Developmental coordination disorder (DCD) occurs when a delay in the development of motor skills, or difficulty co-ordinating movements, results in a child being unable to perform everyday tasks. 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.
The characteristics of children with DCD are usually noticed first by those closest to the child, because the motor difficulties interfere with academic achievement or with activities of daily living, including dressing, playground skills, handwriting, gym activities and sports, etc.
DCD is believed to affect 5-6% of children who are school aged and tends to occur more frequently in boys. It can exist on its own or it may be present in a child who also has other type of specific learning difficulties, speech and/or language impairments and/or attention deficit hyperactivity disorder (ADHD).
How to recognise developmental coordination disorder?
Early detection is helpful so that intervention can be provided to prevent the development of later difficulties.
Prior to attending school, the child may have a delay in sitting, crawling, walking, or speaking. Children additionally may have difficulty with activities such as hopping, jumping or riding a bike, doing puzzles, cutting, colouring and daily living activities, eg fastening buttons, blowing his/her nose, using playground equipment and feeding with cutlery effectively.
Problems seen in the pre-school years continue and become more apparent in the school years, where more demands are placed on the child and they start to struggle in a more obvious way. The child may appear generally clumsy and disorganised. Children may have additional difficulty with handwriting and art projects, play skills (eg riding a bike, ball skills), organising and finding their belongings, physical education, dressing skills, attention and concentration, following instructions, etc. Their sensory development may also be affected, for example avoiding messy play, swings, roundabouts or fidgeting, persistently chewing on clothing or other objects.
What does occupational therapy offer children with DCD?
Following referral to the occupational therapy team, a therapist will organise one or several assessment sessions which may include observations in different settings of functional skills, standardised tests and interviews with parents, teachers and other professionals involved with the child. Results are analysed to gain a full understanding of the child’s strengths and difficulties, then a decision is made on the most appropriate intervention for the child.
There are a number of different ways an occupational therapist can work with children with DCD. This may be individually in a therapy clinic, although we aim to deliver services in the most natural environment for the child, such as school, nursery, or in the home or community settings.
We work in partnership with the child or young person’s family, their teachers and other relevant school professionals, providing assessments and interventions in the following areas:
- participation in productive school activities in relation to functional tasks such as handwriting, using tools and materials in the classroom for different lessons, using scissors, access to a computer and other technology equipment
- self-care and functional skills, ie feeding, dressing, toileting, general hygiene tasks, participation in other school routines, etc
- participation in leisure and play activities ie taking part in sports and games, using playground equipment, developing a range play skills and riding a bike.