Our teacher shared with us a reading that explains motor disorders and the possible interventions for students who have them. I thought the reading was so complete and so easy to understand that I wanted to share it in the web page, to both facilitate a summary to my classmates and to help any other people that might check the web page.
Motor disorders are alterations of the motor system that may be caused by an alteration of one or several of the following systems (Barrachina et al., 2013):
- The central nervous system (CNS)
- The muscular system.
- The bone system.
Some of the diagnosis and their characteristics will be discribed in the following paragraph:
Cerebral palsy: Number of chronic conditions that appear early in development and involve mainly body movement, muscle tone and coordination. Causes: Damage or faulty development of one or more parts of the brain (especially the motor cortex, in the frontal lobes) (Mitchell and Ziegler, 2013). Characteristics: Not progressive, does not become worse over time, but it becomes more problematical, because as we grow older we are expected to develop our skills considerably. Symptoms: Difficulty to create movements, rigidity and muscular weakness, lack of postural control and difficulty with coordination of voluntary movements, involuntary movements, lack of equilibrium, grimaces. Affected body parts: Tetraplegia (both arms and legs), paraplegia (legs), hemiplegia (one side of the body, usually the superior part) and monoplegia (one limb) (Barrachina et al., 2013).
Myopathy: Different illnesses involving a progressive affection of different muscular groups and a loss of their strength (Barrachina et al., 2013).
Spina bifida: Congenital malformation of the spine that leaves a part of the spinal cord without protection. Different degrees of paralysis. Symptoms: lack of skin sensitivity and hydrocephaly (Barrachina et al., 2013).
Spinal muscular atrophy: Genetic degenerative disorder affecting the motor neurons of the spinal cord and the capacity to talk, breath, swallow and postural control. Sometimes implies using a wheelchair from an early age (Barrachina et al., 2013).
Ataxia: Family of disorders, some of them progressive, related to difficulties in balance and coordination. They interfere in the capacity to walk and in doing fast and precise movements (Barrachina et al., 2013).
In the evaluation we must take into account not only the clinical data but also their possibilities to learn, and that involves the school context, which will have to be adapted and will need to provide the resources the child needs (Barrachina et al., 2013). To be evaluated: The competences of the child, needed materials, their communication system, the postural control, and the autonomous movement. Other aspects: Possible cognitive difficulties, curricular skills, autonomous work and literacy teaching (Barrachina et al., 2013). Variables when choosing a type of schooling (shared, ordinary or special): Architectural barriers, availability of the materials and products necessary to promote personal autonomy, access to the curriculum and communication, existence of support staff and educational services for type of students (physiotherapists, speech therapists, and autonomy support staff), evaluation of the motor skills.
Now moving to the educational intervention, we must take into account that many students with motor disorders will not be able to achieve the competences and skills of their same age peers, or not at the same time or in the same way. Hence, the intervention should be focused in helping them to develop the maximum number of functions as possible in an autonomous manner, even if it is not in the way most people do. Students with motor disorders are very heterogeneous, so intervention must be designed individually, taking into account the characteristics of the student and planning the necessary supports. General strategies (Barrachina et al., 2013): Give more time, or simplify the task, eliminate motor obstacles, adapt the methodology to facilitate learning by minimizing motor effort, observe the degree of fatigue, promote autonomous work in all areas of their life, promote the coordination between the different professionals. In the curricular adaptation area, students with motor disorders do not necessarily have cognitive difficulties. In any case, we need to consider the following aspects: Prioritization of objectives, because they often need more time, future needs, in case their disorder is progressive, adapting activities, and adapting the evaluation (oral exams, multiple-choise questions...). When we find a child with difficulties with speech, oral language, we must intervene fast, with a speech therapist that helps them with: Postural and movements control, treatment of organs related to eating (e.g., swallowing, drooling...), treatment of speech disorders: control of breath, voice, articulatory movements and production of phonemes, and acquisition of comprehensive and expressive language: vocabulary, grammar and pragmatic skills (with the cooperation of teachers and parents). In the reading and writing area, some students won’t need support, others will need a computer, others more time, and others multiple supports. It is preferred that the child develops the language skills even if it's through manual or pictorial signs, because to read and write we need to have mastered the phonetic code (speech), so it's not an option to teach the child to write to express themselves if they don't or can't speak, because it won't be effective.
In the AAC area we find that the exit of and intervention with AAC requires the use of specific strategies for teaching and interacting, such as (Barrachina et al., 2013): Establishing dialogues with balanced turns (e.g., avoiding talking too much to fill up silences), accepting all communicative modalities (e.g., gestures, manual signs, facial expressions, sounds, words...) when communicating with the child, providing models of use of the communication system, and use of repetitions and expansions in order to make their talk in a more complex way both in oral speech and in AAC systems.
Finally, it's of great importance the cooperation between professionals and families, because the family is the most stable and persistent support that the child has. And the professionals need to know the situation of the family in order to plan an intervention that the family can afford (in both terms of money and time). Professionals help families to: understand the child’s diagnose and its consequences, be confident in their work with the child, recognize difficulties of the child and alert professionals when these difficulties appear and deal with negative feelings such as rejection or guilt.
I hope this summary helps you both study and understant motor disorders and how to intervene.
Document summarized in this post:
Sidera, F. (2020). Educational Intervention for Students with Motor Disorders. Notes of the subject “Alumnes amb trastorns del desenvolupament: intervenció psicoeducativa” from the Degree of Psychology of the Universitat de Girona.
Other references, extracted from the document:
Augé, C., & Aviñoa, J. (2007). Trabajar la capacidad motriz en la escuela. En Bonals, J., & Sánchez-Cano, M., Manual de asesoramiento psicopedagógico (pp. 701-728). Graó.
Barrachina Andreu, LL., Albertí Boada, M., Coronas Puig-Pallarols, M., Gomar Uteza, C., Palmés Mordillo, C., Romero Ortega, L., Rosell Bultó, C., & Sadurní Montell, N. (2013). Discapacitat sensorial i motriu. Editorial UOC. Retrieved on May 30th from: http://openaccess.uoc.edu/webapps/o2/bitstream/10609/76546/1/Discapacitat%20sensorial%20i%20motriu.pdf
Basil, C. (2014). Los alumnos con parálisis cerebral y otras alteraciones motrices. En A. Marchesi, C. Coll & J. Palacios, Desarrollo psicológico y educación III. Trastornos del desarrollo y necesidades educativas especiales (pp. 303-328).
Departament d’Educació, (s.d.). Guia per a famílies d’infants i joves amb discapacitat motriu. Retrieved ton May 31st from: http://ensenyament.gencat.cat/ca/departament/publicacions/colleccions/guia-families/discapacitat-motriu/
Levine, L. E. & Munsch, J. (2011). Child Development. An active learning approach. UK SAGE Publications.
Mitchell, P. & Ziegler, F. (2013) (2 nd Ed.). Fundamentals of Developmental Psychology. New York: Psychology Press.
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