Developmental coordination disorder

Developmental coordination disorder (DCD), also known as developmental motor coordination disorder, developmental dyspraxia, or simply dyspraxia, is a chronic neurological disorder that begins in childhood. DCD affects the planning of movements and coordination due to inaccurate transmission of brain messages to the body. Impairments in skilled motor movements that interfere with daily living activities can be diagnosed as DCD in the absence of other neurological impairments such as cerebral palsy, multiple sclerosis, or Parkinson's disease.

According to CanChild in Canada, DCD affects 5 to 6 percent of school-aged children. However, the disorder can progress into adulthood, making it a lifelong condition.

Signs and Symptoms

Various areas of development can be affected by DCD, and these persist into adulthood, as there is no cure for the disorder. Individuals often develop coping strategies that can be enhanced through occupational therapy, psychomotor therapy, physiotherapy, speech therapy, or psychological training.

In addition to physical impairments, DCD is associated with memory problems, especially working memory. This can result in difficulty remembering instructions, organizing time, remembering deadlines, losing items, or completing tasks that require remembering multiple steps in sequence. Dyspraxic individuals often have excellent long-term memories despite poor short-term memory. Many benefit from working in structured environments, as repeating routines minimizes difficulties with time management and allows them to commit procedures to long-term memory.

People with DCD sometimes have difficulty moderating sensory information, which can lead to sensory overload and panic attacks. Moderate to extreme difficulty performing physical tasks is experienced by some, and fatigue is common due to the energy expended in executing movements correctly. Some individuals with DCD also suffer from hypotonia or low muscle tone, which can affect balance.

Gross Motor Control

Gross motor control involves the coordination of large muscle groups and whole body movements. Individuals with DCD may have difficulties with balance, posture, and coordination, impacting their ability to perform tasks such as walking, running, or jumping.

Fine Motor Control

Fine motor control involves the coordination of small muscle groups and precise movements, often involving the hands and fingers. Individuals with DCD may struggle with tasks that require fine motor skills, such as writing, buttoning clothing, or using utensils.

Developmental Verbal Dyspraxia

Developmental verbal dyspraxia is a specific type of DCD that affects speech production. Individuals with this condition have difficulty planning and coordinating the muscle movements required for clear speech.

Associated Disorders and Secondary Consequences

Sensory Processing Disorder

Sensory processing disorder (SPD) is a condition in which the brain has difficulty processing sensory information. Some individuals with DCD also experience SPD, which can lead to difficulties in modulating sensory input and increased sensitivity to sensory stimuli.

Specific Language Impairment

Specific language impairment (SLI) is a language disorder that affects comprehension and expression. Some individuals with DCD also have SLI, which can exacerbate communication difficulties.

Psychological and Social Consequences

Individuals with DCD may experience psychological and social consequences, such as low self-esteem, anxiety, and difficulty forming and maintaining relationships. These challenges can stem from struggles with coordination and communication, as well as the impact of negative perceptions and misunderstandings by others.

Diagnosis

Diagnosis of DCD typically involves a comprehensive assessment by a multidisciplinary team, including a pediatrician, psychologist, occupational therapist, and physiotherapist. The assessment process may involve gathering information about the individual's medical history, observing motor skills and coordination, and evaluating cognitive and emotional functioning. The diagnosis of DCD is made when an individual's motor coordination difficulties significantly impact daily functioning and are not better explained by another neurological or physical condition.

Classification

DCD is classified as a neurodevelopmental disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The International Classification of Diseases, 11th Revision (ICD-11), classifies DCD under the category of developmental motor coordination disorders.

Management

Management of DCD typically involves a combination of interventions tailored to the individual's specific needs. These may include:

• Occupational therapy: This therapy focuses on helping individuals develop and improve skills needed for daily living, such as fine motor skills, self-care, and organizational skills.
• Physiotherapy: This treatment aims to improve gross motor skills, balance, and coordination through targeted exercises and activities.
• Speech therapy: For individuals with developmental verbal dyspraxia, speech therapy can help improve speech production and communication skills.
• Psychological support: Counseling or therapy can help individuals with DCD address emotional and social challenges associated with the disorder.

Epidemiology

DCD is estimated to affect approximately 5 to 6 percent of school-aged children. The disorder is more common in males than in females, with a ratio of approximately 2:1. DCD can persist into adulthood, and research suggests that many adults with the disorder continue to experience motor coordination difficulties and related challenges.

History

DCD was first described in the medical literature in the early 20th century, although it was not until the 1970s and 1980s that research on the disorder began to gain momentum. Early studies focused on the characteristics, causes, and consequences of DCD, while more recent research has expanded to include the evaluation of interventions and the development of diagnostic criteria.

Society

Increased awareness of DCD has led to greater recognition of the disorder and its impact on individuals and their families. Advocacy organizations, such as the Dyspraxia Foundation and the DCD Association, provide support, resources, and information to individuals with DCD and their families, as well as to professionals working in the field. Public figures, such as actor Daniel Radcliffe, have also helped raise awareness of DCD by openly discussing their experiences with the disorder.

Notable Cases

Daniel Radcliffe, the actor best known for playing Harry Potter in the film series, has spoken publicly about his experiences with DCD and how it has affected his life.

See Also

• Dyspraxia
• Sensory Processing Disorder
• Specific Language Impairment

External Links

• Dyspraxia Foundation
• CanChild - Developmental Coordination Disorder

Classification	ICD-10: F82 ICD-9-CM: 315.4 MeSH: D019957 DiseasesDB: 31600

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