נופלים בין הכיסאות: תת-אבחון של DCD ביַלְדוּת והשלכותיו בקרב מבוגרים צעירים עם קשיים בקואורדינציה מוטורית

Abstract

Background: Developmental Coordination Disorder (DCD) is prevalent among 6-8% of school-age children, and is defined by major motor-coordination difficulties that significantly and persistently hinder participation in daily activities and quality of life. Evidence suggests that early detection and intervention may improve children with DCDs' daily function and reduce their emotional difficulties. Clinical reports points to possible under diagnosis of DCD. However, the extent of this phenomenon is unknown. The aim of this study was to describe retrospectively the prevalence of receiving DCD diagnosis in a convenience sample of young adults with motor difficulties, as well as to explore their perspectives on receiving a diagnosis. Methods: This mix methods study, included 54 young adults (aged 21-35 years) who met the Diagnostic and Statistical Manual of Mental Disorders 5th edition criteria for DCD were recruited for this study: Percentile < 5 on standardized motor assessment, the Movement Assessment Battery for Children 2nd Edition, report of current and childhood functional-motor difficulties on the Adolescents and Adults Coordination Questionnaire and lack of other neurological conditions such as cerebral palsy. Participants with health conditions other than DCD were excluded. Participants reported on the existence of childhood DCD/Dyspraxia diagnoses and on developmental supports they were received during their childhood. Ten participants were interviewed regarding their perspective on receiving a formal diagnosis. Results: Only three (5.56%) participants were diagnosed with DCD during their childhood. However, 39 (72.22%) received at list one kind of professional support: 22 (40.74%) occupational therapy, 10 (22.73%) physiotherapy, 15 (27.78%) speech therapy, 18 (33.33%) psychotherapy and 10 (22.73%) other complementary treatments. Interviews analysis revealed: (1) childhood included confusion and "otherness", in the absence of an explanation for motor challenges; (2) environmental lack of legitimacy and unawareness of DCD during childhood; and (3) validation and enhanced sense of coherence following a diagnosis. Conclusion: Although identified with difficulties and referred for professional support, adults with DCD were under diagnosed in childhood. As diagnosis can validate 'otherness' experience, under diagnosis can exacerbate stress associated with motor-functional difficulty. To prevent the consequences of future motor difficulties, DCD should be diagnosed in childhood, according to international recommendations.