Developmental Coordination Disorder in Kids: What You Need to Know

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Almost all babies and toddlers can be described as clumsy at times, so how do you know if your child’s uncoordinated tendencies are a red flag?

Babies and toddlers grow at different rates, but there’s a window of time where most reach certain milestones. However, those who seriously lag behind other kids their age when it comes to developing basic motor skills such as sitting, walking, and dressing may possibly have a condition called developmental coordination disorder (DCD), sometimes called “clumsy child syndrome.”

“The term developmental coordination disorder is an attempt to describe poor coordination leading to dysfunction,” explains Michelle Curtin, D.O., a developmental-behavioral pediatrician at Riley Hospital for Children at Indiana University Health. “We don’t have medical tests for DCD specifically, which is how it becomes a diagnosis of exclusion. When everything else is ruled out—and there’s a lot of neurological, neurodevelopmental, and other disorders that have to get checked off the list first—it might be DCD.”

Symptoms of DCD

Almost all babies and toddlers can be described as clumsy at times, so how do you know if your child’s uncoordinated tendencies are a red flag? The following symptoms could all be signs of DCD if they seem to happen much more often in your child as compared to other children their age. “School-aged children who are struggling to learn to draw and write, toddlers who are struggling to learn to walk and run, or preschoolers who are having difficulty with self-care skills like buttoning shirts, brushing teeth, and dressing, would be high on my list for evaluating for DCD, as well as other neurological and neurodevelopmental disorders,” says Dr. Curtin. “Symptoms vary by age, because we expect different things of toddlers versus preschool aged children versus elementary school children.”

For example, here are some red flags if your toddler has been walking for six or more months but still experiences:

  • frequently falling or tripping
  • running into other kids often
  • dropping things very easily

“In general, I worry about weakness, tone differences, and coordination as the elements that go into motor difficulties,” says Dr. Curtin. “I also look for other issues because, often times, motor difficulties cue us in to speech language, social communication, or other difficulties happening in tandem.”

Getting a Diagnosis

According to The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the go-to resource that psychologists, psychiatrists and other medical experts use to diagnose conditions, a child must have the following in order to have DCD:

  1. The child’s coordination and motor skills are significantly below levels expected for their age, usually appearing as clumsiness and slowness.
  2. These motor skill delays interfere with doing normal, everyday things compared to other children their age.
  3. Symptoms show up early in life, usually before nine years old, but often much earlier.
  4. These motor skills problems aren’t better explained by another diagnosis, such as cerebral palsy, visual impairment, or an intellectual disability.

If you’re concerned that your child may meet the above criteria, talk to your primary care doctor who can rule out common things. If a child doesn’t have a good explanation for what’s happening, they may need a specialty evaluation. “Some children may need evaluation through a pediatric neurologist, geneticist, or a developmental-behavioral pediatrician,” explains Dr. Curtin.

The DSM-5 says that five to six percent of school-age children may be affected by DCD, but Dr. Curtin believes it may be higher or lower because, unlike diabetes which has very measureable way to diagnosis the condition, DCD’s lack of medical tests and vague criteria makes it challenging to pin down. “It’s really important to rule out other disorders, like cerebral palsy, that cause motor dysfunction before landing on a diagnosis of DCD because it’s important to be treating the right thing, which may involve medication, family support, and school interventions,” says Dr. Curtin.

Causes & Treatment

“Since we don’t really know how DCD is caused, we don’t really know how to prevent it,” says Dr. Curtin. “However, kids with abnormal tone, both too high or too low, and overall muscle weakness are at risk for a variety of motor difficulties, including DCD.”

There is no cure for DCD, but treatments typically focus on practicing motor skills and strengthening muscles—especially since children with the condition may avoid sports and other activities, which could lead to further weakening of the muscles and weight gain. “DCD often requires physical therapy and/or occupational therapy evaluation and treatment, preferably from folks with expertise working with children,” says Dr. Curtin.

It’s also key to work on the life-impacting skills that the child struggles with, because this could affect not only their functioning but self-esteem. For example, if a child can’t dress herself because she has trouble with zippers, buttons, and pulling on clothes, working with an occupational therapist is best. “This should be paired with appropriate classroom interventions if the dysfunction is impacting school. For instance, a child with significant handwriting difficulties may be better served to type in class when he/she needs to keep up with notes.” Though symptoms may never go away, getting the proper diagnosis and treatment can help your child improve her motor skills and find ways to adapt and thrive.

-- By Holly C. Corbett

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