Developmental Coordination Disorder. A review of current approaches

The ability to move around and act seems a natural condition which is acquired during development without the necessity for specific training. We develop an amazing number of motor skills in relative short time in infancy and childhood, motor skills that range from locomotion to plaiting, requiring gross or fine motor coordination. And we seem to have vast capacities to apply the principles of coordination to new skills, thereby creating new possibilities for tool use, object manipulation, sportive activities, etc. In general, motor development is promoted by interaction with the environment which affords and constrains certain actions and offers models for imitation learning. Some of our skills need specific training and instruction, for example writing, an activity that is unlikely to develop naturally. Some children, however, do not seem to develop their motor skills to a level that is normal for their age. They seem to have difficulty in learning the motor skills that belong to the repertoire of other children of their age, and they are clumsy when using these skills. As a result, they perform at a similar level as younger children and seem to lag behind in their motor development. There may be structural or pathological causes for the motor impairment of these children, i.e. areas in the brain that have some form of structural damage, or a hormone deficit such as in congenital hypothyroidism. For many children with problems in motor skills however, no specific neurological or other medical cause can be found. These children are the subject of this book. In the international diagnostical classification system (DSM) these children are referred to as children with Developmental Coordination Disorder (DCD). In the literature you may find several other terms that relate to DCD, such as clumsiness, dyspraxia, perceptual-motor and sensori-motor integration problems, although there is still debate as to whether these are similar or distinct categories. I sometimes call them ‘delightful clumsy devils’ (dcd), although they themselves may often not feel that way. This book aims to inform the interested reader - professional, researcher, student, teacher and parent alike – about our current knowledge of DCD . It reviews the problems and limitations that children with DCD meet, the major available tests in the domain of perceptual-motor function, the evidence for subtypes and comorbidity, the deficits underlying DCD, the major intervention approaches and their effectiveness, and finally the management of DCD. It should convince the reader of the complementary nature of process and product oriented diagnostics and intervention. It should also stimulate the use of available knowledge, and the use of appropriate instruments for diagnosis, assessment, and treatment or stimulation. The ultimate goal being the optimal development – not just motor development – according to the capacities of the child with DCD, a task for parents, teachers and professionals involved.