Developmental Coordination Disorder (DCD) or Dyspraxia?
The terms used to describe children with coordination difficulties can be confusing; many different names have been used in recent years. The most common terms in the UK today are dyspraxia and developmental co-ordination disorder (DCD).
Broadly speaking, by definition DCD is used as an umbrella term to describe children with coordination difficulties; Currently, DCD is diagnosed when the child’s performance in daily activities that require motor co-ordination is well below that expected for the child’s age and measured intelligence and interferes with academic achievement or activities of daily living (DSM-IV, 1994). A smaller group of these children will also have an impairment or immaturity of the organisation of movement. (Dyspraxia Foundation, 1992). Associated with this there may be problems with language, perception and thought. This smaller group of children may be described as having dyspraxia.
In summary, the child with DCD knows what to do when asked to perform a movement but doesn’t do it very well, whereas the child with a praxis or planning problem (dyspraxia) doesn’t know what to do or how to perform the action.
In reality there is a lot of confusion as both names are used by professionals and the media to describe children with coordination difficulties regardless of whether the correct diagnostic criteria have been applied; hence the importance of a thorough assessment to ensure that intervention is child led and addresses the functional difficulties wherever they occur regardless of the label given.
How common is it?
Developmental coordination disorder (DCD), which includes those children with dyspraxia, is thought to affect up to 10% of the population to varying degrees, it is therefore possible that there is at least one or two child in every classroom with developmental coordination disorder who require specific support for their difficulties. It affects 4x as many boys than girls.
How do I know if my child has DCD?
If you are concerned that your child may have developmental coordination difficulties then take a look at the typical presentations described below. Children will of course have different patterns of these difficulties, i.e. some will have more of the fine motor difficulties; some will have more of the big movement problems; and others will have more of the processing, or organisational difficulties. There can therefore be considerable variance amongst those affected and any intervention needs to be carefully planned based on a comprehensive assessment of the child’s particular needs
What sorts of difficulties do children with DCD experience?
Fine motor difficulties:
Gross motor difficulties:
Eye movements
Associated difficulties
Children with DCD may also have other associated difficulties to a greater or lesser extent. Some other aspects of life that are commonly affected are:
Do children grow out of DCD?
Some do, but research shows that up to 50% of those more severely affected as children still have problems in their teenage years and into adulthood.
Although dyspraxia/ DCD is a life-long condition, early intervention and support can make a considerable difference to children in relation to how it impacts upon a child both in and outside of school. Early intervention can have a positive impact upon the social, emotional, physical and educational outcomes that can be achieved by children.
At the Banana Tree Practice we have a special interest in the assessment and treatment of DCD/Dyspraxia and are fortunate to be able to offer both Occupational Therapy and Physiotherapy input at the assessment and planning stage as well as when offering intervention. This reduces replication and ensures a comprehensive examination of the child’s needs, be they difficulties with fine or gross motor activities, posture and muscle tone, joint range of movement or more functional difficulties. We also believe it is important to liaise with other members of the multidisciplinary team involved with your child to ensure integrated treatment planning including seeing your child in school if requested. We can work together with you and your child’s teacher or support staff to fully implement the advice, treatment and strategies suggested into daily life, both at home and at school.
Broadly speaking, by definition DCD is used as an umbrella term to describe children with coordination difficulties; Currently, DCD is diagnosed when the child’s performance in daily activities that require motor co-ordination is well below that expected for the child’s age and measured intelligence and interferes with academic achievement or activities of daily living (DSM-IV, 1994). A smaller group of these children will also have an impairment or immaturity of the organisation of movement. (Dyspraxia Foundation, 1992). Associated with this there may be problems with language, perception and thought. This smaller group of children may be described as having dyspraxia.
In summary, the child with DCD knows what to do when asked to perform a movement but doesn’t do it very well, whereas the child with a praxis or planning problem (dyspraxia) doesn’t know what to do or how to perform the action.
