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Developmental Conditions

Difficulties with Attention Motor Planning and Perception

What is DAMP?

DAMP is an accepted term in Australia to describe children who present with a mixture of coordination, attention, emotional, speech and sensory perception deficits, including receptive and expressive communication difficulties.

What causes DAMP?

There is no known cause for DAMP. Studies indicate that certain areas in the brain (frontal cortex) responsible for attention, monitoring behaviour, and planning, takes longer to mature in these children. The role of the cerebellum in DAMP has not yet been investigated. More boys than girls have been diagnosed with DAMP.

How DAMP Affects Children?

They may experience receptive communication difficulties such as having poor social understanding and difficulty appreciating the thoughts and feelings of others. They can have trouble making sense of what they hear and also have poor comprehension of written materials when reading.

Children may have expressive communication difficulties.

They may internally know what they want to say, on the level of ‘feeling’ however have significant difficulty putting this in words verbally in order to clearly express themselves. They may have difficulty with emotional control, and some may also have stuttering difficulties related to this. The modulation of voice volume and pitch may also be affected. Children require encouragement, understanding and emotional support as they navigate life with DAMP.

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Prenatal screening and diagnosis

DAMP may include coordination difficulties that express themselves in poor balance, gross and fine motor control. Children may hesitate or stumble on steps, escalators, or when the ground is uneven, and visibility is poor.

They may appear awkward and noisy when running, experience falls, collisions or accidents frequently, find tasks such as swimming, dance, or riding a bike difficult to learn. Activities of daily living such as tying shoelaces may be difficult, and they may often spill food when eating. Children may also have perception problems related to coordination in space, for example have difficulty understanding how to draw, write and read, or misjudging body positions and the location of body parts in space. DAMP symptoms experienced vary significantly from one individual to another.

Parents may observe some attention difficulties. Children may have difficulty being still and concentrating. Activities and tasks may consistently remain unfinished. Despite a desire to do it (sometimes), they may have considerable difficulty completing homework, especially if they are in an even slightly distracting environment (such as if a sibling is entering or leaving the room or a TV is on in the background). They may appear uncomfortable when sitting and prefer slouching or lying down to do academic tasks.

Getting help with DAMP

Occupational Therapy approaches and activities that can support the child and/or their carers include:

  • Expanding abilities: Developing a broad range of skill areas.
  • Social stories: Providing ideas and education around social story development.
  • School transition: Advocating and professionally supporting the transition to school and liaising with teachers, as required.
  • Visual cues can be used to support routine and to introduce new, or a change in tasks.
  • Motor development delay: If there is a delay in motor development, determine the current age level of a child’s abilities.
  • Devise goals: Setting functional goals in collaboration with the child, parents and teachers so that therapy has a common focus beneficial to everyone involved.
  • Educating parents, carers and teachers about DCD, the age-appropriate skills a child should be demonstrating and providing management strategies/ideas to assist the child in the home, at school and in the community.
  • Physical skills: Providing ways/ideas to promote physical activity and participation in team/group activities.
  • Task involvement: Providing alternative ways to encourage task engagement.
  • Direct skill teaching through a task-based approach.
  • Sensory Processing: Enhancing sensory processing in order to gain better attention to task.
  • Underlying skills: Developing the underlying skills necessary to support whole body (gross motor) and hand dexterity (fine motor) skills, such as providing activities to support:
  • Balance and coordination
  • Strength and endurance
  • Attention and alertness
  • Body awareness
  • Movement planning
  • Break tasks into smaller component tasks
  • Provide breaks during and between tasks
  • Provide explicit step by step instructions
  • Use simple language and instructions that are concise
  • Allow longer timeframes in which to complete tasks
  • Have regular exercise and physical activity breaks throughout the day
  • ‘Chunk’ tasks into smaller, manageable components
  • Have a good knowledge of the child’s strengths and weaknesses and areas of extreme interest
  • Use of learning aids (including electronic spellers and dictionaries, word processors, talking calculators, books on tape).

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