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DEVELOPMENTAL COORDINATION DISORDER AND CO-OCCURRING MOTOR DIFFICULTIES IN CHILDREN WITH ATTENTION DEFICIT AND HYPERACTIVITY DISORDER

Year 2025, Volume: 13 Issue: 2, 516 - 528, 25.06.2025

Ramazan Yıldız , Ayşe Yildiz , Şeyma Gürbüz , Müşerrefe Nur Keleş , Esra Güney , Bülent Elbasan

https://doi.org/10.33715/inonusaglik.1642262

Abstract

Children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) commonly experience challenges in both fine and gross motor skills. Nevertheless, the specific domains of dysfunction in these children have yet to be established through comprehensive neurological assessments. This study aims to determine the prevalence of Developmental Coordination Disorder (DCD) in children with ADHD and identify the specific domains of dysfunction. Participants were 32 children diagnosed with ADHD aged between 5 and 12 years (M = 8.5; 75% male) and 36 typically developing children in the same age range (M = 8.1; 63.9% male). DCD and neurological examination were performed using DCD-Q and Touwen examination, respectively. Children diagnosed with ADHD were more prone to having DCD compared to their peers (p< 0.05). According to Touwen's examination, children with ADHD had dysfunction in the domains of involuntary movements, associated movements, coordination-balance, fine manipulation, and sensory function. When a child is diagnosed with both ADHD and DCD, a personalized approach to evaluating and treating both conditions is necessary. A comprehensive assessment that includes neurological components and identifying dysfunctional domains can help determine the most suitable intervention program for children with ADHD.

Keywords

Attention-deficit hyperactive Disorder Comorbidity Developmental coordination disorder Touwen examination

