Diagnostic Criteria

UK DCD descriptor (2018) Movement Matters

 

The descriptor below was developed and agreed by consensus in a group comprised of individuals representing a range of professional bodies and individuals with DCD in the UK which was organised by Movement Matters who represent the UK organisations with an interest in DCD.

 

Developmental Coordination Disorder (DCD), also known as Dyspraxia in the UK, is a common disorder affecting movement and coordination in children, young people and adults with symptoms present since childhood.

 

DCD is distinct from other motor disorders such as cerebral palsy and stroke and occurs across the range of intellectual abilities. This lifelong condition is recognised by international organisations including the World Health Organisation.

 

A person’s coordination difficulties affect their functioning of everyday skills and participation in education, work, and leisure activities. Difficulties may vary in their presentation and these may also change over time depending on environmental demands, life experience, and the support given. There may be difficulties learning new skills.

 

The movement and coordination difficulties often persist in adulthood, although non-motor difficulties may become more prominent as expectations and demands change over time.

 

A range of co-occurring difficulties can have a substantial adverse impact on life including mental and physical health, and difficulties with time management, planning, personal organisation, and social skills.

 

With appropriate recognition, reasonable adjustments, support, and strategies in place people with DCD can be very successful in their lives.

 

The DSM V Diagnostic Criteria for Developmental Co-Ordination Disorder (American Psychiatric Association, 2013)

 

A.  Motor performance that is substantially below expected levels, given the person's chronologic age and previous opportunities for skill acquisition. The poor motor performance may manifest as coordination problems, poor balance, clumsiness, dropping or bumping into things; marked delays in achieving developmental motor milestones (e.g., walking, crawling, sitting) or in the acquisition of basic motor skills (e.g., catching, throwing, kicking, running, jumping, hopping, cutting, colouring, printing, writing).

 

B.  The disturbance in Criterion A, without accommodations, significantly and persistently interferes with activities of daily living or academic achievement.

 

C. Onset of symptoms is in the early developmental period.

 

D. The motor skill deficits are not better explained by intellectual disability (intellectual development disorder) or visual impairment and are not attributable to a neurological condition affecting movement (e.g., cerebral palsy, muscular dystrophy, degenerative disorder).

 

The disturbance is not due to a general medical condition (e.g., cerebral palsy, hemiplegia, or muscular dystrophy).

 

The ICD-11 International Classification of Diseases 11th Revision (2018)

6A04 Developmental motor coordination disorder

 

Developmental motor coordination disorder is characterised by a significant delay in the acquisition of gross and fine motor skills and impairment in the execution of coordinated motor skills that manifest in clumsiness, slowness, or inaccuracy of motor performance. Coordinated motor skills are substantially below that expected given the individual's chronological age and level of intellectual functioning. Onset of coordinated motor skills difficulties occurs during the developmental period and is typically apparent from early childhood. Coordinated motor skills difficulties cause significant and persistent limitations in functioning (e.g., in activities of daily living, school work, and vocational and leisure activities). Difficulties with coordinated motor skills are not solely attributable to a Disease of the Nervous System, Disease of the Musculoskeletal System or Connective Tissue, sensory impairment, and not better explained by a Disorder of Intellectual Development.

 

Inclusions:

 

• Orofacial motor coordination disorder

 

Exclusions:

 

• Abnormalities of gait and mobility (MB44)
• Diseases of the musculoskeletal system or connective tissue (FA00-FC0Z)
• Diseases of the nervous system (8A00-8E7Z)

 

The effects of dyspraxia are different from person to person, and usually include sensory processing difficulties (e.g. hypersensitive to sound, light or touch) and several, or most of the following:

 

• Clumsiness or lack of co -ordination; difficulty tying shoe laces; bumping into things; “falling over thin air”; poor coordination in ball games.
• Difficulty planning, being on time, and organising work.
• Forgetfulness and poor short-term memory.
• Slow and/or illegible hand writing.
• Problems and slowness copying off the blackboard due to dyspraxia in the small muscles of the eye making focusing slower than normal.
• Heightened sensory sensitivity and discomfort. This may affect eating, hair washing, the sense of touch, hearing or vision. The world may be experienced as “too loud, too bright, too fast, and too tight”.
• Sometimes children with dyspraxia are fidgety and restless; they are not comfortable on an ordinary chair.
• They may appear untidy and not aware of personal hygiene.
• Though people with Dyspraxia can enjoy competitive sport, they are unlikely to make the top teams due to lack of co-ordination or slow processing of fast changing activity. (P.E. lessons are often a cause of humiliation and some children will try anything to avoid sports lessons) Individual sports like running, swimming, rowing and karate are a good alternative to team sports.
• They may be easily distractible, and better in one-to-one teaching situations.
• They may have a poor observational and memory of sequencing. Machinery (like photocopiers) may need to have a “How to use me” label on it to jog their memories.
• Because of their own differences in body movement, not noticing other people’s body language they may have difficulty making, or keeping friends.
• Dyspraxic children often feel side lined at school and may have behaviour difficulties, become the class ‘clown’, or withdraw from activities and become loners.
• They often have poor sense of direction. A “buddy” in a new environment can be very helpful to prevent dyspraxic children (and adults) getting lost.
• Depression is common in adults with dyspraxia.
• On the other hand, people with Dyspraxia are often intelligent, creative, good problem solvers, direct in speech, original thinkers, hard working and, if their needs are met and have a lot to offer a school, college or work place.
• Well known people with Dyspraxia: Einstein, Daniel Radcliffe (Harry Potter), Florence Welch and many others.