In reality there is a lot of confusion as both names are used by professionals and the media to describe children with coordination difficulties regardless of whether the correct diagnostic criteria have been applied; hence the importance of a thorough assessment to ensure that intervention is child led and addresses the functional difficulties wherever they occur regardless of the label given.
How common is it?
Developmental coordination disorder (DCD), which includes those children with dyspraxia, is thought to affect up to 10% of the population to varying degrees, it is therefore possible that there is at least one or two child in every classroom with developmental coordination disorder who require specific support for their difficulties. It affects 4x as many boys than girls.
How do I know if my child has DCD?
If you are concerned that your child may have developmental coordination difficulties then take a look at the typical presentations described below. Children will of course have different patterns of these difficulties, i.e. some will have more of the fine motor difficulties; some will have more of the big movement problems; and others will have more of the processing, or organisational difficulties. There can therefore be considerable variance amongst those affected and any intervention needs to be carefully planned based on a comprehensive assessment of the child’s particular needs
What sorts of difficulties do children with DCD experience?
Fine motor difficulties:
- Lack of manual dexterity
- Poor at two-handed tasks e.g. tying shoe laces, using cutlery, cutting with scissors
- Poor manipulative skills e.g. handwriting difficulties, including development of grip and formation of letters
- Difficulty with functional independence skills such as dressing and other self care activities
- Poorly established hand dominance
Gross motor difficulties:
- May be late reaching motor milestones such as crawling, walking, jumping and hopping
- Often may ‘miss out’ the crawling stage
- Poor balance including difficulty in riding a bicycle
- Low muscle tone, resulting in poor sitting and standing posture
- Reduced stamina, tires easily due to the effort required to complete everyday activities
- Hypermobility of the joints
- Poor core muscle strength in trunk, shoulder girdle and pelvic girdle, which in turn may affect balance, coordination and both fine and gross motor skills
- Difficulty using two sides of the body together e.g. when swimming, particularly front crawl when both sides of the body are doing different things
- Difficulty with some physical activities, such as jumping, hopping, skipping
- Poor hand-eye/eye foot co-ordination
- Clumsy gait and movement, awkward gait when running, often slower than peers
- A tendency to fall, trip, bump into people and objects as a result of poor spatial and/or poor body awareness
- May have poor foot posture due to hypermobility and low muscle tone. This can lead to aches and pains in the lower limbs.
Eye movements
- Poor visual tracking: Difficulty in following a moving object smoothly with the eyes without excessive head movement.
- Poor relocating: Cannot look quickly and effectively from object to object (e.g. book to book, blackboard to note pad etc.)
- Poor eye/hand co-ordination
Associated difficulties
Children with DCD may also have other associated difficulties to a greater or lesser extent. Some other aspects of life that are commonly affected are:
- Speech and Language Development
- Social skills, self-esteem and confidence
- Behaviour
- Concentration
- Cognitive ability
Do children grow out of DCD?
Some do, but research shows that up to 50% of those more severely affected as children still have problems in their teenage years and into adulthood.
Although dyspraxia/ DCD is a life-long condition, early intervention and support can make a considerable difference to children in relation to how it impacts upon a child both in and outside of school. Early intervention can have a positive impact upon the social, emotional, physical and educational outcomes that can be achieved by children.
At the Banana Tree Practice we have a special interest in the assessment and treatment of DCD/Dyspraxia and are fortunate to be able to offer both Occupational Therapy and Physiotherapy input at the assessment and planning stage as well as when offering intervention. This reduces replication and ensures a comprehensive examination of the child’s needs, be they difficulties with fine or gross motor activities, posture and muscle tone, joint range of movement or more functional difficulties. We also believe it is important to liaise with other members of the multidisciplinary team involved with your child to ensure integrated treatment planning including seeing your child in school if requested. We can work together with you and your child’s teacher or support staff to fully implement the advice, treatment and strategies suggested into daily life, both at home and at school.