References

  • American Psychiatric Association, D. & Association, A. P. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5): American psychiatric association Washington, DC.
  • Blank, R., Barnett, A. L., Cairney, J., Green, D., Kirby, A., Polatajko, H., ... Wilson, P. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine & Child Neurology, 61(3), 242-285.
  • Bonthrone, A. F., Green, D., Morgan, A. T., Mankad, K., Clark, C. A. & Liégeois, F. J. (2024). Attention and motor profiles in children with developmental coordination disorder: A neuropsychological and neuroimaging investigation. Developmental Medicine & Child Neurology, 66(3), 362-378.
  • Czamara, D., Tiesler, C. M., Kohlböck, G., Berdel, D., Hoffmann, B., Bauer, C.-P., ... Herbarth, O. (2013). Children with ADHD symptoms have a higher risk for reading, spelling and math difficulties in the GINIplus and LISAplus cohort studies. PloS one, 8(5), e63859.
  • Denckla, M. B. & Rudel, R. G. (1978). Anomalies of motor development in hyperactive boys. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 3(3), 231-233.
  • Farran, E. K., Bowler, A., D’Souza, H., Mayall, L., Karmiloff-Smith, A., Sumner, E., ... Hill, E. L. (2020). Is the motor impairment in attention deficit hyperactivity disorder (ADHD) a co-occurring deficit or a phenotypic characteristic? Advances in Neurodevelopmental Disorders, 4, 253-270.
  • Fenollar-Cortés, J., Gallego-Martínez, A. & Fuentes, L. J. (2017). The role of inattention and hyperactivity/impulsivity in the fine motor coordination in children with ADHD. Research in developmental disabilities, 69, 77-84.
  • Green, D., Baird, G. & Sugden, D. (2006). A pilot study of psychopathology in developmental coordination disorder. Child: care, health and development, 32(6), 741-750.
  • Hadders-Algra, M. (2010). Neurological examination of the child with minor neurological dysfunction: Mac Keith Press.
  • Kaiser, M.-L., Schoemaker, M., Albaret, J.-M. & Geuze, R. (2015). What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature. Research in developmental disabilities, 36, 338-357.
  • Kleeren, L., Hallemans, A., Hoskens, J., Klingels, K., Smits-Engelsman, B. & Verbecque, E. (2023). A Critical View on Motor-based Interventions to Improve Motor Skill Performance in Children With ADHD: A Systematic Review and Meta-analysis. Journal of attention disorders, 27(4), 354-367.
  • Klupp, S., Möhring, W., Lemola, S. & Grob, A. (2021). Relations between fine motor skills and intelligence in typically developing children and children with attention deficit hyperactivity disorder. Research in developmental disabilities, 110, 103855.
  • Lee, J., Mayall, L. A., Bates, K. E., Hill, E. L., Leonard, H. C. & Farran, E. K. (2021). The relationship between motor milestone achievement and childhood motor deficits in children with Attention Deficit Hyperactivity Disorder (ADHD) and children with Developmental Coordination Disorder. Research in developmental disabilities, 113, 103920.
  • Martini, R. & Wilson, B. (2012). QUESTIONNAIRE SUR LE TROUBLE DE L’ACQUISITION DE LA COORDINATION (QTAC)©. Repéré à http://dcdq. ca/pdf/DCDQ% 20QTACAdmin Scoring, 20, 282013.
  • McLeod, K. R., Langevin, L. M., Goodyear, B. G. & Dewey, D. (2014). Functional connectivity of neural motor networks is disrupted in children with developmental coordination disorder and attention-deficit/hyperactivity disorder. NeuroImage: Clinical, 4, 566-575.
  • Meachon, E. J., Melching, H. & Alpers, G. W. (2024). The overlooked disorder:(un) awareness of developmental coordination disorder across clinical professions. Advances in Neurodevelopmental Disorders, 8(2), 253-261.
  • Meachon, E. J., Zemp, M. & Alpers, G. W. (2022). Developmental coordination disorder (DCD): Relevance for clinical psychologists in Europe. Clinical psychology in Europe, 4(2), e4165.
  • Mikami, M., Hirota, T., Adachi, M., Takahashi, M., Nishimura, T., Saito, M., ... Yamada, J. (2023). Trajectories of emotional and behavioral problems in school-age children with coordination difficulties and their relationships to ASD/ADHD traits. Research in developmental disabilities, 133, 104394.
  • Montes-Montes, R., Delgado-Lobete, L. & Rodríguez-Seoane, S. (2021). Developmental coordination disorder, motor performance, and daily participation in children with attention deficit and hyperactivity disorder. Children, 8(3), 187.
