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Developmental Co-ordination Disorder or Dyspraxia

(DCD)

  • Clumsiness

  • Developmental dyspraxia

  • Motorial perceptive disorder,

there are a few names given to the Motor Coordination Disorders.

In fact, it is likely that the clumsiness does not represent a single disorder, but it can rather indicate a heterogeneous group of impairments related to the motor control.

In the DSM V, it is defined as a “neurodevelopmental condition with a poor motor performance that may manifest as coordination problems, poor balance, clumsiness, dropping or bumping into things; marked delays in achieving developmental motor milestones (e.g., walking, crawling, sitting) or in the acquisition of basic motor skills (e.g., catching, throwing, kicking, running, jumping, hopping, cutting, colouring, printing, writing). [...] Diagnosable only if such impairment significantly interferes in the academic learning and the daily activities [...] and it does not occur due to a general medical condition (e.g., cerebral palsy, hemiplegia, or muscular dystrophy).

DCD is a heterogeneous disorder, and its manifestations can be diverse and complex.

Based on the co-occurrence of DCD with Attention Deficit and Hyperactivity (ADHD), Autism Spectrum Disorders and Specific Learning Disorders (DSA), the existence of a shared genetic basis has been hypothesised (DSM-5, American Psychiatric Association, 2014).

The incidence of the Developmental Coordination Disorder (DCD) in children between 5-8 years old is estimated to be between 5-6%, with a male-female ratio of 2:1 (DSM-5, 2014).
 

DCD may affect various aspects of a child’s life, from a delay in the acquisition of the main stages of motor development (e.g., control of the trunk; crawling; autonomous walking) to a difficulty in the acquisition, planning and autonomous execution of fine motor sequences (e.g., Writing).

 

But let us look together in detail the characteristics of subjects affected by DCD:

 

PHYSICAL CHARACTERISTICS

  • The child may be awkward in movement (e.g., bumping into things when walking, dropping objects repeatedly)

  • Gross motor and fine motor difficulties (e.g., example screwing / unscrewing, buttoning / unbuttoning, using scissors correctly, closing the zip, making a knot)

  • Difficulties in the acquisition and execution of personal and social autonomy (e.g., wash hands, brush teeth, tie shoes, use knife and fork)

  • Difficulties in the control of static and dynamic balance, integration of multiple sensory channels (e.g., sport activities)

  • Poor academic results in areas relating to the acquisition of writing and logical-mathematical skills

EMOTIONAL / BEHAVIOURAL CHARACTERISTICS

  • Carrying out motor activities requires significant effort for the child with DCD and that is why they will avoid taking part in certain activities

  • They can often develop low self-esteem, low tolerance to frustration and lack of motivation

  • A change in routine can generate opposition considering how much effort it takes for them to plan a new activity

 

The clinical picture varies in relation to the age of the subject

and consequently to the degree of maturation

of the emerging motor skills

(Roberto Militerni, 2015).

 

 

The main signals of such disorders may also refer to the sensorial aspects of the motor learning (e.g., sight, touch, hearing) those are all senses which allow our body to adjust to the environment, therefore the sensorial and perceptive aspects also must be taken into consideration.

The proprioceptive sensations, for instance, constantly flock to the brain transmitting all the necessary information to allow mild adjustments of the body positioning while we move.

Another aspect to be considered is the muscle tone. If your child presents hypotony, inadequate posture when seated or standing, and / or easily gets tired when playing games involving physical activity, they should be referred to a childhood specialist.

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