The Consensus

Diagnosis-Criteria C&D and co-occurring conditions

The following is an interpretation of DSM-IV’s Criterion C & Criterion D reiterating DCD as a ‘specific and separate’ disorder which may (frequently) co-occur with other developmental disorders. There was agreement that the terms minimal brain dysfunction and atypical brain development were not helpful to diagnosis.
Criterion C: “The disturbance is not due to a general medical condition (e.g., cerebral palsy, hemiplegia, or muscular dystrophy) and does not meet criteria for a Pervasive Developmental Disorder” (p58). DCD does not imply aetiology but is a symptom-based diagnosis. One difficulty with the DSM-IV criteria for diagnosing DCD is the lack of clarity surrounding Criterion C. There are many medical conditions that have a lack of motor control as one ‘symptom’ among others and a known condition such as cerebral palsy, hemiplegia or muscular dystrophy should exclude a diagnosis of DCD.
We consider it important to acknowledge that overall, the evidence suggests that DCD is a unique and separate neurodevelopmental disorder which can, and often does, co-occur with one or more other neurodevelopmental disorders. Commonly, these include attention deficit hyperactivity disorder (ADHD), autistic spectrum disorder (ASD) and developmental dyslexia. It is inappropriate to exclude the possibility of a dual diagnosis of DCD and a Pervasive Developmental Disorder, and both should be given if appropriate.
Criterion D concerns the exclusion of individuals with “mental retardation” (p58) when making a diagnosis of DCD. Mental retardation is defined in DSM-IV as an IQ score below 70 (in the UK the term learning difficulties is used rather than mental retardation). DSM IV-TR (2000) states that if MR is present, the motor difficulties are in excess of those usually associated with it. Children with a measured, or presumed, IQ below 70 should not be given a diagnosis of DCD, as these children are known to have a higher risk of motor difficulties.

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