Disorders of motor development (clumsy child syndrome)

  • H. Sigmundsson


This presentation will focus on motor competence, the clumsy child, perceptual deficits in clumsy children and possible neurological dysfunction in this group of children. Motor competence not only allows children to carry out everyday practical tasks, but it is also an important determinant of their level of self-esteem and of their popularity and status in their peer group. Research has shown that about 6–10% of children have motor competences well below the norm. It is unusual for motor problems to simply disappear over time. In the absence of intervention the syndrome is likely to manifest itself. In the clinical literature attempts have been made to establish causal links between surface manifestations of clumsiness and underlying perceptual deficits. In this respect the attention is primarily directed towards the concept of inter- and intra-modal matching, particularly with respect to vision and proprioception, an ability deemed to underlie many real-life motor skills. Neurobehavioural model of inter- and intra-modal matching and deficit model is presented. Findings from studies using this paradigm are discussed and it is argued that clumsiness must be seen as a neurological dysfunction (insufficiency).


Cerebral Palsy Motor Development Posterior Parietal Cortex Motor Problem Child Care Health 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th ed. American Psychiatric Association, Washington DCGoogle Scholar
  2. Bairstow PJ, Laszlo JI (1981) Kinaesthetic sensitivity to passive movements in children and adults, and its relationship to motor development and motor control. Dev Med Child Neurol 23: 606–616PubMedCrossRefGoogle Scholar
  3. Barnett A, Henderson SE (1992) Some observations on the figure drawings of clumsy children. Br J Educ Psychol 62: 341–355PubMedGoogle Scholar
  4. Bender AL (1938) A visual-motor Gestalt test. Res Monogr 3. NY Am Orthopsychiatr AssocGoogle Scholar
  5. Berk L (1997) Child development. Allyn and Bacon, MAGoogle Scholar
  6. Bogen JE (1990) Parital hemispheric independence with the neocommissures intact. In: Trevarthen C (ed) Brain circuits and functions of the mind. Cambridge University Press, New York, pp 215–230Google Scholar
  7. Bogen JE (1993) The Callsoal syndromes. In: Heilman KM, Valenstein R (eds) Clinical neuropsychology, 3rd ed. Oxford University Press, New York, pp 337–407Google Scholar
  8. Bouffard M, Watkinson EJ, Thompson LP, Dunn JLC, Romanow SKE (1996) A test of the activity deficit hypothesis with children with movement difficulties. Adapt Phys Act Quart 13: 61–73Google Scholar
  9. Brenner MW, Gillman S, Zangwill OL, Farrell M (1967) Visuo-motor disability in schoolchildren. Br Med J 4: 259–262PubMedCrossRefGoogle Scholar
  10. Connolly KJ (1970) Skill development: problems and plans. In: Connolly KJ (ed) Mechanisms of motor skill development. Academic Press, LondonGoogle Scholar
  11. Connolly KJ (1986) A perspective on motor development. In: Wade MG, Whiting HTA (eds) Motor development in children: aspects of coordination and control. Martinus Nijhoff, DordrechtGoogle Scholar
  12. Dare MT, Gordon N (1970) Clumsy children: a disorder of perception and motor organisation. Dev Med Child Neurol 12: 178–185PubMedCrossRefGoogle Scholar
  13. Dewey D (1995) What is developmental dyspraxia? Brain Cogn 29: 254–274PubMedCrossRefGoogle Scholar
  14. Drillien C, Drummond M (1983) Developmental screening and the child with special needs: a population study of 5000 children, Heinemann, London (Clin Dev Med 86)Google Scholar
