DIFFERENTIAL DIAGNOSES FOR DEVELOPMENTAL COORDINATION DISORDER

BACKGROUND: The diagnosis of developmental coordination disorder (DCD) is based on four criteria outlined in the Diagnostic and Statistical Manual-5th ed. (American Psychiatric Association, 2013). One of these criteria is that the motor difficulties are not better explained by other diagnoses, such as intellectual disability, visual impairment, or neurological condition. Yet, few studies of children with DCD report how or if other medical conditions have been ruled out, with only 22/176 studies (12.5%) reporting that the children had been assessed by a physician (Smits-Engelsman et al., Hum Mov Sci, 2015:42; 293–306). OBJECTIVES: The purpose of this study was to determine what other conditions could present like DCD. DESIGN/METHODS: A prospective cohort of children referred for suspicion of DCD was assessed by a developmental pediatrician and an occupational therapist. Clinical assessment included developmental history, neurological exam, parent and child interview, standardized motor assessment, and the Developmental Coordination Disorder Questionnaire (Wilson et al., 2007 www.dcdq.ca) completed by a parent or caregiver. Diagnosis of DCD was based on DSM-5 criteria (American Psychiatric Association, 2013) and the European Academy for Childhood Disability guidelines (Blank et al., Dev Med Child Neurol, 2012:54;53–93). RESULTS: Of the 111 children assessed as of July 2016, 79 (71%) received a DCD diagnosis. The remaining 32 (29%) were suspected of having DCD but met the diagnostic criteria for other disorders. Of these 32 children, 16 (50%) were diagnosed with another neurodevelopmental disorder (e.g. fetal alcohol spectrum disorder, learning disability, attention deficit hyperactivity disorder), 8 (25%) were diagnosed with a neurological condition (e.g., cerebral palsy, hypotonia, seizure disorder, Chiari I malformation), and 8 (25%) were diagnosed with a genetic or other medical condition (e.g., microdeletion syndromes, Neurofibromatosis Type 1, Ehlers-Danlos syndrome). CONCLUSION: Results of this study underscore the importance of having children suspected of DCD to be assessed by a pediatrician to determine if there are other diagnoses to explain the child’s motor difficulties. Future directions include increasing awareness of DCD and paediatricians’ role in making a DCD diagnosis, as well as differential diagnoses to consider.

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