Developmental coordination disorder (DCD), also known as dyspraxia, is a commonly occurring condition that affects 5% of children on average. When a certain level of motor coordination is required, children with DCD do not perform as well as their peers in daily life activities (washing, dressing, eating, etc.) and at school (handwriting).
Inserm was commissioned by the French National Solidarity Fund for Autonomy (CNSA) to produce a Collective Expert Review of the scientific knowledge of DCD. Over a two-year period, Inserm’s Collective Expert Reviews Unit coordinated a dozen researchers and consulted ten specialists in order to review a scientific corpus of over 1400 international articles and issue recommendations on improving the diagnosis and management of children with DCD.
DCD varies markedly in its intensity and expression and is often associated with other neurodevelopmental disorders (of language, attention and learning), as well as a high risk of developing emotional, behavioral or anxiety disorders. These impact the child’s quality of life and participation in activities, particularly schoolwork. One of the key obstacles to their academic integration concerns handwriting.
To limit these impacts, the Expert Review states that spotting the signs is paramount when it comes to establishing rapid monitoring and individualized management for the child according to the severity of their condition, verbal competency, age, and any concomitant disorders.
The recommendations put forward by this Collective Expert Review can be summarized according to three main areas of focus.
The first consists of guaranteeing access to diagnosis for everyone, and as soon as possible following identification of the initial signs. In this respect, the Expert Review highlights the need to train professionals, emphasizing the importance of deepening the criteria and standardizing the tools needed to establish a diagnosis according to international standards.
Establishing such a diagnosis involves at the very least the participation of a doctor trained in developmental disorders, as well as that of a psychomotricity therapist or occupational therapist.
The second area of focus concerns what happens post-diagnosis, where there is no one standard intervention of unanimously recognized efficacy. Once diagnosed, it is therefore important to establish appropriate interventions that take into account the child’s profile, quality of life, and that of their family. The experts advise prescribing group sessions for the least affected children and one-on-one sessions for the others. They also recommend preferring interventions that focus on learning the skills needed for school and day-to-day life. Finally, these interventions must increase the involvement of the child’s family, teachers and anyone else interacting with them (sports coaches, etc.).
The objective of the third and final area of focus is to enable each child to get the right support at school. This requires that the school and its staff make the necessary additional arrangements for the child during their exams, in accordance with the French Disability Act (2005). This also involves raising the awareness of and training those involved in supervising and interacting with the child in everyday life, whether at home, school or during leisure
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Expertise collective de l’Inserm, Trouble développemental de la coordination ou dyspraxie, EDP Sciences, Paris, 2019, 630 p.