Dyspraxia and Developmental Coordination Disorder (DCD)

Dyspraxia and developmental coordination disorder (DCD) are two names for the same difficulty, and DCD is the formal diagnosis.⁠² A child with DCD learns and carries out coordinated movements, such as handwriting, dressing and ball skills, well below the level expected for their age, enough to interfere with daily life and school.⁠^1,3 Many children do not outgrow it, but therapy that practices the child’s own goals improves motor skills.⁠^1,4

What is developmental dyspraxia?

Dyspraxia is a common name for developmental coordination disorder (DCD), a condition in which a child learns and carries out coordinated motor skills far below the level expected for their age and their chances to learn. It shows up as clumsiness, such as dropping things or bumping into them.⁠¹ Motor skills can be slow, inaccurate or both,⁠⁷ and the difficulties get in the way of self-care, schoolwork, play and leisure.⁠³

DCD is a formal diagnosis. The DSM-5 lists it among the neurodevelopmental disorders, as the first condition under motor disorders.⁠² It is diagnosed only when the motor problems are not better explained by intellectual disability or a vision problem, or by a neurological condition affecting movement, such as cerebral palsy.⁠³

Children with DCD usually have normal or above-average intellectual abilities, but their coordination difficulties can affect schoolwork, friendships and emotional development.⁠⁹

Is dyspraxia the same as DCD?

In practice, yes. DCD is the diagnostic term, and the international guideline recommends it for clinical and educational use.⁠⁷ It says “dyspraxia” has not become recognized as a separate condition, or as a subgroup of DCD.⁠²

Some organizations use “dyspraxia” more broadly. The UK’s Dyspraxia Foundation uses it to include DCD, but its definition also covers difficulties that are not about movement.⁠² Children with coordination problems are often referred with labels such as dyspraxia, sensory integration disorder or hypermobility rather than DCD,⁠³ and older labels for the same children include developmental dyspraxia, minimal brain dysfunction and “physically awkward.”⁠⁹

So a report that says dyspraxia and one that says DCD usually describe the same difficulty. If a report says dyspraxia, ask whether the four DCD criteria below were assessed.

What is DCD in medical terms?

In the US diagnostic code set (ICD-10-CM), developmental coordination disorder, developmental dyspraxia and clumsy child syndrome all fall under code F82, specific developmental disorder of motor function.⁠¹⁰ In the DSM-5, DCD is a neurodevelopmental disorder listed under motor disorders.⁠²

What are the DSM-5 criteria for developmental coordination disorder?

The DSM-5, and its text revision, the DSM-5-TR, diagnose DCD when all four criteria are met:⁠^1,3

1. A. Motor skills well below age level. Learning and carrying out coordinated motor skills is substantially below what is expected for the child’s age and chances to learn, showing up as clumsiness, slowness or inaccuracy.⁠¹
2. B. Daily life is affected. The motor difficulties significantly and persistently interfere with everyday activities such as self-care, and affect schoolwork, prevocational and work activities, leisure and play.⁠³
3. C. Early onset. Symptoms begin in the early developmental period.⁠³
4. D. Not better explained by something else. The difficulties are not better explained by intellectual disability or visual impairment, and are not due to a neurological condition that affects movement, such as cerebral palsy, muscular dystrophy or a degenerative condition.⁠³

The international guideline adds that DCD cannot be diagnosed when the motor problem is probably due to a lack of practice.⁠² The previous edition, the DSM-IV-TR, put DCD under learning disorders; the DSM-5 moved it to the motor disorders.⁠¹

What are the symptoms and signs of dyspraxia in children?

A child with DCD may seem clumsy, bumping into, spilling or knocking things over, and may find gross motor skills, fine motor skills or both hard to learn. Once learned, some skills can be done quite well while others stay poor.⁠⁶ Some children with DCD are late with early motor milestones, but many are not.⁠¹

Signs of dyspraxia in toddlers and preschoolers

• Trouble managing a spoon, handling a toy, pedaling a tricycle or scribbling with a crayon.⁠⁵
• Delays in skills such as riding a tricycle or bike, catching a ball, using a knife and fork, doing up buttons and printing.⁠⁶
• Self-care skills, such as dressing, that lag behind.⁠⁵

Signs of dyspraxia in school-age children

• Moving awkwardly, tripping often or dropping things.⁠⁵
• Printing or writing poorly, and with great effort.⁠⁵
• Trouble folding clothes, tying shoelaces, and doing up buttons and zippers.⁠⁶
• Taking longer to finish work, and getting distracted or frustrated because tasks take so much effort.⁠⁶
• Difficulty organizing a desk, locker, homework or the space on a page.⁠⁶
• Joining in less at recess, and tiring quickly during physical activity.⁠³

The difficulties often go unrecognized until they start to affect schoolwork.⁠⁵

Signs of dyspraxia in teens and adults

Teens with DCD may struggle at school because of problems with organization, written expression, practical tasks and physical education, and they often report more anxiety and a lower quality of life than their peers.⁠³ Adults with DCD have continuing difficulty with motor skills and with learning new ones, such as driving,⁠² and many report trouble with organization, such as planning ahead and managing money.⁠¹

How common is dyspraxia?

