Developmental coordination disorder



Developmental Coordination Disorder 832
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Definition

Developmental coordination disorder is diagnosed when children do not develop normal motor coordination (coordination of movements involving the voluntary muscles).

Description

Developmental coordination disorder has been known by many other names, some of which are still used today. It has been called clumsy child syndrome, clumsiness, developmental disorder of motor function, and congenital maladroitness. Developmental coordination disorder is usually first recognized when a child fails to reach such normal developmental milestones as walking or beginning to dress him- or herself.

Children with developmental coordination disorder often have difficulty performing tasks that involve both large and small muscles, including forming letters when they write, throwing or catching balls, and buttoning buttons. Children who have developmental coordination disorder have often developed normally in all other ways. The disorder can, however, lead to social or academic problems for children. Because of their underdeveloped coordination, they may choose not to participate in activities on the playground. This avoidance can lead to conflicts with or rejection by their peers. Also, children who have problems forming letters when they write by hand, or drawing pictures, may become discouraged and give up academic or artistic pursuits even though they have normal intelligence.

Causes and symptoms

The symptoms of developmental coordination disorder vary greatly from child to child. The general characteristic is that the child has abnormal development of one or more types of motor skills when the child's age and intelligence quotient (IQ) are taken into account. In some children these coordination deficiencies manifest as an inability to tie shoes or catch a ball, while in other children they appear as an inability to draw objects or properly form printed letters.

Some investigators believe that there are different subtypes of developmental coordination disorder. While there is disagreement over how to define these different subtypes, they can provide a useful framework for the categorization of symptoms. There are six general groups of symptoms. These include:

  • general unsteadiness and slight shaking
  • an at-rest muscle tone that is below normal
  • muscle tone that is consistently above normal
  • inability to move smoothly because of problems putting together the subunits of the whole movement
  • inability to produce written symbols
  • Children with developmental coordination disorder have difficulty performing tasks that require motor skills or eye-hand coordination, such as catching a ball.  (Anthony Nex. CORBIS. Photo reproduced by permission.)
    Children with developmental coordination disorder have difficulty performing tasks that require motor skills or eye-hand coordination, such as catching a ball.
    (Anthony Nex. CORBIS. Photo reproduced by permission.)
  • visual perception problems related to development of the eye muscles

Children can have one or more of these types of motor difficulties.

Developmental coordination disorder usually becomes apparent when children fail to meet normal developmental milestones. Some children with developmental coordination disorder do not learn large motor skills such as walking, running, and climbing until a much later point in time than their peers. Others have problems with such small muscle skills as learning to fasten buttons, close or open zippers, or tie shoes. Some children have problems learning how to handle silverware properly. In others, the disorder does not appear until they are expected to learn how to write in school. Some children just look clumsy and often walk into objects or drop things.

There are no known causes of developmental coordination disorder. There are, however, various theories about its possible causes. Some theories attribute the disorder to biological causes. Some of the possible biological causes include such prenatal complications as fetal malnutrition. Low birth weight or prematurity are thought to be possible causes, but there is no hard evidence supporting these claims.

Demographics

It is estimated that as many as 6% of children between the ages of five and 11 have developmental coordination disorder. Males and females are thought to be equally likely to have this disorder, although males may be more likely to be diagnosed. Developmental coordination disorder and speech-language disorders seem to be closely linked, although it is not clear why this is the case. Children with one disorder are more likely to have the other also.

Diagnosis

The diagnosis of developmental coordination disorder is most commonly made when a child's parents or teachers notice that he or she is lagging behind peers in learning motor skills, is having learning problems in school, or is suffering frequent injuries from falls and other accidents resulting from clumsiness. In most cases, the child's pediatrician will perform a physical examination in order to rule out problems with eyesight or hearing that interfere with muscular coordination, and to rule out disorders of the nervous system. In addition to a medical examination, a learning specialist or child psychiatrist may be consulted to rule out other types of learning disabilities.

The types of motor impairment that lead to a diagnosis of developmental coordination disorder are somewhat vague, as the disorder has different symptoms in different children. There are many ways in which this kind of motor coordination problem can manifest itself, all of which may serve as criteria for a diagnosis of developmental coordination disorder. The core of the diagnosis rests on the child's being abnormally clumsy. To make this determination, the child's motor coordination must be compared to that of other children of a similar age and intelligence level.