  • Pediatrics, A. A. o. (2002). Guidelines for Health Supervision III: Amer Academy of Pediatrics.
  • Raberger, T. & Wimmer, H. (2003). On the automaticity/cerebellar deficit hypothesis of dyslexia: Balancing and continuous rapid naming in dyslexic and ADHD children. Neuropsychologia, 41(11), 1493-1497.
  • Pillay, B. J., Meyer, A. & Mokobane, M. (2019). Fine motor deficits and attention deficit hyperactivity disorder in primary school children. South African Journal of Psychiatry, 25(1), 1-7.
  • Racine, M. B., Majnemer, A., Shevell, M. & Snider, L. (2008). Handwriting performance in children with attention deficit hyperactivity disorder (ADHD). Journal of Child Neurology, 23(4), 399-406.
  • Rasmussen, P. & Gillberg, C. (2000). Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. Journal of the American Academy of Child & Adolescent Psychiatry, 39(11), 1424-1431.
  • Saidmamatov, O., Nascimento, M., Cerqueira, J., Rodrigues, P. & Vasconcelos, O. (2022). Motor skill training programs for children with developmental coordination disorder: Does gender matter? Neuropsychiatrie de l'Enfance et de l'Adolescence, 70(4), 183-194.
  • Samara, D., Sidharta, N., Mediana, D. & Noviyanti, N. (2012). Gender impacts on motor skill proficiency-physical activity relationship in children. Universa Medicina, 31(3), 192-199.
  • Scahill, L. & Schwab-Stone, M. (2000). Epidemiology of ADHD in school-age children. Child and adolescent psychiatric clinics of North America, 9(3), 541-555.
  • Schoemaker, M. M., Ketelaars, C. E., Van Zonneveld, M. & Minderaa, R. B. (2005). Deficits in motor control processes involved in production of graphic movements of children with attention‐deficit‐hyperactivity disorder. Developmental Medicine & Child Neurology, 47(6), 390-395.
  • Segal, D. L. (2010). Diagnostic and statistical manual of mental disorders (DSM‐IV‐TR). The corsini encyclopedia of psychology, 1-3.
  • Smits-Engelsman, B., Schoemaker, M., Delabastita, T., Hoskens, J. & Geuze, R. (2015). Diagnostic criteria for DCD: Past and future. Human movement science, 42, 293-306.
  • Stray, L. L., Stray, T., Iversen, S., Ruud, A., Ellertsen, B. & Tønnessen, F. E. (2009). The Motor Function Neurological Assessment (MFNU) as an indicator of motor function problems in boys with ADHD. Behavioral and Brain Functions, 5, 1-13.
  • Thomas, R., Sanders, S., Doust, J., Beller, E. & Glasziou, P. (2015). Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics, 135(4), e994-e1001.
  • Watemberg, N., Waiserberg, N., Zuk, L. & Lerman‐Sagie, T. (2007). Developmental coordination disorder in children with attention‐deficit–hyperactivity disorder and physical therapy intervention. Developmental Medicine & Child Neurology, 49(12), 920-925.
  • Wilson, B. N., Kaplan, B. J., Crawford, S. G., Campbell, A. & Dewey, D. (2000). Reliability and validity of a parent questionnaire on childhood motor skills. The American Journal of Occupational Therapy, 54(5), 484-493.
  • Wilson, P. H. (2005). Practitioner review: approaches to assessment and treatment of children with DCD: an evaluative review. Journal of child psychology and psychiatry, 46(8), 806-823.
  • Van der Linde, B. W., van Netten, J. J., Otten, B., Postema, K., Geuze, R. H. & Schoemaker, M. M. (2015). Activities of daily living in children with developmental coordination disorder: Performance, learning, and participation. Physical therapy, 95(11), 1496-1506.
  • Yan, J. H. & Thomas, J. R. (2002). Arm movement control: differences between children with and without attention deficit hyperactivity disorder. Research quarterly for exercise and sport, 73(1), 10-18.
  • Yildirim, C. K., Altunalan, T., Acar, G., Elbasan, B. & Gucuyener, K. (2019). Cross-cultural adaptation of the Developmental Coordination Disorder Questionnaire in Turkish children. Perceptual and motor skills, 126(1), 40-49.
  • Zhang, L. & Jin, X. (2007). Functional impairment of attention deficit hyperactivity disorder in children and adolescents. Chin J Pract Pediatr, 22, 872-875.
  • Zwicker, J. G., Harris, S. & Klassen, A. (2013). Quality of life domains affected in children with developmental coordination disorder: a systematic review. Child: care, health and development, 39(4), 562-580.

