Developmental Coordination Disorder

Developmental coordination disorder (DCD) is an often overlooked neurological condition affecting 5-6% of elementary school children, leading to difficulties executing activities for daily living, routine tasks and academic performance. While the condition generally persists into adulthood, early assessment and intervention during the school-age period can make a huge difference in providing effective management over lifespans.

SYMPTOMS OF DCD

Developmental coordination disorder, a condition that can present many challenges for children, can have both immediate and long term effects. For some individuals, the symptoms may appear in early childhood, whereas others might increase their difficulties as they age.

Dyspraxia is a symptom of DCD. This is difficulty with motor coordination. Other areas where children with DCD might have trouble are activities such as crawling, walking, and self-feeding. Some people may call DCD dyspraxia or clumsy child syndrome.

As children get older you might see more motor impairment such as noticeable clumsiness, trouble with drawing, handwriting deficits, and delayed motor milestones. Sports performance is also typically behind what is expected for the child’s age group. 

It is difficult to diagnosis DCD because children vary in the rate of development. Often doctor’s will not make this diagnosis until after 5 years of age.

Decreased strength in muscles is not necessarily a symptom but research does indicate that even when growing at a similar rate, children with DCD do not develop muscle strength gains at the same rate as their typically developing peers (Demers et al, 2020).

SIGNS OF THIS DEVELOPMENTAL DISORDER

Here are some signs you might see in children who may have this disability of DCD:

• awkward walking pattern
• falls or trips frequently
• clumsy children when playing during recess or gym class
• trouble with functional activities such as using a fork and knife
• motor difficulties when playing sports with peers
• trouble with motor tasks like using scissors or tape
• problems with activities of daily living such as getting dressed and tying shoelaces
• difficulties with fine motor skills
• illegible handwriting
• anxiety with physical or motor-based skills
• motor coordination problems in gym class or transitioning between classes 
• delays in age-appropriate gross motor skills 
• organization issues during adolescence
• behavior issues from frustration due to decreased motor control

CAUSES OF DEVELOPMENTAL COORDINATION DISORDER

Researchers are exploring possible clues as to the causes of Developmental Coordination Disorder (DCD). There are some risk factors but it is thought that there may be a connection between DCD and the cerebellum. This part of the brain has an important role in helping children acquire stable movement control. 

However, due to its varied symptoms affecting multiple areas beyond motor coordination issues, it’s unlikely that one single factor can explain all cases. More research into identifying potential triggers for DCD continues!

DIAGNOSIS OF DCD

If you notice your child lagging behind in physical skills development and struggles learning new movements, you may need an evaluation from your pediatrician or neurologist to get a diagnosis of DCD from the DSM-5. 

The doctor will use diagnostic criteria to determine if a child has DCD. They will need to conduct some tests such as the Movement Assessment Battery or the Bruininks-Oseretsky Test of Motor Proficiency in order to assess motor performance.

The doctor will check for signs of other nervous system disorders like cerebral palsy, attention deficit hyperactivity disorder (ADHD), learning disabilities, behavioral disorders, specific language impairment, sensory processing differences, and autism spectrum disorder if present. 

Early recognition is essential for minimizing any potential psychological issues down the line that could arise due to DCD. If your pediatrician has additional questions, they may refer you to a neurologist.

INTERVENTIONS FOR DEVELOPMENTAL COORDINATION DISORDER

It may not be easy for children with coordination difficulties to successfully execute the day-to-day motor tasks. With practice, effort and careful selection of interventions (just right challenges), gradual improvement will become evident over time! 

Interventions aimed at minimizing the effects of these challenges can make all the difference in helping them participate more fully in typical childhood activities – an important goal achieved through dedicated support from parents and caregivers.

Other health professionals may be recommended such as occupational therapists and physical therapists. They will evaluate the child to determine whether occupational therapy or physical therapy is necessary.

WHAT DOES THE RESEARCH SAY?

Advances in research show that the best way to help children achieve activity and participation goals is through an individualized, task-oriented approach. These recommendations guide kids as they come up with unique solutions for movement problems by teaching them functional skills based on their needs or interests. This is for activities of daily living, sports, school tasks, leisure activities, and more. Doing so allows them to explore different ways of physical expression while understanding how each one affects outcomes!

