Lasten motoriset koordinaatiohäiriöt : kehitysneuropsykologinen seurantatutkimus

The aim of this study was to describe motor clumsiness in children (developmental coordination disorder), its features and developmental changes between the ages of 5 and 11 years. For this study, all 5-year old children (N=1138) living in a Finnish town (Lahti) were screened during an extended health examination and motorically delayed children were identified. A sample of motorically delayed children (N=106 at age 7) and an age- and sex-marched control group (N=40 at age 7) were followed at ages 7, 9 and 11, using a large number of motor and neuropsychological tests. The study also included teacher and parent ratings concerning learning and behavioral problems and assessment of cognitive abilities. The problems in motor development which were detected by using a simple screening procedure (visual-motor and gross motor items and developmental milestones) tended to be clearly present in approximately half of the subjects up to at least age 11. At the age of 1l clumsy children had about a three-fold occurrence of different kinds of learning disabilities compared to the control group. The clearest behavioral correlate of motor clumsiness was inattention/passivity. By using clustering methods six reliable subgroups were identified at age 7 and re-examined at 9 and 11. clustering was based on motor and neuropsychological variables. The main feature in the first subgroup was general developmental delay in motor and cognitive functions. The second group was cognitively normal but they had gross motor difficulties. The third group had problems in motor control, the fourth in visual-spatial skills. The fifth group had similar difficulties to the fourth but in milder form. The main feature in the sixth group was kinesthetic problems. The meaning of motor clumsiness as a specific developmental problem and the use of motor assessment as a part of screening also for other kinds of developmental disabilities is discussed.