Dyspraxia/DCD

Children

Dyspraxia/DCD can be difficult to identify because it looks different from one child to the next. It may even differ from one day to the next.

Listed below are the diverse areas that may be impacted by Dyspraxia/DCD as well as what the child may experience. Remember, all children with Dyspraxia/DCD will have some difficulties with fine and/or gross motor skills. Other areas of impact may differ depending on the child.

Signs & Symptoms

How is Dyspraxia/DCD Diagnosed?

Who Can Help With Treatment?

Stories

Additional Resources for Children

Additional Resources for Parents

“Parents, educators, physicians, and therapists working with children with DCD must recognize how their quality of life is affected by the physical and emotional toll of their efforts to participate successfully in daily activities.”

Zwicker et al., 2017

Signs & Symptoms

Movement, Coordination & Motor Planning

Symptoms of Overlapping Conditions

Symptoms Other than Movement

Difficulties Living with Dyspraxia/DCD

Main Symptoms: Movement, Coordination & Motor Planning

Difficulty coordinating large (gross motor) and/or small (fine motor) body movements.

Possible history of:

Feeding difficulties as infant (struggling to coordinate mouth movements needed for effective sucking/swallowing)
Delayed developmental milestones (rolling over, sitting, walking)

May demonstrate:

Poor pencil grip
Messy handwriting
Difficulty using utensils and scissors
Avoids games and toys needing good hand dexterity
Immature Art work
Tendency to spill
Difficulty learning how to tie shoes
Difficulty learning how to ride a bike
Difficulty running, hopping, or jumping
Trouble tracking across a page
Slow and uncertain actions
Difficulty kicking or catching a ball
Trouble sitting still for long periods

Symptoms of Overlapping Conditions

Someone with Dyspraxia/DCD may have another diagnosis at the same time.

Focus

Concentrating and staying on task.

May:

Have a hard time in a whole class setting, but do significantly better on a one-to-one basis
Have limited attention span
Be Impatient and/or impulsive
Intrude in other people’s activities
Struggle to keep up with peers
Leave tasks unfinished
Forget or leave belongings behind

Speech & Language

Producing and using language.

May have been late in reaching speaking milestones.

May demonstrate:

Difficulty writing thoughts on paper
Inconsistent use of capitals and punctuation when writing
Immature handwriting
Difficulty explaining needs or answering a question
Difficulty retelling an incident

May:

Blurt things out or be slow to respond
Not know when to speak up
Not learn from past consequences

Sensory Processing

Responding to input from the senses.

May:

Be over or under sensitive to stimuli such as noise, light, feel of clothes, food textures
May avoid playing roughly or play too roughly
Eat only certain foods and refuse to try new foods
Have difficulty sitting still for long periods of time
Perform repetitive movements such as flapping, tapping, swinging feet, fidgeting

Symptoms Other Than Movement

Someone with Dyspraxia/DCD may have symptoms in addition to movement and coordination.

Visual Spatial Processing

Perceiving how far objects are from you and from each other.

May:

Bump into objects and people
Have difficulty tracking and/or skip words when reading
Struggle with 3D images
Be hesitant to use the stairs
Have difficulty following directional instructions with no understanding of in/on/behind/in front of
Have trouble with copying from the board.
Need lines on paper to guide writing across a page

Executive Function

Planning, monitoring, and executing tasks.

May:

Appear to not learn instinctively, must be taught skills.
Have trouble with math
Be generally poorly organized
Have trouble following sequential steps/instructions
Have trouble retelling a story
Have trouble organizing thoughts to put on paper
Planning, organizing, and carrying out daily chores

Working Memory

Remembering and using information for a short time.

May experience difficulty with:

Remembering instructions
Following instructions
Remembering something just read
Misplacing items and finding them

Difficulties of Living with Dyspraxia/DCD

The stress of living with Dyspraxia/DCD may lead to emotional or mental health issues.

Emotional Regulation

Managing one’s emotions and/or behavior.

May:

Exhibit immature behavior
Fit in to socially accepted behavior at school, but throw tantrums at home
Become overly excited quickly and take a while to settle down
Become upset easily, especially when unable to complete a task
Have difficulty coping with change

Social Interaction & Participation

Communicating and interacting with others.

May:

Find it difficult to keep friends or judge how to behave in company
Prefer the company of adults and struggle to maintain relationships with peers
Exhibit a growing awareness of difficulties, affecting confidence and self-esteem
Be susceptible to bullying

May not:

Pick up on non-verbal cues
Make eye contact when interacting with others

Mental Health

Experiencing emotional and psychological well-being.

May experience:

Depression
Anxiety
Distractibility
Obsessive and/or compulsive behavior
Lack of interest in preferred activities
Changes in school performance
Low self-esteem

Fatigue

Feeling tired or lacking energy.

May experience:

“Running out of steam” quickly
Lack of interest in activities
Irritability
Forgetfulness
Sleep difficulties, including wakefulness at night and nightmares
Avoidance of tasks
Frequent headaches and/or stomach aches

How is Dyspraxia/DCD Diagnosed?

Signs and symptoms will begin early in life, but a diagnosis may be made at any age.

A formal diagnosis will use criteria for Code 315.4 Developmental Coordination Disorder from The Diagnostic and Statistical Manual (DSM-5) or for Code 6A04 Developmental Motor Coordination Disorder (Developmental Dyspraxia) in the International Classification of Diseases (ICD-11), the global standard for diagnostic health information. For an official diagnosis, all the criteria in the DSM-5 or the ICD-11, which are fairly similar to each other, must be met.

Here is a high-level summary of the main diagnostic criteria:

Motor skills are significantly below the level expected for the individual’s age.
Lack of motor skills and coordination affects activities of daily life at home, school, and/or the workplace.
Symptoms were present early in life.
Difficulties with motor skills are not better explained by other medical conditions such as intellectual disability, neurological conditions or visual impairment.

In the United States, Dyspraxia/DCD must be diagnosed by a medical doctor (MD).

A diagnosis will include assessment of the following:

Medical history including development and symptoms
Gross and fine motor skills, coordination and balance
Other possible causes of motor difficulties.

Healthcare professionals providing input for a diagnosis may include:

Neurologist
Pediatric Neurologist
Neuropsychologist
Pediatrician
Developmental Pediatrician
Occupational Therapist
Physical Therapist
Psychologist

A diagnosis will include the following:

Interviewing the individual and their family members

to gather information about the individual’s history of coordination problems

Observing the individual's performance of everyday tasks

to assess their motor skills and coordination

Conducting a neurological examination

to rule out other conditions that may be causing the individual’s symptoms

Who Can Help With Treatment?

There is no cure, however there are therapies and treatments available to help an individual in reaching their goals and full potential.

The best treatments for Dyspraxia/DCD and overlapping conditions, with or without an official diagnosis, are therapies that support the individual’s needs:

Occupational Therapist

An occupational therapist helps develop skills specific to everyday activities at home, school, and work.

Physical Therapist

A physical therapist uses exercises, equipment, and hands-on therapy to help develop motor skills.

Developmental Optometrist

A developmental optometrist helps improve visual skills using exercises to strengthen the connection between the eyes and the brain.

Psychologist / Mental Health Professional

Psychological therapy can strengthen mental health by improving resilience in the face of challenges and by addressing issues such as depression and anxiety.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a structured, goal-oriented type of talk therapy used by mental health professionals to help people understand and change negative thought patterns and improve coping skills.

Neuropsychologist

In addition to providing assessments for diagnosis of Dyspraxia/DCD, a neuropsychologist may help individuals develop learning and coping strategies tailored to their individual needs.