Quality of life and psychosocial functioning in adolescents with
developmental coordination disorder and attention-deﬁcit–
Faculty of Kinesiology and Physical Education, University of Toronto, Toronto,
This commentary is on the original article by Dewey and Volkovinskaia
on pages 711–717 of this issue.
Dewey and Volkovinskaia
present an interesting study
that examines quality of life in adolescents with attention-
deﬁcit–hyperactivity disorder (ADHD), developmental
coordination disorder (DCD), comorbid DCD and
ADHD, and those without either condition. Using a mul-
ti-method approach, the paper offers the following contri-
butions to the literature.
First, the authors recognized that while DCD and
ADHD are often comorbid, children and adolescents fre-
quently present with only one of these disorders. While we
might reasonably assume that adolescents with comorbid
conditions would be more adversely affected with sec-
ondary health outcomes, it is important not to lose sight of
children whose primary presenting problem is either
motor- or attentional-based, as these children will
undoubtedly also be at greater risk for mental and physical
health problems. Second, by including semi-structured
interviews in conjunction with the administration of scales,
the authors have allowed the voices of adolescents with
DCD and ADHD to speak to readers. When one considers
the relative paucity of qualitative work in the ﬁeld of DCD
research, the results of this study are of particular impor-
tance as we gain greater insight to the lived experiences of
children with these conditions. Finally, while the authors
did not ﬁnd any group differences on total scores for
health-related quality of life, analysis of subscales did reveal
some important differences; particularly in relation to
social relationships/functioning and mental health-related
The self-referential labels of ‘weird’, ‘oddball’, ‘misﬁts,
and ‘reject’ also point to mental health-related concerns, as
well as social isolation and marginalization. These ﬁndings
lead to a growing body of research that has demonstrated
that children and adolescents with motor coordination
problems (i.e. DCD) are at greater risk for depression and
Importantly, negative self-concept, which is
clearly reﬂected here in the quotes provided by study par-
ticipants, is increasingly recognized to be one of the princi-
pal reasons as to why children and adolescents report
greater depressed affect and anxious symptoms.
seems to be little doubt that being isolated, bullied,
excluded, and marginalized – common experiences for
these children and adolescents – would lead to negative
self-images and feelings of psychological distress.
This work and other research points to the clinical
importance of tracking mental health in children with
DCD and comorbid DCD and ADHD. For children and
adolescents with these conditions, it is important to assess
mental health status routinely and regularly. It also sug-
gests that therapies which target only motor coordination
and/or attentional problems might be insufﬁcient to
address negative social and mental health sequelae. The
complexity of these disorders, along with concurrent and
secondary health concerns, suggest the importance of a
multidisciplinary approach to their management. Referral
to a psychologist and psychiatrist, and/or inclusion of a
mental health professional on a treatment team, should
improve quality of life and psychosocial functioning for
these children. More research is required to ﬁnd the right
intervention mix to address not only the symptoms of these
disorders, but also broader issues related to well-being, and
social and individual functioning.
1. Dewey D, Volkovinskaia A. Health-related quality of life
and peer relationships in adolescents with developmental
coordination disorder and attention-deﬁcit–hyperactivity
disorder. Dev Med Child Neurol 2018; 60: 711–7.
2. Green D, Baird G, Sugden D. A pilot study of psy-
chopathology in Developmental Coordination Disorder.
Child Care Health Dev 2006; 32: 741–50.
3. Cairney J, Rigoli D, Piek J. Developmental coordination
disorder and internalizing problems in children: The
environmental stress hypothesis elaborated. Dev Rev 2013;
4. Mancini VO, Rigoli D, Cairney J, Roberts LD, Piek JP.
The elaborated environmental stress hypothesis as a
framework for understanding the association between
motor skills and internalizing problems: a mini-review.
Front Psychol 2016; 7: 239.
5. Rigoli D, Kane RT, Mancini V, et al. The
relationship between motor proﬁciency and mental
health outcomes in young adults: A test of the Environ-
mental Stress Hypothesis. Hum Mov Sci 2017; 53: