No convincing evidence off benefit from process-oriented treatment or a standard occupational therapy approach in children with developmental co-ordination disorder.

Objective To compare process-oriented treatment (POR_x) with 'typical sensorimotor programmes' and with no treatment in children with developmental coordination disorder (DCD). Design Randomized controlled trial. Setting Children referred to a home care school health support programme in Ontario. Patients Seventy-nine children aged 7-12 years were randomized to three groups by a research assistant not involved in the study. Inclusion criteria were: IQ ≥ 85 on WISC-R or equivalent, motor difficulty (≤ -ISD on fine or gross motor or composite scores on Bruininks-Oseretsky), deficient performance rating on the tasks of Ayres' clinical observations, normal hearing and vision, no specific neurological disorder and receiving no therapy. The number of families refusing randomization is not stated. Intervention Children in the POR_x group received kinaesthetic training as described by Lazlo and Bairstow (1985), receiving 5-12 sessions per child over 5 weeks. Children in the standard group received occupational therapy programmes designed to meet their specific needs (24 sessions over 9 weeks) while the comparison group received no therapy for II weeks. Main outcome measures Children were assessed pre-treatment, on completion of treatment (5 weeks for POR_x and no treatment groups, 9 weeks for traditional group) and 6 weeks after completion of treatment. Assessors were blind to allocation. The measures used were: the developmental test of visual-motor integration, the Stott test of motor impairment, the Southern California sensory integration test and the kinaesthetic sensitivity test. Main results Three children assigned to the no treatment group withdrew after randomization and two from the traditional group dropped out during treatment, leaving 27 in the POR_x group and 24 in each of the others. A number of children missed various components of the assessment and sample size varied from 72-74 on different measures. In essence, no significant differences were found between groups or over time except on one subscale of the kinaesthetic sensitivity test where the POR_x group showed significant improvement at both immediate and follow-up assessment. Conclusions ' Children with DCD treated with either a traditional approach using a mixture of sensory integrative, gross motor, fine motor and perceptual motor activities or with POR_x showed no convincing benefit compared to those receiving no treatment. [ABSTRACT FROM AUTHOR]