Developmental Coordination Disorder

Developmental Coordination Disorder also known as Dyspraxia

Evidence

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818573/ 

Sally Scott-Roberts and Catherine Purcell 

 Developmental coordination disorder (DCD) is classified as a motor disability in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Much of the research concerning the impact of living with this motor disability has focused on children; however, there is now a general recognition that DCD is a lifelong condition, with three quarters of children going on to experience difficulties in adulthood. Individuals who are diagnosed with DCD have difficulties with the learning of and the execution of effective and efficient motor skills, which can significantly impact upon a range of activities of daily living. These difficulties exist in the absence of an underlying physical or neurological condition, intellectual delay or visual impairment. Difficulties with both gross and/or fine motor skills described in childhood are reported to continue into adulthood and can have a negative impact on academic and vocational performance. Clinical feedback from adults living with DCD suggests that they continue to have difficulties with balance and safe functional mobility 

Education

What is Developmental Coordination Disorder?

Developmental Coordination Disorder (DCD) is a motor disorder that affects how people move and coordinate their movements.  It is estimated that this disorder affects approximately 5% of the population, and the prevalence is higher amongst people who were born preterm. Every individual may experience difficulties in different ways.  These difficulties may impact on participation in everyday life skills including in education, and every day activities.

People with DCD can not have their difficulties with movement explained by a general medical condition such as; Cerebral Palsy, Hemiplegia or Muscular Dystrophy. Studies involving school-aged children showed increased numbers of DCD among children who had very low birth weights below 1500 g or were very preterm under 32 weeks than among age children born at term with normal birth weights. This means not all babies born very small and very early will have this problem but within the numbers of children that have this problem an increase prevalence was born early and small for gestation.

DSM-5 classifies DCD as a motor disorder under the broader heading of neurodevelopmental disorders. The DSM-5 criteria for DCD are as follows:

• Acquisition and execution of coordinated motor skills are below what would be expected at a given chronologic age and opportunity for skill learning and use; difficulties are manifested as clumsiness (eg, dropping or bumping into objects) and as slowness and inaccuracy of performance of motor skills (eg, catching an object, using scissors, handwriting, riding a bike, or participating in sports)
• The motor skills deficit significantly or persistently interferes with activities of daily living appropriate to the chronologic age (eg, self-care and self-maintenance) and impacts academic/school productivity, prevocational and vocational activities, leisure, and play
• The onset of symptoms is in the early developmental period
• The motor skills deficits cannot be better explained by intellectual disability or visual impairment and are not attributable to a neurologic condition affecting movement (eg, cerebral palsy, muscular dystrophy, or a degenerative disorder)

Developmental Coordination Disorder (DCD)  is a common disorder that affects movement and co-ordination. It is also known as dyspraxia). This disorder affects basic motor skills such as walking or sitting upright and fine motor skills such as writing or picking up small objects in children and adults. It is a condition that will last for life and is recognised by international organisations, including the World Health Organization. DCD is different from other motor disorders such as cerebral palsy and stroke, and occurs in people of all intellectual abilities.

Symptoms of DCD or Dyspraxia

The symptoms can vary between individuals and may change over time.

Co-ordination difficulties are the main problem. The co-ordination difficulties associated with DCD can reduce the person's ability to participate and function in education and employment.

Difficulties with self-care, writing, typing, riding a bike and playing may start in childhood and continue into adulthood and as an adult may also experience new difficulties, for example with driving a vehicle or ‘do it yourself’ tasks.

Other Difficulties Relating to Adulthood

Adults with dyspraxia may also have social and emotional difficulties, as well as problems with time management, planning and personal organisation. These may affect the person's education or employment.

Diagnosing Adult DCD or Dyspraxia

See your doctor if you think you have undiagnosed co-ordination or movement difficulties. You may be referred for an assessment by a physiotherapist or an occupational therapist, who will look at your ability to move. DCD is a condition only really recognised in the last 20 years or so. This means there could be many adults with dyspraxia who were not diagnosed as children.

Who is affected?

It is more common in men, and often runs in families. It is not known what causes DCD, but some children born prematurely and small for gestational age have a higher risk of having this disorder.

People with DCD may also have other conditions, such as:

• attention deficit hyperactivity disorder (ADHD)
• dyslexia
• autistic spectrum disorder
• speech and language impairments
• difficulty learning or understanding maths (dyscalculia)

Empowerment

Treating DCD/Dyspraxia in Adults

DCD does not affect intelligence, but may make learning new skills more difficult. Adults with dyspraxia may have developed coping strategies to find ways around everyday tasks they find difficult. For example, you may find your movement problems improve as you find ways to adapt. As you grow older and accept yourself, your confidence and self-esteem may also improve. This may be because the pressure to 'fit in' as an adult is not as strong as when you were a child and teenager.

Some people also find staying fit helps their co-ordination, reduces feelings of fatigue and helps with potential weight gain.

Therapies

Although there is no cure for this disorder, there are therapies to help adults cope. These are described below.

• Occupational therapy can help you find ways to remain independent and manage everyday tasks such as dressing yourself or getting to the local shops. Your occupational therapist can help you work out practical solutions.
• Talking therapies such as cognitive behavioural therapy (CBT) or solution-focused brief therapy (SFBT) may also help. CBT aims to help you talk about your problems and identify ways to change your behaviour so you can manage your problems more effectively. SFBT aims to help you identify what you wish to achieve through therapy, rather than talking about the problem itself.
• Speech and language therapy can be useful if you have problems with speech or language, or both. Your therapist will arrange a programme to address your needs.

Other conditions

If you have DCD, you may also have another health condition that requires separate treatment. For example:

• Depression or feelings of sadness this can be treated with a combination of exercise, talking therapies and medication
• Anxiety feelings of worry and unease and this can be treated with medication, talking therapies and a number of self-help measures, such as relaxation techniques

Useful websites and resources:

https://canchild.ca/en/diagnoses/developmental-coordination-disorder/related_resources

https://raisingchildren.net.au/guides/a-z-health-reference/development-coordination-disorder-dcd

https://drkamps.ca/what-is-dcd

https://www.ndis.gov.au/applying-access-ndis/am-i-eligible

https://dcdaustralia.org.au

DSF - When should an adult be assessed?

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