Developmental Coordination Disorder: What Is It?

Developmental Coordination Disorder (DCD) has been described \nunder a variety of labels including minimal cerebral palsy, minimal \nbrain dysfunction, clumsy child syndrome, developmental dyspraxia, \nsensory integrative dysfunction and mild motor problems.1 Collier \nfirst discussed the concept of developmental motor disorder in the \nearly 1900s. He used the term "congenital maladroitness" to describe \nthe developmental motor problems evidenced by children.2 By 1925, \ndoctors and therapists in France were noting that many children with \ndisabilities displayed motor awkwardness. They referred to this condition as "motor weakness" or "psychomotor syndrome."3 Orton4 \nidentified abnormal clumsiness as one of the six most commonly \noccurring developmental disorders. He indicated that different types \nof developmental motor disorders may exist and that disorders in \npraxis and gnosis might result in motor skills deficits that were different from those arising from pyramidal, extrapyramidal or cerebellar \ndysfunction. More recently, Ayres5 referred to the clumsiness seen in \nsome learning disabled children as developmental dyspraxia. She defined it as a disorder of sensory integration, interfering with the ability \nto plan and execute skilled or non-habitual motor tasks. She said that \nchildren with dyspraxia could attain a high degree of skill in specific \nactivities that they practised; however, these skills were very specific \nand did not generalize to other similar activities. Gubbay6 described \nchildren with dyspraxia as clumsy children who display impaired \nperformance of skilled movement despite normal intelligence and normal findings on a conventional neurological exam. Dawdy7 questioned the idea that children needed to demonstrate normal intelligence before being diagnosed as developmentally dyspraxic. He \nsuggested that children&s;s motor skills should be compared to their \nlevel of cognitive development. If motor skills were significantly \npoorer than one would predict based on cognitive skills, dyspraxia was \na possible diagnosis.