eMedicine Specialties > Pediatrics: Developmental and Behavioral > Medical Topics

Motor Skills Disorder: Follow-up

Author: Anna Maria Wilms Floet, MD, Assistant Professor, Assistant Professor of Pediatrics, Department of Pediatrics, Behavior and Developmental, University of Maryland School of Medicine
Coauthor(s): J Martin Maldonado-Durán, MD, Principal Investigator for Child and Family Center, Department of Psychiatry, Child and Adolescent Division, Family Service and Guidance Center; Jill Glinka, OTR, Occupational Therapist; Sari Lubin, OT, Occupational Therapist, Shoam Hospital, Israel
Contributor Information and Disclosures

Updated: Dec 12, 2006

Follow-up

Inpatient & Outpatient Medications

  • No specific pharmacologic treatments improve motor performance.
  • In children who have essential tremor that is severe enough to interfere with motor abilities, propranolol and other beta-blocker agents can be used. This therapy is described in the eMedicine article Essential Tremor.

Complications

  • Some children with DCD become demoralized, develop poor self-esteem, and withdraw from daily activities including those involving motor tasks (eg, drawing, writing).
  • They may develop a feeling of being different.
  • In some cases, children who show withdrawal behaviors are mistakenly believed to be poorly motivated, lazy, or not willing to make the effort to do a good job.
  • Pediatricians and other health professionals must be sensitive to the signs and symptoms of emotional withdrawal based on a child's fear of failure and a sense of hopelessness.
  • Children who have poor self-esteem and who accept the premise that they are lazy, incapable, or stupid require intervention from a mental health professional. Children who continue to have these feelings without help often show poor social functioning and compromised emotional development.

Prognosis

  • In the absence of intervention, children with motor coordination disorder tend to have symptoms that persist through adolescence into adulthood.
  • In follow-up study of children in whom motor coordination disorder was diagnosed at the age of 15 years, Cantell et al (1994) found that 46% had persistent symptoms at the age of 25 years.

Patient Education

  • Children aged 6 or 7 years can be positively counseled to make modifications in school and in social situations to make the best of their limitations in motor tasks.
  • Acknowledging these facts and helping the children understand that this problem is not voluntary on their part and not due to lack of effort or intellectual skill is important.
  • As with other chronic medical conditions, the patient can be helped to understand the nature of the condition, to live with it, and to participate in its treatment.

Miscellaneous

Special Concerns

  • Controversy exists regarding how much accommodation should be implemented in school for a child with a motor coordination difficulty.
    • In a child who has severe problems writing, opinions regarding how school personnel should attempt to help differ. Some think that the child should be expected to practice extensively with the expectation that the handwriting will improve; others believe that this child should be allowed to exclusively use a word processing keyboard. In some cases, a child with a writing problem dictates his or her thoughts to others and does not attempt to write.
    • These complicated decisions regarding the creation of the most responsible and effective school intervention for a given child can be decided only on a case-by-case basis after experienced professionals performed individualized evaluations.
  • A controversial issue is whether adolescents with DCDs should be able to obtain a license to drive a car.
    • Adolescents are typically eager to learn to drive to increase their mobility and to expand peer relationships.
    • Adolescents with DCDs may have difficulties with right-left coordination, crossing the body midline, depth perception, or other abilities that compromise optimal driving ability.
    • No generalizations can be applied to this situation because a rational and responsible decision depends on an individual evaluation of the given adolescent's abilities or difficulties and on the degree of danger of the activity.
 


More on Motor Skills Disorder

Overview: Motor Skills Disorder
Differential Diagnoses & Workup: Motor Skills Disorder
Treatment & Medication: Motor Skills Disorder
Follow-up: Motor Skills Disorder
References
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Further Reading

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Keywords

motor skills disorder, developmental coordination disorder, DSM IV, developmental motor coordination disorder, motor clumsiness, clumsy child syndrome, developmental dyspraxia, specific developmental disorder of motor function, ICD 10, clumsiness, dyscoordination disorder, motor dyspraxia, minimal cerebral palsy, developmental coordination disorder, DCD

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Contributor Information and Disclosures

Author

Anna Maria Wilms Floet, MD, Assistant Professor, Assistant Professor of Pediatrics, Department of Pediatrics, Behavior and Developmental, University of Maryland School of Medicine
Anna Maria Wilms Floet, MD is a member of the following medical societies: American Academy of Pediatrics and Society for Developmental and Behavioral Pediatrics
Disclosure: Nothing to disclose.

Coauthor(s)

J Martin Maldonado-Durán, MD, Principal Investigator for Child and Family Center, Department of Psychiatry, Child and Adolescent Division, Family Service and Guidance Center
J Martin Maldonado-Durán, MD is a member of the following medical societies: Kansas Medical Society
Disclosure: Nothing to disclose.

Jill Glinka, OTR, Occupational Therapist
Disclosure: Nothing to disclose.

Sari Lubin, OT, Occupational Therapist, Shoam Hospital, Israel
Disclosure: Nothing to disclose.

Medical Editor

Chet Johnson, MD, Medical Director, Child Development Unit, Department of Pediatrics, Professor, University of Kansas Medical Center
Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

CME Editor

Carrie Sylvester, MD, MPH, Director of Education in Child and Adolescent Psychiatry, Professor, Departments of Psychiatry and Pediatrics, Northwestern University Medical School
Carrie Sylvester, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, American Medical Women's Association, American Psychiatric Association, and American Society for Adolescent Psychiatry
Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD, Professor of Clinical Psychiatry, Department of Psychiatry and Biobehavioral Sciences, Division Chair of Child and Adolescent Psychiatry, Director of Training, Child and Adolescent Psychiatry Residency Program, University of Southern California Keck School of Medicine
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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