Dikkat Eksikliği ve Hiperaktivite Bozukluğu Olan Çocuklarda Gelişimsel Koordinasyon Bozukluğu ve Eşlik Eden Motor Güçlükler

Year 2025, Volume: 13 Issue: 2, 516 - 528, 25.06.2025

Ramazan Yıldız , Ayşe Yildiz , Şeyma Gürbüz , Müşerrefe Nur Keleş , Esra Güney , Bülent Elbasan

https://doi.org/10.33715/inonusaglik.1642262

Abstract

Dikkat Eksikliği/Hiperaktivite Bozukluğu (DEHB) tanısı konulan çocuklar genellikle hem ince hem de kaba motor becerilerinde zorluklar yaşarlar. Bununla birlikte, bu çocuklarda işlev bozukluğunun belirli alanları kapsamlı nörolojik değerlendirmelerle henüz belirlenmemiştir. Bu çalışma, DEHB'li çocuklarda Gelişimsel Koordinasyon Bozukluğu'nun (GKB) yaygınlığını belirlemeyi ve işlev bozukluğunun belirli alanlarını tanımlamayı amaçlamaktadır. Katılımcılar, 5 ila 12 yaşları arasında DEHB tanısı konulan 32 çocuk (M = 8,5; %75 erkek) ve aynı yaş aralığındaki 36 tipik gelişim gösteren çocuktu (M = 8,1; %63,9 erkek). GKB ve nörolojik muayene sırasıyla DCD-Q ve Touwen muayenesi kullanılarak yapıldı. DEHB tanısı konulan çocuklar, akranlarına kıyasla GKB'ye daha yatkındı (p< 0,05). Touwen muayenesine göre, DEHB'li çocuklarda istemsiz hareketler, ilişkili hareketler, koordinasyon-denge, ince manipülasyon ve duyusal işlev alanlarında işlev bozukluğu vardı. Bir çocuğa hem DEHB hem de GKB tanısı konduğunda, her iki durumu da değerlendirmek ve tedavi etmek için kişiselleştirilmiş bir yaklaşım gereklidir. Nörolojik bileşenleri içeren ve işlevsiz alanları belirleyen kapsamlı bir değerlendirme, DEHB'li çocuklar için en uygun müdahale programını belirlemeye yardımcı olabilir.

Keywords

Dikkat eksikliği ve hipekaktivite bozukluğu Komorbidite Gelişimsel koordinasyon bozukluğu Touwen muayenesi

