Neurological diagnoses in children potentially fulfilling the criteria for developmental coordination disorder

Developmental coordination disorder (DCD) is a neurodevelopmental condition characterized by delayed motor development and non-progressive coordination impairments. DCD can be diagnosed in children fulfilling four diagnostic criteria: (1) delayed acquisition or performance of motor skills for age; (2) interference of motor impairments with daily life activities; (3) onset in the early developmental period; (4) absence of an underlying alternative neurological disorder (AltND) explanatory for the symptoms.

Clinically, the distinction between DCD and AltND based on the observable symptoms (i.e. the phenotype) can be challenging, as many AltNDs present with a phenotype that may fulfill the first three criteria for DCD. Consequently, children with an AltND may initially be mistakenly diagnosed with DCD (i.e. false positive diagnosis) until additional diagnostic examinations reveal an underlying cause for the phenotype.

In our cohort of 50 patients phenotypically fulfilling the first three criteria for DCD, we investigated whether neurological phenotypic assessment could predict the final diagnosis (DCD, n = 31/50; AltND, n = 19/50). Predictive values were low for both the diagnosis of DCD (52%) as well as for the diagnosis of AltND (21%), with a false positive rate of approximately 79%. A genetic etiology was exposed in 58% of patients ultimately diagnosed with an AltND (n = 11/19). Moreover, statistical comparison of 51 clinical and diagnostic features between children diagnosed with DCD and those with AltND did not reveal any distinguishing parameters.