DCD is common. Estimates range from 2% to 20% of children, and 5% to 6% is the figure most often quoted.⁠² Stricter definitions give lower numbers: in a large UK birth cohort, 1.7% of 7-year-olds met the DSM-IV criteria, and more children had probable DCD.⁠¹¹

Boys are diagnosed more often than girls, at ratios from 2:1 to 7:1 depending on the study.⁠²

What causes dyspraxia?

The cause is not yet clear.⁠⁵ Researchers have suggested a link with the cerebellum, the part of the brain that makes movements automatic and monitors them as they happen.⁠⁵ A 2022 meta-analysis of 100 studies found differences in how children with DCD guide movement with their eyes, combine thinking with movement and learn motor skills, and atypical structure and function in sensory-motor and prefrontal brain regions.⁠¹²

Some factors make DCD more likely:

• Being born very preterm, before 32 weeks, or at very low birth weight, which raises the odds about sixfold.⁠^1,13
• Being born before 37 weeks or under 2,500 grams, or growing up in a family with a lower socioeconomic background.⁠¹¹
• Being small for gestational age, or first walking independently at 15 months or later.⁠¹
• Being a boy.⁠²

When should a child be assessed for dyspraxia?

When a child seems unusually clumsy or keeps falling behind on gross or fine motor skills,⁠¹ and the problems interfere with taking part at home, at school or on the playground.⁠⁶ Start with your child’s doctor, who checks that the movement problems are not caused by another physical, neurological or behavioral condition.⁠¹⁴

How is dyspraxia diagnosed?

A medical professional, or a team qualified to assess the criteria, diagnoses DCD.⁠⁷ Ideally the team includes a physician, such as a developmental pediatrician, child neurologist or child psychiatrist, and an occupational or physical therapist.⁠¹ The assessment usually includes:

• A history and physical exam, to rule out other causes such as cerebral palsy, muscular dystrophy, arthritis or the side effects of medicines.⁠^1,2
• A questionnaire such as the 15-item Developmental Coordination Disorder Questionnaire, which helps identify DCD in children aged 5 to 15.⁠¹
• A standardized motor test, usually the Movement Assessment Battery for Children (MABC-2) or the Bruininks-Oseretsky Test (BOT-2). A total score at or below the 16th percentile meets the motor criterion, and a score at or below the 5th percentile is clear evidence of DCD.⁠⁷
• How the difficulties affect daily life, at home, at school and at play.⁠³

At what age can dyspraxia be diagnosed?

Usually at age 5 or older, when the criteria can be applied more accurately, though signs may show much earlier.⁠³ Because young children’s motor development varies so much, the international guideline recommends diagnosing DCD before age 5 only when the impairment is severe, and then on at least two motor assessments at least 3 months apart.⁠⁷ DCD is often identified after age 5, when the demands of school make minor motor problems more noticeable.⁠¹⁴

Who can diagnose dyspraxia in a child?

A doctor, or a team that includes one where the law requires it.⁠⁷ In the US, physical therapists are not licensed to diagnose DCD on their own, but their examination can inform the diagnosis.⁠³ Once a doctor has ruled out other medical and neurological explanations, an occupational or physical therapist usually assesses the motor skills.⁠¹⁴

Is dyspraxia or DCD a learning disability?

No. DCD is a motor disorder: the DSM-IV-TR grouped it with learning disorders, but the DSM-5 classes it as a motor disorder within the neurodevelopmental disorders.⁠¹ Under IDEA, a specific learning disability excludes learning problems that are mainly the result of motor disabilities.⁠¹⁵

The two often go together, though. Specific learning disabilities occur in 17.8% to 27.5% of children with DCD,⁠¹ and some children with DCD do less well than their peers at school, especially in reading and math.⁠²

Is dyspraxia (DCD) a disability?

It can be, depending on how much it limits a person. Section 504 protects people with a physical or mental impairment that substantially limits a major life activity, such as caring for oneself, manual tasks, walking or learning.⁠¹⁶ Federal law defines a developmental disability as a severe, chronic disability that starts before age 22 and substantially limits at least three areas of major life activity, such as self-care, learning and mobility.⁠¹⁷ IDEA’s disability categories do not name DCD.⁠¹⁵

What conditions go with dyspraxia?

DCD often comes with other conditions:⁠¹

• ADHD, the most frequent. Several studies, mostly of clinical samples, suggest that 50% or more of children with DCD have it.⁠²
• Specific language impairment, in up to 70% (see speech and language).⁠¹
• Specific learning disabilities, in 17.8% to 27.5%.⁠¹
• Anxiety, in 16.7% to 33.8%, and depression, in 9.1% to 11.8%.⁠¹
• Autism, in 4.1% to 8.2%.⁠¹
• Childhood apraxia of speech, which commonly occurs with DCD.⁠¹⁸

Physical health is affected too. Children with DCD tend to have lower fitness, strength and endurance and to be less active,⁠¹⁹ and they are more likely to be overweight or to have hypermobile joints.⁠¹ On average they also have more anxiety and depression symptoms than their peers.⁠²⁰

Does dyspraxia affect executive function?

Often, yes. A 2022 meta-analysis found deficits in children with DCD across inhibitory control, visual and verbal working memory, and shifting attention.⁠¹² Into adulthood, people with DCD report problems planning ahead and managing money,⁠¹ and young adults and their parents name executive functioning and social skills as key concerns.⁠²¹

Is dyspraxia linked to low muscle tone?

