A Child Who’s ‘Unathletic’? 5–6 in 100 Have Developmental Coordination Disorder

[Financial News] Five to six out of every 100 school-aged children have developmental coordination disorder, which makes it difficult to learn and perform movements appropriate for their age. But many are simply regarded as “clumsy children,” causing them to miss the opportunity for timely assessment and treatment.
A, a 7-year-old boy born prematurely at 33 weeks’ gestation who is due to start elementary school next year, often misstepped while running or bumped into chairs and desks. He was also slower than his peers at writing and using scissors. When a ball came toward him, he would shrink back or dodge it, and he had trouble throwing and catching a ball. Although he wanted to spend time with his friends, he could not join the group and would often play alone or avoid physical activities. His parents, who had been told that his infant and toddler developmental screenings showed no problems, thought he lacked athletic coordination or was simply a little clumsy, and expected him to improve naturally as he grew.
Even if a child like A received normal results on infant and toddler screenings, there is no guarantee that everything is fine. Difficulties may become apparent later, as motor tasks grow more complex after the child starts school.

Professor Shin Hyun-yi of the Department of Rehabilitation Medicine at Chung-Ang University Hospital explained, “Developmental coordination disorder is a neurodevelopmental disorder that makes it difficult to learn and perform motor skills appropriate for one’s age, interfering with academic performance, daily life, and participation in play. It can occur even when there are no problems with general intelligence or muscle strength, so it is also necessary to assess whether the difficulties may be due to other neurological or visual problems.”

Motor development should be monitored more closely in children born prematurely or with low birth weight. A Canadian study found that children born before 32 weeks of gestation or weighing less than 1,500 grams at birth had at least six times the risk of developmental coordination disorder as children born at full term. Another study found more suspected cases among children born at 32–33 weeks. Birth history alone is not enough to make a judgment, however; actual motor function and difficulties in daily life should also be considered.
ADHD, autism spectrum disorder, language delays, and learning disorders can also occur alongside it. Co-occurrence with ADHD is not uncommon, so if a child diagnosed with ADHD is unusually clumsy in their movements, it is a good idea to assess their motor development as well.
Difficulties with motor skills can also affect a child’s emotions and relationships with peers. Repeatedly failing at movements can undermine confidence and lead children to avoid physical activity or withdraw from friendships. A cohort study that analyzed data on 6,902 children in the United Kingdom found that children suspected of having developmental coordination disorder were about twice as likely to report depressive symptoms as those who were not suspected of having it. International clinical guidelines also recommend assessing self-esteem and psychosocial well-being alongside motor function.

Internationally standardized motor assessment tools such as the “MABC-2” are used for diagnosis. They assess manual dexterity, ball skills, and balance, among other abilities, and compare a child’s performance with the developmental level of their peers. Diagnosis is not based on test results alone; observations by parents and teachers, difficulties in daily life and play, and clinical examination findings are considered together.
Treatment primarily involves task-oriented rehabilitation, in which children practice movements they have difficulty with in everyday life. They repeatedly practice activities they need, such as writing, using scissors, throwing and catching a ball, and jumping rope, with the difficulty adjusted to their level of ability. An important goal is not only to improve motor skills but also to build confidence and independence by increasing what they can do on their own.
The condition is often identified around the time a child starts elementary school, but treatment is not limited to early childhood. School-aged children and adolescents can also improve their motor skills and ability to manage daily activities with training tailored to their needs. According to a follow-up study cited in international clinical guidelines, about 50–70% of children with developmental coordination disorder continue to experience motor difficulties in adolescence. This is why clumsy movements should not be dismissed as individual differences alone; appropriate assessment and support are needed.
Professor Shin said, “If a child was born prematurely or is clumsier than their peers, it is a good idea to have their motor development assessed around the time they start elementary school. Identifying difficulties early and consistently practicing the movements they need can help improve motor skills, build confidence in what they can do on their own, and support their emotional well-being.”

*Often falls or bumps into things around them
*Has more difficulty than peers with fastening buttons, zipping up, tying shoelaces, or using chopsticks
*Has difficulty writing or using scissors and tires easily during activities that require using their hands
*Has unusual difficulty throwing and catching a ball or avoids ball games
*Repeatedly struggles with sports or play and has difficulty interacting with peers
*Was born prematurely or with low birth weight, and there are concerns about their motor development  



[email protected] Jeong Myeong-jin, Medical Correspondent Reporter