RESEARCH BASED INTERVENTIONS AND TIPS

Here are several, research based, developmental coordination disorder interventions for children to help them succeed.

1. Encourage practice of functional tasks required in the daily routine and everyday life.
2. Practice multiple, short sessions versus one long session i.e. practice a skill 5 minutes per day versus 35 minutes/week.
3. Vary the practice sessions.
4. Facilitate the use of cognitive strategies.  Ask the child to set goals, to self check skills and problem solve.
5. Break down large tasks into smaller chunks.

Read about more DCD interventions here.

HANDWRITING INTERVENTIONS AND DCD

Research indicates that children with developmental coordination disorder have a higher percentage of errors within their letter formations than their typically developing peers. Explicit teaching of letter formation may help improve handwriting speed and letter formation in children with DCD. Read more here.

PHYSICAL THERAPY INTERVENTIONS FOR DEVELOPMENTAL COORDINATION DISORDER

The researchers recommend the use of task-oriented and traditional physical therapy interventions for children with DCD with clear goals and outcome measures for individual children. Read more here.

GOALS ANS STRATEGIES USED

One research study looked closely at the goals and strategies used for children with DCD. The results of the study indicated the following regarding goal setting:

• Leisure was the most common goal type followed by productivity and then self-care goals.

The data indicated that the following were the most frequently used strategies:

• Supplementing task knowledge – any verbalization of task specific information or how to get/access task-specific information.
• Body position – any verbalization of attention to, or shifting of the body, whole or in part, relative to task.
• Task modification – any discussions regarding the specifics or modification of the task, or parts of the task, or any modification of the task or any action to change the task, or parts of the task.

Read more about Goals and Strategies for DCD here.

INTERVENTIONS FOR THROWING AND CATCHING

Quiet eye training (QET) has been used in the past to help children improve their throwing and catching skills.  Recent research investigated whether teaching throwing and catching to a group of children with DCD using a gaze training intervention (i.e., QET) could improve their skills and help decrease the negative psychosocial impact of motor skill deficits. 

The researchers concluded that quiet eye training may help to address deficits in the motor and psychosocial skills of children with DCD. Read more about teaching throwing and catching skills to children with DCD here.

DCD AND WALKING

Children with a trait of developmental coordination disorder may have lower walking efficiency, leading to increased energy expenditure. Fortunately, modifications can be made through interventions that are designed to heighten their physical function and help them join in activities more easily (Ito et al, 2023).

OPHTHALMIC ABNORMALITIES AND DEVELOPMENTAL COORDINATION DISORDER

When it comes to visual impairments, research suggests that children with severe DCD had abnormalities in binocular vision, refractive error, and ocular alignment. It is recommend that children with DCD be assessed for ocular abnormalities, as early intervention may improve long-term visual outcome.

CONCLUSION ON DEVELOPMENTAL COORDINATION DISORDER

If your child displays any of the above-listed symptoms, it’s important to reach out to a doctor or therapist as soon as possible. Early intervention is key when it comes to developmental disorders like DCD. 

Even if your child is already school-aged, there are plenty of research-based interventions that can help them improve their motor skills and succeed in life. With the right support system, children with DCD can grow up to lead happy and healthy lives.

References:

Can Child. Causes of Developmental Coordination Disorder. Retrieved on 1/10/23 from https://www.canchild.ca/en/diagnoses/developmental-coordination-disorder/causes-identification

Demers, I., Moffet, H., Hébert, L., & Maltais, D. B. (2020). Growth and muscle strength development in children with developmental coordination disorder. Developmental Medicine & Child Neurology, 62(9), 1082-1088.

Ito, T., Sugiura, H., Ito, Y., Nakai, A., Narahara, S., Noritake, K., Takahashi, D., Natsume, J., & Ochi, N. (2023). Decreased Walking Efficiency in Elementary School Children with Developmental Coordination Disorder Trait. Clinical Rehabilitation. https://doi.org/10.1177/02692155221150385

NHS. Developmental co-ordination disorder (dyspraxia) in children. Retrieved on 1/10/23 from https://www.nhs.uk/conditions/developmental-coordination-disorder-dyspraxia/