Sometimes. Low muscle tone or loose joints, balance problems and low physical activity are often seen with DCD, but significant hypotonia is a red flag that needs prompt referral to a doctor (see hypotonia).⁠³

What is the treatment for developmental dyspraxia?

Therapy that practices the activities a child needs and wants to do. The international guideline recommends activity- and participation-oriented approaches to improve motor skills, its strongest grade of recommendation (level A),⁠⁷ and the 2026 APTA guideline strongly recommends task-oriented approaches guided by the child’s goals.⁠³ The two task-oriented approaches with the strongest evidence are motor skill training and CO-OP.⁠³

Approaches that train underlying processes instead of the task itself (process-oriented approaches) are not recommended for improving motor performance. In a 2013 meta-analysis their effect was weak (d = 0.12), against strong effects for task-oriented intervention (d = 0.89).⁠⁸ Evidence for supplements is insufficient.⁠⁸

Fitness, such as strength, endurance and flexibility, should be part of planning therapy, and family, teachers and others should be involved so the child gets enough practice in everyday settings.⁠⁷

Does therapy for dyspraxia work?

For motor skills, yes, with caveats. A 2025 meta-analysis of 32 randomized trials found that motor-based therapy improved overall motor skills (g = 1.00) and balance (g = 0.57).⁠⁴ It found no significant improvement in fine motor skills or in psychosocial outcomes, and only one small study measured participation.⁠⁴ A 2017 Cochrane review of task-oriented interventions was more cautious, with very little confidence in the size of the effect.⁠²²

In practice: therapy reliably improves the movements a child practices. It has not been shown, on its own, to change how much a child takes part with friends or how they feel about themselves.⁠⁴

Is sensory integration therapy good for dyspraxia?

The evidence is inconclusive. The international guideline found inconclusive evidence for sensory integration therapy, and for kinesthetic training, in DCD,⁠⁷ and process-oriented approaches as a group are not recommended for improving motor performance.⁠⁸

What is CO-OP therapy for dyspraxia?

CO-OP (Cognitive Orientation to daily Occupational Performance) is a task-oriented approach in which the child chooses their own goals and discovers strategies to reach them.⁠²³ Rather than giving instructions, the therapist uses questions and coaching so the child finds their own solutions.⁠²³

At its core is a four-step strategy the child learns to use on their own: Goal (what I want to do), Plan (how I will do it), Do (try the plan) and Check (did it work, and what should change).⁠²³

What happens in CO-OP sessions?

• Before therapy: the child sets the goals; in one trial, three motor goals of their own.⁠^23,24
• Session 1: the therapist teaches Goal–Plan–Do–Check.⁠²³
• Sessions 2 to 10: the child practices using the strategy on each goal, and works out specific strategies with the therapist’s guidance.⁠²³
• Last session: the goals are reviewed and progress is evaluated.⁠²³

Most studies used 10 weekly one-hour sessions.⁠²³ Parents learn the approach too, so they can support it in everyday life,⁠²³ and in one randomized trial they kept a logbook of practice at home.⁠²⁴ In that trial of children aged 8 to 12, children kept their gains 3 months after treatment, and CO-OP worked as well for children with DCD and ADHD as for those with DCD alone.⁠²⁴

Physical therapists need extra training to use CO-OP in full.⁠³

Occupational therapy and physical therapy for dyspraxia

Both professions treat DCD with task-oriented approaches.⁠^3,24 An occupational therapist often gives strategies for handwriting and other classroom tasks, tips to make dressing and feeding easier, activities to improve coordination, and ideas for leisure and sports.⁠⁶ A physical therapist focuses on motor skills, fitness and physical activity, and can contribute to the diagnosis.⁠³

Read more: occupational therapy for dyspraxia and physical therapy for dyspraxia.

What happens in a therapy session for DCD?

Task-oriented sessions share common principles: practicing a task in parts and then as a whole, many repetitions of the specific task, practice in different places and situations, gradually harder demands, guided self-discovery (for example, watching video of their own practice), and the right kind of feedback.⁠³

How much therapy does a child with DCD need?

The APTA guideline does not set one dose. It suggests enough sessions to reach about 100 minutes of practice a week for an average of 9 weeks per goal, combining therapy with practice at home and school: for example, one or two therapy sessions a week plus a home program.⁠³ In the international guideline’s review, effective programs lasted 10 weeks on average, and longer programs (20 to 30 hours) did not do better than shorter ones (10 to 15 hours).⁠⁷

How can school help a child with dyspraxia?

School is where much of DCD shows, and practice there works. A 2026 meta-analysis of school-based motor skill programs found large gains in motor performance (g = 1.06), largest with practice at least 3 times a week and at least 500 minutes in total; programs led by teachers did better than those run by outside staff.⁠²⁵ In the Partnering for Change model, an occupational therapist works with teachers and parents to change the child’s daily environment.⁠²⁶

Classroom changes CanChild suggests:

• Extra time for fine motor work such as math, writing and art, and a less neat product accepted when speed matters.⁠⁶
• Prepared worksheets when copying is not the point of the lesson.⁠⁶
• A computer as early as possible, to reduce handwriting in later grades.⁠⁶
• Other ways to show learning, such as oral reports, drawings or typed work.⁠⁶
• Extra time or computer access for tests that need a lot of writing.⁠⁶

In physical education:

• Break activities into smaller parts that are meaningful and achievable.⁠⁶
• Choose activities the child can succeed at least half the time, and reward effort, not skill.⁠⁶
• Make participation, not competition, the goal.⁠⁶

Our resources for teachers include material you can share with the school.

