ConditionChildren's health
Developmental Coordination Disorder (Dyspraxia)
Developmental coordination disorder (DCD), often called dyspraxia, is a common condition in which a child's motor coordination is well below what is expected for their age, interfering with daily activities, school and play. Children may be clumsy, slow to learn to dress, ride a bike or catch a ball, and have messy handwriting. It affects about 5 to 6 in 100 school-age children and is not caused by a muscle disease or low intelligence. Task-focused occupational and physical therapy help children build skills.
Also called: DCD, dyspraxia, developmental dyspraxia, motor coordination disorder
At a glance
- What it is
- A neurodevelopmental condition affecting the planning and coordination of movement.
- How common
- About 5% to 6% of school-age children; more often diagnosed in boys.
- Signs
- Clumsiness, difficulty with handwriting, dressing, ball skills, cycling and sports.
- Often occurs with
- ADHD, dyslexia, language disorder, autism.
- Treatment
- Task-oriented occupational and physical therapy, school accommodations, support for self-esteem.
When to get help
See a doctor within a day or two
- Loss of motor skills a child previously had, or new weakness, unsteadiness or frequent falls
- Clumsiness with headaches, vomiting or changes in behavior
Book a routine appointment
- A child who is much clumsier than peers or struggles with dressing, eating with utensils or handwriting
- Late motor milestones, such as walking after 18 months
- A child avoiding sports or playground activities and becoming frustrated or withdrawn
Usually safe to manage at home
- Mild clumsiness in a young child that improves steadily with practice and does not affect daily life
Signs of DCD by age
Preschool
- late to sit, crawl or walk (though many children with DCD reach milestones on time)
- bumping into things and falling often
- difficulty with stairs, jumping, hopping or pedaling a tricycle
- messy eating and trouble using a spoon or fork
- difficulty with puzzles, building blocks or drawing
School age
- slow, messy or effortful handwriting; difficulty copying from the board
- trouble with buttons, zippers and shoelaces
- poor ball skills: catching, throwing, kicking
- difficulty learning to ride a bike or swim
- slow at changing for gym class
- trouble organizing belongings and following multistep instructions
- tiredness after physical tasks
Teenagers and adults
DCD does not simply go away. Teens may struggle with sports, typing, shaving, makeup, cooking and learning to drive, and with organizing schoolwork. Adults may continue to have difficulty with coordination and organization but often develop effective strategies.
Diagnosis
A diagnosis requires all of the following:
- motor coordination substantially below age expectations
- difficulties that significantly interfere with daily living, school or play
- onset in early childhood
- difficulties not better explained by intellectual disability, vision problems or a neurological condition such as cerebral palsy or muscular dystrophy
Assessment usually involves a pediatrician or developmental pediatrician to rule out other conditions, and an occupational or physical therapist who uses standardized tests such as the Movement Assessment Battery for Children (MABC-2). Questionnaires completed by parents and teachers help describe daily impact. Diagnosis is usually made after age 5, as younger children's motor skills vary widely.
Conditions that often occur with DCD
| Condition | How often |
|---|---|
| ADHD | About half of children with DCD |
| Dyslexia and other learning disorders | Common |
| Developmental language disorder | Common |
| Autism spectrum disorder | Increased |
| Anxiety and low self-esteem | Common, often from repeated struggles |
Children should be screened for these, as treating them together improves outcomes.
Causes
The exact cause is unknown. DCD is thought to involve differences in how the brain plans, sequences and learns movements, especially in networks linking the cerebellum and motor areas. It is more common in children born prematurely or with low birth weight. It is not caused by laziness or lack of practice.
Treatment
Task-oriented therapy
The best evidence supports task-oriented approaches delivered by occupational or physical therapists. These focus directly on the skills the child wants or needs to do, such as tying shoelaces or riding a bike, rather than general exercises.
- CO-OP (Cognitive Orientation to Occupational Performance): children learn a "goal, plan, do, check" strategy to solve motor problems.
- Neuromotor task training: practicing specific skills with structured feedback.
- Group motor skills programs and active video games as add-ons.
School support
- extra time for written work and tests
- using a keyboard or speech-to-text instead of handwriting
- pencil grips, slanted writing boards and lined or graph paper
- simplified uniforms with Velcro or elastic
- adapted physical education focusing on participation and fitness
Home strategies
- break tasks into small steps and practice them regularly
- choose individual activities such as swimming, cycling or martial arts that allow progress at the child's pace
- praise effort and progress rather than results
- encourage physical activity to support fitness and confidence
Outlook
Children with DCD can improve their skills with targeted practice, though difficulties often persist into adulthood in some form. Supporting self-esteem, fitness and participation is as important as building motor skills, because children with DCD are at higher risk of anxiety, low physical activity and social difficulties.
Frequently asked questions
What are the signs of dyspraxia in a child?
Common signs include frequent falls and bumping into things, difficulty with buttons and shoelaces, messy handwriting, poor ball skills, trouble learning to ride a bike, and messy eating. These difficulties are more than expected for the child's age and affect daily life.
Is dyspraxia the same as developmental coordination disorder?
In everyday use, yes. Developmental coordination disorder is the official medical diagnosis, while dyspraxia is a widely used term, especially in the UK. Some clinicians use "dyspraxia" more narrowly for difficulties with motor planning.
Can a child grow out of DCD?
Many children improve with practice and therapy, but DCD is usually a lifelong difference to some degree. With support, most children develop strategies that let them participate fully in school, sport and work.
Is DCD linked to ADHD?
Yes. About half of children with DCD also have ADHD. Each condition can make the other harder to manage, so children with one should be checked for the other.
Sources
This guide was written from current patient and clinical guidance, including:
- European Academy of Childhood Disability: International clinical practice recommendations on DCD
- American Psychiatric Association: DSM-5-TR, developmental coordination disorder
- CanChild Centre for Childhood Disability Research: DCD resources
- NHS: Developmental co-ordination disorder (dyspraxia) in children
- American Occupational Therapy Association: Children with DCD