Children with developmental coordination disorder (DCD) have a motor impairment that affects their ability to perform everyday tasks. Although severity of motor impairment can be measured, methods for assessing the perceived impact of DCD on daily activities have not been established. The purpose of this study was to use a child-focused approach to understand children's views of the impact of DCD on the activities that they perform daily. Children aged 5–10 years, referred with coordination difficulties to occupational therapists, were assessed using the Movement Assessment Battery for Children: children who received scores below the 15th percentile were included. The Perceived Efficacy and Goal Setting System (PEGS), a pictorial scale validated as a method for engaging children with disabilities, was administered to examine the children's perceptions of their competence in performing everyday activities and to identify goals for therapy. Parent and teacher concerns were collected by a questionnaire. The children, parents and teachers shared many concerns about the impact of DCD on physical tasks and on academic activities such as handwriting. The children expressed additional concerns, however, about their ability to perform daily self-care tasks and leisure activities, which were rarely recognised by the adults. Children require specialised methods to enable them to express their views and the PEGS appears to be suitable for this purpose.

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.

In this article, we provide an overview of current considerations of spirituality in family therapy literature and practice. We suggest that whatever practice of therapy is undertaken, implicity or explicitly it will reflect views on the connection between spirituality and family therapy--connections involving clients' and therapists' beliefs. A thematic framework based on dimensions of the instrumental and metaphysical is outlined. Clinical approaches and practices within these connections are discussed.

Background: Several studies have suggested an association between the functional Val 158 Met polymorphism in the Catechol-O-Methyltransferase (COMT) gene and neurocognitive performance. Two studies showed that subjects with the low activity Met allele performed better on the Wisconsin Card Sorting Test (WCST) and another study found an effect on processing speed and attention.

This article sets out to provide a conceptual framework for appreciating the range of psychosocial issues faced by families with genetic conditions. The framework is based on three components: a psychosocial typology of chronic illness; a consideration of the time phases of an illness / condition; and a systems view of the family life cycle as outlined by Rolland (1994) in relation to chronic illness. The particular nature of genetic conditions in relation to these components is outlined and discussed. Specifically, the quality of “uncertainty” associated with genetic disease is elaborated and a “pre-illness” phase is identified and outlined. Clinical examples of the framework as applied to Huntingtoris Disease and Duchenne Muscular Dystrophy are described. Implications for practice are discussed.