Can a child with dyspraxia get an IEP or a 504 plan?

Possibly. IDEA’s disability categories do not name DCD, so eligibility for special education rests on the school’s evaluation, and a child who needs only a related service, and not special education, generally does not qualify under IDEA.⁠¹⁵ Section 504 covers students whose impairment substantially limits a major life activity, such as manual tasks, caring for oneself or learning.⁠¹⁶ Some children need an individualized plan, while classroom changes are enough for others.⁠⁶ See IEPs and 504 plans.

How can parents help a child with dyspraxia at home?

• Practice the real task, often. Practice between sessions is part of effective therapy: the international guideline calls for family support to create chances to practice,⁠⁷ and home programs are part of the APTA practice schedule.⁠³
• Teach new skills in small steps. CanChild advises breaking an activity into smaller parts and keeping the setting predictable at first, then changing it gradually.⁠⁶
• Keep your child active. Children with DCD tend to lose fitness over time,⁠⁵ and many prefer, and do better at, individual sports such as swimming, running, cycling or skiing than team sports.⁠⁶
• Use active video games as an add-on only. They should not replace other physical activity.⁠³
• Praise effort. Children whose DCD is not recognized are often seen as lazy or unmotivated.⁠⁶
• Watch mood as well as movement. Children with DCD have more anxiety and depression symptoms on average, and routine screening for emotional difficulties is recommended.⁠²⁰

Does dyspraxia go away?

Usually not completely. Children with DCD do not simply outgrow it,⁠¹ and in many cases it persists into adolescence, with 50% to 70% of children still having motor difficulties.⁠² Follow-up studies describe two paths, persistence and catching up,⁠²⁷ and in a 10-year follow-up most children still had coordination difficulties, poor self-concept and problems at school, though they differed in how well they had learned to cope.⁠²⁸

Dyspraxia in teens and adults

The 2019 international guideline was the first to make recommendations for adolescents and adults with DCD. Most young people and adults with DCD benefit from individual support, for example to learn specific skills for daily life, study or work, such as using tools, keyboarding or driving.⁠² In young adulthood, handwriting can remain a problem while self-care often is not.⁠²¹ DCD can be diagnosed even when it was not identified until adolescence or adulthood, as long as symptoms began in childhood.⁠⁷

Dyspraxia vs. apraxia, dysgraphia and somatodyspraxia

Three other terms are often mixed up with dyspraxia.

Is dyspraxia the same as apraxia of speech?

No. Childhood apraxia of speech (CAS) is a speech sound disorder: the child has trouble planning and programming the movements for speech, even though reflexes and muscle tone are typical.⁠¹⁸ Some professionals still call it developmental verbal dyspraxia, which is why the words get mixed up.⁠¹⁸ DCD affects coordination more broadly, and the two can occur together.⁠¹⁸ See apraxia of speech and speech therapy for verbal dyspraxia.

What is the difference between dyspraxia and dysgraphia?

Dysgraphia is a problem with writing: letter formation, spacing, spelling, speed, grammar or composition. The DSM-5 places it under specific learning disorder rather than defining it as a separate disorder,⁠²⁹ while DCD is a motor disorder.⁠¹ They overlap: around half of people with DCD also have impaired writing.⁠²⁹ See dysgraphia.

What is the difference between dyspraxia and somatodyspraxia?

Somatodyspraxia comes from sensory integration theory, not the DSM. In Ayres Sensory Integration it is a pattern linking praxis, the planning of unfamiliar actions, with how a child perceives touch, and these patterns are not meant as diagnoses.⁠³⁰ A proposed classification of sensory processing disorder also uses “dyspraxia” for difficulty planning and sequencing movements, as a subtype of sensory-based motor disorder, beside postural disorder.⁠³¹ Neither is the same as a DCD diagnosis. See sensory-based motor disorder and postural disorder.

What are the myths about dyspraxia?

• Myth: dyspraxia is just clumsiness. DCD is a formal diagnosis in the DSM-5, and it is diagnosed only when the motor problems interfere with daily life.⁠^2,3
• Myth: children grow out of it. Children do not simply outgrow DCD, and many still have motor difficulties as teens.⁠^1,2
• Myth: a child with dyspraxia is lazy. Children whose DCD is not recognized are often seen as lazy or unmotivated.⁠⁶
• Myth: dyspraxia comes from low intelligence. DCD is diagnosed only when intellectual disability does not better explain the motor problems,⁠³ and children with DCD usually have normal or above-average intellectual abilities.⁠⁹
• Myth: drills for underlying skills are the best therapy. Process-oriented approaches are not recommended; practicing the task itself works better.⁠⁸

RelatedOccupational therapyPhysical therapySpeech therapyOccupational Therapy for Dyspraxia (DCD) in ChildrenPhysical Therapy for Dyspraxia (DCD): A Parent's GuideSpeech Therapy for Verbal Dyspraxia (Apraxia of Speech)

