Thursday 20 September 2018

Helping children with coordination difficulties master riding a bicyle

cycling coach with child

In this programme, bike riding is broken into small steps. Each child is allocated a cycling ‘coach’ who works with them on 10 skills.

children doing bike safety checks

The children are practising the bike safety check

children walking with bike

Learning to walk with the bike is one of the 10 skills taught

drawings made by child

Nine-year-old Ada who participated in the programme, made drawings to illustrate how she felt before and after she learnt to cycle.

In this blog, Dr Mellissa Prunty, Lecturer in Occupational Therapy at Brunel University London, presents a pilot programme set up to help children with dyspraxia learn to cycle. At the end of the one week programme, all children and their parents reported an improvement in the child’s perceived cycling ability.

Developmental Coordination Disorder (DCD/’dyspraxia’)

Children and young people with developmental coordination disorder (DCD) have significant difficulties with motor coordination which impacts on activities of daily living. They are less physically active, have poorer levels of physical fitness and are at greater risk of obesity compared to typically developing peers.

Learning to ride a bike is an important rite of passage for children, the benefits of which could counteract secondary issues associated with DCD by providing a source of moderate-to-vigorous physical activity and opportunities for social participation.

While children with DCD have difficulties with learning key childhood skills, bike riding is the one skill that most children with DCD really want to learn. Research has shown that children with DCD are able to learn skills through direct teaching and practice of the task, with the help of therapists or coaches. The trouble is there is no written guide or well defined, replicable intervention for teaching children with DCD how to cycle.

We have been working closely with another community-based cycling group in Oxford to develop ways of evaluating the effectiveness of cycling interventions for children with DCD. This blog presents the work of a university-based cycling group at Brunel University London.

I’m happy because I’m not left out…before all of my friends could ride a bike and I couldn’t so I couldn’t join in…I ride my bike with my Dad, we can have a race and I beat him every time because I’ve been practicing lots.

- Molly, 11 years old

Brunel University London Cycling Group

The cycling group at Brunel University London is a highly structured one-week cycling intervention that can be delivered by either Allied Health Professionals and/or cycling instructors in the community. Drawing on specific teaching principles, the intervention involves presenting bike riding in small steps and progressing at rates that appropriately challenge each child as an individual.

The group is run by an Occupational Therapist for four mornings over half-term for two hours a day in the safe space of Brunel University London Sports Centre. Each child is allocated a cycling ‘coach’ (occupational therapy student) who works with the child on 10 skills:

  1. Put on helmet
  2. Bike safety check
  3. Walk with the bike
  4. Mount and dismount
  5. Walk while seated
  6. Scooting
  7. Use of brakes
  8. Independent pedalling
  9. Steering
  10. Cycling indoors

The coaches use techniques such as breaking the task down into small achievable parts, adapting the task by making it easier or harder, demonstration, verbal feedback, repetition/practice, positive reinforcement and modifying the bike such as taking pedals off, lowering the saddle etc.

Pilot effectiveness

In our initial pilot work, eight children with DCD took part in the group, seven of which learned to cycle independently. All children and their parents reported an improvement in the child’s perceived cycling ability on the last day.

What the children and their parents thought

We followed up with the children to see what the benefits were six months later.

Pilot programme participants Ada and Molly were happy to share their story.

Molly, 11 Years Old

The Content of the Cycling Group: "First we learnt to walk with the bike and how to put on [our] helmet, then we learnt more about walking with the bike, and on the third day we were like scooting with one leg, and the next day I learned how to do it with two legs, and then I just started riding a bike.“ 

The Benefits of Learning to Cycle: "I’m happy because I’m not left out…before all of my friends could ride a bike and I couldn’t so I couldn’t join in” …"now sometimes I go cycling with my friends"…"I ride my bike with my Dad, we can have a race and I beat him every time because I’ve been practicing lots.“

I feel very very happy…I’ve drawn myself being happy because I can ride a bike now and I’m shouting to my mummy and daddy and my sister I can ride a bike now.

- Ada, 9 years old

Molly’s Mother

About the Cycling Group: “It’s about giving them a place where everyone is at the same stage. None of them know how to ride, so they don’t feel like they have to know anything in advance and breaking it into steps is the most important thing because before that Molly wouldn’t have been able to, she wouldn’t have been able to ride.”

Molly has since joined a Cycling Club. “She has joined the local [mainstream] cycling club and goes there every Saturday for two hours. Of course, at the beginning, she wasn’t the with the advanced riders because they divided them into a beginners group that were confident in braking and going uphill, but she has moved through that group now and she really really likes cycling.”

Ada, 9 Years Old

Ada made drawings to illustrate how she felt before and after she could cycle.

When talking about the picture before she could ride a bike, Ada said:

“This is me being sad…because I’m the only one in my class that couldn’t ride a bike. I saw other children riding bikes and I wanted to ride too because it looked fun because they knew how to ride a bike…in my picture I’m saying I want to learn to ride a bike like other children”

When talking about the picture after she could ride a bike, Ada said:

“I feel very very happy…I’ve drawn myself being happy because I can ride a bike now and I’m shouting to my mummy and daddy and my sister I can ride a bike now.”

Ada’s Mother

“I was really happy, obviously I was quite emotional, from a point where you know she has difficulties with her movement. I think I partly thought it’s one of those things she may not be good at or do, but over the course of the week you can see her confidence building, her gradually doing better and then towards the end actually cycling. You know it was quite an emotional experience and she was really chuffed with herself as well.”

Future Directions

In partnership with our colleagues in Oxford, we are looking at ways of formally evaluating these types of cycling interventions to examine their effectiveness.

By supporting children with DCD to learn how to cycle it may increase social participation and physical activity in this group.

It may also create a bridge into the mainstream Bikeability programmes for children who need additional input before entering Level 1.



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