Developmental coordination disorder (DCD) is a neurodevelopmental disorder that manifests itself as difficulties in acquisition and execution of coordinated motor skills, and difficulties that are manifested as clumsiness as well as slowness and inaccuracy of performance of motor skills. This motor skills deficit significantly and persistently interferes with activities of daily living, and impacts academic/school productivity, prevocational and vocational activities, leisure, and play. Difficulties in specific motor skills performance are long-standing and non-progressive. Onset of symptoms is in the early developmental period, and motor skills deficits are not better explained by intellectual disability or visual impairment and are not attributable to a neurological condition affecting movement. It occurs in approximately 7% of children, and is more common in boys. It is more common in children with low birth weight, in prematurely born children, and in children with attention disorders, autistic spectrum disorders, or with speech and language disorders. Children with DCD are too often identified in school, and not sooner.
The main purpose of our quantitative and qualitative research was to identify children with DCD, and apply our comprehensive special educational diagnostic assessment of children with DCD before entering school.
In the first part of the study, a screening procedure was carried out using 3 tests (the Movement ABC, the Developmental Test of Visual-Motor Integration and the Developmental Coordination Disorder Questionnaire), which included 196 five-year-olds from Ljubljana public kindergartens.
In our given sample there were 6.6% of children with clinical signs of DCD, 1.5% of them with severe motor problems in terms of DCD. Male to female ratio was 1.6:1. In the borderline DCD group ratio was equal between genders. Results of children with DCD were statistically different from the results of children without DCD in all three tests and in all parts of the tests.
In the second, qualitative part of the study, 5 case studies involving boys with presumable DCD were analised, based on comprehensive diagnostic assessment using established diagnostic assessment tools, on interviews with parents and professional staff in kindergartens, on the observation and assessment of children's competences in activities of daily living, and on the assessment of children’s individual developmental achievements.
Results showed no specific deviations in term of social factors for the assessed children with DCD. Analysis of the developmental factors, on the other hand, showed different risk factors in early childhood. As expected, the assessed children had problems in gross motor skills, motor planning, lateral dominance, fine motor skills, perception, and in activities of daily living (slowness, difficulties in dressing themselves, in feeding, personal care, and a specific play). Some difficulties were also encountered in individual’s communication, speech and language, some had difficulties in the socio-emotional domain, some with motivation, and some had attention difficulties. Their strengths were in the verbal domain and in cognitive abilities.
Based on our findings, we developed a two-stage model of identification and a comprehensive special educational diagnostic assessment of five-year-old children with DCD. In our final model, the screening process included only the Movement ABC and the Developmental Coordination Disorder Questionnaire. A wide range of other diagnostic assessment tools, observation and information received from significant others was included in the later comprehensive diagnostic assessment, for which we proposed a wider range of the team of professionals, that is to take a more interdisciplinary approach. In the end, our research showed a diversity of the DCD phenomenon, an importance of assessing both strengths and difficulties in a child, and a poor insight of child's significant others into his developmental achievements.
Furthermore, some other important and currently not yet researched DCD aspects were found, such as a higher prevalence of girls than expected in a group of children with a borderline DCD, the exceptional psychometric properties of Developmental Coordination Disorder Questionnaire, which was applied to preschool teachers, and finally, the important role of assessing strengths in children with DCD.