Sx

Developmental Coordination Disorder

search

Developmental Coordination Disorder, Clumsy Child Syndrome, Clumsiness in Children

  • See Also
  1. Developmental Milestone
  2. Muscle Weakness in Children (Pediatric Neuromuscular Disorders)
  • Definition
  1. Clumsy child with normal intelligence, no focal deficit
  • Signs
  1. General
    1. Difficulty with sports participation
  2. Difficult gross motor skills
    1. See Gross Motor Milestones
    2. Clumsy walking or Running
    3. Difficulty climbing or jumping
  3. Difficult fine motor skills
    1. See Fine Motor Milestones
    2. Difficult buttoning, zipping or tying
    3. Difficulty holding crayon or pen
    4. Difficulty with crafts
    5. Poor handwriting
  4. Commonly abnormal findings on exam
    1. Abnormal Rapid Alternating Movements
    2. Abnormal balance
      1. Unable to stand 15 seconds feet together, arms out
      2. Unable to tandem stand 15 seconds with eyes closed
    3. Unable to hop in place alternating feet
  5. Red flag findings suggestive of alternative diagnosis
    1. Motor weakness
    2. Ataxia
    3. Hypotonia or hypertonia
  • Diagnosis (DSM IV Criteria)
  1. Gross Motor Milestones or Fine Motor Milestones not met
  2. Interferes significantly with academics or daily living
  3. Not due to other medical condition
    1. Cerebral Palsy
    2. Hemiplegia
    3. Muscular Dystrophy
    4. Pervasive Developmental Disorder
  • Differential Diagnosis
  1. Mental Retardation
  2. Attention Deficit Hyperactivity Disorder (ADHD)
  3. Traumatic Brain Injury
  4. Mild Cerebral Palsy
  5. Congenital Chorea
  6. Decreased Visual Acuity
  7. Orthopedic Abnormality
  • Prognosis
  1. Coordination Disorder persists into adulthood
  • Management
  1. Encourage supportive environment
  2. Encourage motor appropriate sports participation
    1. Try activity with chance of success (e.g. swimming)
  3. Tailor academic activities to motor abilities
  4. Occupational Therapy
  • References
  1. Silver in Tasman (1997) Psychiatry, p. 638-9
  2. Hamilton (2002) Am Fam Physician 66(8):1435-40 [PubMed]