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  • DCD

  • Clumsy child syndrome

  • Motor dyspraxia

  • Developmental dyspraxia

  • Sensory integrative dysfunction

  • Disorder of attention, motor, and perception

  • Minor coordination dysfunction




  • 315.4 Developmental coordination disorder




  • F82 Specific developmental disorder of motor function




  • 5C: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System—Congenital Origin or Acquired in Infancy or Childhood 1



A 5-year-old male is referred for outpatient physical therapy for frequent falling. The parents report he takes Strattera for attention deficit hyperactivity disorder (ADHD) and gets frustrated when trying to play with his 4-year-old sister. Upon examination, the therapist notes the child has mild hypotonia especially in his trunk, has difficulty balancing on one leg, and has poor coordination with kicking or catching a ball. He has fair abdominal strength and descends stairs in a step-to-step pattern.




  • Difficulty performing complex gross or fine motor-coordination tasks

Essentials of Diagnosis

  • No cognitive or neurological dysfunction

General Considerations

  • Four criteria

    • Difficulty performing age-appropriate motor skills

    • Child has had sufficient opportunity to attain motor skills

    • No medical reason for motor difficulty

    • Difficulties impact academics or ADLs


  • Fifty percent of children with developmental coordination disorder (DCD) also have ADHD2, 3

  • Affects 5% to 6% of all children4

  • Affects twice as many males as females4





  • Decreased strength

  • Difficulty with coordination

    • Ball skills

      • Catching

      • Throwing

      • Kicking

    • Single-limb stance

    • Jumping

    • Hopping on one foot

    • Skipping

  • Ligamentous laxity

  • Hypotonia5

  • Soft neurological signs6

  • Atypical gait pattern

Functional Implications

  • Falls or trips often

  • Bumps into objects, other people

  • Difficulty using motor skills in new settings

Possible Contributing Causes

  • Premature birth4

Differential Diagnosis

  • Head injury

  • Progressive neurological disorder

  • Brain tumor

  • Autism

  • Pervasive developmental disorder7

  • Cerebral palsy8,9

  • Visual disturbances



Diagnostic Procedures

  • Parent–teacher questionnaires: Connors, Burks

  • Psychological testing

  • IQ testing

  • Developmental and Psychosocial evaluation




  • None for DCD

  • Medications available for ADHD

    • Methylphenidate drugs

    • Amphetamines

    • Dexmethylphenidate

    • Dextroamphetamine

    • Lisdexamfetamine

FIGURE 236-1

Upper motor neuron pathways. Tracts at bottom left are shown outside the cord for clarity only. (From McPhee SJ, Hammer GD. Pathophysiology of Disease: An Introduction to Clinical Medicine. 6th ed. New York, NY:2009, McGraw Hill.)

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