What is Developmental Coordination Disorder (DCD) / Dyspraxia?
DCD (often called dyspraxia in the UK) is a neurodevelopmental condition marked by motor coordination substantially below what would be expected for a child’s age and opportunities for learning. It typically becomes apparent in early childhood and affects the acquisition and execution of motor skills used for everyday activities.
How it affects children and young people
- Motor skills: Poor gross and/or fine motor coordination (clumsy, slow, or inaccurate movements), difficulty with tasks such as running, catching, handwriting, using cutlery, dressing, or riding a bike.
- Motor planning and sequencing: Difficulty planning, initiating, and coordinating multi-step movements (praxis problems).
- Daily living and independence: Challenges with self-care, school tasks (handwriting, PE), and participation in play and leisure activities.
- Academic impact: Slow or illegible handwriting, difficulty with tasks needing speed/coordination, affecting classroom performance and confidence.
- Social and emotional: Low self‑esteem, anxiety, social withdrawal, or frustration due to repeated failure or peer difficulties.
- Secondary effects: Fatigue from effortful movement, reduced participation in physical activity (with potential long‑term health effects).
- Co-occurrence: Frequently seen with other neurodevelopmental conditions—e.g., ADHD, autism spectrum disorder, language disorders, specific learning disorders—and with sensory processing differences.
Diagnostic criteria (DSM‑5)
A diagnosis of DCD requires all five criteria below:
A. The acquisition and execution of coordinated motor skills is substantially below that expected for the individual’s chronological age and opportunity for skill learning and use. Manifestations may include clumsiness (e.g., dropping or bumping into objects) and slowness and inaccuracy of performance of motor skills (e.g., catching an object, using scissors, handwriting).
B. The motor skill deficits in Criterion A significantly and persistently interfere with activities of daily living appropriate to the chronological age (e.g., self‑care, school productivity and/or leisure) and impact academic/school productivity, vocational activities, leisure, and play.
C. The onset of symptoms is in the early developmental period.
D. The motor skill deficits are not better explained by intellectual disability, visual impairment, or a neurological condition affecting movement (e.g., cerebral palsy, muscular dystrophy, degenerative disorder).
E. If another neurodevelopmental condition is present (e.g., autism, ADHD), the motor difficulties are in excess of what would be expected from that condition alone.1
Diagnostic process and assessment considerations
- Multidisciplinary assessment is recommended (e.g., occupational therapy, paediatrics, physiotherapy, educational psychology, sometimes speech and language if co-occurring language/communication concerns).
- Clinical history: developmental milestones, family history, impact on daily life, school reports.
- Standardised motor assessments: e.g., Movement Assessment Battery for Children (MABC-2/MABC-3), Bruininks‑Oseretsky Test of Motor Proficiency (BOT-2).
- Functional measures and goal‑based tools: e.g., Canadian Occupational Performance Measure (COPM), Goal Attainment Scaling.
- Screen for co-occurring conditions (ADHD, ASD, learning disorders, sensory issues) and rule out alternative medical/neurological causes.
- Consider environmental and opportunity factors (lack of practice/opportunity can mimic motor delay).
Prevalence and prognosis
- Prevalence estimates vary but are commonly cited around 5–6% of school-aged children.
- Lifelong condition for many; early diagnosis with targeted intervention (task‑specific motor training, occupational therapy, physiotherapy, adaptations and supports) improves functional outcomes and participation.
When to refer
- Persistent motor difficulties affecting daily life, school, play, or safety; delayed milestones; marked clumsiness; or concerns from parents/teachers warrant further assessment and referral to specialist services.
How do we diagnose:
Assessment for Developmental Coordination Disorder is completed in conjunction with a Consultant Paediatrician, from The Assessment Practice
This collaborative approach ensures a comprehensive understanding of the child’s motor skills and functional abilities.
The assessment may include:
- A full developmental and medical review
- Assessment of gross and fine motor skills
- Functional observation of everyday tasks
- Input from occupational therapy specialists
- Consideration of the child’s needs at home and school