The prevalence of developmental co-ordination disorder among primary school

Developmental Co-ordination Disorder will have an impact in the gross motor, and the (cid:977)ine motor co-ordination of daily living activities of children and the academic performance of children with Developmental Co-ordination Disorder is low due to handwriting dif(cid:977)iculty. There are also de(cid:977)icits in reading skills, working memory skills and mathematical skills. There may be problems associated with psychosocial aspects in relationship with peers and socialisa-tion, low self-esteem, anxiety and low mood. The DCD prevalence in the United States is 5-8%, 5.6% in Egypt, 5.7% in Greek and 1.8% in the United Kingdom and 5.9% in Canada, 30% in Brazil and India it is found to be 1.6% in West India, 21.6% in Karnataka. In Tamil Nadu at Kattupakkam, it was found to be 3.22%, and Kattankulathur had 1.37%. Since there is no evidence of DCD prevalence in Primary schools at Tamil Nadu, the current study aims at (cid:977)ind-ing the prevalence of DCD among primary school children at Kancheepuram. This Survey, with a cross-sectional study, was initiated. Two hundred children participated in the study. The Developmental Co-ordination Disorder Questionnaire (DCDQ) was used to identify DCD in primary school children at Kancheepuram. Seventy children were identi(cid:977)ied as DCD, and it revealed that the prevalence rate was 120.20 in 1000 children. The prevalence estimate was high in boys than in girls. There is a prevailing estimate of 120.20 in 1000 children of Developmental co-ordination disorder between the age group of 5 and 11 years exists among primary schools at Kancheepuram. The study concluded the need for early identi(cid:977)ication and intervention to promote awareness among parents and teachers in a school setting about developmental co-ordination disorder.


INTRODUCTION
Developmental Co-ordination Disorder will have an impact in the gross motor and the ine motor co-ordination of daily living activities of children. Despite its high prevalence, knowledge about Developmental Coordination Disorder is not familiar and less recognised in Primary schools and other medical settings. The academic performance of children with Developmental Co-ordination Disorder is low due to handwriting dif iculty. There are also de icits in reading skills, working memory skills and mathematical skills. There may be problems associated with psychosocial aspects in relationship with peers and socialisation, low self-esteem, anxiety and low mood. The sequence of all these issues leads to low performance in school. Therefore, while evaluating and managing a child with DCD considering all factors which hinder motor performance must be evaluated (Wright and Sugden, 2008).
The co-activations of the cerebellum, prefrontal cortex and the basal ganglia is required when a task is complicated, when a task demands condition change, or when it needs quick response and adequate concentration required to perform the task. Another relationship between the motor and cognitive abilities states that these abilities might have a similar developmental timeline with skills increasing appropriate to the age between 5 and 10 years.
Concrete processing like perception and decisionmaking are affected, where processing this information will be dif icult while performing skilled movements. The information input is associated with the anticipation for decision-making and cognitive abilities. The motor abilities and cognitive skills of children with Developmental Coordination Disorder have a relationship between each other, as the rhythmic co-ordination, walking pattern and posture, catching and stopping action describes the impaired cognitive skills like forward modelling, executive function, and components of sensoryperceptual function (Landgren et al., 1996).
The abilities of children with DCD are limited and slow in the cognitive decision-making process in comparison with normally developing children. The children with DCD exhibit poor motor ability performance. This led to underachievement in academic performance due to gross motor and ine motor dificulties (Gueze and Borger, 1993).
The children with DCD exhibit their functional dif iculties from 3 domains as postural alignment, motor learning skills, and sensorimotor co-ordination tasks. The dif iculty lies in of daily living like dressing up, tying a shoelace, handling utensils, riding tricycles and bikes, ball catching, and writing. Eventually, DCD affects the child in all of these aspects and the quality of life, especially if there is the presence of any co-morbid condition like ADHD (Sankar and Monisha, 2018). Children with DCD have the following problems in performing daily living activities like eating and dressing. Using utensils, cutting food into small pieces are the problematic areas for these children. Trouble in Drinking milk without spilling and picking food from the plate in right proportions results in frustration for both the child and their families (Sankar and Monisha, 2019).
Dressing issues occur while handling fasteners, and learning several steps to tie shoes can be dif icult.
These children with DCD have an overall slow speed dressing and even at eating when the skills which they possess are inadequate, This becomes more troublesome when the child's age is increasing as their demands increases in dressing and hygiene, for instance, thoroughness in hair washing, and tooth brushing (Wilson et al., 2009). When children tend to initiate their academic life, they struggle with motor coordinating activities and motor planning in academic performance, outdoor sports activities and group activities. In sports and outdoor activity skills, the children with DCD face problems in throwing and catching a ball, balancing, skipping, hopping, or jumping. The parents and caregivers of children with DCD refer; their children do not come under the category of sports performing kind in comparison with other children. In a classroom setting, these children exhibit dif iculties in dexterity and ine motor skills and gross motor activities or even both in certain situations . The prevalence of developmental co-ordination disorder is increasing worldwide, as they are connected with the children's quality of life. They face dif iculties in action planning, organising, adapting to movements and learning new skills, which affects the daily living activities, play, and academic performance. The DCD prevalence in the United States is 5-8%, 5.6% in Egypt, 5.7% in Greek and 1.8% in the United Kingdom and 5.9% in Canada, 30% in Brazil and India it is found to be 1.6% in West India, 21.6% in Karnataka. In Tamil Nadu at Kattupakkam, it was found to be 3.22%, and Kattankulathur had 1.37%8. Since there is no evidence of DCD prevalence in Primary schools at Tamil Nadu, the current study aims at inding the prevalence of DCD among primary school children at Kancheepuram.

METHODOLOGY Participants
This cross-sectional study-survey design was initiated after getting institutional ethical clearance from the SRM Institute of Science and Technology. After getting informed consent signed from the parents of children with DCD, Door to door survey was conducted by using the Developmental Coordination Disorder Questionnaire.
Two hundred Children (n=200) participated in the study. Both boys and girls between the ages of 5-11 years (Mean age=7.5 years with a standard deviation of 1.2 years) were included, and this study was a review study and has been conducted by the same author over the similar geographical area in an entirely different time frame.
The time frame the study has been initially conducted is 2011 after ten years; again in 2019-2020, the prevalence estimate has been calculated at Kancheepuram. Children were selected based on the speci ic inclusion and exclusion criteria, and their demographic data are listed in Table 2 The developmental co-ordination disorder questionnaire was distributed after obtaining permission from the corresponding principals of primary schools at Kancheepuram. The DCDQ were distributed to the parents, teachers and student counsellor and the illed questionnaires were collected back for scoring and interpreting the scores for data analysis (Table 1).
Descriptive statistical analysis was used to identify the prevalence of Developmental Co-ordination Disorder among primary school children at Kancheepuram. The results revealed that the prevalence of DCD in primary school at Kancheepuram was 120.20 in 1000 children (Table 3) DISCUSSION "Developmental co-ordination disorder" is a neurodevelopmental disorder chie ly categorised by de icits in gross and ine motor co-ordination which is considerably below than predictable for an individual's age, in the absence of neurological and intellectual de icits. Therefore the dif iculties in coordination harm daily living tasks and individual wellbeing. It was found to affect 5% of school-aged children (Missiuna et al., 2008).
The current study was carried out to estimate the prevalence rate of Developmental Co-ordination Disorder amongst "primary school" children at Kancheepuram. In this study, two hundred children at risk were included in the study. The result revealed that seventy children were screened with DCD. The prevalence of DCD found in West India was 1.16%, where children between the age of 5 and 15 years participated in the study.
According to the DSM-5 criteria, the prevalence rate was 0.8% in southern India. Besides with the physical aspects, children with DCD tend to exhibit psychosocial issues secondarily, of which it includes emotional or behavioural disorders, low self-esteem, anxiety and depression, poor social and peer relationships. Children diagnosed with DCD face emotional and behavioural problems. They are exhibited as internalising and externalising problems according to the individual. These internalising and externalising problems can be considered as subgroups of emotional or behaviour problems. Internalising behaviours are inward-directed while externalising behaviours manifest themselves as outward excessive worries.
Externalising behaviours include a child violating the social norms or rules, ignoring teacher's instructions or hyperactive behaviours (Valentini et al., 2012).
DCD has also been found with increased levels of anxiety, depression, and introversion and expression of de iant behaviours. While talking about depression and DCD, the most commonly affected are the adolescents with DCD and ADHD as comorbidity exhibit depressive symptoms, due to their poor co-ordination skills. In general children with DCD experienced slower reaction times and less accuracy in bimanual tasks, timing and sequencing problems. Besides, the performance de icits in DCD also include dif iculties with preparing oneself for the upcoming action, rhythmic co-ordination, executive functions like set-shifting, attention and lexibility, walking pattern and posture, catching and interceptive action, and components of sensory-perceptual function, e.g. Visual-sensory processing, tactile perception, kinaesthesia, processing speed. It is also found that children with DCD experienced strength and power de icits in knee extension and lexion tasks. They also ind dif iculties in motor planning and modulation activities.
While discussing the academic achievement of children with DCD, they display other types of a developmental trait as dif iculties in communication, disabilities in learning, and being hyperactive.Additionally, there are academic de icits, along with working memory and arithmetical skills .
They experience psychosocial problems like low self-esteem, anxiety and eventually leads to poor performance in school. It is suggestive that children should be engaged in physical activity and it can reduce the co-ordination dif iculties. The current study was conducted in primary school chil-  Two hundred children participated in the study out of which 80 were boys, and 120 were girls. dren, where the schools decided to choose children who had co-ordination dif iculties and distributed the developmental co-ordination disorder questionnaires to the parents of children with co-ordination dif iculties. The current study shows a difference in both genders, which might be due to the behaviour of boys exhibiting motor in co-ordination and their corresponding dif iculties at home and classroom.

CONCLUSION
The study established that 120.20 in 1000 children at risk of "developmental co-ordination disorder" between ive and eleven years of age in primary school children at Kancheepuram. The study concludes that there is a need for an awareness program and screening for Developmental Co-ordination Disorder, and that has to be done regularly in a school setting. Educational camps on developmental coordination disorder promote awareness effectively among teachers and parents.