Priya Patel, M.S.
Developmental Coordination Disorder (DCD) is a delay in the development of motor skills, or difficulty in coordinating movements, which results in problems performing in sports and everyday tasks (American Psychiatric Association, 2013). Around 4- to 10% of school aged children in United States are affected by DCD (American Psychiatric Association, 2013). DCD prevalence rates range from about 2% in the United Kingdom to 19% in Greece, with a worldwide average of 6%. Owing to its increasing prevalence rate across the world, DCD has gained worldwide attention among medical and research communities.
The exact pathology behind DCD is still unclear, but deficits in motor planning and learning seem to be responsible for DCD. Children with DCD typically do not have any disturbances in muscle tone, sensory function or involuntary movements. Some children have difficulty in fine-motor skills, while others may have problems with gross- motor skills and some having difficulty in both. They may be clumsy in their movements, show difficulty in learning new motor skills, or have difficulty performing activities of daily living. These difficulties lead to inactivity in children with DCD, leading to several secondary complications later on, viz., obesity and coronary vascular problems being the most common of all.
Commonly used assessment tools for diagnosis of DCD are the Bruininks – Qseretsky Test for Motor Proficiency-2 (BOT-2), and the Movement Assessment Battery for Children-2 (MABC-2) (Bruininks, 2005; Henderson et al., 2007). While these tests are popular in research and clinical settings, some regard them as costly and time consuming. The revised Developmental Coordination Disorder Questionnaire (DCDQ’07) (Wilson et al., 2007), a parent based questionnaire, is a widely used screening test for diagnosis of DCD that is both cost and time efficient. The instrument has been translated and adapted for use in several countries, including: Italy, Canada, Brazil, and Taiwan, India. It consists of 15 items and assesses fine motor skills, gross motor skills, and general coordination. Children found to be suspect of DCD using the DCDQ’07 then undergo more stringent motor assessment using either the MABC-2 or BOT-2. In addition to being time and cost efficient, another merit of the DCDQ’07 is that parents are more likely to agree to their child's assessment initially and when the child is found to be at risk.
While previously it was believed that a child with DCD outgrew the condition, studies show that coordination difficulties in fact may worsen with increasing age. Difficulties with DCD no longer remain confined to everyday activities but may become part of the individual’s social, emotional, and behavioral domains of life. However, functional mobility and participation outcomes can be improved with intervention. The specific remedial movement activities (program) would obviously depend on results of the motor assessment. Guidelines from the European Academy for Childhood Disability (EACD) recommend that all children with DCD should receive intervention (Blank et al., 2012). With all that said, there is a dire need for early identification of children with DCD in order to ensure a timely remedial intervention and prevention of secondary complications.
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM, 5th ed.). Arlington, VA: American Psychiatric Association.
2. Blank R, SMITS-ENGELSMAN B, Polatajko H, Wilson P. (2012). European Academy of Childhood Disability (EACD): Recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version). Developmental Medicine and Child Neurology 54:54-93.
3. Bruininks RH. (2005). Bruininks-Oseretsky Test of Motor Proficiency, (BOT-2). Minneapolis, MN: Pearson Assessment.
4. Henderson SE, Sugden DA, Barnett AL. (2007). Movement assessment battery for children – 2nd ed., Movement ABC-2. Examiner’s manual. London: Harcourt Assessment.
5. Wilson BN, Kaplan BJ, Crawford SG, Roberts G. (2007). The Developmental Coordination Disorder Questionnaire 2007©©(DCDQ’07). Administrative Manual for the DCDQ107 with Psychometric Properties. www.dcdq.ca