3 Prevalence and Impact

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3.1 General

The prevalence of DCD in the UK is between 6% and 10%, which is approximately 2-3 children in every class of 30^{5, 6}. The needs of the majority of these children can be met by parents and school staff with only a relatively small number of children requiring specialist assessment and therapy. The condition is more common in boys than girls1,5 and is often referred to as the “hidden handicap”⁵.

Most children with DCD have normal intelligence but have difficulty performing co-ordinated movements^{2, 5}. The literature clearly shows that children with DCD may have significant academic, social, emotional and behavioural difficulties. Children with DCD have lower perceived physical competence than children without the disorder,⁷ with adolescents in particular perceiving themselves as less competent and having less social support than their peers⁸8. Low self-esteem and social isolation are common.

They experience difficulties in many areas of daily living tasks such as dressing and in school, problems with handwriting and organisation are common ^{9, 10}9,10. Failure in school from an early age has been described in the literature. Portwood identified some 77% of children with Special Educational Needs and behavioural difficulties as having DCD¹¹.

In addition, DCD may co-exist with other problems such as learning difficulties, specific language disorders, Attention Deficit Hyperactivity Disorder (ADHD) or Autistic Spectrum Disorder – Asperger’s Syndrome^{12, 13}. It is noted that each of these co-morbid conditions may also exist in their own right without DCD.

Although children mature and their co-ordination skills improve, it is recognised that without intervention these children may underachieve academically and socially on a long term basis¹⁴. Difficulties often persist and in older children may be masked until a child meets a new environment or physical challenge. Indeed, poor psychosocial functioning may continue into adulthood, particularly if DCD is present together with ADHD¹⁵. It is therefore important that such children are recognised at an early age and appropriate support provided.

3.2 Speech and Language

Speech and language is the most common developmental cause for parental concern¹⁶. It is estimated that up to 1 in 5 pre-school children have delayed/disordered speech and language¹⁶. Overall, approximately 5.95% of 0-16 year olds have speech and language difficulties¹⁷.

Those with delayed speech and language often have delayed motor development as part of a general developmental delay. Their difficulties tend to resolve with maturation.

For many years it has been recognised that children whose primary difficulty lies with Speech and Language often exhibit co-ordination difficulties; similarly children whose primary difficulty lies with co-ordination may also have Speech and Language difficulties. In a review of the literature Hill found 40-90% of children with specific language impairment (SLI) had co-ordination difficulties¹⁸. She used the term SLI to denote those children who had no other previously identified difficulties such as hearing loss, sensory or physical impairment or learning difficulty to account for their speech and language difficulty.

It is not uncommon for children with DCD to be referred to Speech and Language Therapy before their co-ordination difficulties are recognised.

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