Diagnosis

The characteristics of children with DCD are usually noticed first by those closest to the child (parents, classroom teacher) because the motor difficulties interfere with successful participation at home, at school or on the playground. DCD is commonly identified and diagnosed after age 5, when minor motor problems (often noted when the child was young) are made more noticeable by the structured demands of a school environment.

When a child is suspected of having motor coordination difficulties, it is critical that they are seen by a family doctor or pediatrician to ensure that that the movement problems are not due to any other physical, neurological, or behavioural disorders and to determine whether more than one disorder may be present. DCD can exist on its own or it may be present in a child who also has learning disabilities, speech/language impairments and/or attention deficit hyperactivity disorder.  Information provided by parents, the child's teacher, and from an assessment by an occupational and/or physical therapist (OT and/or PT) can be very helpful in assisting a physician with making a diagnosis. For children with co-occurring language, attentional, and learning problems, the involvement of other health care practitioners will be important.

Diagnostic Criteria for DCD

A diagnosis of DCD is made by a medical doctor when the following criteria are observed:

• Performance in daily activities that require motor coordination is substantially below that expected, given the person's chronological age and measured intelligence.  This may be manifested by:

  • Marked delays in achieving motor milestones (e.g., walking, crawling, sitting)
  • Dropping things
  • Clumsiness
  • Poor performance in sports
  • Poor handwriting
• The disturbance in Criterion A significantly interferes with academic achievement or activities of daily living.
• The disturbance is not due to a general medical condition (e.g., cerebral palsy, hemiplegia, or muscular dystrophy) and does not meet criteria for a Pervasive Developmental Disorder.
• If mental retardation is present, the motor difficulties are in excess of those usually associated with it.

Source: Diagnostic and Statistical Manual (DSM IV-TR, 2000)

Children with DCD usually achieve early major motor milestones (e.g., walking) within the broad range of normal limits but may have difficulty learning new motor skills (e.g., riding a tricycle).  In order to meet diagnostic criteria for DCD, the motor coordination difficulties must impact on the child's ability to perform in self-care and/or academic areas (e.g., difficulty with buttons/zippers, drawing/painting).

Why diagnose DCD?

A diagnosis of DCD can be quite helpful to the family, the school and the child. Even without a diagnosis, parents know that something is not right with their child's development. Without being able to identify the coordination difficulties as DCD, parents may search aimlessly as they try and explain their child's symptoms. Providing a diagnosis can reassure parents, confirm their observations, acknowledge the reality that this disorder places on their families, and give them something tangible to deal with. Children with DCD are more likely to become successful in home and school environments when task and environmental adaptations are made, both of which are made more possible through an accurate diagnosis. Recognition and diagnosis of DCD allows parents, extended family and teachers to access research literature, educational resources, tips, strategies and support groups and can provide access to the services and supports families need including possible formal identification within the educational system. Perhaps most importantly, the secondary consequences associated with DCD can be prevented.