Reflections on using a community-based and multisystem approach to transforming school-based intervention for children with developmental motor disorders

Evidence-based management of Developmental Coordination Disorder (DCD) in school-age children requires putting into practice the best and most current research findings, including evidence that early identification, self-management, prevention of secondary disability, and enhanced participation are the most appropriate foci of school-based occupational therapy. Partnering for Change (P4C) is a new school-based intervention based upon these principles that has been developed and evaluated in Ontario, Canada over an 8-year period. Our experience to date indicates that its implementation in schools is highly complex with involvement of multiple stakeholders across health and education sectors. In this paper, we describe and reflect upon our team’s experience in using community-based participatory action research, knowledge translation, and implementation science to transform evidence-informed practice with children who have DCD

Salivary Gland Disorders and Diseases

Saliva plays an important role in maintaining healthy oral mucosa and teeth as well as oral function by continually covering and lubricating the oral tissues. Salivary gland dysfunction designates decreased saliva flow rate (salivary gland hypofunction), increased saliva flow rate (sialorrhea or hypersalivation), and changed saliva composition. Xerostomia (the subjective feeling of oral dryness) is often associated with salivary gland hypofunction and may severely affect nutritional intake, social interaction and quality of life. Local or systemic disorders and diseases are common causes of compromised saliva secretion. Some of these are related to gland pathology or to the pathophysiological conditions of the host, whereas others affect the gland innervation or are an iatrogenic result of treatment of a disease (e.g., radiation therapy for head and neck cancer, side effects of medications). In general, many patients suffering from diseases that influence salivary gland function also undergo treatments that may impair saliva secretion and/or induce xerostomia as an adverse effect. Consequently, it can be difficult to distinguish what can be attributed to the disease per se or what can be induced by treatment (e.g., medication intake). Thus, a thorough diagnostic workup and early diagnosis of salivary gland dysfunction are crucial to provide appropriate evidence-based treatment of salivary gland dysfunction to prevent oral sequelae and to initiate individualized alleviating management strategies of xerostomia.</p