Sources

1. Harris SR, Mickelson ECR, Zwicker JG. Diagnosis and management of developmental coordination disorder. Canadian Medical Association Journal. 2015;187(9):659–665. doi:10.1503/cmaj.140994 (PMID 26009588).
   Show the passageHide the passage

   “The acquisition and execution of coordinated motor skills is substantially below that expected given the individual’s chronological age and opportunity for skill learning and use. Difficulties are manifested as clumsiness (e.g., dropping or bumping into objects)”; in DSM-IV-TR it was under “learning disorders”, and “in DSM-5, it is subcategorized as a motor disorder”; the team “should include a physician (e.g., child psychiatrist, developmental pediatrician, child neurologist) and an occupational therapist or physical therapist”; the “15-item questionnaire helps to identify children 5–15 years old”; “Although some children with developmental coordination disorder may have delayed motor milestones, many do not”; risk factors include “very preterm birth (OR 6.28”, small for gestational age and “independent walking at 15 months or later”; co-occurring: ADHD (50%), specific language impairment (up to 70%), specific learning disabilities (17.8%–27.5%), anxiety (16.7%–33.8%), depression (9.1%–11.8%), autism (4.1%–8.2%); hypermobility and overweight are secondary consequences; children with the disorder do not outgrow it; in adulthood, “executive functioning (e.g., planning ahead and managing money) continued to be compromised”.
2. Blank R, Barnett AL, Cairney J, Green D, Kirby A, Polatajko H, 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). European Academy of Childhood Disability guideline.
   Show the passageHide the passage

   “the term ‘dyspraxia’ has not become recognized as a separate entity or subgroup of DCD. The international consensus does not recommend use of the term ‘dyspraxia’”; the Dyspraxia Foundation (UK)’s definition “is broader than that for DCD, including various non‐motor difficulties”; DCD is “the first condition identified under a subsection called Motor Disorders”; “Current prevalence estimates for DCD range from 2% to 20% of children, with 5% to 6% being the most frequently quoted percentage in the literature”; “DCD is more common in males than in females, with male:female ratios varying from 2:1 to 7:1”; ADHD is “the most frequent co‐occurring disorder with DCD”, at “a rate of 50% or higher” in several studies; “50% to 70% of children continuing to have motor difficulties” into adolescence; the diagnosis is not possible “if the motor deficit is probably due to a lack of practice”; “Studies of adults with DCD reveal continuing difficulties with a range of motor skills and when learning new skills, such as driving”; “The first international recommendations to consider adolescents and adults with DCD”; “most young people and adults with DCD benefit from individualized support”. Valid, by its own terms, “at the latest until 31st December 2022”.
3. Sargent B, Mueller M, Iverson E, Frazier M, Kaplan SL. Physical therapy management of children with developmental coordination disorder: a 2026 evidence-based clinical practice guideline from the American Physical Therapy Association Academy of Pediatric Physical Therapy. Pediatric Physical Therapy. 2026;38(2):296–333. doi:10.1097/pep.0000000000001284 (PMID 42047444).
   Show the passageHide the passage

   DCD “affects 5% of school-age children”; the DSM-5-TR criteria B to D; “A formal diagnosis of DCD is typically made when a child is 5 years of age or older”; “PTs in the United States are not licensed to independently diagnose DCD”; early indicators include “frequent tripping (clumsy gait), less participation during recess, decreased endurance with physical activity”; “Physical conditions frequently associated with DCD include hypotonicity or joint laxity, balance deficits”; red flags requiring immediate referral: “history of trauma, headaches or blurred vision, deterioration in motor skills, or significant hypertonia or hypotonia”; PTs should use task-oriented approaches “guided by the child’s goals and meaningful activities” (strong); “The 2 task-oriented approaches with the strongest evidence are motor skill training” and CO-OP; the principles of task-oriented practice; “PTs require additional training to use CO-OP in its entirety”; “a cumulative practice schedule of 100 minutes per week for an average of 9 weeks”; active video gaming has “low-quality evidence”, and PTs must educate families “not to displace AVG with other productive physical activities”.
4. Gao J, Yang Y, Xu X, Huang D, Wu Y, Ren H, 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).
   Show the passageHide the passage

   “A total of 32 studies were included in the meta-analysis”; motor-based interventions “significantly improved the overall motor skills (g = 1.00” and “balance function (g = 0.57”; improvements in “psychosocial factors” “were not significant, nor were improvements in children’s participation levels observed”; “the effect on fine motor skills” was not significant; “Only 1 study (12 participants)” reported participation.
5. CanChild Centre for Childhood Disability Research, McMaster University. Causes and identification (developmental coordination disorder). Checked October 6, 2026.
   Show the passageHide the passage

   “it is not yet possible to offer a clear answer about what causes DCD”; researchers suggest “a possible link between the cerebellum and the challenges seen with DCD”; early signs as “the child tries to manage a spoon, manipulate a toy, pedal a tricycle or scribble with a crayon”; DCD may be suspected if the child “moves awkwardly”, “frequently trips, or drops things” or “prints or writes poorly, and with much effort”; “children with DCD are commonly not recognized until their difficulties begin to affect their schoolwork”; they “have been noted to lose physical fitness over time”.
6. Missiuna C. Children with developmental coordination disorder: at home and in the classroom (CanChild, McMaster University; booklet, 2003). Checked October 6, 2026.
   Show the passageHide the passage