The difference between a child who has developmental coordination disorder and one who is simply clumsy and awkward can be hard to determine. For a child to be diagnosed with developmental coordination disorder there must be significant negative consequences for the child's clumsiness. The negative effects may be seen in the child's performance in school, activities at play, or other activities that are necessary on a day-to-day basis. Also, for developmental coordination disorder to be diagnosed, the child's problems with motor coordination cannot result from such general medical conditions as muscular dystrophy, and cannot result directly from mental retardation . Some criteria require that the child have an IQ of at least 70 to be diagnosed with developmental coordination disorder.

Treatments

No treatments are known to work for all cases of developmental coordination disorder. Experts recommend that a specialized course of treatment, possibly involving work with an occupational therapist, be drawn up to address the needs of each child. Many children can be effectively helped in special education settings to work more intensively on such academic problems as letter formation. For other children, physical education classes designed to improve general motor coordination, with emphasis on skills the child can use in playing with peers, can be very successful. Any kind of physical training that allows the child to safely practice motor skills and motor control may be helpful.

It is important for children who have developmental coordination disorder to receive individualized therapy, because for many children the secondary problems that result from extreme clumsiness can be very distressing. Children who have developmental coordination disorder often have problems playing with their peers because of an inability to perform the physical movements involved in many games and sports. Unpopularity with peers or exclusion from their activities can lead to low self-esteem and poor self-image. Children may go to great lengths to avoid physical education classes and similar situations in which their motor coordination deficiencies might be noticeable. Treatments that focus on skills that are useful on the playground or in the gymnasium can help to alleviate or prevent these problems.

Children with developmental coordination disorder also frequently have problems writing letters and doing sums, or performing other motor activities required in the classroom— including coloring pictures, tracing designs, or making figures from modeling clay. These children may become frustrated by their inability to master tasks that their classmates find easy, and therefore may stop trying or become disruptive. Individualized programs designed to help children master writing or skills related to arts and crafts may help them regain confidence and interest in classroom activities.

Prognosis

For many people, developmental coordination disorder lasts into adulthood. Through specialized attention and teaching techniques it is possible over time for many children to develop the motor skills that they lack. Some children, however, never fully develop the skills they need. Although many children improve their motor skills significantly, in most cases their motor skills will never match those of their peers at any given age.

Prevention

There is no known way to prevent developmental coordination disorder, although a healthy diet throughout pregnancy and regular prenatal care may help, as they help to prevent many childhood problems.

See also Disorder of written expression

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. text revised. Washington DC: American Psychiatric Association, 2000.

Sadock, Benjamin J., and Virginia A. Sadock, eds. Comprehensive Textbook of Psychiatry. 7th ed. Vol. 2. Philadelphia: Lippincott Williams and Wilkins, 2000.

PERIODICALS

Kadesjo, Bjorn, and Christopher Gillberg. "Developmental Coordination Disorder in Swedish 7-year-old Children." Journal of the American Academy of Child and Adolescent Psychiatry 38 (July 1999): 820-829.

Rasmussen, Peder, and Christopher Gillberg. "Natural Outcome of ADHD with Developmental Coordination Disorder at Age 22 years: A Controlled, Longitudinal, Community-Based Study." Journal of the American Academy of Child and Adolescent Psychiatry 39 (November 2000): 1424.

Smyth, Mary M., Heather I. Anderson, A. Church. "Visual Information and the Control of Reaching in Children: A Comparison Between Children With and Without Developmental Coordination Disorder." Journal of Motor Behavior 33 (September 2001): 306.

ORGANIZATIONS

American Academy of Pediatrics. 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098. (847) 434-4000. <www.aap.org> .

Tish Davidson, A.M.

Developmental disorders see Pervasive developmental disorders



User Contributions:

Melissa
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Feb 14, 2009 @ 3:15 pm
Are there any support groups or forums about this?
O
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Aug 14, 2009 @ 11:23 pm
Being a 15 year old male with this pretty much sucks.

My current school is small so PE is okay, but im moving to a big school soon and DAMN am I nervous :s
Debbie S.
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Nov 19, 2009 @ 5:17 pm
As an ed consultant and member of IECA (Independant Educational Consultants Association), I have run into this developmental disorder and yes, I agree that even many professionals in school do not understand this! I have seen adolescents thrive in specific boarding schools where there is little emphasis on sports and a lot on many other kinds of activities. Unfortunately, these schools can be expensive. Check out online.
Michele
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Jan 31, 2010 @ 12:12 pm
I have just been diagnosed with 'Dyspraxia', I am 38 and there is so little information on the net and books about this for adults. Just because it starts in childhood does not mean that adults should not get the same amount of help, if anything adults should get more as we have had many years to pick up 'bad habits' so that we can cope with it. As I have just been diagnosed with this does not mean I can handle things better, it means I need help.
Pamela Das
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Feb 1, 2010 @ 3:03 am
Hello I am 19 year old now. I find difficulty in tying hair and i find difficulty in doing other house chores also. Does that mean I have Developmental coordination disorder. But i am good at studies.

Mostly girls in my class used to do make ups and all at the age of 14 year but i was not interested at that time because i cannot put lipstick easily. but now i am interested and want to do. am i having this disorder?

Please help me
Pamela Das
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Feb 1, 2010 @ 3:03 am
Hello I am 19 year old now. I find difficulty in tying hair and i find difficulty in doing other house chores also. Does that mean I have Developmental coordination disorder. But i am good at studies.

Mostly girls in my class used to do make ups and all at the age of 14 year but i was not interested at that time because i cannot put lipstick easily. but now i am interested and want to do. am i having this disorder?

Please help me
Nancy
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Feb 3, 2010 @ 1:01 am
I have a 10 yr old son with this. It has been so painful for him - he won't even play tag or kickball at recess because it is too humilitating for him. He has gotten to the point where he just wanders around by himself. I have enrolled him at a small, private school next year that emphasizes science & academics. He is excited to go. I hope things are better for him there. He does swim year round on a local swim team and does okay with that; it's hard work, & he'll never be one of their best swimmers. But he trains consistently, and after 2 years, he's no longer their worst swimmer, either. He's made big strides and does respectably well.
maria
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Feb 3, 2010 @ 6:06 am
I can identify with whatyou say Nancy about your son being left out or not being able to jion in.
The headmistress at my sons school feels he has dcd and she and I have written a referal to have our concerns looked into. I wondered what happens? He is having his eyes and hearing checked this week. I am worried and I think relieved all at the same time. He has always had difficulties which seem pretty standard with DCD his teacher says he is clever, but ask him to write and he goes haywire. I have always known something was not right for him, he is eight and if we can get the right kind of help for him it seems he will not need to suffer. What is the right kind of help?
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Jun 16, 2010 @ 9:21 pm
I have a 12 yr old son who has dcd and it is frustrating for him because he has a twin brother who is normal. I hope to get him into swimming this summer. I heard that swimming helps a lot. At 12, he can not tie his shoes and fasten his buttons. I am working with him to achieve at least the basic functions of daily living.

To get help or get your child tested, go through your child's school teacher, psychologist, social worker and special staff. They will have the child referred to a neurologist for testing. Based on the test from the neurologist, he will be placed in special education services and will be able to receive much needed help.
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Jun 10, 2011 @ 8:20 pm
I suffer from this condition physically, I have extremely bad hand eye coordination and it affects my daily life greatly plus many other things I do. Is there any possible medication to help me? I've already tried training and other things. Thankyou for any help- emails are welcome
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Jun 24, 2011 @ 11:23 pm
trying to get the security code to let me post
trying to get the security code to let me post
Trev
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Aug 8, 2012 @ 4:16 pm
I am an occupational therapist who works with a variety of children, including those with DCD. While I understand the concern for wanting to fix something which is going wrong, please remember to emphasize and spend more time strengthening what is going right. Try seeing the child's preferences (go to activities, people, and environments) as their strengths, and help them maximize their skills in this area. People of all abilities are successful in life by building their strengths, rather than fixing a weakness. I have a student now who may be very awkward (clumsy) physically, but has some great artistic talents. Though we can improve participation some in PE, where is her life going to be the most successful and fulfilled? By emphasizing strengths development, and addressing weakness in the context of keeping them from interfering with strengths being actualized, the child will feel more loved, supported, confident, and motivated - and ultimately will be more successful.
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Aug 10, 2012 @ 6:06 am
Hi My son is 10 years and after lots of referals to and from Educational Pyschologists (We thought he was Dyslexic) he has just been diagnosed with DCD. He doesn't really struggle with a lot of physical activities but really does struggle accademically. He has been refered to a occupational therapist now but I am hoping that you may be able to give a little more advice on his accademics. Thanks.

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