Revised July 10, 2006
Developmental Coordination Disorder: Guide for Families
Compiled by Dr. Michael Cheng, MD
Disclaimer
The content of this document is for general information and education only. The accuracy, completeness, adequacy, or currency of the content is not warranted or guaranteed. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should always seek the advice of physicians or other qualified health providers with any questions regarding a health condition. Any procedure or practice described here should be applied by a health professional under appropriate supervision in accordance with professional standards of care used with regard to the unique circumstances that apply in each practice situation. The authors disclaim any liability, loss, injury, or damage incurred as a consequence, directly or indirectly, or the use and application of any of the contents of this document.
This work is “licensed” under a Creative Commons License (Attribution-Non Commercial-Sharelike 2.0, which means that you are free to copy, distribute, display and perform the work, and make derivative works as long as you give the original author credit, the work is not used for commercial purposes, and if you alter, transform, or build upon this work, you may distribute the resulting work only under a license identical to this one.
Where to Get this Handout
This handout is available from in the Mental Health Information section. Any comments and suggestions are welcome and will help ensure this handout is helpful.
Table of Contents
Introduction
Where is it seen?
How common is Developmental Coordination Disorder?
What are the symptoms of Developmental Coordination Disorder?
What are the risks for youth with Developmental Coordination Disorder?
Interview Questions for the Parent
Screening Questions for the Adolescent
Referral to Professional Help
What can families do about it?
Step-by-step
Ottawa Resources
Weblinks
Introduction
Having good coordination is an essential skill for all day-to-day activities. From dressing in the morning, to writing/typing during the day, to playing sports.
It is naturally that some people are more coordinated than others.
At the extreme end however, are youth with such poor coordination and clumsiness, that it causes problems with day-to-day life. These youth tend to avoid physical activity, or are distressed by it.
Where is it seen?
Problems with motor coordination can occur in otherwise normal children, but is commonly seen together with other conditions such as:
- Learning disorders (particularly nonverbal learning disorder)
- Attention-deficit/hyperactivity disorder
- Various congenital problems (e.g., premature birth, low birthweight, mental retardation).
- Sensory processing disorders (aka sensory integration problems).
Although the official diagnostic term in the DSM-IV is Developmental Coordination Disorder, defined as “marked impairment in the development of motor coordination”, there are other related terms that have been used in the literature.
How common is Developmental Coordination Disorder?
It is estimated that 6 percent of children ages 5 to 11 in the United States have DCD.
What are the symptoms of Developmental Coordination Disorder?
Youth with DCD tend to have:
- Developmental delays in sitting up, crawling, and walking
- Deficits in handwriting
- Problems in gross motor coordination (jumping, hopping, standing on one foot)
- Problems in fine motor coordination (tying shoelaces, tapping one finger to another)
- Clumsiness
Youth with DCD in early childhood may have the following warning signs:
- Child aged 1–4 with delays, or troubles with gross motor skills and fine motor skills (e.g., those used for running, climbing, and drawing and for self-care activities such as dressing, tying shoelaces, and buttoning shirts)
They tend to appear
- underactive and sedentary throughout their school years and may not attain even moderate levels of proficiency in most types of physical activities.
- DCD, particularly when combined with other problems, is rarely identified until a child is at least 8 years old.
- Having problems with coordination, such as:
- Tripping over their own feet
- Running into other people, or bumping into things
- Have troubles with holding objects
- Unsteady gait
- Significant problems with sports, e.g. troubles catching the ball
- Having troubles with handwriting
What are the risks for youth with Developmental Coordination Disorder?
Because good coordination is required for so many everyday activities, having poor coordination is a risk for poor academics, poor self-esteem, and poor participation in physical activity. If not dealt with appropriately, as these youth become teenagers, they may continue to have significant problems functioning.
Interview Questions for the Parent
- Any problems with your child avoiding physical activity?
- Any problems with activities requiring eye-hand coordination? E.g. handwriting, catching/;throwing a ball, balancing on one foot, riding a bike.
- Any problems with your child feeling uneasy when doing in group physical activities? If so, which ones?
- Any problems with your child being clumsy?
- E.g. Does your child often trip, fall down, or bump into things?
Screening Questions for the Adolescent
- Some people are naturally more coordinated, and others are less coordinated. How about you? Where are you on that scale?
- How do you find gym class (or phys ed class)?
- What do you like about it?
- What don’t you like?
- What types of physical activity do you like? (e.g. sports, dancing, games)
- Do you do any of these with your friends or family?
- Do you think you are good at any of them?
- Compared to other teens, how well do you think you do? Do you have to work harder at it, or does it come easily to you?
- When the other teens are choosing people for teams, are you among the first people chosen, or among the last people chosen?
Referral to Professional Help
Children or youth that are having problems with motor coordination that interfere with home or school should be referred to a health professional.
The first step is to see one’s family physician or pediatrician, and ensure that there are no medical problems (e.g. cerebral palsy or other developmental problems) that are contributing to the problem.
Then, professionals such as an occupational therapist (OT) or physiotherapist (PT) may be helpful in further assessing and helping with coordination.
What can families do about it?
Children and adolescents with DCD and their families need to know that motor coordination problems will not simply disappear on their own; they need special effort to help the situation improve.
Step-by-step
The best way to help with DCD is to:
- Set developmentally appropriate motor/physical activity goals, and help the child reach them, step-by-step.
- Find physical activities that the child/youth enjoys
- Due to problems with low self-esteem, it is often helpful to avoid competitive activities
- Although group sports are preferred because they can help develop a sense of sportsmanship, if those are too difficult, it may often be helpful to encourage more individual sport
- Expectations for physical activity – parents should remember that children and adolescents with DCD have no physiological barriers to being physically active. However, remember that these children may have psychological barriers such as embarrassment that needs to be addressed to help get them physically active
Ottawa Resources
- In Ottawa, if DCD is suspected in a child who is under the age of 5, the child’s physician can refer to CHEO Occupational Therapy Services for an assessment
- If the child receives a diagnosis of DCD, s/he may have access to further resources such as psychology or speech/language
- Seeing an occupational therapist (OT) or physiotherapist (PT) with expertise in Developmental Coordination Disorder
- To find an OT/PT in Ottawa, visit and look for the section on OT/PT
Weblinks
- The CanChild Centre for Childhood Disability Research
- Bright Futures at Georgetown University