   The child “may bump into, spill, or knock things over”; may be delayed in skills “such as tricycle or bike riding, ball catching, handling a knife and fork, doing up buttons, and printing”; “Once learned, certain motor skills may be performed quite well while others may continue to be performed poorly”; daily living difficulties such as “folding clothes, tying shoelaces, doing up buttons and zippers”; “An Individualized Education Plan may be needed for some children; however, the following modifications may be sufficient for others”: extra time for fine motor work, prepared worksheets, “Introduce computers as early as possible”, other ways to show learning, “Provide additional time, and/or computer access, for tests and exams”; in physical education, “Break down the gym activity into smaller parts”, choose activities with success “at least 50% of the time. Reward effort, not skill”, “Make participation, not competition, the major goals”; many prefer “individual sports (e.g., swimming, running, bicycling, skiing)”; the OT may give “tips to make dressing and feeding easier” and “ideas for community leisure and sports activities”; unrecognized children “are often perceived to be lazy or unmotivated”; “most children do not outgrow these problems”. Practical guidance, not trial evidence.
7. Blank R, Barnett AL, Cairney J, Green D, Kirby A, Polatajko H, et al. International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder: pocket version (Appendix S1, supporting information). Developmental Medicine & Child Neurology. 2019;61(3):242–285. doi:10.1111/dmcn.14132 (PMID 30671947).
   Show the passageHide the passage

   “For clinical and educational purposes we recommend the term DCD”; R2, the diagnosis is made “by a medical professional or a multi-professional team”; “we recommend that a formal diagnosis of DCD under the age of 5 years is only made in cases of severe impairment”, then on “at least two motor assessments carried out at least 3 months apart”; “Onset of symptoms in childhood (although not always identified until adolescence or adulthood)”; the symptoms “may include slowness and/or inaccuracy of motor skills”; on the MABC-2 or an equivalent test, “the 16th centile (1 SD) for the total score” is the cut-off, and “Scores at or below the fifth centile should be considered as unequivocal evidence of DCD”; R12 suggests the MABC-2 or the BOT-2; R22 recommends “activity-oriented and participation-oriented approaches” (level A), which “should involve family, teacher, significant others, and/or environmental support”; “the evidence is inconclusive for the effectiveness of sensory integration therapy” and for kinesthetic training; “Mean duration of new effective studies was 10 weeks”, and “long training protocols (20–30h) do not seem to be more effective than shorter ones (10–15h)”; R25, active video games as “a useful adjunct”; R26, physical fitness “is considered as part of intervention planning”; in some countries “the diagnosis can only be made by a medical doctor”.
8. Smits-Engelsman BCM, Blank R, van der Kaay AC, Mosterd-van der Meijs R, Vlugt-van den Brand E, Polatajko HJ, et al. Efficacy of interventions to improve motor performance in children with developmental coordination disorder: a combined systematic review and meta-analysis. Developmental Medicine & Child Neurology. 2013;55(3):229–237. doi:10.1111/dmcn.12008 (PMID 23106530).
   Show the passageHide the passage

   “A comparison between classes of intervention showed strong effects for task-oriented intervention (d(w) =0.89) and physical and occupational therapies (d(w) =0.83), whereas that for process-oriented intervention was weak (d(w) =0.12)”; “Process-oriented approaches are not recommended for improving motor performance in DCD, whereas the evidence for chemical supplements for children with DCD is currently insufficient for a recommendation.”
9. CanChild Centre for Childhood Disability Research, McMaster University. Developmental coordination disorder. Checked October 6, 2026.
   Show the passageHide the passage

   “Children with DCD usually have normal or above average intellectual abilities. However, their motor coordination difficulties may impact their academic progress, social integration and emotional development”; earlier labels include “developmental dyspraxia, minimal brain dysfunction, perceptuo-motor dysfunction, physically awkward”; “Motor milestones are often not delayed; the delay is usually in the acquisition of motor skills”.
10. National Center for Health Statistics (CDC). ICD-10-CM tabular list and index, FY2027 (code files). “F82 Specific developmental disorder of motor function Clumsy child syndrome Developmental coordination disorder Developmental dyspraxia”. Checked October 6, 2026.
11. Lingam R, Hunt L, Golding J, Jongmans M, Emond A. Prevalence of developmental coordination disorder using the DSM-IV at 7 years of age: a UK population-based study. Pediatrics. 2009;123(4):e693–e700. doi:10.1542/peds.2008-1770 (PMID 19336359).
    Show the passageHide the passage

    “A prevalence of 1.7% is lower than studies that have not taken into account the impact of poor motor coordination on daily living”; 222 more children had “probable developmental coordination disorder”; risk was higher “in families from lower socioeconomic backgrounds, in children with a birth weight of <2500 g, and those born before 37 weeks’ gestation”.
12. Subara-Zukic E, Cole MH, McGuckian TB, Steenbergen B, Green D, Smits-Engelsman BCM, et al. Behavioral and neuroimaging research on developmental coordination disorder (DCD): a combined systematic review and meta-analysis of recent findings. Frontiers in Psychology. 2022;13:809455. doi:10.3389/fpsyg.2022.809455 (PMID 35153960).
    Show the passageHide the passage

