Occupational Therapy for Dyspraxia (DCD) in Children

Dr. Eva Lassey, PT, DPT reviewed the motor and sensory content in this article. The remaining content follows published guidance from the sources named on the page.View full bio · How we write and who reviews it · Last updated October 6, 2026

Occupational therapy is central to supporting children with dyspraxia, clinically diagnosed as developmental coordination disorder. International clinical practice guidelines are clear about what works: task-oriented approaches, which work directly on the everyday activities a child wants to be able to do, rather than approaches targeting underlying processes in the hope that skills follow. Cognitive Orientation to daily Occupational Performance — CO-OP — is among the recommended treatments and is supported by several systematic reviews.⁠² It teaches a child a problem-solving strategy they can apply themselves, which is why it generalizes better than approaches delivered to the child. DCD affects approximately 5 to 6 percent of children and commonly co-occurs with ADHD.⁠¹

Key takeaways

Dyspraxia is clinically diagnosed as developmental coordination disorder, and occupational therapy is central to supporting it.
International clinical practice guidelines are clear about what works: task-oriented approaches, which work directly on the everyday activities a child wants to be able to do.
Meta-analyses indicate the most effective therapies are task-oriented approaches, motor training programs, and physical therapy.
CO-OP teaches a child a strategy, goal-plan-do-check, that they then apply to new tasks themselves, which is why it generalizes.
Approaches targeting underlying processes rather than the activity itself have weaker support and frequently do not transfer.
If a program is working on coordination abstractly rather than on tying shoelaces, ask why.
DCD involves motor-cognitive processes including executive function, so organization is part of the work rather than a separate issue.

Developmental coordination disorder is a recognized DSM-5 diagnosis affecting motor coordination, with international clinical practice guidelines. → DCD and dyspraxia

What does occupational therapy do for a child with dyspraxia?

Occupational therapy works on the everyday activities a child with dyspraxia finds hard — dressing, handwriting, using cutlery, school tasks, play — by practicing those activities directly, with the family and school involved so practice continues between sessions.⁠¹

The specific activities the child wants to do — handwriting, dressing, using cutlery, riding a bike, tying laces · motor planning and sequencing · handwriting and school tasks · organization, since DCD involves motor-cognitive processes including executive function · adapting tasks and environments · building the child's own problem-solving strategies

International guidance describes these activity-focused approaches as covering personal care, play, leisure and sport, arts and crafts, and academic tasks, and says they must aim to carry over into daily life in every setting where the child needs the skill.⁠¹ Planning and organization belong in the work because difficulties with executive function are common in DCD and persist into early adulthood.⁠¹ A first appointment usually combines a history from you and the school, watching your child try the activities that are hard, and a standardized motor test such as the MABC-2.⁠¹ For the gross motor, balance and fitness side, see physical therapy for dyspraxia.

What is CO-OP and task-oriented training?

Task-oriented training means practicing the actual activity rather than an underlying skill, and CO-OP (Cognitive Orientation to daily Occupational Performance) is a task-oriented approach in which the child learns a problem-solving strategy and applies it to activities they have chosen.⁠^1,2

Task-oriented approaches are recommended. Meta-analyses indicate the most effective therapies are task-oriented approaches, motor training programs, and physical therapy.⁠¹ The international guidance gives activity- and participation-oriented approaches, naming task-specific training, Neuromotor Task Training and CO-OP, its strongest level of recommendation.⁠¹

CO-OP teaches a child a strategy — goal, plan, do, check — that they apply to new tasks themselves. That's why it generalizes, where approaches working on underlying components frequently don't transfer. In CO-OP the child sets the goals with the therapist, discovers strategies through a general problem-solving approach, and the family is involved to make practice happen and help skills transfer.⁠²

A 2023 systematic review of 20 studies found that every measure of activities and participation improved with CO-OP, and that group sessions looked promising; most of the studies were at the lower levels of evidence, so the reviewers ask for trials that can measure effect sizes.⁠²

Approaches targeting underlying processes rather than the activity itself have weaker support. If a program is working on "coordination" abstractly rather than on tying shoelaces, ask why. A 2025 meta-analysis of 32 trials found task-oriented approaches the most effective for motor skills, and also found that motor-based therapy of any kind did not improve participation on its own.⁠³

Handwriting, dressing and self-care: which does OT work on first?