References

  • American Psychiatric Association, D. & Association, A. P. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5): American psychiatric association Washington, DC.
  • Blank, R., Barnett, A. L., Cairney, J., Green, D., Kirby, A., Polatajko, H., ... Wilson, P. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine & Child Neurology, 61(3), 242-285.
  • Bonthrone, A. F., Green, D., Morgan, A. T., Mankad, K., Clark, C. A. & Liégeois, F. J. (2024). Attention and motor profiles in children with developmental coordination disorder: A neuropsychological and neuroimaging investigation. Developmental Medicine & Child Neurology, 66(3), 362-378.
  • Czamara, D., Tiesler, C. M., Kohlböck, G., Berdel, D., Hoffmann, B., Bauer, C.-P., ... Herbarth, O. (2013). Children with ADHD symptoms have a higher risk for reading, spelling and math difficulties in the GINIplus and LISAplus cohort studies. PloS one, 8(5), e63859.
  • Denckla, M. B. & Rudel, R. G. (1978). Anomalies of motor development in hyperactive boys. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 3(3), 231-233.
  • Farran, E. K., Bowler, A., D’Souza, H., Mayall, L., Karmiloff-Smith, A., Sumner, E., ... Hill, E. L. (2020). Is the motor impairment in attention deficit hyperactivity disorder (ADHD) a co-occurring deficit or a phenotypic characteristic? Advances in Neurodevelopmental Disorders, 4, 253-270.
  • Fenollar-Cortés, J., Gallego-Martínez, A. & Fuentes, L. J. (2017). The role of inattention and hyperactivity/impulsivity in the fine motor coordination in children with ADHD. Research in developmental disabilities, 69, 77-84.
  • Green, D., Baird, G. & Sugden, D. (2006). A pilot study of psychopathology in developmental coordination disorder. Child: care, health and development, 32(6), 741-750.
  • Hadders-Algra, M. (2010). Neurological examination of the child with minor neurological dysfunction: Mac Keith Press.
  • Kaiser, M.-L., Schoemaker, M., Albaret, J.-M. & Geuze, R. (2015). What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature. Research in developmental disabilities, 36, 338-357.
  • Kleeren, L., Hallemans, A., Hoskens, J., Klingels, K., Smits-Engelsman, B. & Verbecque, E. (2023). A Critical View on Motor-based Interventions to Improve Motor Skill Performance in Children With ADHD: A Systematic Review and Meta-analysis. Journal of attention disorders, 27(4), 354-367.
  • Klupp, S., Möhring, W., Lemola, S. & Grob, A. (2021). Relations between fine motor skills and intelligence in typically developing children and children with attention deficit hyperactivity disorder. Research in developmental disabilities, 110, 103855.
  • Lee, J., Mayall, L. A., Bates, K. E., Hill, E. L., Leonard, H. C. & Farran, E. K. (2021). The relationship between motor milestone achievement and childhood motor deficits in children with Attention Deficit Hyperactivity Disorder (ADHD) and children with Developmental Coordination Disorder. Research in developmental disabilities, 113, 103920.
  • Martini, R. & Wilson, B. (2012). QUESTIONNAIRE SUR LE TROUBLE DE L’ACQUISITION DE LA COORDINATION (QTAC)©. Repéré à http://dcdq. ca/pdf/DCDQ% 20QTACAdmin Scoring, 20, 282013.
  • McLeod, K. R., Langevin, L. M., Goodyear, B. G. & Dewey, D. (2014). Functional connectivity of neural motor networks is disrupted in children with developmental coordination disorder and attention-deficit/hyperactivity disorder. NeuroImage: Clinical, 4, 566-575.
  • Meachon, E. J., Melching, H. & Alpers, G. W. (2024). The overlooked disorder:(un) awareness of developmental coordination disorder across clinical professions. Advances in Neurodevelopmental Disorders, 8(2), 253-261.
  • Meachon, E. J., Zemp, M. & Alpers, G. W. (2022). Developmental coordination disorder (DCD): Relevance for clinical psychologists in Europe. Clinical psychology in Europe, 4(2), e4165.
  • Mikami, M., Hirota, T., Adachi, M., Takahashi, M., Nishimura, T., Saito, M., ... Yamada, J. (2023). Trajectories of emotional and behavioral problems in school-age children with coordination difficulties and their relationships to ASD/ADHD traits. Research in developmental disabilities, 133, 104394.
  • Montes-Montes, R., Delgado-Lobete, L. & Rodríguez-Seoane, S. (2021). Developmental coordination disorder, motor performance, and daily participation in children with attention deficit and hyperactivity disorder. Children, 8(3), 187.
  • Pediatrics, A. A. o. (2002). Guidelines for Health Supervision III: Amer Academy of Pediatrics.
  • Raberger, T. & Wimmer, H. (2003). On the automaticity/cerebellar deficit hypothesis of dyslexia: Balancing and continuous rapid naming in dyslexic and ADHD children. Neuropsychologia, 41(11), 1493-1497.
