title: Phenotypic variability in developmental coordination disorder: Clustering of generalized joint hypermobility with attention deficit/hyperactivity disorder, atypical swallowing and narrative difficulties.
abstract: Developmental coordination disorder (DCD) is a recognized childhood disorder mostly characterized by motor coordination difficulties. Joint hypermobility syndrome, alternatively termed Ehlers-Danlos syndrome, hypermobility type (JHS/EDS-HT), is a hereditary connective tissue disorder mainly featuring generalized joint hypermobility (gJHM), musculoskeletal pain, and minor skin features. Although these two conditions seem apparently unrelated, recent evidence highlights a high rate of motor and coordination findings in children with gJHM or JHS/EDS-HT. Here, we investigated the prevalence of gJHM in 41 Italian children with DCD in order to check for the existence of recognizable phenotypic subgroups of DCD in relation to the presence/absence of gJHM. All patients were screened for Beighton score and a set of neuropsychological tests for motor competences (Movement Assessment Battery for Children and Visual-Motor Integration tests), and language and learning difficulties (Linguistic Comprehension Test, Peabody Picture Vocabulary Test, Boston Naming Test, Bus Story Test, and Memoria-Training tests). All patients were also screening for selected JHS/EDS-HT-associated features and swallowing problems. Nineteen (46%) children showed gJHM and 22 (54%) did not. Children with DCD and gJHM showed a significant excess of frequent falls (95 vs. 18%), easy bruising (74 vs. 0%), motor impersistence (89 vs. 23%), sore hands for writing (53 vs. 9%), attention deficit/hyperactivity disorder (89 vs. 36%), constipation (53 vs. 0%), arthralgias/myalgias (58 vs. 4%), narrative difficulties (74 vs. 32%), and atypical swallowing (74 vs. 18%). This study confirms the non-causal association between DCD and gJHM, which, in turn, seems to increase the risk for non-random additional features. The excess of language, learning, and swallowing difficulties in patients with DCD and gJHM suggests a wider effect of lax tissues in the development of the nervous system.
authors.forename: Claudia
authors.initials: C
authors.lastname: Celletti
authors.forename: Giorgia
authors.initials: G
authors.lastname: Mari
authors.forename: Giulia
authors.initials: G
authors.lastname: Ghibellini
authors.forename: Mauro
authors.initials: M
authors.lastname: Celli
authors.forename: Marco
authors.initials: M
authors.lastname: Castori
authors.forename: Filippo
authors.initials: F
authors.lastname: Camerota
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D004535:Ehlers-Danlos Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007802:Language; D007859:Learning Disabilities / Q000150:complications / Q000503:physiopathology; D008297:Male; D019957:Motor Skills Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D013060:Speech; D011795:Surveys and Questionnaires
keywords: attention deficit/hyperactivity disorder; coordination; hypermobility; language; speech; swallowing