Developmental coordination disorder

315.4 Developmental Coordination Disorder

Diagnostic Features

The essential feature of Developmental Coordination Disorder is a marked impairment in the development of motor coordination (Criterion A). The diagnosis is made only if this impairment significantly interferes with academic achievement or activities of daily living (Criterion B). The diagnosis is made if the coordination difficulties are not due to a general medical condition (e.g., cerebral palsy, hemiplegia, or muscular dystrophy) and the criteria are not met for Pervasive Developmental Disorder (Criterion C). If Mental Retardation is present, the motor difficulties are in excess of those usually associated with it (Criterion D). The manifestations of this disorder vary with age and development. For example, younger children may display clumsiness and delays in achieving developmental motor milestones (e.g., walking, crawling, sitting, tying shoelaces, buttoning shirts, zipping pants). Older children may display difficulties with the motor aspects of assembling puzzles, building models, playing ball, and printing or handwriting.

Associated Features and Disorders

Problems commonly associated with Developmental Coordination Disorder include delays in other nonmotor milestones. Associated disorders may include Phonological Disorder, Expressive Language Disorder, and Mixed Receptive-Expressive Language Disorder.

Prevalence

Prevalence of Developmental Coordination Disorder has been estimated to be as high as 6% for children in the age range of 5-11 years.

Course

Recognition of Developmental Coordination Disorder usually occurs when the child first attempts such tasks as running, holding a knife and fork, buttoning clothes, or playing ball games. The course is variable. In some cases, lack of coordination continues through adolescence and adulthood.

Differential Diagnosis

Developmental Coordination Disorder must be distinguished from motor impairments that are due to a general medical condition. Problems in coordination may be associated with specific neurological disorders (e.g., cerebral palsy, progressive lesions of the cerebellum), but in these cases there is definite neural damage and abnormal findings on neurological examination. If Mental Retardation is present, Developmental Coordination Disorder can be diagnosed only if the motor difficulties are in excess of those usually associated with the Mental Retardation. A diagnosis of Developmental Coordination Disorder is not given if the criteria are met for a Pervasive Developmental Disorder. Individuals with Attention-Deficit/Hyperactivity Disorder may fall, bump into things, or knock things over, but this is usually due to distractibility and impulsiveness, rather than to a motor impairment. If criteria for both disorders are met, both diagnoses can be given.

Diagnostic criteria for 315.4 Developmental Coordination Disorder

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, or 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.

Coding note: If a general medical (e.g., neurological) condition or sensory deficit is present, code the condition on Axis III.