Dyspraxia (DCD): coordination & everyday skills

The formal diagnosis is developmental coordination disorder (DCD). “Dyspraxia” is widely used, especially in the UK, but there is no international agreement on exactly what it means.

Health professionals often prefer “DCD” because “dyspraxia” can also describe movement problems that start later, after a stroke or head injury.

DCD can affect

• Fine motor skills, like using a pencil or doing buttons
• Gross motor skills, like kicking a ball or climbing stairs
• Motor planning, like the many steps of tying a shoe

Children with DCD can learn some movement tasks well, but find it hard to pick up new skills expected for their age. Their early milestones are often on time; the delay is usually in learning motor skills.

The words are sometimes mixed up. With apraxia, a person can’t do a movement at all, even though they understand and want to. Dyspraxia is a partial difficulty doing movements accurately.

It can look like

• Later rolling, sitting, crawling or walking
• Trouble with stacking cups and similar toys
• Taking longer to learn to use a spoon or fork
• Taking longer to feed themselves or get dressed

It can look like

• Bumping into things or falling often
• Drawing, coloring and writing behind others their age
• Trouble with scissors
• Trouble jumping, catching, throwing or kicking a ball
• Trouble with stairs and balance

It can look like trouble with

• Brushing teeth
• Buttons and zips
• Getting dressed
• Tying shoelaces

As children get older, written work can become a bigger challenge, and learning may feel harder even though intelligence isn’t affected. Some children start avoiding sports and active play.

Some also seem restless, with lots of arm or leg movement.

Adults may find these harder

• Balance and judging space, like bumping into or dropping things
• Driving and playing sport
• Tying shoelaces and using small tools

Learning new skills, remembering information, and planning and organising time can all be harder for adults with dyspraxia.

Ideas that can help

• Calendar alerts for every appointment
• Checklists for routines you do often
• One set place for keys, wallet and phone
• Written notes after meetings or conversations

The NHS notes that adults with dyspraxia can find social situations and managing emotions harder. Anxiety and depression can come along too.

Examples of adjustments

• A quieter place to work
• Extra time for reading and tasks
• Speech-to-text for writing tasks
• Written as well as spoken instructions

In the U.S., the Job Accommodation Network (JAN) gives free, confidential advice on job changes and the ADA. Visit askjan.org or call (800) 526-7234.

Children who avoid active play can end up in a cycle: they withdraw, get less fit, and have fewer chances to play and make friends. Encouraging an active life helps break that cycle.

Motor difficulties can affect school progress, friendships and emotional development.

Ideas that help

• Arrange play around things they enjoy, like building, music or board games
• Invite one friend at a time to start
• Practise a playground game at home first, without an audience

Good therapy plans focus on confidence as well as movement. Ongoing encouragement and noticing progress are a big part of support.

Ideas that help

• Celebrate small wins, like a first zipped coat
• Make room for things they shine at
• Name the effort: “You kept trying, even when it was hard.”

For adults, the NHS says talking therapies such as CBT or mindfulness may be recommended. Anxiety and depression are more common with dyspraxia and deserve care of their own.

DCD is more likely with

• Being born before 37 weeks, and more so before 32 weeks
• A family history of DCD
• Low birth weight

The NHS also lists alcohol or drug use during pregnancy as a risk factor. Many children with DCD have none of these risk factors.

DCD often comes with

• ADHD
• Anxiety and depression
• Autism
• Dysgraphia (writing)
• Language and speech delays
• Sensory processing differences
• Slow processing speed

Each needs its own support. See ADHD: understanding it, Dysgraphia: when writing is hard and Sensory overwhelm in everyday life.

Similar movement problems can come on later in life after a stroke, head injury or other neurological condition. This is different from developmental DCD.

The team may include

• A child psychologist
• An occupational or physical therapist
• A pediatric neurologist
• A pediatrician

There is no single medical test. The team looks at medical and developmental history, small and big movements, coordination, balance and thinking skills, and how much it affects daily life and school.

Other causes of movement difficulty, like cerebral palsy or muscular dystrophy, are ruled out first.

Adults can ask their family doctor about an assessment. It may cover your history, including childhood, how things affect daily life, and your movement, balance and coordination. Family, employers or teachers may be asked for input.

In the U.S., children with dyspraxia who are eligible may get an Individualized Education Program (IEP), and therapy services may be part of it.

Occupational therapy is the main treatment. Therapists work on everyday skills like holding scissors, writing or catching a ball, and find practical ways to manage tasks at home, school or work.

Physical therapy (physiotherapy) can build strength and support balance, coordination and posture, for children and adults.

Task-focused therapy picks the exact skills a person needs or wants, and teaches them directly. Hard movements are broken into smaller steps and practised regularly.

Research supports learning the specific tasks that are taught. Skills don’t always carry over to new tasks, so choose the ones that matter most.

One approach, called CO-OP (Cognitive Orientation to Occupational Performance), teaches skills alongside a simple talk-it-through plan. Children learn to spot the problem, try solutions and check how it went.

It has worked well in research clinics and shown some carry-over to other skills. Studies are still testing it in everyday settings.

Making a task easier is a valid part of support, like adding special grips to pens and pencils.

Examples

• A chair and desk at the right height
• A sloped writing surface, like a slant board
• An end locker, and time to learn how to open it
• Pencil grips and easy-grip or loop scissors
• Raised-line or graph paper

Examples

• A computer for written work
• Extra time for tests and writing
• Fill-in-the-blank worksheets to cut down copying
• Oral answers on tests
• Speech-to-text or a scribe
• Teaching notes shared ahead of time

Examples

• Extra time to get changed for gym or ready for recess
• Extra time to move between classes
• Movement breaks during the day
• Physical skills taught in small parts before a lesson

Try saying

• “Let’s break it into small steps.”
• “Your body is still learning this. That’s okay.”
• “Would a different tool make it easier?”
• “I saw how hard you worked on that.”

Try not to say

• “Be careful, you’re so clumsy.”
• “Hurry up, it’s just buttons.”
• “Why can’t you just catch it?”
• “Your writing is so messy.”

Comments like these can feed frustration and avoidance, which make anxiety and low mood more likely.

Activities with a repeated movement pattern, which don’t need constant split-second adjustments, are often successful once learned. These “lifestyle sports” bring health benefits for life.

Examples

• Cycling
• Running
• Skating
• Skiing
• Swimming

Sports where things change fast, like team ball games, are usually harder for people with DCD. That doesn’t mean they’re off-limits. It may just take more practice or a gentler league.

Ideas that help

• Choose activities for fun, not competition
• Let a coach or instructor know what helps
• Practise new skills in private first
• Try a few things before settling on one

• CanChild (McMaster University, Canada): canchild.ca, with DCD guides for families and teachers
• Center for Parent Information and Resources: parentcenterhub.org (find your free U.S. state Parent Center)
• Understood (from the National Center for Learning Disabilities): understood.org

In the UK, you can speak to a GP, health visitor, school nurse or special educational needs co-ordinator (SENCO). Adults in the UK may get help at work through Access to Work.