Need to know.

In this part 2 of a deep dive into Support for Developmental Coordination Disorder (DCD), also known as dyspraxia, you will find:

• An outline some of the key things you can do at home to support your child
• A list of the most current therapies recommended and others still in their infancy
• Accommodations and adjustments you can advocate for at your child’s school to help them succeed

Read Part 1: What is Developmental Coordination Disorder (Dyspraxia) to get a better understanding of DCD: the obvious and less evident signs; ADHD as a co-occurring condition; and the impact of the condition. 

Tips & strategies

Your child will need a lot of support in every facet of their life to be confident, positive, and physically healthy. There are many strategies you can use to help them day-to-day and that will form the foundations for long-term outcomes.

Supporting your child at home: 

Prioritise downtime and breaks

Your child has to manage the inefficiency and additional mental effort that goes into processing, planning, and executing their movements, which often results in fatigue. Make an effort to allow them lots of downtime throughout the day and breaks while doing tasks.

Functional clothing and shoes

Buy clothes with a simple design like elastic waistbands, no buttons, elastic shoe laces, or velcro. You want to make the process of getting dressed/undressed a lot easier for your child to reduce effort and frustration.

Find and leverage strengths

Focus on the things your child is good at and find physical activities that they are more likely to succeed in. Building self-confidence is a crucial component in keeping your child physically and mentally healthy.

Develop spatial awareness/reasoning skills

There are plenty of fun ways to develop spatial awareness in everyday life. You can involve your child in the following activities:

• Draw 3D objects
• Complete jigsaws
• Rotate shapes in a mirror, making note of the changes you see
• Assembling model kits
• Playing video games
• Planning a route on a map and then taking the journey without it
• Making origami

Routine and Structure

Children with ADHD have been found to have issues coordinating and synchronising sensory (like seeing or hearing) and motor (movement) information in a precise and accurate manner. Establishing a consistent daily routine can help your child anticipate tasks and transitions, improving their ability to plan and complete individual steps in a routine. Scaffold the process by talking them through each task, because audio input helps guide your child through the process and can reduce frustration.

Visual Aids

Use visual schedules or charts to make tasks and routines more manageable. One research study suggested that children with DCD may have a potential issue with timing perception, and the use of visual cues can help them learn and retain knowledge better than just being told what to do.

Look into Therapy

There is very little reliable research on which therapies have the best outcomes in improving DCD symptoms.

The two types of therapy that have the most evidence in improving functioning in children with DCD include:

1. Task-oriented interventions – These are aimed at learning specific motor skills that are particularly difficult for the child. The key is to tailor it to the individual needs and particular interests of your child. The use of equipment, like hoops, ropes and ladders, and outdoor games, are also core features of a good program.
   
   
2. Occupational/Physical Therapy – Traditionally, both use an approach that relies on the idea that motor skills have a developmental ladder. Most interventions focus on basic training of gross motor/fine motor, and the development of these basic motor abilities first before developing specific motor skills. 

Other treatments still in their infancy of research include: 

• Process-oriented therapy – This is focused on more global functions (e.g., sensory integration, visual-motor perception, and muscle strength) but these were not as effective as the task-oriented strategies, and occupational and physical therapies in improving DCD-related difficulties.

• Wii-fit, core stability training, self-concept training, Tae Kwon Do, table tennis, and aquatic therapy – At present these activities are not recommended treatments for DCD because the results for these interventions are negligible, small, or there is stronger evidence for more effective interventions. That said, if your child is willing to participate in these sports or enjoy using a Wii-fit (or the equivalent on Switch), you should encourage these activities as they contribute to your child’s physical health and self-confidence.

• Combined action observation and motor imagery (AOMI) – This therapy involves children observing movement videos whilst imagining simultaneously the sensations of executing the same movement. There is little conclusive evidence and more research needs to be done.

• Omega fatty acid supplements – There is some evidence that a mild disorder of fatty acid metabolism may be linked to dyslexia, DCD, and ADHD. Supplements containing DHA, EPA, AA, and DGLA can in some cases improve the management of these conditions. You will need to consult your doctor to run more tests and assess whether your child is a good candidate for omega fatty acid supplements.

• Cerebellar anodal transcranial direct current stimulation (atDCS)/transcranial direct current stimulation (tDCS) – these are forms of non-invasive brain stimulation using a low electrical current, that aim to alter how the brain’s cells work. Researchers believe that it helps the brain become more flexible and better at fixing itself. Although the treatment is safe in children, there is little conclusive evidence of its use to improve DCD symptoms.

Whatever treatments you decide to use, record your observations and therapy notes in the Keywell app so that you can track how your child is progressing. Having this information can help you and your child’s healthcare team make better decisions about what to stop or continue. 

Supporting your child at school: collaboration with teachers and school staff is crucial

Individualised Education/Learning Plan (IEP/ILP)

Work with the school to create an IEP/ILP tailored to your child’s needs. This includes:

• Assistive Technology – Agree on the use of technology or adaptive tools to aid in learning and organisation. This includes dictation apps to capture ideas and write narratives
  
  
• Extra time to complete tasks – Especially with fine motor activities such as maths, writing a story, practical science tasks, and art
  
  
• Physical education/sport/gym – Agree on accommodations required for specific activities so that they meet your child’s abilities and assist with setting appropriate expectations to ensure success and reduce the risk of injury. The aim is to focus on participation, not competition
  
  
• Options for presenting work – This includes the delivery of answers orally rather than in written format, via video presentation, etc
  
  
• iPad or laptop for typing – Although this is a skill that can take time to acquire, it is often easier than writing with a pen
  
  
• Remove additional motor tasks – Where possible, have printed notes to reduce the additional effort children with DCD need to complete them

Educate Teachers

Provide teachers with information about DCD and its challenges. Share this article and other resources to help them gain a deeper understanding of why your child needs adjustments and accommodations.