  15. Dunn HG (1986) Sequelae of low birthweight: the Vancouver study. Mac Keith Press with Blackwell Scientific; Lippincott, Philadelphia (Clin Dev Med 95/96)Google Scholar
  16. Edelman GM (1987) Neural Darwinism. Basic Books, New YorkGoogle Scholar
  17. Edelman GM (1992) Bright air, brilliant fire: on the matter of the mind. Basic Books, New YorkGoogle Scholar
  18. Faglioni P, Basso A (1985) Historical perspectives on neuroanatomical correlates of limb apraxia. In: Roy EA (ed) Neuropsychological studies of apraxia and related disorders. Elsevier Science Publishers B.V., Amsterdam, pp 3–44Google Scholar
  19. Fleishman EA (1966) Human abilities and the acquisition of skill. In: Bilodeau EA (ed) Acquisition of skill. Academic Press, New York, pp 147–167Google Scholar
  20. Galin D, Diamond R, Herron J (1977) Development of crossed and uncrossed tactile localisation on the fingers. Brain Lang 4: 588–590PubMedCrossRefGoogle Scholar
  21. Galin D, Johnstone J, Nakel L, Herron J (1979) Development of the capacity for tactile information transfer between hemispheres in normal children. Science 204: 1330–1332PubMedGoogle Scholar
  22. Geffen G, Nilsson J, Quinn K (1985) The effect of lesions of the corpus callosum on finger localisation. Neuropsychologia 4: 497–514CrossRefGoogle Scholar
  23. Geschwind N (1975) The apraxias: neural mechanisms of disorders of learned movement. Am Sci 63: 188–195PubMedGoogle Scholar
  24. Gessel A (1954) The ontogenesis of infant behaviour. In: Carmichael L (ed) Manual of child psychology, 2nd ed. Wiley, New YorkGoogle Scholar
  25. Gibson JJ (1966) The senses considered as perceptual systems. Houghton Mifflin, BostonGoogle Scholar
  26. Gillberg C, Rassmussen P, Carlströom G, Svenson B, Waldenström E (1982) Perceptual, motor and attentional deficits in six-year-old children. Epidemiological aspects. J Child Psychol Psychiatry 23: 131–144PubMedGoogle Scholar
  27. Gollnitz G (1960) A revision of the Oseretsky Test of Motor Ability (unpublished)Google Scholar
  28. Gordon N, McKinley I (1980) Helping clumsy children. Churchill Livingstone, EdinburghGoogle Scholar
  29. Gottlieb G (1970) Conceptions of prenatal development. In: Aronson LR, Tobach E, Lehrman DS, Rosenblatt JS (eds) Development and evaluation of behaviour: essays in memory of T. C. Schneirla. WH Freeman, San Francisco, pp 111–137Google Scholar
  30. Gottlieb G (1976) Conceptions of prenatal development: behaviour embroyology. Psychol Rev 83: 215–234PubMedCrossRefGoogle Scholar
  31. Gottlieb G (1998) Normal occurring environmental and behaviuour influences on gene activity: from central dogma to propabilistic epigenesis. Psychol Rev 105: 792–802PubMedCrossRefGoogle Scholar
  32. Graham FK, Kendell BS (1960) Memory for designs test. Revised general manual. Percept Mot Skills 11: 147–188CrossRefGoogle Scholar
  33. Gubbay SS (1975) The clumsy child: a study of developmental and agnosic ataxia. Saunders, LondonGoogle Scholar
  34. Gubbay SS, Ellis T, Walton JN, Court SDM (1965) Clumsy children: a study of apraxia and agnosic deficits in 21 children. Brain 88: 295–312PubMedGoogle Scholar
  35. Hadders-Algra M (2000) The clumsy child — at the border of cerebral palsy? In: Velcikovic Peret M, Neville B (eds) Cerebral palsy. Elsevier Science, AmsterdamGoogle Scholar
  36. Harter S (1987) The determinants and mediational role of global self-worth. I. Children. In: Eisenberg N (ed) Contemporary topics in developmental psychology. Wiley, New York, pp 219–242Google Scholar
