An integrated stress-adaptation framework for understanding mental health in developmental coordination disorder and comorbid neurodevelopmental conditions (ISAF-DCD)

Developmental Coordination Disorder (DCD) is associated with elevated rates of anxiety and depression, as well as reduced quality of life, yet the mechanisms linking motor difficulties to these outcomes remain incompletely specified. This article presents and critically evaluates the Integrated Stress-Adaptation Framework for DCD (ISAF-DCD), which synthesizes empirical findings on DCD with established stress theories, including the Environmental Stress Hypothesis, the transactional model of stress, and the Conservation of Resources model. Although the framework is presented with reference to comorbid neurodevelopmental conditions broadly, its evidential basis and worked examples concentrate specifically on attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD); generalization to other neurodevelopmental conditions is plausible but has not been evaluated here. ISAF-DCD proposes that motor coordination difficulties influence mental, cognitive, and physical health through interacting environmental demands, primary and secondary stressors, appraisal and response processes, and personal and social factors. The framework is bidirectional and developmentally sensitive, allowing outcomes to feed back into subsequent stress and adaptation processes across the lifespan. I examine the model’s conceptual coherence, empirical support, and potential clinical utility, arguing that ISAF-DCD offers a theoretically grounded heuristic for organizing a fragmented literature while remaining provisional. Its proposed contributions include clarifying the multiple roles of resilience and social support, refining the classification of environmental demands, incorporating neurodevelopmental comorbidity as a cross-cutting factor, and representing reciprocal relationships between stress and motor functioning. To improve falsifiability, I specify the temporal and functional roles of key dual-role constructs and derive five core, empirically distinguishable propositions that differentiate ISAF-DCD from an expanded Environmental Stress Hypothesis. Direct empirical support for some components, particularly the proposed corticolimbic mechanisms, remains limited. ISAF-DCD should therefore be treated as a hypothesis-generating framework, focused primarily on ADHD and ASD as comorbid conditions and on mental health as its central but not exclusive outcome domain, that requires rigorous longitudinal and intervention-based evaluation.