Developmental Coordination Disorder (DCD)

INTRODUCTION:

Definition:

Developmental Coordination Disorder (DCD) is used to describe children with disturbances in their psychomotor development subtending voluntary motor skills, but normal neurologic examination, and preserved intellectual abilities.

Developmental coordination disorder (DCD) is a common neurodevelopment disorder with prevalence estimates range from 5% to 6% among school-age children and widespread implications.

Children usually develop the ability to sit, stand, walk and talk at a predictable age. When they are delayed in reaching these milestones, it may be due to a developmental problem.

Developmental Coordination Disorder (DCD) is a lifelong condition characterized by delay in gross motor skills (ex. Hopping, Jumping & climbing), delay in fine motor skills (ex. Dexterity) and they have problems in postural control and bilateral skills leading to difficulty in coordinating movements and significantly impacting the activities of daily living.

CAUSES OF DEVELOPMENTAL COORDINATION DISORDER:

Performing coordinated movements is a complex process involving many different nerves and areas of the brain.
Any problems with this process can lead to problems with movement and coordination.

It is not generally known why coordination does not develop as well as other skills in children with Developmental Coordination Disorder (DCD).

However, several risk factors have been identified that can increase a child's chance of developing Developmental Coordination Disorder (DCD).

These include:

Prematurity

Low birth weight

Family history of Developmental Coordination Disorder (DCD)

Mother drinking alcohol or taking illegal drugs while pregnant

 

DIAGNOSIS:

Developmental coordination disorder (DCD) can be difficult to diagnose because symptoms can be confused with other conditions. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria for the diagnosis of developmental disorder (DCD) are:

Criteria-A

The acquisition and execution of coordinated motor skills is substantially below that expected given the individual’s chronological age and opportunity for skill learning and use. Difficulties are manifested as clumsiness (e.g., dropping or bumping into objects) as well as slowness and inaccuracy of performance of motor skills (e.g., catching an object, using scissors or cutlery, handwriting, riding a bike or participating in sports).

Criteria-B

The motor skills deficit in criterion A significantly and persistently interferes with activities of daily living appropriate to chronological age (e.g., self-care and self-maintenance) and affects academic/school productivity, prevocational and vocational activities, leisure and play.

Criteria-C

Onset of symptoms is in the early developmental period.

Criteria-D

The motor skills deficits are not better explained by intellectual disability (intellectual developmental disorder) or visual impairment and are not attributable to a neurologic condition affecting movement (e.g., cerebral palsy, muscular dystrophy, degenerative disorder).
AREAS OF DYSFUNCTION:

Difficulty in executing coordinated motor actions

Difficulty in gross motor skills

Difficulty in fine motor skills

Poor motor learning (motor planning, learning new movements, adaptation to change, etc).

Deficits in postural control (hypotonia or hypertonia, immature distal control, poor static and dynamic balance, etc).

Poor body awareness

Sensorimotor coordination difficulty

Difficulty in eye movements

Visual perceptual/ visual motor difficulties

IMPACTS OF DYSFUNCTION ON DAILY LIFE:

Various ADLs may be affected by this disorder,

At 4-6 years:

Display a strange gait

Have problems getting dressed (buttons, shoelaces)

Difficulty in using cutlery and crockery (spoon, cup)

Poor drawing or painting skills

Clumsy use of scissors

Difficulty riding a tricycle or bicycle

At 6-14 years:

Difficulty writing, drawing, and using scissors

clumsiness in ballgames

At 14-18 years:

They continue to have problems with handwriting or typing

They are generally poor at sports and tend to avoid sporting activities and other forms of physical activity

OTHER PROBLEMS:

They may exhibit associated behavioral problems

They may have emotional, social, and affective difficulties

Anxious or depressive symptom

Poor self-esteem

Loneliness

Poor attention and concentration

Difficulty in following instructions

INTERVENTION:

Multidisciplinary approach

Occupational Therapist

Speech and language therapist

Physiotherapist

Paediatrician

Educational and clinical psychologist

An Occupational Therapist can help your child with motor skills, social skills and everyday activities at home and school, such as bathing, getting dressed and holding a pen or pencil to write.

A physiotherapist may help with range of movement, posture and overall strength and stability.

A speech and language therapist can work with your child to help their speech and communication.

An educational psychologist can work with your child to help their learning skills.

Treatment approaches used for Developmental Coordination Disorder (DCD):

(a) Sensory integration

(b) process-oriented approach

(c) Task-oriented approach

(d) Perceptual motor training

(e) Combinations of these.