  37. Haywood KM (1993) Life span motor development. Human Kinetics Publishers, ChampaignGoogle Scholar
  38. Heilman KM, Rothi LJG (1993) Apraxia. In: Heilman KM, Valenstein R (eds) Clinical neuropsychology, 3rd ed. Oxford University Press, New York, pp 141–163Google Scholar
  39. Henderson SE (1992) Clumsiness or developmental co-ordination disorder: a neglected handicap. Curr Paediatr 2: 158–162CrossRefGoogle Scholar
  40. Henderson SE (1993) Motor development and minor handicap. In: Kalverboer AF, Hopkins B, Geuze RH (eds) Motor development in early and later childhood. Longitudinal approaches. European Network on Longitudinal Studies on Individual Development (ENLS). Cambridge University Press, CambridgeGoogle Scholar
  41. Henderson SE, Hall D (1982) Concomitants of clumsiness in young schoolchildren. Dev Med Child Neurol 24: 448–460PubMedCrossRefGoogle Scholar
  42. Henderson SE, Sugden D (1992) The movement assessment battery for children. The Psychological Corporation, KentGoogle Scholar
  43. Hofsten C von, Rösblad B (1988) The integration of sensory information in the development of precise manual pointing. Neuropsychologia 26: 805–821CrossRefGoogle Scholar
  44. Hulme C, Lord R (1986) Review clumsy children — a review of recent research. Child Care Health Dev 12: 257–269PubMedCrossRefGoogle Scholar
  45. Hulme C, Biggerstaff A, Moran G, McKinley I (1982a) Visual, kinaesthetic and cross-modal judgements of length by normal and clumsy children. Dev Med Child Neurol 24: 461–471PubMedCrossRefGoogle Scholar
  46. Hulme C, Smart A, Moran G (1982b) Visual perceptual deficits in clumsy children. Neuropsychologia 20: 475–481PubMedCrossRefGoogle Scholar
  47. Hulme C, Smart A, Moran G, McKinley I (1984) Visual, kinaesthetic and cross-modal judgements of length by clumsy children: a comparison with young normal children. Child Care Health Dev 10: 117–125PubMedCrossRefGoogle Scholar
  48. Jeeves MA (1990) Agenesis of the corpus callosum. In: Nebes RD, Corkin S (eds) Handbook of neuropsychology. Elsevier Science Publishers B.V., Amsterdam, pp 99–114Google Scholar
  49. Jongmans M (1989) The relationship between perception and action in manual control of children with specific movement difficulties. Faculty of Human Movement Sciences. Free University, Amsterdam (unpublished)Google Scholar
  50. Kalat JW (1995) Biological psychology. Brooks/Cole Publishing Company, USAGoogle Scholar
  51. Kolb B, Whishaw IQ (1996) Fundamentals of human neuropsychology. W. H. Freeman and Company, New YorkGoogle Scholar
  52. Laszlo JI, Bairstow PJ (1980) The measurement of kinaesthetic sensitivity in children and adults. Dev Med Child Neurol 22: 454–464PubMedCrossRefGoogle Scholar
  53. Laszlo JI, Bairstow PJ (1985) Perceptual motor behaviour: developmental assessment and therapy. Holt, Rinehart and Winston, LondonGoogle Scholar
  54. Laszlo JI, Bairstow PJ, Bartrip J, Rolfe UT (1988) Clumsiness or perceptuo-motor dysfunction. In: Colley AM, Beech JR (eds) Cognition and action in skilled behaviour. Elsevier Science Publishers B.V., AmsterdamGoogle Scholar
  55. Lee DN, Daniel BM, Turnball J, Cook ML (1990) Basic perceptuo-motor dysfunctions in cerebral palsy. In: Jennerod M (ed) Attention and performance. XIII. Motor representation and control. Erlbaum Associates, Hillsdale, pp 593–603Google Scholar
  56. Lee DN, Hofsten C von, Cotton E (1997) Perception in action approach to cerebral palsy. In: Connolly KJ, Forssberg H (eds) Neurophysiology and neuropsychology of motor development. Mac Keith Press, LondonGoogle Scholar
