A 4-year-old boy has normal gross motor development but shows difficulty with fine motor tasks, poor coordination, trouble with buttons, and has unclear speech with good comprehension. Neurological examination is normal. IQ testing is appropriate for age. Which is the MOST appropriate classification?

• A Cerebral palsy (dyskinetic type) — poor coordination with normal IQ
• B Intellectual disability — fine motor delay is a component of global delay
• C Speech-language disorder — unclear speech is the primary diagnosis
• D Developmental coordination disorder (DCD/Dyspraxia) — impaired motor coordination not explained by neurological disease or intellectual disability ✓

Explanation

Developmental Coordination Disorder (DCD), also called dyspraxia, is characterized by significantly impaired acquisition and execution of coordinated motor skills (below age expectations) that interferes with daily activities (dressing, using utensils, handwriting), in the absence of neurological disease (normal neuro exam, no UMN/LMN signs) or intellectual disability. Unclear speech here may reflect verbal dyspraxia (a subtype). Cerebral palsy requires upper or lower motor neuron signs and is not just poor coordination with normal examination. Global developmental delay implies multiple domains affected including cognitive — excluded here by normal IQ.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.