Developmental co-ordination disorder (DCD), also known as dyspraxia, is a condition affecting physical co-ordination. It causes a child to perform less well than expected in daily activities for their age, and appear to move clumsily.

DCD is thought to be around 3 or 4 times more common in boys than girls, and the condition sometimes runs in families.

This topic is about DCD in children, although the condition often causes continued problems into adulthood. 

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Symptoms-DCD (dyspraxia) in children

Developmental co-ordination disorder (DCD) can cause a wide range of problems. Some of these may be noticeable at an early age, while others may only become obvious as your child gets older.

Problems in infants

Delays in reaching normal developmental milestones can be an early sign of DCD in young children. For example, your child may take slightly longer than expected to roll over, sit, crawl or walk.

You may also notice that your child:

  • shows unusual body positions (postures) during their 1st year
  • has difficulty playing with toys that involve good co-ordination, such as stacking bricks
  • has some difficulty learning to eat with cutlery

These signs might come and go.

Problems in older children

As your child gets older, they may develop more noticeable physical difficulties, plus problems in other areas.

Movement and co-ordination problems

Problems with movement and co-ordination are the main symptoms of DCD.

Children may have difficulty with:

  • playground activities such as hopping, jumping, running, and catching or kicking a ball. They often avoid joining in because of their lack of co-ordination and may find physical education difficult
  • walking up and down stairs
  • writing, drawing and using scissors – their handwriting and drawings may appear scribbled and less developed compared to other children their age
  • getting dressed, doing up buttons and tying shoelaces
  • keeping still – they may swing or move their arms and legs a lot

A child with DCD may appear awkward and clumsy as they may bump into objects, drop things and fall over a lot.

But this in itself isn't necessarily a sign of DCD, as many children who appear clumsy actually have all the normal movement (motor) skills for their age.

Some children with DCD may also become less fit than other children as their poor performance in sport may result in them being reluctant to exercise.

Additional problems

As well as difficulties related to movement and co-ordination, children with DCD can also have other problems such as:

  • difficulty concentrating – they may have a poor attention span and find it difficult to focus on 1 thing for more than a few minutes
  • difficulty following instructions and copying information – they may do better at school in a 1-to-1 situation than in a group, so they can be guided through work
  • being poor at organising themselves and getting things done
  • being slow to pick up new skills  – they need encouragement and repetition to help them learn
  • difficulty making friends – they may avoid taking part in team games and may be bullied for being "different" or clumsy
  • behaviour problems – often stemming from a child's frustration with their symptoms
  • low self-esteem

Although children with DCD may have poor co-ordination and some additional problems, other aspects of development – for example, thinking and talking – are usually unaffected.

When to seek medical advice

If you're concerned about your child's health or development, talk to a GP or health visitor, or speak to a nurse, doctor or special educational needs co-ordinator (SENCO) at your child's school.

If necessary, they can refer your child to a community paediatrician, who will assess them and try to identify any developmental problems.

Treatment-DCD (dyspraxia) in children.

DCD cannot be cured, but there are ways to help your child manage their problems.

A small number of children, usually those with mild symptoms of clumsiness, may eventually "grow out" of their symptoms.

However the vast majority of children need long-term help and will continue to be affected as teenagers and adults.

Once DCD has been diagnosed, a treatment plan tailored to your child's particular difficulties can be made. This plan may involve a variety of specialists.

A treatment plan, combined with extra help at school, can help your child manage many of their physical difficulties, improve their general confidence and self-esteem, and help them to become a well-adjusted adult.

Healthcare professionals

Several healthcare professionals may be involved in your child's care.

For example, your child may need help from a paediatric occupational therapist, who can assess their abilities in daily activities, such as:

  • using cutlery
  • dressing
  • using the toilet
  • playing
  • fine movement activities such as writing

A therapist will then work with a child, their carers and their teachers to help find ways to manage any problems.

Your child may also receive help from a paediatric physiotherapist. They can assess their abilities and create a therapy plan especially for them, which may include activities to improve walking, running, balance and co-ordination, among others.

Other healthcare professionals involved in your child's care may include:

  • a paediatrician – a doctor who specialises in the care of babies and children
  • a clinical psychologist – a healthcare professional who specialises in the assessment and treatment of mental health conditions
  • an educational psychologist – a professional who helps children who are having trouble progressing with their education because of emotional, psychological or behavioural factors