What is Developmental Coordination Disorder (DCD)?

admin232159
Aug 1
5 min read

Statistics

Developmental coordination disorder (DCD) is a motor skill disorder that affects 5-6% of primary school kids, that equates to 1 child in every classroom. In Australia, for every 3-4 males affected, 1 female is affected. Children with DCD struggle with coordinating their movements, which results in difficulties or an inability to perform everyday tasks such as climbing playground equipment, catching a ball, getting dressed or handwriting.

Diagnostic Criteria

To be diagnosed with DCD, 4 criteria must be met:

The child is delayed in gross motor skills, given their age & opportunity to practice. That is the child has adequate practice and is behind their peers in gross motor skills. [Note: Motor milestones such as rolling, crawling and walking are not delayed. Rather the acquisition of motor skills such as running and catching etc. are delayed.]
Onset is within the early developmental period (2.5 – 7 years)
Movement difficulties significantly interfere with academic productivity, leisure/play activities and self-care activities.
Movement difficulties cannot be explained by intellectual disability, visual impairment or other neurological conditions that impact movement such as cerebral palsy or muscular dystrophy. [Please note that a GP or paediatrician is required to rule this out.]

Why do children with DCD struggle?

Children usually store movement patterns in their brain and access these ‘maps’ when required. Children with DCD struggle with creating, storing or retrieving these maps. Therefore, every time they complete a movement task, it is as if they are learning it for the first time. As a result, children with DCD are unable to use past experiences to help them plan their movements, they use the information they are processing as the event is occurring in real time. This means that some tasks that are complex or completed in a difficult environment are much harder for children with DCD to execute. Furthermore, children with DCD are often more likely to also have co-existing conditions such as autism spectrum disorder (ASD), childhood apraxia of speech (CAS), attention deficit hyperactivity disorder (ADHD) or sensory processing disorder (SPD). These conditions add up to make movement even more difficult for children with DCD.

Common features of DCD

Children with DCD present across a spectrum. One child may have mild difficulty across fine motor, gross motor, postural stability, and everyday activities; while another child may struggle severely but only across tasks that require hand-eye coordination. That being said, if your child exhibits a few of the features of DCD listed below, it is important to see a GP/paediatrician to rule out other medical conditions.

Appear clumsy or awkward, especially compared to friends or siblings or similar age (eg. clumsy running pattern)
Struggles with dressing & tying shoe laces
Frequently tripping or dropping things
Frequently walking or bumping into objects without realising
Unable to appropriately distance themselves between objects or invading other people’s personal space without being aware
Avoids physical activity or motor-based activities
Difficulty or delayed in gross motor skills such as running, jumping, hopping, catching and kicking
Difficulty with fine motor tasks such as hand writing, doing buttons or tying shoe laces
Difficulty in planning complex movements or sequences. For example: struggles with touch head, nose then toes
Difficulty learning new movement tasks
Difficulty with unpredictable sports (eg. Soccer, tennis, AFL)
Difficulty with tasks that require both sides of the body. For example cutting with scissors, swinging a bat
Reduced balance and stability. For example, unsteady or struggles with stepping over objects or walking on uneven ground
Increased fatigue when completing motor tasks, especially compared to peers. Indicating that motor tasks require more effort, thus causing rapid fatigue.
Takes increased time to complete motor tasks such as jumping.
Difficulty with academic work that requires handwriting.

Due to movement difficulties children with DCD may have reduced confidence as they are unable to keep up with their peers or siblings. Children with DCD may also be easily frustrated when completing tasks due to the increased difficulty for them. As a result, to increased emotional outbursts and resulted self-confidence, children with DCD are at an increased risk of developing anxiety and depression.

Children with DCD may appear silly. This is a coping mechanism to assist with avoiding motor activities that they struggle with. Alternatively, children with DCD may play with younger kids as those kids may be at the same motor level as them.

How can physiotherapy & occupational therapy help?

Children with DCD may result to poor coping mechanisms that manifest as self-destructive behaviours. Children with DCD often withdraw from social and physical participation due to the difficulties they face. As a result, children with DCD may be at risk of developing obesity and cardiovascular disease, develop further behavioural and emotional issues, and have poor mental health.

Children with DCD do not ‘grow out’ of movement difficulties. However, depending on their difficulties and goals, physiotherapists and occupational therapists can develop client-centred strategies that can assist in addressing these difficulties so that children with DCD can confidently participate in movement based activities with their peers. This will help them develop a strong sense of self, which improves their confidence, and builds social skills as they participate with others.

What are some things that can be done at home?

Each child is different and has different needs, therefore providing general advice can be difficulty. However, some of the strategies below may be helpful depending on what your child struggles with and what their goals are.

Break down tasks into smaller components, provide demonstrations and verbal prompts: this allows your child to practice the action in digestible increments. As they improve, string the task together. Providing demonstration & verbal cues helps their brain plan the action they need to complete.
Mental visualisation: Prior to completing a movement task, ask your child to visualise the task in their head.
Consider their environment: Movement tasks are already difficult for children with DCD. Their brain must work harder to achieve tasks. If their environment is highly stimulating (eg. Lots of noise, lots of light, lots of activity) the brain must also process that information, while also trying to complete a difficult task - this makes success harder to achieve. Start in a calm environment with minimal distractions. As your child improves in their ability to complete the task, start by introducing things that simulate the environment they need to complete the task in.
‘Just right’ challenge: Ensure the task is challenging, but is set up in a way your child can succeed. As they continue to succeed, increase the difficulty.
Daily life: Activities and tasks should be incorporated into daily life so your child has opportunity to practice the task. Even though the task is difficult, construct the task in such a way that caters to your child’s hobbies. For example, if your child loves animals & is struggling to jump, stick green dots (“lily pads”) from your child’s door to their bed. Every time they see the dots they must pretend to be a frog and leap onto the pads.
Ensure sports participation is selected appropriately. Children with DCD struggle in team sports, especially as age increases and the demand becomes high. Team sports are highly unpredictable, making it difficult for children with DCD as they struggle with motor planning. Select individualised, repetitive sports such as cycling, running, swimming, ice skating, martial arts, dance etc.

Whilst these strategies can be completed in the home, school or community setting, it is important to reach out to a health professional to ensure your child is able to achieve goals and tasks that are important to and essential for them.

If your child is struggling with coordinated movement, or you suspect something is not right, contact us at admin@abctherapy.com.au as we can help assess your child’s needs.