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Prevalence of developmental coordination disorder using the DSM-IV at 7 years of age: a UK population-based study
Raghu Lingam1, Linda Hunt, Jean Golding
1Centre for Child and Adolescent Health, Department of Community-Based Medicine,University of Bristol, Bristol B566JS, United Kingdom. raghu.lingam@bristol.ac.uk
Insights
Developmental Coordination Disorder (DCD) affects 1.7% of UK children at age 7, impacting daily life. This prevalence is lower than previously thought when considering functional daily living impacts.
Area of Science:
- Developmental Pediatrics
- Child Psychology
- Public Health Epidemiology
Background:
- Developmental Coordination Disorder (DCD) is a neurodevelopmental condition affecting motor skills.
- Accurate prevalence data is crucial for understanding the condition's impact and resource allocation.
- Previous studies may have overestimated prevalence due to varying diagnostic criteria.
Purpose of the Study:
- To determine the prevalence of DCD in 7-year-old children using strict Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria.
- To assess the impact of motor coordination difficulties on daily living activities.
- To identify risk factors associated with DCD in a large UK birth cohort.
Main Methods:
- Utilized data from the Avon Longitudinal Study of Parents and Children (ALSPAC) UK birth cohort.
- Assessed motor coordination in over 7000 children using standardized tests (manual dexterity, ball skills, balance).
- Defined DCD using the 5th percentile for coordination impairment and excluded children with neurological conditions or IQ <70.
Main Results:
- A prevalence of 1.7% (17 per 1000) for DCD was found in 6990 children aged 7-8 years.
- An additional 2.5% (222 children) met criteria for probable DCD using broader cut-offs.
- Increased risk of DCD was associated with lower socioeconomic status, low birth weight (<2500g), and preterm birth (<37 weeks gestation).
Conclusions:
- This study provides the first prevalence estimate of DCD using strict criteria in a representative UK cohort.
- The identified prevalence of 1.7% is lower than some previous estimates, highlighting the importance of functional impact assessment.
- DCD is a significant, often unrecognized, cause of childhood disability requiring greater awareness and support.
Objective:
To calculate the prevalence of developmental coordination disorder at 7 years of age by using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria in a large UK birth cohort.
Methods:
Cases of developmental coordination disorder were defined by using data from the Avon Longitudinal Study of Parents and Children, a UK birth cohort. The motor coordination of >7000 children was assessed by using tests that measured manual dexterity, ball skills, and balance. The 5th percentile of the derived Avon Longitudinal Study of Parents and Children coordination impairment score was used to define severe motor coordination difficulties. Data from national handwriting tests and an activities-of-daily-living scale quantified the impact of poor coordination on daily life. Children with known neurologic conditions or an IQ of <70 were excluded.
Results:
Complete data were available from 6990 children aged 7 to 8 years who attended the coordination session and completed the writing test or activities-of-daily-living scale. One hundred nineteen children met criteria for developmental coordination disorder, resulting in a prevalence of 17 of 1000 children at a mean age of 7.5 years (SD: 2.9 months). An additional 222 children were considered as having "probable developmental coordination disorder" by using broader cut-offs for coordination testing and activities of daily living. There was an increased risk of developmental coordination disorder in families from lower socioeconomic backgrounds, in children with a birth weight of <2500 g, and those born before 37 weeks' gestation.
Conclusions:
This is the first study to use strict criteria to define the prevalence of developmental coordination disorder in a representative cohort of UK children. A prevalence of 1.7% is lower than studies that have not taken into account the impact of poor motor coordination on daily living but indicates that poor coordination is an important, and often hidden, cause of disability in childhood.
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