Identification & Assessment

Identification and Assessment

While delayed motor milestones may be the first sign, this may not be the case for many children. Difficulties with learning new movements that require coordination or skill are more likely to indicate that something is not quite right. In early childhood where “learning by doing” is a key aspect, school related activities often take a lot of effort and success is limited. Parents often feel that their child is not developing as quickly or as well as their peers or siblings.

Some classic signs include:

  • Clumsy or poorly coordinated movement – for example bumping into things, dropping objects.
  • Awkward movement
  • Frequent trips and falls
  • Writing is messy, slow and requires more effort
  • Difficulty with daily living activities e.g. using utensils, scissors, opening jars.
  • Avoids physical activity or team sports
  • Finds it difficult to learn new skills

It is important to remember that not all individuals with DCD will be the same. There are varying degrees of impact on daily living activities, challenges in learning new skills, and whether they have co-occurring conditions.

Quotes:

"he seems to have lots of bruises from bumping into things all the time" "her colouring-in is so messy compared to the other kids in year 1" "the teacher told me he can’t keep up with the other kids copying down class notes" "he holds his fork like a club when cutting meat" "buttons and shoelaces are a struggle"

Diagnostic Criteria

A diagnosis of DCD is based on medical history, physical examination, school or workplace reports and individual assessment. The following criteria for diagnosis are:

  1. 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).
  2. 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 impacts academic/school productivity, prevocational and vocational activities, leisure and play.
  3. Onset of symptoms is in the early developmental period
  4. The motor skills deficits are not better explained by intellectual disability (intellectual developmental disorder),or visual impairment and are not attributable to a neurological condition affecting movement (e.g. cerebral palsy, muscular dystrophy, degenerative disorder).

Source: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, Psychiatric Association, 2013. p74.

Teachers: Signs in the Educational Environment

Early Years. In the pre-school environment learning is based on play, a ‘learn by doing’ environment. For children with DCD these tasks take on significant effort and often they are not successful in their tasks. They may find it difficult to stack blocks, mould play dough, draw with chalk, or thread beads. In the playground they find it difficult to balance, climb on play equipment and are always caught in chasey. These experiences are important for building their fine and gross motor skills necessary for more complex tasks as they get older. Young children may get frustrated easily and misbehave.

Primary School. By primary school they may be struggling with pre-academic tasks such as colouring-in, cutting using scissors, and crafts. As they get older they begin to have difficulty writing and keeping up in class, manipulating small objects for maths, science and craft, participating in school sporting activities, and moving about the structured class room setting. Children may begin to show signs of social and emotional difficulties and behavioural problems may become present.

Secondary School. By secondary school the speed required for writing neatly becomes more apparent and legibility continues to be a problem. Individuals with DCD may avoid sporting activities, feign illness, and begin to exhibit more social and emotional problems.

It is important to note that an individual with DCD does not necessarily have an intellectual impairment. The physical impairment, most often depicted in their hand written work, may disguise their true intellectual ability. For an interesting article please see "They’re Bright but Can't Write: Developmental Coordination Disorder in school aged children".

Useful Resources

Developmental Coordination Disorder questionnaire (DCDQ)

A parent report questionnaire used to identify coordination problems in children aged 5-15 years. http://dcdq.ca/

CanChild – Do you know a child who is clumsy?

A flyer for coaches and sports instructors.

http://dcd.canchild.ca/en/AboutDCD/resources/DCDPhysAct_Dec9Final.pdf

A flyer for community group leaders and instructors.

http://dcd.canchild.ca/en/AboutDCD/resources/C-DCD-ECommunityGroupFlyer030501.pdf

CanChild Educational Resources

http://dcd.canchild.ca/en/EducationalMaterials/home.asp