Whichever matters most to the child and family: guidance on DCD asks that intervention priorities weigh both motor and non-motor factors, and that goals be set at the level of everyday activities and participation, often using an interview-based measure such as the Canadian Occupational Performance Measure.⁠¹

In CO-OP the child identifies the goals with the therapist, so a first goal is often something the child wants badly: tying shoelaces, riding a bike, a sport.⁠² Handwriting comes up early for many families because it is a particular problem in DCD and a common reason for referral. The guidance suggests handwriting practice built around the activity itself, with ways for the child to judge their own work, and teaching keyboarding early alongside it.⁠¹ Fine motor goals usually take more practice time than gross motor ones.⁠¹

What can school do alongside OT?

School can give the child time and opportunity to practice the skills therapy is working on, adjust tasks so motor difficulty does not hide what the child knows, and support keyboarding, because international guidance asks therapists to advise teachers as well as parents.⁠¹

Practice in context. The guidance asks for ample opportunity to practice movement skills at school as well as at home, especially complex ones.⁠¹
Keyboarding and tablets. Taught early, in parallel with handwriting, so poor handwriting does not get a child labeled as underachieving.⁠¹
PE and the playground. Children start comparing their abilities with peers at about 5, mostly in sport and playground games, and repeated failure there affects self-esteem; support from school helps prevent avoidance.⁠¹
Older students. Teenagers and adults with DCD report keyboarding instead of handwriting, phone apps and alarms, and building on their strengths as coping strategies.⁠¹
Teacher information. Teachers need to understand the child’s difficulty with motor learning to support it.⁠¹

School-wide programs have not yet been shown to improve motor skills in children with DCD, so these are supports for the child rather than a substitute for therapy.⁠¹ If handwriting is the main concern, our page on dysgraphia covers how it is assessed, and our page on motor planning explains the planning side.

What do OT goals for dyspraxia look like?

Ties his own shoelaces · Writes a paragraph legibly within the lesson · Uses a knife and fork at dinner · Rides a bike without stabilizers

Each goal names a task the child can do or cannot yet do, which is how the guidance asks for goals to be set and measured, with progress checked using standardized measures at the end of a block of therapy.⁠¹ You can find a pediatric occupational therapist near you.

Frequently Asked Questions

Is dyspraxia the same as DCD?

Dyspraxia is the widely used term; developmental coordination disorder is the diagnostic term in the DSM-5. Unlike sensory processing subtypes, DCD is a formal diagnosis with international guidelines.

What approach should we ask for?

Task-oriented. International guidelines recommend working directly on the activities the child wants to do. CO-OP is among the named recommended treatments.

How common is DCD?

Approximately 5 to 6 percent of children.

Does it co-occur with ADHD?

Frequently. ADHD is the condition most often reported alongside DCD; in clinical samples, half or more of children with DCD also have ADHD.

Will my child grow out of it?

Often not entirely: motor difficulties continue into adolescence in 50 to 70 percent of children with DCD. Skills do improve with the right approach, and the 2019 international recommendations were the first to address adolescents and adults.

Should my child learn to type if handwriting is hard?

Yes, alongside handwriting practice rather than instead of it. International guidance suggests teaching keyboarding early to children with DCD who have handwriting problems, to improve the legibility and neatness of schoolwork.

Sources

Blank R, Barnett AL, Cairney J, et al. International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine & Child Neurology. 2019;61(3):242–285. doi:10.1111/dmcn.14132 (PMID 30671947)
Madieu E, Gagné-Trudel S, Therriault P-Y, et al. Effectiveness of CO-OP Approach for Children With Neurodevelopmental Disorders: A Systematic Review. Archives of Rehabilitation Research and Clinical Translation. 2023;5(2):100260. doi:10.1016/j.arrct.2023.100260 (PMID 37312979)
Gao J, Yang Y, Xu X, Huang D, Wu Y, et al. Motor-based interventions in children with developmental coordination disorder: a systematic review and meta-analysis of randomised controlled trials. Sports Medicine – Open. 2025;11(1):59. doi:10.1186/s40798-025-00833-w (PMID 40419841).

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child.