What is DCD?
Developmental Coordination Disorder (DCD), also known as dyspraxia, is a common disorder affecting fine and gross motor movement and coordination in both children and adults.
DCD can affect a child’s ability to participate in everyday tasks within education, self-care and play. These difficulties can also continue into adulthood, although difficulties may change over time depending upon their environment and experience.
DCD can be influenced by a number of factors resulting in a disruption to messages sent between the brain and the body. Additionally, this can also be influenced by difficulty with perceiving, processing and integrating sensory information from the environment. This impairment subsequently affects a child’s ability to plan, organise and carry out movements in a smooth, coordinated way.
There are a number of challenges which those with DCD may demonstrate such as difficulty with:
- Performing coordinated physical activities such as hopping, jumping, riding a bike, throwing / catching or kicking a ball
- Navigating stairs
- Performing tasks that require fine motor skills such as using cutlery when eating, doing up buttons and tying shoe laces. Plus other tasks relating to dressing could be more difficult for them
- Handwriting and using scissors
- Difficulties with sequencing and organising additional actions within everyday activities
Children with DCD may also be delayed in reaching developmental milestones (such as sitting, crawling, walking or speaking). Individuals with DCD can also find organisation, attention and speech and language challenging. As a result of these difficulties, children and adults with DCD may have low self-esteem and appear reluctant to participate in activity compared to their peers.
How to Assess for DCD?
DCD is diagnosed by a doctor (usually a paediatrician), however they often require additional information from specialist assessments carried out by an Occupational Therapist.
This might include assessment of an individual’s functional abilities within their usual daily routine (for example, handwriting, dressing, using a knife and fork etc).
In addition to this, individuals are also assessed using a standardised assessment called the Movement Assessment and Battery for Children (MABC) created by Henderson and Sugden in 2007.
Movement Accessory and Battery for Children Assessment (MABC)
The MABC looks at the individual’s gross motor skills (using large muscles to produce body movements such as jumping/balancing/movement) and fine motor skills (using small muscles for more precise actions such as writing/placing small pegs in a peg board). The assessment measures this against other children in a similar age group.
The test is sub-divided into three performance areas; manual dexterity, ball skills and static and dynamic balance. This includes asking your child to perform a series of motor tasks in a specified way in order to provide information on sequencing and planning of movement through clinical observation. The assessment can also include an adult reported checklist to gain additional information on your child’s motor skills (this could be completed by caregiver, teacher or other professional who works with the child).
Total test scores at or below the 5th percentile denote a significant movement difficulty, scores between the 5th and 15th percentile suggest a degree of difficulty that is borderline, and above the 15th percentile implies no motor problem.
This is outlined in the Leeds Consensus (2006) below:
Developmental Coordination Disorders (which encompass our understanding of dyspraxia) are recognised as a diagnosis when a child’s total performance is at or below the 5th percentile, and where ‘performance in daily activities that require motor coordination is substantially below that expected given the person’s chronological age and intelligence.
Although signs of the condition are present from an early age, children vary widely in their rate of development. This means a definite diagnosis of DCD does not usually happen until a child with the condition is 5 years old or more.
A diagnosis can be made by a doctor who will ensure that the movement problems are not due to any other known physical, neurological or behavioural disorders, and determine whether more than one disorder may be present.
More information about DCD can be found in these helpful links.