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In 2002, I learned my nephew was struggling in school. I was perplexed because he was a smart, articulate fourth-grader who loved to tell stories. But his teachers said his handwriting was illegible and his grades were suffering. That mystery marked the beginning...

Doctors’ Notes: How to help your ‘clumsy’ child | Toronto Star

In 2002, I learned my nephew was struggling in school. I was perplexed because he was a smart, articulate fourth-grader who loved to tell stories. But his teachers said his handwriting was illegible and his grades were suffering. That mystery marked the beginning...

Doctors’ Notes: How to help your ‘clumsy’ child | Toronto Star

In 2002, I learned my nephew was struggling in school. I was perplexed because he was a smart, articulate fourth-grader who loved to tell stories. But his teachers said his handwriting was illegible and his grades were suffering. That mystery marked the beginning of my research into why some children are physically awkward and how this impacts their quality of life.

Forty years ago, you might have heard of “minimal brain dysfunction” or “clumsy child syndrome” — there were almost as many different diagnoses as there were children with the condition. In 1994, the term “developmental coordination disorder” emerged to encompass all children who have significant problems with motor function.

It’s a disorder that affects approximately six per cent of Canadian school-aged children, and as of yet, we do not know its causes. One possibility is that it occurs after an insult to the brain during fetal development, or soon after birth, when the areas that govern movement are formed.

Cascade effect

For a long time, these children have been somewhat invisible. I often hear “not everybody is an athlete,” but I’m quick to point out that we’re not just talking about poor sports skills. We’re talking about children who struggle with everyday activities like tying their shoelaces, doing up buttons, holding a pencil and handwriting.

Understandably, it can have a cascade effect on physical fitness, mental well-being and social participation. At the very core, it affects a child’s ability to play. These children are less likely to be physically active, and they’re more likely to have higher rates of depression and anxiety. The consequences of physical inactivity can be lifelong — research shows that if children are overweight or obese, they’re much more likely to suffer from these conditions as an adult.

We don’t yet have enough information on how the condition evolves, but we do think it persists into adulthood. We also know that people learn to adapt and cope with the disorder. I’m particularly interested in studying children because they have trouble hiding their limitations and can be bullied. Adults can adapt. For example, an adult might choose to not go skiing, or could type with a keyboard instead of taking notes.

Current research

While we don’t yet know how to permanently correct the underlying disorder, we’re creating programs to increase participation in physical activity. How can we get these children moving? We need to take a child-centred approach because no two children with the disorder are alike. We see children who struggle with fine motor skills like handwriting, and others who have difficulties with larger movements.

In my research, we work directly with the community and perform movement assessment tests on children. We then inform parents of at-risk children and follow them in long-term studies. We want to understand their capabilities and create customized activities that translate into long-term participation.

What can parents do?

The need for a diagnosis depends on the severity of motor problems a child or youth experiences and the resulting negative impact. If a child isn’t particularly skilled at sports, he or she could easily find other strengths to develop. But if this child also has difficulty with day-to-day activities, is getting low grades at school or is socially isolated, then a diagnosis can help.

While we are cautious about labelling a child, we do want to give them coping strategies to deal with their limitations. It’s a fine balance.

Parents can consult their family physician, who may refer their child to a pediatrician, occupational therapist or physiotherapist. Parents can also consult resources including canchild.ca.

The future

So, how did my nephew and his immediate family deal with developmental coordination disorder?

I’m happy to report that he graduated from college and is currently living in Scotland with his partner while she attends graduate school. Like so many people his age, he is still figuring out what to do with his life, but he has worked in the health field as a personal trainer and seems to thrive by applying his people skills while working with others.

His case illustrates that with the proper support, love and encouragement, children with motor coordination problems can adapt and thrive. The future is bright for this area of research and for everyone affected by this disorder.

Professor John Cairney holds appointments in the Department of Psychiatry, the Dalla Lana School of Public Health and the Faculty of Kinesiology and Physical Education at the University of Toronto. Doctors’ Notes is a weekly column by members of the U of T Faculty of Medicine. Email doctorsnotes@thestar.ca .

Professor John Cairney holds appointments in the Department of Psychiatry, the Dalla Lana School of Public Health and the Faculty of Kinesiology and Physical Education at the University of Toronto. Doctors’ Notes is a weekly column by members of the U of T Faculty of Medicine. Email doctorsnotes@thestar.ca .

Our editors found this article on this site using Google and regenerated it for our readers.

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