Monitoring and Follow-Up

Key Concepts
  • Children with DCD should be monitored closely because they are at higher risk for deterioration in physical health, and social and emotional problems
  • A collaborative interdisciplinary team approach is critical for the effective management of the child with DCD

Why is ongoing monitoring of children with DCD important?

Because DCD is a multifaceted disorder, the long-term effects are difficult to predict. As the child grows older, his or her needs may change. In childhood, many activities are motor-based. Children with DCD have trouble engaging in any of these activities, whether they are taking place at home, at school, or in the community.  A child's decision to take part in, or withdraw from, physical activity can have long-lasting effects.  The most evident impact is on the development of movement skills.  But the equally significant, if less obvious, impact on the child's fitness, health, social contacts and friendships, must not be overlooked. Children with DCD need to be monitored more carefully than typically developing children for:

  • deterioration in physical and cardiovascular fitness  (with potential for obesity)
  • withdrawal from social activities
  • victimization and bullying
  • depression and anxiety

 

Monitoring for physical deterioration

It is particularly important to watch for signs of increasing deterioration in physical fitness in children with DCD. When children with DCD are first diagnosed, it is often the emotional and behavioural symptoms that are most readily noticed. Problems with physical fitness or obesity may not be present early on or may be overlooked. As the child with DCD matures, he or she may show signs of a growing reluctance to participate in sports or other physical activities. If this situation is not addressed, it may lead to a significant decline in fitness and activity levels, as well as serious, long-term health consequences. For "signals to watch for", see Recognizing Physical Health Concerns in Children and Adolescents with DCD.

Monitoring for onset of mental health and social issues

Young children with DCD may be unaware of differences in their ability to perform everyday tasks. Once they reach seven or eight years of age, however, they begin to compare themselves and their abilities with those of their peers. Peer comparison happens with typically developing children as well. As early as Grade 3, children with DCD may be taunted, teased or bullied by their classmates. Feelings of low self-worth may result and children with DCD may withdraw from organized and informal activities and show signs of depression. To find more information about recognizing social isolation and the onset of mental health issues, see Recognizing Depression.

Who is involved in the monitoring and management of children with DCD?

To effectively manage the needs of a child with DCD over time, a collaborative team approach, involving an interdisciplinary team of healthcare professionals is best. This type of team can help develop early management plans that may improve the child's developmental outcomes.

Once a child has been identified as having DCD and the diagnosis given, involvement of other healthcare professionals may be necessary for the assessment of co-occurring conditions and intervention. Depending on the needs that are identified, interventions may be provided by any of a number of different healthcare professionals. Successful treatment approaches involve various allied health professionals, the child's parents, physician and teachers.