Clumsiness, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Clumsiness, a Developmental coordination disorder is a medical childhood disorder that produces poor coordination and clumsiness.
About 6-8 % of children seem to be developing in the normal way but have difficulties with coordination and with learning new skills which involves their function and involvement at home, at school and in the playground.
The underlying cause for the movement problems children with DCD have is linked to abnormal brain development that influences the way in which the brain produces connections (internal models) between different components of the brain when learning a new skill.
This in turn forces the child's capability to use data from the senses to prepare, adjust and control their movements.
DCD influences fine and gross motor abilities, balance and posture, basic motor patterns (walking, running, jumping) and especially skilled action that need practice, managing, attention and working memory (ball skills, drawing and handwriting, sport skills).
Children with this disorder may:
1. Have trouble holding objects
2. Have an unsteady walk
3. Run into other children
4. Trip over their own feet
Some frequent symptoms are:
1. Clumsiness
2. Delays in sitting up, crawling, and walking
3. Difficulties with sucking and swallowing during first year of life
4. Difficulties with gross motor coordination
DSM 5 manual diagnostic criteria
A. Motor performance that is considerably below expected levels, given the person's chronologic age and previous opportunities for skill acquisition.
The poor motor performance may present as:
1. Coordination problems,
a. Poor balance,
b. Clumsiness,
c. Dropping or bumping into things;
2. Marked delays in achieving developmental motor milestones
a. Walking,
b. Crawling,
c. Sitting
3. In the acquisition of basic motor skills
B. The coordination disturbance considerably and persistently affects activities of daily living or academic achievement
C. Onset of symptoms is in the early developmental period.
Treatment
Physical education and perceptual motor training (combining movement with tasks that need thinking, like math or reading) are the best methods to treat coordination disorder.
To learn a motor skill takes practice along with perseverance and an ability to tolerate failure.
Parents and teachers are best placed to encourage repeated practice as part of everyday life

TABLE OF CONTENT
Introduction
Chapter 1 Clumsiness, A Development Co-ordination Disorder
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 ADHD
Chapter 8 ODD
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Jan 11, 2017
• ISBN: 9781370537105

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Clumsiness,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2016 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Clumsiness, a Developmental Co-ordination Disorder, Diagnosis, Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Clumsiness)

This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 amazon kindle books and 250 into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring you the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Clumsiness (Developmental coordination disorder)

What is Clumsiness, A Developmental coordination disorder (DCD)?

Developmental coordination disorder is a medical childhood disorder that produces poor coordination and clumsiness.

About 6-8 % of children seem to be developing in the normal way but have difficulties with coordination and with learning new skills which involves their function and involvement at home, at school and in the playground.

Developmental Coordination Disorder (DCD) is the worldwide accepted name for this disorder.

The underlying cause for the movement problems children with DCD have is linked to abnormal brain development that influences the way in which the brain produces connections (internal models) between different components of the brain when learning a new skill.

This in turn forces the child's capability to use data from the senses to prepare, adjust and control their movements.

DCD influences fine and gross motor abilities, balance and posture, basic motor patterns (walking, running, jumping) and especially skilled action that need practice, managing, attention and working memory (ball skills, drawing and handwriting, sport skills).

What is dyspraxia?

Children with coordination problems are occasionally given a diagnosis of dyspraxia.

Dyspraxia is a loose diagnosis that places coordination disorders with a whole variety of attention, emotional self-regulation, anxiety, short term working memory problems.

Unlike DCD, there are no formal criteria for a diagnosis of dyspraxia and this makes it very perplexing because different people use the term dyspraxia in different ways.

It is also why a diagnosis of dyspraxia is not accepted by many pediatricians.

Placing all these different developmental disorders into one diagnosis has serious disadvantages because it avoids clear thinking about the different factors causing the everyday difficulties the child is having.

The better decision is to separately recognize the motor learning difficulty (DCD) and the related developmental disorders such as anxiety disorder, attention disorders, developmental language disorder, poor working memory and autism.

This gives a better approach into the variety of difficulties the child has and access to data about the different disorders.

The link between DCD, attention and an anxious nature

Children with DCD often have a very careful, apprehensive or anxious temperament.

This character trait is known as behavioral inhibition (BI) and involves a child's behavior, attention skills and capability to take on challenges and learn new skills.

Some children with poor coordination also have widespread joint hyper-mobility which is in turn related with an apprehensive nature.

BI and anxiety behaviors

They have a very careful or apprehensive response to an event or state that is new, challenging or erratic:

1. Poor awareness and emotional self-regulation - outbursts and meltdowns, distractible, fight or flight reaction to challenges

2. Prevention as a method to treat negative arousal and anxiety

3. Poor tolerance of failure, do not like producing errors, perfectionism

4. Apprehension of heights, loud and erratic noises, busy environments, uncertainty

5. Social unease and separation anxiety

What are the causes of DCD?

Causes

A small number of school-age children have some kind of developmental coordination disorder.

Children with this disorder may:

1. Have trouble holding objects

2. Have an unsteady walk

3. Run into other children

4. Trip over their own feet

Developmental coordination disorder may occur alone or with attention deficit hyperactivity disorder (ADHD) or other learning disorders, such as communication disorders or disorder of written expression.

It is now normally established that children with DCD have abnormal brain development that influences the way they learn new skills.

They seem to have problems forming internal images (also called internal models) that develop the basis for learning, planning and coordination of motor skills.

The causes of different brain development in DCD are not fully known but there seem to be some genetic factors present.

Preterm birth and stressful birth situations are also related to DCD.

Also children with a diagnosis of DCD often have one or more co-existing developmental disorders linked to a very careful and highly sensitive nature, self-regulation, anxiety, attention and working memory which affect their learning of new skills.

Collectively this means that in order to assist a child with DCD it is essential to understand all the factors that cause poor motor action so that a proper plan of action can be applied to help the child.

The cause of developmental co-ordination disorder (DCD) is not known, even though it is believed to be caused by a difficulty in the development of the brain.

Performing smooth, planned motions is a complicated process which affects the senses, muscles and central nervous system (brain, nerves and spinal cord).

Any difficulty in this process could possibly result in disorders with movement and co-ordination.

Even though it is not known exactly what causes DCD, there is a known link between DCD and:

1. Being born prematurely (before the 37th week of pregnancy)

2. Having a family history of DCD, even though it is not known exactly which genes may be affected in the condition

3. Being born with a low birth weight

4. The mother taking alcohol or illegal drugs while pregnant

The reasons a child with DCD has poor coordination

DCD is a specific motor learning developmental disorder.

Children with DCD have problems learning and adapting the internal models.

These internal models are the plans within the brain that link data