Health Scan: DCD – not just ADHD

Nearly everyone has heard of attention-deficit hyperactivity disorder (ADHD), but DCD is similarly troublesome.

By JUDY SIEGEL-ITZKOVICH
Children studying in a library 370 (photo credit: Thinkstock/Imagebank)
Children studying in a library 370
(photo credit: Thinkstock/Imagebank)
Nearly everyone has heard of attention-deficit hyperactivity disorder (ADHD), but there is another disorder no less troublesome.
Children who have difficulty carrying out routine tasks such as getting dressed, playing with particular types of games, drawing, copying from the board in school and typing at the computer could be suffering from developmental coordination disorder (DCD), and not necessarily from ADHD, says Prof. Sara Rosenblum of the University of Haifa’s department of occupational therapy, whose new study set out to shed light on the problem. In quite a few cases, children are not diagnosed early enough or are diagnosed incorrectly. This can lead to frustration and a sense of disability and even a decline that will ultimately require psychological therapy, she explains.
A person with DCD suffers from childhood and throughout adult life. Unlike various illnesses or trauma, says Rosenblum, this disorder is expressed in the inability to control the process of carrying out a particular motor task, consolidate it in memory and repeat the same task automatically. Simple tasks, such as closing buttons, tying laces or writing – which for healthy people become automatic – are difficult to carry out for people with DCD.
When these children grow up, they are more likely to have trouble with temporal and spatial organization and have difficulty estimating distance and speed, which could prevent them from learning to drive successfully or even riding a bicycle, she adds.
Since the deficit is neuralbased – it is founded in atypical brain activity – it is particularly difficult to diagnose in children. Going undiagnosed often worsens the individuals sense of frustration and shame, and sufferers are therefore more likely to grow up to be introverted adults.
The current study, conducted by Rosenblum and Dr. Miri Livneh-Zirinski of Kupat Holim Meuhedet, sets out to identify DCD in children by means of a simple and noninvasive test of writing tasks.
Two sample groups participated in the study – 20 children diagnosed with DCD and 20 more with no known symptoms of the disorder.
Each participant was asked to write his or her name, list the letters of the alphabet and copy a full paragraph. The tasks were conducted using a special electronic pen and pad and a program developed by the researcher that shows objective measures that relate to the temporal and spatial characteristics of the writing and pressure on the pad.
These measures can be analyzed with regard to motor, sensory and cognitive performance by taking note of elements such as in-air time per stroke, force of writing and the time taken to write each letter.
The study found that the two groups showed very different characteristic s in various parameters. Those with DCD took up to three times longer than the other children writing each letter; they also held the pen in the air for longer; and they put more pressure on the pad with the pen. The researchers said these results give further emphasis to the suffering that children with DCD undergo in the classroom and any time they are required to complete a writing task.
Children with DCD are “transparent.” They have no physiological or intellectual deformities, and in many cases they are above average in intelligence. But they are not able to complete tasks that require coordination between motor, sensory and cognitive functions. The study comes to show how a simple everyday task can be used to diagnose individuals with DCD, and subsequently enable them to get the necessary treatment and guidance with occupational therapy, concludes Rosenblum.
TOO EARLY, TOO SOON Babies born just a few weeks early have worse health outcomes than full-term babies, according to a study in the UK recently published in the British Medical Journal. The authors, from the Universities of Leicester, Liverpool, Oxford and Warwick and from the National Perinatal Epidemiology Unit, studied over 18,000 British babies born between September 2000 and August 2001. Health outcomes were studied when the infants reached nine months, three years and five years of age.
Health outcomes assessed included height, weight and body mass index, while parents also reported on number of hospital visits, long-standing illness, disability or infirmity, wheezing, use of prescribed medication and overall rating of child’s health.
Both moderate- to latepreterm (32 to 36 weeks) and early-term (37 to 38 weeks) babies required re-admission to hospital in the first few months more often than fullterm babies (39 to 41 weeks).
Those born between 33 and 36 weeks had an increased risk of asthma and wheezing compared to full-term babies.
The authors found that the shorter the pregnancy, the greater the risk of poor health outcomes. The greatest contribution to disease at the age of both three and five was being born moderate- or latepreterm or early-term.The study also discovered that mothers of children born at less than 37 weeks were more likely to be single and less likely to have educational qualifications or to work in managerial positions. Mothers of very preterm babies were more likely to smoke and less likely to breastfeed for four or more months than those delivered at or beyond 37 weeks.
The authors say it is mistaken just to group babies as preterm or term, as the study demonstrates a “continuum of increasing risk of adverse outcome with increasing prematurity, even approaching full term gestation.” They call for further study of factors that influence health outcomes for babies born between 32 and 38 weeks gestation so that the planning and delivery of healthcare services can be further improved.