Dyspraxia (Developmental Coordination Disorder)

What dyspraxia is

The brain plans a movement, sequences it and adjusts it based on feedback from the body. In dyspraxia, this process works less efficiently, so movements are slower, less accurate and need more effort to learn. Muscles and nerves are normal, and the difficulties are not caused by another medical condition such as cerebral palsy.

Dyspraxia vs DCD

In the US and in medical classification (DSM-5), the diagnosis is developmental coordination disorder. "Dyspraxia" is widely used in the UK and by the public, sometimes with a broader meaning that includes difficulties with organization, planning and speech. "Verbal dyspraxia" (childhood apraxia of speech) is a related but separate speech condition. See developmental coordination disorder.

Signs at different ages

Babies and toddlers

• late to sit, crawl or walk, or skipping crawling
• difficulty feeding, or messy eating long after peers
• frequent falls and bumping into things

Preschool and school-age children

• clumsiness, tripping and dropping things
• difficulty running, hopping, jumping, catching or kicking a ball
• trouble learning to ride a bike or swim
• slow, effortful or messy handwriting, and avoiding drawing or writing
• difficulty with buttons, zippers, shoelaces, cutlery and scissors
• trouble copying from the board or organizing schoolwork
• avoiding physical play and sports, and tiring easily
• lower self-confidence, frustration or anxiety

Teens and adults

• difficulty learning to drive
• untidy handwriting and slow typing
• difficulty with grooming, shaving, makeup and cooking
• problems with organization, time management and planning
• poor spatial awareness and difficulty with directions
• fatigue from the extra effort everyday tasks require

Related conditions

Many children with DCD also have:

• ADHD (about half of children with DCD)
• dyslexia and other learning disorders
• speech and language difficulties
• autism spectrum disorder
• anxiety and low mood, especially in adolescence
• lower physical fitness and higher risk of excess weight, due to avoiding activity

Causes and risk factors

The exact cause is unknown. It is linked to differences in how the brain processes motor information. Risk factors include:

• premature birth, especially before 32 weeks
• low birth weight
• family history of DCD
• male sex
• exposure to alcohol in pregnancy

Diagnosis

There is no single test. Diagnosis is based on four criteria:

1. Motor skills are clearly below what is expected for age and opportunity to learn.
2. The difficulties interfere significantly with daily living, school, play or work.
3. Symptoms started in early childhood.
4. They are not better explained by intellectual disability, vision problems or a neurological condition.

A pediatrician rules out other causes, and an occupational or physical therapist uses standardized assessments such as the Movement Assessment Battery for Children (MABC-2). Diagnosis is usually made from age 5, though it can be suspected earlier. Adults can also be assessed.

Treatment and support

DCD cannot be cured, but skills improve with the right support.

Therapy

• Task-oriented approaches: practicing the specific skills the child wants or needs to do, broken into steps. Cognitive Orientation to Occupational Performance (CO-OP) and neuromotor task training have the best evidence.
• Occupational therapy: handwriting, dressing, self-care, using tools, organization.
• Physical therapy: balance, strength, coordination and confidence in physical activity.
• Speech therapy if speech is affected.

At school

• extra time for tests and written work
• keyboards, laptops or speech-to-text software
• pencil grips, slanted writing boards, and lined or graph paper
• simplified instructions and visual checklists
• adapted physical education that emphasizes participation over competition
• an IEP or 504 plan in US schools

At home and work

• clothing with elastic waists, Velcro and slip-on shoes
• practice in short, frequent sessions
• individual activities like swimming, cycling, dance or martial arts
• workplace adjustments for organization and handwriting

Outlook

DCD is lifelong, but many people develop strategies and find their own strengths. Early identification and support improve skills, confidence and participation. Mental health support may be needed, because frustration and social difficulties can lead to anxiety or low self-esteem.

Frequently asked questions

What is dyspraxia?

Dyspraxia, or developmental coordination disorder, is a lifelong condition that affects how the brain plans and coordinates movements. People with it find tasks like handwriting, dressing, sports and later driving harder to learn and perform. It does not affect intelligence.

What are the signs of dyspraxia in a child?

Signs include late motor milestones, clumsiness, frequent falls, difficulty with ball games, riding a bike or swimming, messy handwriting, and trouble with buttons, shoelaces and cutlery. Many children also tire easily and avoid physical activities.

Can adults have dyspraxia?

Yes. DCD continues into adulthood, and many adults were never diagnosed as children. They may struggle with driving, handwriting, organization, grooming and time management. Adult assessment and occupational therapy can help.

Is dyspraxia the same as autism?

No. Dyspraxia mainly affects motor coordination, while autism affects social communication and involves restricted or repetitive behaviors. The two can occur together, and some autistic people have coordination difficulties as well.

Can dyspraxia be cured?

There is no cure, but skills improve with practice, occupational and physical therapy, and adjustments at school or work. Many people develop effective strategies and lead full, successful lives.