Disorders of Childhood: Motor Skills Disorders

Children that appear to have extremely poor coordination may be suffering from a Motor Skills Disorder. This difficulty in coordination interferes with achievement or age-appropriate activities of daily living (e.g., walking, playing catch, etc). The only disorder in the Motor Skills Disorder category is called Developmental Coordination Disorder, which we discuss below.

Developmental Coordination Disorder

Children with Developmental Coordination Disorder (sometimes referred to as Dyspraxia) show extreme clumsiness and/or significant impairment in motor coordination. In order to be diagnosed with this disorder, the child's performance in daily activities requiring motor coordination must be significantly below what is expected based on their age and intelligence level. Examples of delays include problems with achieving motor milestones (e.g., walking), dropping things, or poor handwriting.

Symptoms of Developmental Coordination Disorder vary with age and developmental stage. Young children may experience significant delays in walking, tying shoelaces, buttoning, or zipping. Older children may have problems with the motor aspects of activities like completing puzzles, building models, playing with balls, or writing. Generally speaking, a child will show symptoms of the disorder when they first attempt a complicated activity. It is less common that a child will become proficient at one of these activities and then later develop difficulties performing the skill required.

According to the DSM, approximately 6% of children meet the criteria for this disorder. Usually, Developmental Coordination Disorder is diagnosed in children who are 5-11 years old. Males may be more likely to be diagnosed with this disorder, but prevalence information suggests that males and females are equally affected.

Diagnosis

If you suspect that your child may suffer from Developmental Coordination Disorder, consult with your pediatrician. The first step in diagnosis is conducting a complete physical, neurological, and motor exam in order to determine that other movement or neuromuscular disorders such as Muscular Dystrophy are not causing the problems. During this exam, the clinician will likely ask you about various major developmental milestones to try to understand just how "off track" your child's development may be. The clinician should also refer you to a child neuropsychologist (a psychologist with expertise in assessing behavior and skills that are related to brain structure and function), for more extensive assessment with some of the following tools:

Reitan-Indiana Neuropsychological Test Battery for Children

This assessment for children ages 5-8 years provides a measure of overall functioning, and hones in on specific motor skills or impairments that may be present. A corresponding test for older children (ages 9-14), the Halstead Neuropsychological Test Battery for Children, is also available.

Bender Gestalt Test

The Bender Gestalt Test is used to assess visual-motor integration and visual perception skills (e.g., whether the eyes and the parts of the brain related to vision communicate with each other appropriately). This test consists of nine figures that the child must copy.

Bruininks-Oseretsky Test of Motor Proficiency

The Bruininks-Oseretsky Test of Motor Proficiency assesses the fine and gross motor skills of children ages 4 to 14. These tasks often appeal to children because they are similar to typical childhood activities (e.g., throwing/catching a ball, running, doing pushups). This test is the most widely used assessment of motor ability, and can be used on a wide range of children, from able-bodied individuals to those with severe physical handicaps.