This Developmental
coordination disorder has been estimated to occur in up to 6%
of primary school aged children. These conditions have historically
been termed developmental motor coordination disorder, clumsiness,
dyscoordination disorder, or motor dyspraxia.
Motor coordination
in daily activities is substantially less than you would expect,
considering the patient's age and intelligence. This may be shown
by dropping things, general clumsiness, poor handwriting or sports
ability or by pronounced delays in developmental motor milestones
such as sitting, crawling or walking.
This incoordination materially impedes academic achievement or
daily living.
It is not due to a general medical condition such as cerebral
palsy or muscular dystrophy.
Criteria for a Pervasive
Developmental Disorder are not fulfilled.
If there is Mental Retardation,
the incoordination is worse than you would expect with these problems.
Associated
Features:
Hypertonic
or hypotonic. If infants react strongly to any slight auditory
or visual stimulation by becoming stiff or by arching the back,
this is a sign of hypertonicity and hyperreactivity.
Infants
with motor challenges are often delayed in achieving milestones
such as the ability to roll over, to sit with help, and to sit
without help.
Toddlers
who have subtle motor skills deficits in chewing may not accept
foods that require greater chewing ability.
Children
may have difficulty in the ability to make a pincer grasp (to
pick up small objects with the index finger and the thumb).
Infants
who are unable to walk after age 18 months may have hypotonicity
or hypertonicity, poor muscular strength or coordination, and
difficulty with managing equilibrium, balance, and posture.
Lack of
a hand preference may signal that the normal dominance and specialization
of the brain hemispheres is not occurring.
Inability
to hold and use a pencil in a typical fashion may indicate a
problem differentiating various muscle areas and activating
them at will.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore,
in his diagnostic attempt, has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Learning
Disorder: Written Expression
Pervasive
Developmental Disorder
Cebral Palsey
Cause:
Genetic, intrauterine,
and environmental factors may contribute to poor abilities in
motor functioning.
Treatment:
No single type of treatment
can be applied to all children with motor coordination disorder
nor is one treatment successful with all. Existing evidence does
not permit the conclusion that one of the methods described below
is generally or uniformly better than the others.
Counseling
and Psychotherapy [ See
Therapy Section ]:
The
best treatment is perceptual-motor stimulation, but at present
there is no complete and sure cure. Some clumsiness is likely
to persist into adulthood, and the disorder is frequently accompanied
by other disorders, with a disability in written expression one
of the more likely ones.
