Could you please let me know where DAMP and Aspergers crossover, and where to find more info on DAMP?
DAMP stands for Deficits in Attention, Motor Control and Perception. Put simply, it is a combination of features of Attention Deficit Hyperactivity Disorder (ADHD) and Developmental Coordination Disorder (DCD). ADHD is characterised by attention deficits, inappropriate overactivity, and problems with impulsiveness, while DCD is characterised by persistent motor control problems in absence of clear intellectual disability or cerebral palsy and other major neurological disabilities.
Essentially, DAMP is defined by a combination of:
- hyperactivity/impulsivity, and
- impairing deficit in at least one of the following: gross motor, fine motor, perception, or speech-language.
DAMP was first described by Christopher Gillberg in the 1980s and the diagnostic label has been used by clinicians in Sweden and Denmark for some 20 years. But it is not universally accepted as a distinct disorder and it is not described and defined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition). On the other hand, the DSM-5 (as well as previous editions of the DSM) describes the criteria for Autism Spectrum Disorder (Autism), ADHD and DCD.
Researchers and clinicians have argued that it is preferable to diagnose children who meet criteria for both ADHD and DCD with those two separate conditions, rather than with DAMP, because ADHD and DCD are relatively well researched and treatments for both are available.
In contrast, there is relatively little research on DAMP and what there is originates mostly from Gillberg’s laboratory, whose findings have not been replicated by other research groups. As far as we know there is no research on DAMP in Australia, but many Australian researchers are interested in studying ADHD, DCD and related disorders.
Referring to studies of the 1970s-1990s, Gillberg (2003, see link below) argued that in children “with severe DAMP, autistic features were extremely common, amounting to what would nowadays be diagnostic status for ‘autism spectrum disorder’ in no less than two thirds of the cases. Several of the cases …. met full operationalised criteria for Asperger’s syndrome…. ”. And in a later study (Sturm, Fernell & Gillberg, 2004) researchers found that 72% of Autistic children (mostly high-functioning, such as Asperger’s syndrome) also met criteria for DAMP, 75% had motor difficulties, 95% had attention deficits, and 57% were hyperactive.
Other researchers (for example Landa & Rao, 2013) have also found that ADHD can co-occur with Autism. In their study 29% of Autistic children between 4 and 8 years of age were rated by their parents as having clinically significant symptoms of ADHD. In other studies (for example, Fournier, Hass, Naik, Lodha & Cauraugh, 2010) Autistic children were found to have “substantial motor coordination deficits”, and the authors concluded that “motor coordination deficits …. are a cardinal feature of ASD”. Thus, there seems to be a relatively large proportion of Autistic children who also have attention, hyperactivity and/or motor coordination problems. Much more research is needed to define more precisely the nature of these co-occurring difficulties.
By Dr Darren Hocking and Dr Elfriede Ihsen