Children with Developmental Coordination Disorder: A flyer for medical practitioners

Developmental Coordination Disorder (DCD) is a motor skills disorder that affects 5 to 6% of school-aged children in North America. A diagnosis of DCD is made when a child has significant motor coordination difficulties which impact on the child’s ability to perform academic tasks and/or daily living skills. Children with DCD lack the motor coordination necessary to perform everyday tasks that are appropriate for their age. They are, however, of normal or above average intellect and do not meet the criteria for other neurological disorders of movement (i.e. cerebral palsy, muscular dystrophy). DCD may co-exist with other neurodevelopmental conditions such as attention deficit disorder and speech/ language delays. If more than one neurodevelopmental condition is present, all diagnoses should be given so the children receive the intervention and school accommodations that they need (American Psychiatric Association, 2000). 

A child with DCD will demonstrate significant difficulty with self-care tasks (e.g., dressing, using utensils, morning routines); academic tasks (e.g., printing, handwriting, copying, organizing seatwork, gym class); and leisure activities (e.g., sports, playground activities, social interactions). Parents may not always share their concerns about a child’s motor skills but will often report behaviours such as fatigue, school avoidance, reluctance to participate in physical activities, frustration, anger, low self-esteem and depression. ‘These warning signs should be investigated and a referral should be made to an occupational therapist and/or physiotherapist who has experience working with children for further assessment.

More detailed information about the differential diagnosis of DCD can be found in three excellent articles by Harris, Mickelson, & Zwicker (2015), Gibbs, Appleton & Appleton (2007) and Hamilton (2002). Educational materials about DCD that are suitable for physicians, parents, teachers and other health professionals can be found on the DCD section of the CanChild website, including the new MacHealth DCD Physician Module.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-V) (5th ed.). Washington, DC: Author.

Harris, S. R., Mickelson, E. C., & Zwicker J. G. (2015). Diagnosis And Management Of Developmental Coordination Disorder. Canadian Medical Association Journal, 187(9), 659-665. doi:10.1503/cmaj.140994.

Gibbs, J., Appleton, J., Appleton, R. (2007). Dyspraxia or developmental coordination disorder? Unravelling the enigma. Archives of Disease in Childhood. 92, 534-539.

Hamilton, S. (2002). Evaluation of clumsiness in children. American Family Physician, 66, 1435-1440.