  • Pillay, B. J., Meyer, A. & Mokobane, M. (2019). Fine motor deficits and attention deficit hyperactivity disorder in primary school children. South African Journal of Psychiatry, 25(1), 1-7.
  • Racine, M. B., Majnemer, A., Shevell, M. & Snider, L. (2008). Handwriting performance in children with attention deficit hyperactivity disorder (ADHD). Journal of Child Neurology, 23(4), 399-406.
  • Rasmussen, P. & Gillberg, C. (2000). Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. Journal of the American Academy of Child & Adolescent Psychiatry, 39(11), 1424-1431.
  • Saidmamatov, O., Nascimento, M., Cerqueira, J., Rodrigues, P. & Vasconcelos, O. (2022). Motor skill training programs for children with developmental coordination disorder: Does gender matter? Neuropsychiatrie de l'Enfance et de l'Adolescence, 70(4), 183-194.
  • Samara, D., Sidharta, N., Mediana, D. & Noviyanti, N. (2012). Gender impacts on motor skill proficiency-physical activity relationship in children. Universa Medicina, 31(3), 192-199.
  • Scahill, L. & Schwab-Stone, M. (2000). Epidemiology of ADHD in school-age children. Child and adolescent psychiatric clinics of North America, 9(3), 541-555.
  • Schoemaker, M. M., Ketelaars, C. E., Van Zonneveld, M. & Minderaa, R. B. (2005). Deficits in motor control processes involved in production of graphic movements of children with attention‐deficit‐hyperactivity disorder. Developmental Medicine & Child Neurology, 47(6), 390-395.
  • Segal, D. L. (2010). Diagnostic and statistical manual of mental disorders (DSM‐IV‐TR). The corsini encyclopedia of psychology, 1-3.
  • Smits-Engelsman, B., Schoemaker, M., Delabastita, T., Hoskens, J. & Geuze, R. (2015). Diagnostic criteria for DCD: Past and future. Human movement science, 42, 293-306.
  • Stray, L. L., Stray, T., Iversen, S., Ruud, A., Ellertsen, B. & Tønnessen, F. E. (2009). The Motor Function Neurological Assessment (MFNU) as an indicator of motor function problems in boys with ADHD. Behavioral and Brain Functions, 5, 1-13.
  • Thomas, R., Sanders, S., Doust, J., Beller, E. & Glasziou, P. (2015). Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics, 135(4), e994-e1001.
  • Watemberg, N., Waiserberg, N., Zuk, L. & Lerman‐Sagie, T. (2007). Developmental coordination disorder in children with attention‐deficit–hyperactivity disorder and physical therapy intervention. Developmental Medicine & Child Neurology, 49(12), 920-925.
  • Wilson, B. N., Kaplan, B. J., Crawford, S. G., Campbell, A. & Dewey, D. (2000). Reliability and validity of a parent questionnaire on childhood motor skills. The American Journal of Occupational Therapy, 54(5), 484-493.
  • Wilson, P. H. (2005). Practitioner review: approaches to assessment and treatment of children with DCD: an evaluative review. Journal of child psychology and psychiatry, 46(8), 806-823.
  • Van der Linde, B. W., van Netten, J. J., Otten, B., Postema, K., Geuze, R. H. & Schoemaker, M. M. (2015). Activities of daily living in children with developmental coordination disorder: Performance, learning, and participation. Physical therapy, 95(11), 1496-1506.
  • Yan, J. H. & Thomas, J. R. (2002). Arm movement control: differences between children with and without attention deficit hyperactivity disorder. Research quarterly for exercise and sport, 73(1), 10-18.
  • Yildirim, C. K., Altunalan, T., Acar, G., Elbasan, B. & Gucuyener, K. (2019). Cross-cultural adaptation of the Developmental Coordination Disorder Questionnaire in Turkish children. Perceptual and motor skills, 126(1), 40-49.
  • Zhang, L. & Jin, X. (2007). Functional impairment of attention deficit hyperactivity disorder in children and adolescents. Chin J Pract Pediatr, 22, 872-875.
  • Zwicker, J. G., Harris, S. & Klassen, A. (2013). Quality of life domains affected in children with developmental coordination disorder: a systematic review. Child: care, health and development, 39(4), 562-580.
There are 40 citations in total.

Details

Primary Language English
Subjects People With Disability
Journal Section Araştırma Makalesi
Authors

Ramazan Yıldız 0000-0002-8007-7854

Ayşe Yildiz 0000-0002-1101-1069

Şeyma Gürbüz 0000-0002-1949-3859

Müşerrefe Nur Keleş 0000-0001-8274-8212

Esra Güney 0000-0002-4043-8301

Bülent Elbasan 0000-0001-8714-0214

Early Pub Date June 17, 2025
Publication Date June 25, 2025
Submission Date February 18, 2025
Acceptance Date June 5, 2025
Published in Issue Year 2025 Volume: 13 Issue: 2

Cite

APA Yıldız, R., Yildiz, A., Gürbüz, Ş., Keleş, M. N., et al. (2025). DEVELOPMENTAL COORDINATION DISORDER AND CO-OCCURRING MOTOR DIFFICULTIES IN CHILDREN WITH ATTENTION DEFICIT AND HYPERACTIVITY DISORDER. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 13(2), 516-528. https://doi.org/10.33715/inonusaglik.1642262
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