Need to know: A look at Developmental Coordination Disorder (Dyspraxia).

Developmental Coordination Disorder (DCD), also known as dyspraxia, is a neurodevelopmental condition that affects motor coordination and planning. Children with DCD have difficulty with moving their bodies in a smooth and coordinated way, which can make it hard to do everyday things at home, school, or with friends. 

Difficulties with coordination don’t present the same in every child. Some kids with DCD might find it harder to do big movements, like running or jumping and others might struggle more with small movements, like writing neatly. 

Researchers believe that children with DCD struggle with movement because they can’t create an internal model of how external movement should happen in the outside world. We learn by comparing how an action looks and feels against a mental picture. As we practise a movement we check it against our internal model and if it doesn’t look or feel right we adapt and correct it. Without this mental picture, it is much harder to learn a physical action because we have no mental reference point. 

Although DCD is a common condition, affecting around 5-8% of school-aged children, it is not easily identifiable and poorly understood. Signs of DCD in your child may look like:

• Takes longer to learn early skills like sitting, crawling, and walking.
• Finds it hard to run, jump, hop, and catch or throw things compared to other kids.
• Has difficulty with closing their lips to blow bubbles or blowing out birthday candles.
• Looks a bit clumsy, slow, and unsure when moving.
• Needs to be taught physical skills instead of figuring them out naturally.
• Often stumbles and falls.
• Has an unorthodox pencil grip and writes slowly.
• Struggles with getting dressed and using eating utensils.
• Doesn’t understand words like “on,” “under,” “over,” or “in front of” very well.
• Has trouble knowing how to act around others, which may impact their ability to make and keep friends.
• Feels worried and has low self-confidence as a result of being different from their peers.
• Has trouble focusing and reacts strongly to things as a result of the frustration of their external movements not aligning with their internal mental model.
• Works better one-on-one or in a small group.
• Has a tough time following directions.
• Struggles with managing time.
• Often misplaces things.

While many of the markers above present very early in life, children with potential DCD are not prioritised for therapy, instead parents are told to ‘watch and wait’. Movement problems in children often get noticed when they begin school. However, there isn’t a consistent system for identifying these issues, referring kids for diagnosis, or providing therapy.

DCD often overlaps with ADHD, approximately 50% of kids diagnosed with ADHD also have motor coordination problems.

Why it’s important

DCD and ADHD can share common traits, leading to misdiagnosis but also co-occurrence. Both conditions may involve difficulties with:

• Concentration and attention: Children with DCD may struggle to concentrate due to the effort required to complete simple tasks, similar to those with ADHD.
  
  
• Organisation: Executive function challenges, common in ADHD, can also affect children with DCD, making tasks like organising school work a struggle.

Recognising DCD is the first step to providing support, but because it can present differently in every child, you need to look more closely at some of the potential signs. If you are wondering whether your child has DCD, think about the following areas of impact and consider your child’s difficulties.

Motor Skills Challenges 

Gross motor: these are movements that use large muscle groups in the legs and arms like running, swimming, jumping, and throwing/catching a ball. 

Questions – Did your child learn to ride their bike unassisted at the same time as their peers? Do they resist playing ball games with other kids?

Fine motor: these movements are small and controlled usually involving the use of our hands, wrists, feet, and toes like eating with utensils, cutting with scissors, and writing with a pencil. 

Studies have found that the handwriting of children with DCD differs from other typically developing peers.  Students with DCD were observed during writing tasks and the following was noted:

• More pressure was applied to the pencil on the paper. 
• More time was spent hovering over their workbook without putting pencil to paper. 
• Slower at getting thoughts down on paper within the first minute of writing. 
• Hand movements weren’t smooth, and their writing looked messy and less organised.

Questions – does your child struggle to hold a pen or pencil comfortably? Do they find it difficult to gather their ideas and thoughts to create a narrative or other text? 

Motor planning: this refers to tasks/activities that involve multi-step or successive movements, such as tying a shoe or putting on pants with a zipper and button.

Questions – does your child appear defiant during routines when they are expected to get dressed or pack their bag? Are they oppositional and argumentative when it comes to chores? 

Cognitive challenges

Children with DCD may face certain learning challenges in areas such as maths, processing speed, and working memory. 

Questions – does your child find it difficult to do simple calculations in their head? Do they take longer than their peers to think about a question and answer?

Spatial awareness/reasoning Issues

A very common sign of DCD is a clumsy child who frequently bumps into objects or people.  Spatial reasoning is essential when learning to use tools and utensils like cutlery. 

Questions – does your child struggle with tasks like drawing within lines? Do they have difficulty doing puzzles or building with blocks?

Social and Emotional Struggles

Children with DCD experience frustration, low self-esteem, and difficulties in social situations. Making and keeping friends can be an issue because children with DCD are often excluded and bullied because of their differences.

Questions – does your child have difficulties in making and keeping friends? Does your child use self-deprecating language?

You can access the Developmental Coordination Disorder Questionnaire and scoring criteria at no cost at www.dcdq.ca if you want to investigate further.

It’s important to remember that difficulty with moving and coordination can make a big impact on a child’s life. It can affect how they feel about themselves and how others see them. These problems can make it hard for kids to reach their potential at school, make friends easily, and do well at sports. Staying on top of your child’s mental health is crucial in ensuring the best outcome for them.