links to relevant web sites
  • Quality standards: this is a list of the quality standards that we report on annually on this web site and these are designated by QS where they appear in the text

Who can refer and how?

We accept referrals from any professional. If you are concerned about your child, please discuss your worries with your GP, health visitor or other professional who is working with you and your child, as they can make a referral.

While we do not accept referrals directly from families, the referral must include acknowledgement that you have consented to the referral.

A referral form is included in the Associated Documents section of this web page for use

Care Pathway

Detailed Actions to be Completed

Referral for DCD Assessment

Please note that in our service:

  • We use an electronic patient record to hold our clinical notes and documents. This in turn is accessible by other professionals who work for Whittington Health and helps greatly with our information sharing
  • We welcome and actively seek, and act on feedback from all who use our services (QS-2)
Children referred for a DCD assessment will be seen in the first instance by OT. Any referrals received in Community Paediatrics requesting a DCD assessment will be forwarded to our OT service as the key first step in this assessment pathway.
 
 
 
OT Assessment

Your child will need to be seen and assessed by an OT in the first instance. The OT will take a history and examination, take into account your and your child’s teacher’s views and undertake a number of assessment tests of your child that typically include:

  • DCD Questionnaire
  • Movement ABC
  • Beery Visual-Motor Integration test
  • Sensory Assessment

They will also ask for:

  • The latest report from your child’s SENCO
  • If there is any Educational Psychology assessment (in order to rule out learning difficulties/cognitive delay)
  • A vision check
  • A hearing check

 

Having gathered all this information and if your OT thinks that a diagnosis of DCD is possible, they will discuss your child with the Community Paediatrician

 
 
Assessment Appointments
 

It may take several appointments to complete the diagnostic assessment and to get all the results and questionnaires back (e.g. parent and teacher Conner's questionnaires).

For most children there will also be a school observation and discussion with school staff to get a first-hand description of the child or young person’s profile of strengths and difficulties.

 
 
DCD Clinic

Your child will be seen by a developmental paediatrician who will take a medical and developmental history, and do a physical examination of your child with a focus on their neurological examination

Towards the end of appointment the OT will join the paediatrician and together they will discuss your child’s history, the findings of the examination and all the assessments undertaken and information gathered by the OT – it is at this point that the diagnostic criteria is reviewed to see if you child does warrant a diagnosis of DCD or not. If so then you will be given the diagnosis on the day with both your paediatrician and OT present in the same room

The paediatrician and OT will write a joint report which is circulated to an agreed list of professionals as well as yourself. We aim to get this completed and with you within 2 weeks of the clinic (QS-1)

If the diagnosis is confirmed we will give you written information about DCD also on the day


 
Post Diagnosis OT Input

Your OT will set out their recommendations depending on your child’s functioning. If not already completed, you child will be offered either group therapy sessions or a block of 1 to 1 sessions.

Any review period will be agreed.

 
 
Paediatric Follow up

Generally most children will be discharged form this clinic as the management rests with your OT.

Where there are other identified problems or more complex concerns about your child’s development, or if there is diagnostic uncertainty, then there is always the option for follow up with the paediatrician in one of general paediatric clinics.

  
 
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Associated Documents

Resources Table

Useful links  
This is an NHS site setting out information on DCD, its assessment and diagnostic criteria.
 
 
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Quality Standards Table

QS-1
We will send out our clinic letters within 2 weeks of the appointment
 
QS-2
We welcome, actively seek and act on feedback from all who use our services
 
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Working on it!