Rehabilitation of developmental disorders and motor dysfunction

© Cambridge University Press 2013. The majority of childhood-onset developmental and psychiatric disorders involve motor disturbances that may appear as a “developmental vulnerability.” These include motor delays related to genetic or pathogenic care, frank movement disorders (e.g. ataxic gait seen in Rett’s disorder, cerebral palsy), or behavioral abnormalities involving movement (e.g. repetitive and stereotypical movements present in a number of pervasive developmental disorders). For each child the severity of motor disturbances ranges from mild to profound depending on the neurodevelopmental complexity, disorder co-morbidities, and the degree of intellectual impairment. Movement disorders that occur in a developmental context may change over time and can be difficult to define. The aim of this chapter is to provide an overview of the main developmental disorders that involve motor dysfunction, focusing on autism in children. Autism is one of the most distressing disorders of childhood, impairing social, communicative, behavioral, and motor functioning. The clinical co-morbidity of autism, cerebral palsy, and intellectual disability will be used to highlight and explore: (1) the overlap between neurological and psychiatric disorders which involve motor dysfunction, and (2) the need for multidisciplinary approaches to assessment and management, which take into consideration careful assessment of cognitive, motor, psychiatric, and social factors. There are two main psychiatric classification systems which outline diagnostic criteria for developmental disorders; the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) [1] published by the American Psychiatric Association and (2) International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10, 1992) [2] published by the World Health Organization. This chapter will refer to DSM-IV-TR categorization of developmental disorders as the more commonly used system in Australia and the USA.