What if your child is clumsy?

by on August 5, 2011

in Monthly

Coordination Disorder

Q: My son appears to be very clumsy. He struggles to get dressed after gym class. Some teachers have called him “lazy”. What can we do to help him, because we are concerned about his self-esteem?

A: The diagnosis of a Developmental Coordination Disorder (DCD) should be considered. This is a condition which was probably under-diagnosed in the past. The longer these children struggle along without the proper therapy, the more at risk they become for having lower self-esteem and academic struggles.

It affects 5-6% of the school aged population and boys are affected more often than girls by a factor of 2 to 1. Some experts in the field estimate an even higher ratio in boys (a factor of 5:1)

These children struggle to integrate all the necessary sensory information that will allow them to perform common motor skills. They appear to be awkward at common activities such as: doing up buttons, getting dressed, tying shoelaces, and using a knife and fork. Using a scissors can be frustrating—especially when their peers in preschool have no trouble assembling crafts.

They may drop things easily, bump into objects, knock things over, spill liquids regularly, struggle to maintain balance  and  have troubles with their handwriting—to the point where it impacts their academic progress severely enough that they fall behind, even when their IO’s are above average.

Athletically they may find it hard to skip, jump, or keep up with other kids. Baseball, tennis and handling a hockey stick may be particularly difficult (Any activity that requires good eye-hand coordination can prove to be challenging)

 A thorough neurological exam will show that there is no serious situation such as cerebral palsy, stroke or muscular dystrophy. There may or may not be a history of delayed walking, crawling or sitting when the doctor enquires about past motor milestones. Some children with DCD may also have associated conditions such as Attention Deficit and Hyperactivity Disorder, Learning Disabilities and speech delays. The majority have a normal or above normal IQ.

The exact cause of DCD remains uncertain. McMaster Medical School has an excellent website (www.canchild.ca) where more information can be found about possible causes.  

In the Pediatric Weight Clinic in Calgary a number of obese patients have this condition. Currently some of these children are being studied in terms of how their clumsiness impacts their physical activity and emotional development (for more information call 403.547-8992 or visit www.pediatricweighclinic.com)

It is ideal to make the diagnosis of DCD early in life, in order to teach patients ways to compensate for their coordination challenges. Sadly, too many kids have been falsely accused of being lazy or unmotivated. Parents and teachers may also be critical of them if they refuse to play with peers on playgrounds, seek out younger friends, or become withdrawn or shy as a result of getting frustrated by constantly failing. They may also be at a higher risk of getting teased, bullied and rejected in activities that require team efforts.

An occupational therapist (OT) and a psychologist can help these families the most. An OT can teach the child motor skills that may compensate for his or her lack of coordination. (For an in-depth explanation of all the various intervention see  Individual sports such as running or swimming may help the child do better, as opposed to baseball and tennis. In the gym class the teacher should help the child by breaking down activities in smaller parts; effort should be rewarded—not skill; larger balls should be used when the child plays catch; changes should be introduced gradually; participation as opposed to competition should be encouraged; and equipment may need to be modified in order to decrease the risk of injury

In the classroom proper positioning for table work should be ensured. Extra time may be needed to complete tasks; computers may help circumvent handwriting and printing challenges; messy handwriting may have to be tolerated; widely spaced lines for writing can be used; a child may be allowed to present a report orally—as opposed to writing; drawing can be used to illustrate thoughts and in some cases the child should be allowed to dictate stories or book reports.

Parents may want to use clothing that is easy get on and off. Velcro shoes may be used instead of shoes with laces. The child should be encouraged to engage in practical activities that will help to improve motor tasks—such as setting a table, packing a lunch or organizing a knapsack.

DCD is a condition that is not outgrown. However with constant support, encouragement and training by an OT many of these children grow up, learn to compensate and become famous. The actor in Harry Potter movies, Daniel Radcliffe, is a living example of how having DCD may not doom a child to failure.

Comments on this entry are closed.

Previous post:

Next post: