OCTOBER 15, 2002 / VOLUME 66, NUMBER 8
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AMERICAN FAMILY PHYSICIAN
1435
fiable medical or neurologic condition but
had difficulties in coordination that interfered
with academic performance and/or socializa-
tion. In recent years, the term “clumsy child
syndrome” has been somewhat replaced by
the term “developmental coordination disor-
der” (DCD), essentially a recapitulation of
Gubbay’s diagnostic criteria, that is formal-
ized in the Diagnostic and Statistical Manual
of Mental Disorders, 3d ed. (DSM-III)4 and
revised in the fourth edition (DSM-IV).5
Although various other terms are used to
describe children with minor motor difficul-
ties, we have confined terminology in this
article to “clumsy child syndrome” and DCD,
using them interchangeably.
Learning disabilities, emotional problems,
conduct disorder, and oppositional defiant dis-
order are more common in children with
DCD.6 Children with concomitant DCD and
attention-deficit/hyperactivity disorder (ADHD)
are particularly at risk for such problems.1,6-8
Prevalence
While epidemiologic studies estimate that
significant clumsiness affects 5 to 15 percent
of school-aged children, the estimate with the
M
any school-aged children
struggle to learn motor
skills that their peers have
already mastered. Such
children, often described
as “clumsy,” may have difficulties with writing
and self-help skills such as dressing and self-
feeding. The diagnosis of clumsiness in chil-
dren is often missed because parents may not
recognize their child’s uncoordination as a sig-
nificant medical problem. When parents men-
tion their child’s awkwardness to a physician,
their concerns may be dismissed; physicians
commonly reassure parents that children will
outgrow clumsiness. In the past 20 years, how-
ever, research has demonstrated convincingly
that in the majority of children, these motor
deficits tend to persist throughout, rather than
resolve during, adolescence and adulthood.1,2
In 1975, Gubbay3 coined the term “clumsy
child syndrome” to describe children of