  57. Leemrijse C (2000) Developmental coordination disorder: evaluation and treatment. Free University, AmsterdamGoogle Scholar
  58. Losse A, Henderson SE, Elliman D, Hall D, Knight E, Jongmans M (1991) Clumsiness in children. Do they grow out of it? A 10-year follow-up study. Dev Med Child Neurol 33: 55–68PubMedCrossRefGoogle Scholar
  59. Mæland AF (1992) Identification of children with motor coordination problems. Adapt Phys Act Quart 9: 330–342Google Scholar
  60. McGraw MB (1945) The neuromuscular maturation of the human infant. Columbia University Press, New YorkGoogle Scholar
  61. Mima T, Sadato N, Yazawa S, Hanakawa T, Fukuyama H, Yonekura Y, Shibasaki H (1999) Brain structures related to active and passive finger movements in man. Brain 122: 1989–1997PubMedCrossRefGoogle Scholar
  62. Mishkin M, Ungerleider LG, Macho KA (1983) Object vision and spatial vision: two cortical pathways. Trends Neurosci 6: 414–417CrossRefGoogle Scholar
  63. Morris PR, Whiting HTA (1971) Motor impairment and compensatory education. G Bell and Sons, PhiladelphiaGoogle Scholar
  64. Mountcastle VB, Lynch JC, Georgopoulos A, Sakata H, Acuna CJ (1975) Posterior parietal association cortex of the monkey: command functions for operations within extrapersonal space. J Neurophysiol 38: 871–908PubMedGoogle Scholar
  65. O’Leary DS (1980) A developmental study of interhemispheric transfer in children aged five to ten. Child Dev 51: 743–750PubMedGoogle Scholar
  66. Orton ST (1937) Reading, writing and speech problems in children. Norton, New YorkGoogle Scholar
  67. Oseretsky NI (1923) A metric scale for studying the motor capacity of children (in Russian)Google Scholar
  68. Powell RP, Bishop DVM (1992) Clumsiness and perceptual problems in children with specific language impairment. Dev Med Child Neurol 34: 755–765PubMedCrossRefGoogle Scholar
  69. Preilowski B (1972) Possible contribution of the anterior forebrain commissures to bilateral coordination. Neuropsychologia 10: 267–277PubMedCrossRefGoogle Scholar
  70. Preilowski B (1990) Intermanual transfer, interhemispheric interaction, and handedness in man and monkeys. In: Trevarthen C (ed) Brain circuits and functions of the mind. Cambridge University Press, New York, pp 160–180Google Scholar
  71. Quinn K, Geffen G (1986) The development of tactile transfer of information. Neuropsychologia 24: 793–804PubMedCrossRefGoogle Scholar
  72. Robinson DL, Goldberg ME, Stanton GB (1978) Parietal association cortex in the primate: sensory mehanisms and behavioural modulations. J Neurophysiol 41: 910–932PubMedGoogle Scholar
  73. Rostoft MS, Sigmundsson H (2004) Developmental co-ordination disorder: different perspectives on the understanding of motor control and co-ordination. Adv Physiother 6: 11–19CrossRefGoogle Scholar
  74. Rösblad B, Hofsten C von (1992) Perceptual control of manual pointing in children with motor impairments. Physiother Theory Pract 8: 223–233Google Scholar
  75. Sandström CI (1953) Sex differences in localisation and orientation. Acta Psychol 9: 82–96CrossRefGoogle Scholar
  76. Sandström CI, Lundberg I (1956) A genetic approach to sex differences in localisation. Acta Psychol 12: 247–253CrossRefGoogle Scholar
  77. Schoemaker MM, Kalverboer AF (1994) Social and affective problems of children who are clumsy: how early do they begin? Adap Phys Act Quart 11: 130–140Google Scholar
  78. Sherrington CS (1906) The integrative action of the nervous system. Yale University Press, New HavenGoogle Scholar
  79. Shirley MM (1931) The first two years: a study of twenty-five babies, vol 1. Postual and locomotor development. University of Minnesota Press, MinneapolisGoogle Scholar