    One hundred studies; deficits in “voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning” and “atypical neural structure and function across sensori-motor and prefrontal regions”; “Quite pervasive deficits of executive function were observed in DCD across inhibitory control, visual and verbal working memory, and executive attention (or set shifting)”.
13. Edwards J, Berube M, Erlandson K, Haug S, Johnstone H, Meagher M, et al. Developmental coordination disorder in school-aged children born very preterm and/or at very low birth weight: a systematic review. Journal of Developmental & Behavioral Pediatrics. 2011;32(9):678–687. doi:10.1097/dbp.0b013e31822a396a (PMID 21900828).
    Show the passageHide the passage

    Children born very preterm (<32 weeks) or at very low birth weight (<1500 g) had “a significant increase in the likelihood of DCD”, with odds ratios of 6.29 and 8.66 for scores below the 5th and between the 5th and 15th percentiles.
14. CanChild Centre for Childhood Disability Research, McMaster University. Assessment and diagnosis (developmental coordination disorder). Checked October 6, 2026.
    Show the passageHide the passage

    A family doctor or pediatrician first makes sure “that the movement problems are not due to any other physical, neurological, or behavioural disorders”; then “an assessment by an occupational therapist (OT) and/or physical therapist (PT) would be helpful”; “DCD is commonly identified and diagnosed after age 5, when minor motor problems (often noted when the child was young) are made more noticeable by the structured demands of a school environment”.
15. Code of Federal Regulations, 34 CFR §300.8, Child with a disability (IDEA). Checked October 6, 2026.
    Show the passageHide the passage

    The categories (“an intellectual disability, a hearing impairment” and the rest) do not name DCD; “Specific learning disability does not include learning problems that are primarily the result of visual, hearing, or motor disabilities”; a child who “only needs a related service and not special education” is not a child with a disability under the part, unless the related service counts as special education under State standards. Text as published in the eCFR (up to date as of October 5, 2026).
16. Code of Federal Regulations, 34 CFR §104.3, Definitions (Section 504 of the Rehabilitation Act). Checked October 6, 2026.
    Show the passageHide the passage

    The regulation’s term is “handicapped person”: one who “has a physical or mental impairment which substantially limits one or more major life activities”; “Major life activities means functions such as caring for one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working.” Text as published in the eCFR (up to date as of October 5, 2026).
17. United States Code, 42 U.S.C. §15002, Definitions (Developmental Disabilities Assistance and Bill of Rights Act; 2024 edition, govinfo). Checked October 6, 2026.
    Show the passageHide the passage

    A developmental disability is “a severe, chronic disability” that “is manifested before the individual attains age 22”, “is likely to continue indefinitely” and causes “substantial functional limitations in 3 or more of the following areas of major life activity”, including self-care, language, learning and mobility.
18. American Speech-Language-Hearing Association. Childhood apraxia of speech (Practice Portal). Checked October 6, 2026.
    Show the passageHide the passage

    “Childhood apraxia of speech (CAS) is a pediatric neurological speech sound disorder”, with “reflexes are intact and muscle tone is typical”; the impairment is “due to difficulty planning and/or programming” speech movements; some professionals still call it “developmental apraxia of speech” or “developmental verbal dyspraxia”; developmental coordination disorder is among the motor problems that commonly co-occur.
19. Rivilis I, Hay J, Cairney J, Klentrou P, Liu J, Faught BE. Physical activity and fitness in children with developmental coordination disorder: a systematic review. Research in Developmental Disabilities. 2011;32(3):894–910. doi:10.1016/j.ridd.2011.01.017 (PMID 21310588).
    Show the passageHide the passage

    Forty studies: “body composition, cardiorespiratory fitness, muscle strength and endurance, anaerobic capacity, power, and physical activity have all been negatively associated, to various degrees, with poor motor proficiency”.
20. Omer S, Jijon AM, Leonard HC. Research review: internalising symptoms in developmental coordination disorder: a systematic review and meta-analysis. Journal of Child Psychology and Psychiatry. 2019;60(6):606–621. doi:10.1111/jcpp.13001 (PMID 30485419). “A significant, moderate effect of DCD on internalising symptoms was found (g = 0.61)”; “This highlights the importance of routine screening for emotional difficulties in DCD”.
21. Kirby A, Edwards L, Sugden D. Emerging adulthood in developmental co-ordination disorder: parent and young adult perspectives. Research in Developmental Disabilities. 2011;32(4):1351–1360. doi:10.1016/j.ridd.2011.01.041 (PMID 21334175).
    Show the passageHide the passage

    “some motor skills such as handwriting continue to impact in emerging adulthood, not all skills are as problematic, such as self-care skills”; “executive functioning, and social skills seem to be a key areas of concern for both young adults and their parents”.
22. Miyahara M, Hillier SL, Pridham L, Nakagawa S. Task-oriented interventions for children with developmental co-ordination disorder. Cochrane Database of Systematic Reviews. 2017;(7):CD010914. doi:10.1002/14651858.cd010914.pub2 (PMID 28758189). Fifteen studies; “We have very little confidence in the effect estimate”; “The conclusions drawn from previous reviews, which unanimously reported beneficial effects of intervention, are inconsistent with our conclusions.”
23. Gimeno H, Polatajko H. The Cognitive Orientation to daily Occupational Performance approach in childhood-onset disabilities. Developmental Medicine & Child Neurology. 2025;67(8):977–985. doi:10.1111/dmcn.16260 (PMID 40033547).
    Show the passageHide the passage

