II. Definition
- Clumsy child with normal intelligence, no focal deficit
III. Signs
-
General
- Difficulty with sports participation
- Difficult gross motor skills
- See Gross Motor Milestones
- Clumsy walking or Running
- Difficulty climbing or jumping
- Difficult fine motor skills
- See Fine Motor Milestones
- Difficult buttoning, zipping or tying
- Difficulty holding crayon or pen
- Difficulty with crafts
- Poor handwriting
- Commonly abnormal findings on exam
- Abnormal Rapid Alternating Movements
- Abnormal balance
- Unable to stand 15 seconds feet together, arms out
- Unable to tandem stand 15 seconds with eyes closed
- Unable to hop in place alternating feet
- Red flag findings suggestive of alternative diagnosis
- Motor weakness
- Ataxia
- Hypotonia or hypertonia
IV. Diagnosis (DSM IV Criteria)
- Gross Motor Milestones or Fine Motor Milestones not met
- Interferes significantly with academics or daily living
- Not due to other medical condition
V. Differential Diagnosis
- Mental Retardation
- Attention Deficit Hyperactivity Disorder (ADHD)
- Traumatic Brain Injury
- Mild Cerebral Palsy
- Congenital Chorea
- Decreased Visual Acuity
- Orthopedic Abnormality
VI. Prognosis
- Coordination Disorder persists into adulthood
VII. Management
- Encourage supportive environment
- Encourage motor appropriate sports participation
- Try activity with chance of success (e.g. swimming)
- Tailor academic activities to motor abilities
- Occupational Therapy
VIII. References
- Silver in Tasman (1997) Psychiatry, p. 638-9
- Hamilton (2002) Am Fam Physician 66(8):1435-40 [PubMed]