Smart but clumsy: The hidden impact of DCD on gifted children

By chance, in the past few weeks, I received two similar referrals. Parents and school were concerned about, not coincidentally, boys who were indeed smart but seemed to struggle with various things both at school and at home, not meeting expectations. In both cases, characteristics were initially mentioned that strongly suggested ADHD: the boys didn’t sit still on their chairs, were the last to change after gym class, wrote with messy handwriting, and often acted the clown. However, upon further questioning, entirely different difficulties came to light. The parents had often unconsciously adjusted to these issues. For instance, despite being at a primary school age, mealtimes were always a messy affair. Clothes with buttons were not purchased, and neither of the children had managed to learn how to tie their shoelaces up to that point. One of these boys also fell remarkably often. They didn’t like sports, but as it was said, they preferred to have their noses in books. Alarm bells went off, especially because I had previously worked as a DCD case coordinator. When I cautiously suggested this hypothesis, the parents had never heard of it but immediately recognized the described picture.

What is DCD?

DCD stands for Developmental Coordination Disorder, also known as motor coordination disorder. It is a developmental disorder that typically manifests in childhood and is characterized by difficulties in coordinating movements. Children with DCD often struggle with fine and gross motor skills, which can hinder them in everyday activities such as writing, washing, dressing, cycling, or other physical activities. It is estimated that over 5% of all children are affected, especially boys.

Twice exceptional

Twice exceptional children are gifted and also experience a learning or developmental disorder. Common disorders in this category include ADHD, ASD, or dyslexia, but DCD should definitely not be overlooked. Due to their strong cognitive abilities, gifted children can often compensate for these challenges. Many children exhibit clown-like behavior to avoid showing their peers that they cannot perform certain tasks according to typical standards. On the other hand, it also happens that their giftedness is barely apparent due to the motor difficulties they face. Sometimes, both issues can cancel each other out, and nothing is actually identified (Baum & Olenchak, 2002; Desmet et al., 2024). A common issue in clinical practice is that gifted children with DCD are often referred with a suspected diagnosis of autism, ADHD, or specific learning disorders instead of DCD, leading to misdiagnoses due to insufficient knowledge among educators and healthcare professionals in recognizing DCD (Desmet et al., 2024).

How to recognize DCD?

The most noticeable sign is motor clumsiness, often observed as early as preschool. Cutting, coloring within the lines, or painting can be difficult. Some skills, such as learning to ride a bike or swim, are mastered, but take longer than average. Spatial awareness seems to be less developed. For instance, when building with Lego, it can be challenging to translate a plan into the actual construction. Attaching small pieces together is also tricky. These children struggle to plan and control the necessary movements. For example, they may use too much force, causing a piece to fly off. This control and planning are also necessary when pouring a drink. Either too little comes out of the spout, or they end up tipping the bottle almost upside down. Balance is less stable, so they tend to fall more frequently than other children. Catching or throwing a ball accurately is very difficult.

At school, the most noticeable difficulty is handwriting. Capital letters are often drawn rather than written. Some children never fully master this. Spelling errors are more frequent because they focus too much on letter formation, forgetting to write letters or losing focus on spelling. Additionally, all tasks requiring both hands are difficult, and this happens more often during a school day than one might expect. For example, putting papers into a folder; when drawing a line, the ruler often moves in the opposite direction with the writing hand.

Consequences

Children tend to avoid activities they struggle with. They may start to feel insecure, lose self-confidence, and experience anxiety about failure. This is especially true for children who set very high standards for themselves and seem to fall short of expectations. Younger children may show signs of frustration, sometimes even tantrums. Many movements that are considered normal, or even just sitting upright on a chair, require an enormous amount of energy for them. These children can be very tired after a school day. Sometimes, this can lead to them withdrawing from social activities.

Diagnosis and treatment

A thorough medical history can provide a lot of valuable information. There are also standardized questionnaires available. Physiotherapists can conduct motor assessments, such as the Movement ABC. DCD is included in the DSM-5 classification, and the diagnosis is confirmed by a doctor. Other underlying causes must be ruled out, of course.

When an IQ test is administered to these children, their motor limitations must be taken into account. For example, it will be difficult for them to form symbols during a task that measures processing speed, which could lead to incorrect interpretations and conclusions. According to research by Sumner et al. (2016), children with DCD score poorly in processing speed, working memory, and tasks under time pressure, such as visual puzzles and math.

Through a combination of physiotherapy and occupational therapy, children can learn certain movements and activities, and their balance can be improved. Psychoeducation is also essential for their well-being. In adulthood, most individuals with DCD have developed enough compensatory strategies so that the disorder is much less noticeable. Moreover, no one will be asking if you can do a somersault anymore .

A few tips for schools to consider

• First and foremost, view these children as gifted and work with their strengths to optimally support their talent development (Desmet et al., 2024).
• Ensure that the children can sit with both feet firmly on the ground.
• Provide enough space for them to work.
• Extra time may be necessary.
• Learning to type and using a computer often leads to significant progress in academic learning.
• Use adapted materials, such as a non-slip mat or a ruler with a handle.
• An accordion folder is often more practical for storing papers than a ring binder.
• A comprehensive list can be found on this website: https://dyspraxis.be/hulpmiddelen/ (in Dutch).
• And most importantly, focus on the effort, not the result.

References

• Baum, S. M., & Olenchak, F. R. (2002). The alphabet children: GT, ADHD, and more. Exceptionality, 10(2), 77–91. https://doi.org/10.1207/S15327035EX1002_3 

• Desmet, O., Gevaert, T., & Olenchak, F.R. (2024) A profile of gifted individuals with Developmental Coordination Disorder, Roeper Review, 46(2), 120-130, https://doi.org/10.1080/02783193.2024.2309388 

• Sumner, E., Pratt, M. L., & Hill, E. L. (2016). Examining the cognitive profile of children with developmental coordination disorder. Research in Developmental Disabilities, 56, 10–17. https://doi.org/10.1016/j.ridd.2016.05.012

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