    CO-OP “involves client-chosen functional goals” and “guiding the discovery of cognitive strategies”; “Rather than providing direct instruction, the CO‐OP therapist facilitates clients to find their own solutions to their own problems”; the global strategy “Goal‐Plan‐Do‐Check”; “Phase 2 is the acquisition phase, which generally comprises 10 intervention sessions”; “The first session involves teaching the global strategy Goal–Plan–Do–Check”; in the last session “the goals are reviewed, and progress is evaluated”; parents learn the approach to “support the use of the intervention’s key features in everyday life”; most individual studies used “10 hourly sessions weekly”.
24. Izadi-Najafabadi S, Gunton C, Dureno Z, Zwicker JG. Effectiveness of Cognitive Orientation to Occupational Performance intervention in improving motor skills of children with developmental coordination disorder: a randomized waitlist-control trial. Clinical Rehabilitation. 2022;36(6):776–788. doi:10.1177/02692155221086188 (PMID 35466705).
    Show the passageHide the passage

    Children aged 8 to 12 chose “three personal motor goals”; CO-OP was given by registered occupational therapists, “once weekly for one hour” over 10 weeks; “Parents were provided with a logbook” for home practice; “Three months after treatment, children maintained their gains”; it was “similarly effective for children with developmental coordination disorder with/without attention deficit hyperactivity disorder”.
25. Pohjanvirta A, Pöyliö T, Robinson K, Asunta P, Huovinen T, Lubans DR, et al. School-based motor skill interventions for children and adolescents with developmental coordination disorder: a systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation. 2026 (published ahead of print). doi:10.1016/j.apmr.2026.06.004 (PMID 42285334).
    Show the passageHide the passage

    “We found a large effect on motor performance (Hedges g=1.06”; “training frequency of at least 3 times a week and total dose of at least 500 minutes yielding the largest effects”; “teacher-led interventions showing larger effects”.
26. Missiuna CA, Pollock NA, Levac DE, Campbell WN, Whalen SDS, Bennett SM, et al. Partnering for Change: an innovative school-based occupational therapy service delivery model for children with developmental coordination disorder. Canadian Journal of Occupational Therapy. 2012;79(1):41–50. doi:10.2182/cjot.2012.79.1.6 (PMID 22439291).
    Show the passageHide the passage

    “The model emphasizes the partnership of the occupational therapist with educators and parents to change the life and daily environment of a child.”
27. Cantell MH, Smyth MM, Ahonen TP. Two distinct pathways for developmental coordination disorder: persistence and resolution. Human Movement Science. 2003;22(4–5):413–431. doi:10.1016/j.humov.2003.09.002 (PMID 14624826). Finnish adolescents first assessed at age 5: “two developmental paths for those with early perceptual motor problems: ‘persistence’ and ‘catching up’”.
28. Losse A, Henderson SE, Elliman D, Hall D, Knight E, Jongmans M. Clumsiness in children: do they grow out of it? A 10-year follow-up study. Developmental Medicine & Child Neurology. 1991;33(1):55–68. doi:10.1111/j.1469-8749.1991.tb14785.x (PMID 1704864).
    Show the passageHide the passage

    Seventeen children identified at age six: “the majority of children still have difficulties with motor co-ordination, have poor self-concept and are experiencing problems of various kinds in school”, with “individual differences in the extent to which the children have learned to cope”.
29. Chung PJ, Patel DR, Nizami I. Disorder of written expression and dysgraphia: definition, diagnosis, and management. Translational Pediatrics. 2020;9(Suppl 1):S46–S54. doi:10.21037/tp.2019.11.01 (PMID 32206583).
    Show the passageHide the passage

    Dysgraphia covers “problems with letter formation/legibility, letter spacing, spelling, fine motor coordination, rate of writing, grammar, and composition”; the DSM-5 “includes dysgraphia under the specific learning disorder category, but does not define it as a separate disorder”; “around half of those with DCD also exhibit impaired writing abilities”.
30. Botha M, van der Linde J, Mailloux Z. Patterns recognized in Ayres Sensory Integration: a scoping review. Brain Sciences. 2026;16(7):700. doi:10.3390/brainsci16070700 (PMID 42512475).
    Show the passageHide the passage

    “Praxis refers to the use of sensory information in the planning and execution of goal-directed tasks”; somatodyspraxia “reflects the strong association between the praxis tests and the perception of temporal and spatial qualities of tactile input”; “the patterns are not intended as diagnoses or labels”.
31. Miller LJ, Nielsen DM, Schoen SA, Brett-Green BA. Perspectives on sensory processing disorder: a call for translational research. Frontiers in Integrative Neuroscience. 2009;3:22. doi:10.3389/neuro.07.022.2009 (PMID 19826493). A proposed classification: “Within sensory-based motor disorder two subtypes are proposed: Postural disorder, which reflects problems in balance and core stability, and dyspraxia, which encompasses difficulties in motor planning and sequencing movements.”

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. Sensory and motor concerns are best assessed by an occupational or physical therapist who can evaluate your individual child.