Are referrals to occupational therapy for developmental coordination disorder appropriate?
Are referrals to occupational therapy for developmental coordination disorder appropriate?
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DOI：
10.1136/adc.2002.016303
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发表时间：
2004-02-01
影响因子：
5.2
通讯作者：
Sibert, JR
中科院分区：
文献类型：
--
作者：
Dunford, C;Street, E;Sibert, JR
目的：评估儿童转介到职业治疗服务在格温特与发展协调障碍（DCD）的推定诊断，以调查其referreration.Methods的适当性：非紧急转介到职业治疗小组的儿童协调困难在格温特2001年6月和2002年2月进行了研究。确定了89名5至10岁的儿童。排除了13名不符合DCD标准的儿童。剩下76名儿童，其中67人得到了实际评估。如果使用运动ABC的第15百分位数，则26名儿童符合DSM IV中的四个标准之一，41名儿童不符合（38%）。如果使用第五百分位数，则有21名儿童符合DSM中的四个标准之一，46名儿童不符合DSM中的四个标准之一（31%）。在主要的治疗者群体中，学校护士的成功率最高，为48%;儿科医生的成功率为32%。成功率最低的是教育心理学家和教师，只有20%的病例实际上患有DCD。这些差异并没有达到统计学意义。结论：不到三分之一的转介到职业治疗的DCD实际上有诊断。这表明，需要进一步的培训和指导。这包括对DSM IV标准及其解释的了解和理解。这将减少耗时和不必要的评估。带有清单的分诊程序将是一个很好的前进方向，我们希望设计一个程序来帮助推荐人完成这一过程。
Aims: To assess children referred to the Occupational Therapy Service in Gwent with a presumptive diagnosis of developmental coordination disorder (DCD) in order to investigate the appropriateness of their referral.Methods: Non-urgent referrals to the occupational therapy team for children with coordination difficulties in Gwent between June 2001 and February 2002 were studied.Results: Eighty nine children, aged 5 - 10 years, were identified. Thirteen children who would not meet the DCD criteria were excluded. This left 76 children, 67 of whom were actually assessed. If the 15th centile for the Movement ABC is used, 26 children met and 41 failed one of the four criteria in DSM IV (38%). If the 5th centile is used, 21 children met and 46 failed one of the four criteria in the DSM (31%). Of the major groups of referrers, school nurses did the best with 48% success rate; better than the paediatricians with 32%. The worst success rate was in educational psychologists and teachers, with only 20% of cases referred actually having DCD. These differences did not quite reach statistical significance.Conclusions: Less than a third of referrals to occupational therapy for DCD actually have the diagnosis. This suggests that referrers need further training and guidance. This includes a knowledge and understanding of the DSM IV criteria and their interpretation. This would reduce the number of time consuming, unnecessary assessments being done. A triage procedure with a checklist would be a good way forward and we hope to devise one to assist referrers with this process.