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Gepubliceerd in: Tijdschrift voor Kindergeneeskunde 5/2003

01-04-2003 | Artikelen

Kinderen met een motorische coördinatiestoornis (dcd) in de kinderrevalidatie: motorische problematiek en comorbiditeit

Auteurs: Drs. B. C. T. Flapper, S. Scholten-Jaegers, M. M. Schoemaker

Gepubliceerd in: Tijdschrift voor Kindergeneeskunde | Uitgave 5/2003

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samenvatting

Doel van dit onderzoek was het beschrijven van de ontwikkelingsproblematiek van een populatie schoolgaande kinderen die vanwege een onhandige motoriek verwezen was naar een kinderrevalidatieafdeling.
Uit de resultaten bleek dat 63% van de verwezen kinderen voldeed aan de criteria voor een motorische coördinatiestoornis (developmental coordination disorder, dcd). De kinderen met dcd vertoonden allen ernstige motorische problemen en eenderde van hen had tevens een dysgrafie. Hoewel de verbale intelligentiescore van deze groep kinderen gemiddeld was, lag het totale intelligentiequotiënt (iq) beneden gemiddeld, vanwege de lage prestaties op performale onderdelen van de intelligentietest. De prestaties op de Taaltest voor Kinderen waren normaal. Teruggetrokken gedrag (16%) en gedragsproblemen thuis (51%) en op school (28%) werden door ouders en leerkrachten significant vaker aangegeven dan in de normpopulatie. De zelfwaardering van de kinderen was bij 25% laag. Naast dcd werd bij 50% van de kinderen de diagnose aandachtsstoornis (add) gesteld. Het geheel aan problematiek leidde bij 30% tot een verwijzing naar het speciaal onderwijs.
Uit dit onderzoek kan geconcludeerd worden dat kinderen met dcd die voor behandeling verwezen werden naar een kinderrevalidatieafdeling, een ernstige variant van dcd hebben met beperkingen in veel motorische vaardigheden, vaak in combinatie met cognitieve problemen, add en internaliserend gedrag. Artsen die met kinderen met dergelijke motorische problematiek geconfronteerd worden, moeten zich daarom bewust zijn van het feit dat de motorische problemen een signaal kunnen zijn voor meer complexe ontwikkelingsstoornissen, die om vroegtijdige herkenning en multidisciplinaire behandeling vragen.
Voetnoten
1
De diagnose dcd wordt gesteld als aan de volgende nationaal geldende criteria is voldaan:
– de kinder(revalidatie)arts heeft bij lichamelijk onderzoek motorische coördinatieproblemen vastgesteld;
– een neurologische aandoening ter verklaring van de coördinatieproblemen is niet waarschijnlijk;
– de uitslag van de Movement Assessment Battery for Children (m-abc) is afwijkend (totaalscore ≥ p15 of een score in een subtest ≥5);
– mentale retardatie (totaal iq≥70) is uitgesloten.
 
2
In de dsm-iv (apa)29 is een aantal specifieke ontwikkelingsstoornissen geclassificeerd, waartoe onder andere behoren: aandachtsstoornis (adhd: attention deficit hyperactivity disorder), contactstoornis (pdd-nos: pervasive developmental disorder not otherwise specified) en motorische stoornis (dcd: developmental coordination disorder).
 
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Metagegevens
Titel
Kinderen met een motorische coördinatiestoornis (dcd) in de kinderrevalidatie: motorische problematiek en comorbiditeit
Auteurs
Drs. B. C. T. Flapper
S. Scholten-Jaegers
M. M. Schoemaker
Publicatiedatum
01-04-2003
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Tijdschrift voor Kindergeneeskunde / Uitgave 5/2003
Print ISSN: 0376-7442
Elektronisch ISSN: 1875-6840
DOI
https://doi.org/10.1007/BF03061432

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