  80. Sigmundsson H (1999) Inter-modal matching and bi-manual co-ordination in children with hand-eye co-ordination problems. Nordisk Fysioterapi 3: 55–64Google Scholar
  81. Sigmundsson H (2003) Perceptual deficits in clumsy children: inter-and intra-modal matching approach — a window into clumsy behaviour. Neural Plast 10: 27–38PubMedGoogle Scholar
  82. Sigmundsson H, Whiting HTA (2002) Hand preference in children with developmental coordination disorders: cause and effect? Brain Cogn 49: 45–53PubMedCrossRefGoogle Scholar
  83. Sigmundsson H, Hopkins B (2004) Do ‘clumsy’ children have visual recognition problems? Child Care Health Dev 31: 155–158CrossRefGoogle Scholar
  84. Sigmundsson H, Ingvaldsen RP, Whiting HTA (1997a) Inter-and intra-sensory modality matching in children with hand-eye co-ordination problems. Exp Brain Res 114: 492–499PubMedCrossRefGoogle Scholar
  85. Sigmundsson H, Ingvaldsen RP, Whiting HTA (1997b) Inter-and intra-sensory modality matching in children with hand-eye co-ordination problems: exploring the developmental lag hypothesis. Dev Med Child Neurol 12: 790–796Google Scholar
  86. Sigmundsson H, Whiting HTA, Ingvaldsen RP (1999a) Putting your foot in it! A window into clumsy behaviour. Behav Brain Res 102: 131–138CrossRefGoogle Scholar
  87. Sigmundsson H, Whiting HTA, Ingvaldsen RP (1999b) Proximal versus distal control in proprioceptively guided movements of motor-impaired children. Behav Brain Res 106: 47–54PubMedCrossRefGoogle Scholar
  88. Sigmundsson H, Hansen PC, Talcott JB (2003) Do ‘clumsy children have visual deficits’. Behav Brain Res 139: 123–129PubMedCrossRefGoogle Scholar
  89. Smyth TR (1991) Abnormal clumsiness in children: a programming defect? Child Care Health Dev 17: 283–294PubMedCrossRefGoogle Scholar
  90. Smyth TR (1992) Impaired motor skill (clumsiness) in otherwise normal children: a review. Child Care Health Dev 18: 283–300PubMedCrossRefGoogle Scholar
  91. Smyth TR (1994) Clumsiness in children: a defect of kinaesthetic perception? Child Care Health Dev 20: 27–36PubMedCrossRefGoogle Scholar
  92. Sperry RW(1974) Lateral specialisation in the surgically separated hemispheres. In: Schmitt FO, Worden FG (eds) The neurosciences: third study program. MIT Press, Cambridge, pp 5–19Google Scholar
  93. Stott DH (1966) A general test of motor impairment for children. Dev Med Child Neurol 8: 523–531PubMedCrossRefGoogle Scholar
  94. Søvik N, Mæland AF (1986) Children with motor problems (“clumsy children”). Scand J Educ Res 30: 39–53Google Scholar
  95. Trevarthen C (1974) Cerebral embroylogy and the split brain. In: Kinsbourne M, Smith WL (eds) Hemispheric disconnection and cerebral function. Charles C Thomas, Springfield, pp 208–236Google Scholar
  96. Walton JN, Ellis E, Court S (1962) Clumsy children: developmental apraxia and agnosia. Brain 85: 603–612PubMedGoogle Scholar
  97. Yakolev PI, Lecours AR (1967) The myelogenetic cycles of regional maturationof the brain. In: Minkowski A (ed) Regional development of the brain in early life. Davis, PhiladelphiaGoogle Scholar
  98. Zaidel E (1998) Sterognosis in the chronic split brain: hemispheric differences, ipsilateral control and sensory integration across the midline. Neuropsychologia 36: 1033–1047PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 2005

Authors and Affiliations

  • H. Sigmundsson
    • 1
  1. 1.Research Group for Child Development, Department of Sociology and Political ScienceNorwegian University of Science and TechnologyTrondheimNorway

Personalised recommendations