Developmental Coordination Disorder - Sunnybrook Neonatal Follow-Up Clinic
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Developmental Coordination Disorder

What is Developmental Coordination Disorder (DCD)?

  • Developmental Coordination Disorder, also known as “DCD”, is a disorder of skilled or coordinated movements.
  • Children with DCD experience challenges with everyday tasks as they have difficulty learning and performing movements that need coordination. By definition, these challenges significantly impact daily life.
  • Movement difficulties for children with DCD are not due to other conditions such as intellectual delay, visual impairment, or other neurological conditions that affect movement.
  • DCD is not typically diagnosed before the age of five years.

How common is DCD? 

  • Studies show that 5-6 % of all school-aged children have DCD.
  • Research tells us that children who were born very early (less than 32 weeks’ gestation) or who had a very low birth weight (less than 1500 grams) are more likely to develop DCD than children born full term or with a normal birth weight.

What does DCD look like?

  • Since children with DCD have difficulty doing tasks that involve coordinated movements, they are sometimes described as “clumsy.”
  • Sadly, children with DCD are sometimes seen as being “lazy” because they may avoid doing certain tasks. Children with DCD are not lazy – in fact, they need to work even harder than their peers to do the same tasks. They may avoid tasks because they have difficulty getting started, or because once they get started, they do not know how to do the task without a lot of effort. (This can be frustrating!)
  • Tasks that children with DCD may find difficult include:
Task: What this might look like:
Putting on and taking off clothing, especially doing up and undoing zippers and buttons
  • Taking longer than peers or siblings to get ready for the day, for gym class, or for time outdoors
Tying shoelaces
  • Taking longer than peers or siblings to get ready for the day, for gym class, or for time outdoors
Handling utensils
  • Taking longer to eat than siblings or peers
  • Messy eating
  • Difficulty cutting food into smaller pieces
Printing
  • Avoiding written work
  • Taking longer to finish written tasks than peers, or not finishing class work
  • Disruptive behaviour in the classroom or at homework time
Cutting with scissors
  • Avoiding crafts
  • Taking longer to do crafts than peers
  • Jagged cutting
  • Disruptive behaviour in the classroom or during craft time
Walking and running without tripping
  • Knocking things over or bumping into things
  • Avoiding physical activities
Throwing or kicking a ball
  • Avoiding physical activities

 

What should I do if I think my child has DCD?

  • If your child is followed by the Sunnybrook Neonatal Follow Up Clinic, and is at least five years old, contact us at (416) 480-6100, x 87722 or followup@sunnybrook.ca and we will arrange for a visit with our Occupational Therapist (OT). At this visit, the OT will ask you some questions about your child’s motor coordination at home, school, and play, and will lead your child through several activities that require motor coordination. This assessment is “standardized” because it is done the same way every time, and by every person who leads it. This allows for an accurate assessment of your child’s motor coordination compared to other children his or her age.
  • If your child is not followed by the Sunnybrook Neonatal Follow Up Clinic, talk to your child’s paediatrician or family doctor to discuss your concerns. Consider taking along this information sheet from the CanChild Centre for Child Disability Research.

Do schools recognize DCD?

  • Some schools and teachers will understand what DCD means, and others are still learning, as “DCD” is a relatively new name for this condition. If your child has DCD, and you would like to help his or her teachers learn more about it, try sharing the flyers available at these links:
  • Children with DCD can get support through School Health Support Services in public, Catholic, French, private, and home schools. An application for this service must be made by school staff. It can take some time before a child is seen through School Health Support Services.
  • When children with DCD are having a very difficult time in school, they may qualify for an “IEP”, or Individualized Education Plan. This plan lays out special accommodations a child might need in order to succeed in school.

What is the best intervention for DCD?

  • Children with DCD do not usually outgrow their difficulties with coordination. While learning and mastering new motor tasks can continue to be a challenge for children with DCD, they CAN learn how to do everyday tasks, and any task they are excited to learn! Research is beginning to show the best interventions for DCD are those that are “task-oriented,” in other words, they help the child learn specific skills (for example, doing up a zipper or throwing a ball at a target). Interventions that are “deficit-oriented” and focus on improving a child’s motor weaknesses such as balance and strength, are less effective.

What activities are recommended for children with DCD?

  • To help children with DCD have fun with physical activities, think about trying:
    • Activities that involve individual performance and participation instead of team sports and competition. This type of activity encourages participation and celebrates individual success. Examples: gymnastics, martial arts, skating, dance.
    • Activities that use repetitive movements instead of more complicated actions. These activities have fewer complex steps and are easier for children to learn (and to get really good at them!) Examples: running, skating, bike riding, skiing.

How do I find help for my child with DCD or motor coordination difficulties?

  • To help your child learn or master everyday movements or tasks that are difficult, you may want the help of an Occupational Therapist (OT) or a Physiotherapist (PT). OTs and PTs who work with children are experts in childhood development and movement. When looking for an OT or a PT to help your child, be sure to find out if they have had experience working with children who have DCD or motor coordination difficulties. Look for someone who has some experience in this area.
  • For services covered by the Ontario Health Insurance Plan (OHIP): 
    • Ask your family physician for a referral
    • Ask your child’s teacher and/or school principal for a referral to School Health Support Services
    • Contact your Local Health Integration Network: lhins.on.ca Select your area >> Select “Home and Community Care” >> Under “I’m a Client”, select “Find out more”

Helpful Links:

The CanChild Centre for Childhood Disability Research provides helpful information about DCD for parents, teachers, and health professionals. See the links below:

An Overview: Developmental Coordination Disorder 

Online Workshop: English   French

Flyers:

Booklet:

Additional Resources

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, (5th ed.). Arlington, VA: American Psychiatric Association.

Blank, R., Smits-Engelman, B., Polatajko, H., Wilson, P. (2012). European Academy for Childhood Disability (EACD): Recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version). Developmental Medicine & Child Neurology, 54, 54—93. doi: 10.1111/j.1469-8749.2011.04171.x

Edwards, J., Berube, M., Erlandson, K., Haug, S., Johnstone, H., Meagher, M., Sarkodee-Adoo, S., & Zwicker, J. G. (2011). 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, 32, 678–687. doi: 10.1097/DBP.0b013e31822a396a

Polatajko, H. J., Fox, M., & Missiuna, C. (1995). An international consensus on children with developmental coordination disorder. Canadian Journal of Occupational Therapy, 62, 3–6.

Sugden, D. A., Chambers, M., & Utley, A. (2006). Development Coordination Disorder as a Specific Learning Difficulty. Leeds Consensus Statement 2006. Leeds, UK: Economic & Social Research Council.

Zwicker, J. G., Missiuna, C., Harris, S. R., & Boyd, L. A. (2012). Developmental coordination disorder: A review and update. European Journal of Paediatric Neurology, 16, 573—581. Dog: 10.1016/j.ejpn.2012.05.005