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Developmental Coordination Disorder

Reviewed by Psychology Today Staff

Developmental coordination disorder, sometimes referred to as motor clumsiness, is a movement condition that manifests during child development and is marked by difficulty learning fine and gross motor skills compared to children of the same age. Children with this disorder may struggle with everyday activities such as getting dressed, eating meals, and playing games with others as a result of poor motor coordination skills.

In addition to the resulting lack of physical fitness, developmental coordination disorder can also influence a child's self-esteem and social abilities. The condition usually continues into adulthood, but treatment can greatly improve motor skills and provide helpful strategies to navigate everyday tasks.

Symptoms

Signs of developmental coordination disorder include:

  • Delay in achieving motor milestones such as sitting, crawling, or walking
  • Persistent clumsiness, including dropping objects or bumping into walls or furniture
  • Finding it difficult to catch a ball, participate in games or sports, or ride a bike
  • Unsteady walk, tripping over feet
  • May have difficulty navigating stairs or uneven ground
  • Difficulty engaging in tasks that require fine motor skills such as assembling puzzles, buttoning shirts, eating with utensils, or building blocks
  • May have unclear or labored handwriting

Individuals with developmental coordination disorder, or DCD, may struggle predominantly with gross motor skills or fine motor skills; they may also find both equally challenging. Children may, in some cases, be able to carry out everyday motor tasks with great effort; however, they will likely struggle to move at the same speed as their peers and may become frustrated much more easily. In other instances, children may “revert” to less developed behaviors, such as eating with their fingers rather than struggling with utensils.

A diagnosis of developmental coordination disorder may be given if the motor skill impairment interferes with activities of daily living and negatively impacts a person’s ability to participate in school, work, leisure, and play. Per the DSM-5, symptoms should first appear in early childhood and not be better explained by another condition, such as a visual impairment or dysgraphia.

How common is developmental coordination disorder?

About 5 percent of children between ages 5 and 11 are diagnosed with developmental coordination disorder; approximately 2 percent can be categorized as “severe.” The condition affects more boys than girls, at a ratio between 2:1 and 7:1 in severe cases.

Is developmental coordination disorder a learning disability?

Developmental coordination disorder is not considered a learning disability; instead, it is classified as a neurodevelopmental disorder, similar to ADHD, that primarily affects motor skills. However, challenges with motor skills can interfere with learning in many cases—for example, a child may struggle to write down her thoughts legibly without becoming frustrated. Children may also struggle in gym class or other physical activities at school.

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Causes

The root cause of developmental coordination disorder is unknown. Like other neurodevelopmental disorders, current evidence points to a combination of genes and environment. Those born into families with a history of DCD are at greater risk, and prenatal developmental setbacks—such as being born early or being small for one's gestational age—appear to play a substantial role in the later development of DCD.

Researchers also know that there is a consistent problem with rhythmic coordination and timing among children with developmental coordination disorder, as well as deficits in executive functioning that affect working memory, inhibition, and attention. Researchers have noted that dysfunction in these areas mimics that of ADHD and that the disorders frequently co-occur, suggesting a potential overlap between the two conditions, though the exact connection between the two remains the subject of debate.

What are the risk factors for developmental coordination disorder?

Children who were exposed to alcohol in the womb, who were born preterm, or who were of low birth rate appear to be at heightened risk for DCD. Additional risk factors include being male and/or having a family history of developmental coordination disorder.

Is developmental coordination disorder genetic?

Experts believe that genetics play some role in developmental coordination disorder, as the condition tends to run in families. However, the exact cause of the disorder is not fully understood. 

Treatment

Children with developmental coordination disorder greatly benefit from early intervention efforts. Treatment may include occupational or physical therapy, physical education, or the implementation of helpful strategies, such as encouraging children who have trouble writing to use a computer to take notes. Perceptual motor training, which combines physical movement with math or reading tasks that require thinking, is also a common treatment for children with developmental coordination disorder. The severity of the condition plays a role in how much a child can improve.

While many children see an improvement in symptoms with treatment over the long term, 50 to 70 percent of children continue to have problems with coordinated movement through adolescence. The severity of the condition does not worsen over time, but developmental coordination disorder does continue into adulthood.

Can developmental coordination disorder be cured?

As with other neurodevelopmental disorders, there is no “cure” for DCD and the condition is considered lifelong. However, treatment—especially occupational therapy and/or physical therapy—can greatly improve fine and gross motor skills, muscle tone, and self-esteem in a child with DCD.

Can medication help treat developmental coordination disorder?

No medications are currently approved for the treatment of developmental coordination disorder. The condition often co-occurs with other disorders, however, such as ADHD; in some cases, treating comorbid conditions with medication may be part of a comprehensive treatment plan. 

References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.      
U.S. National Library of Medicine. MedlinePlus. Developmental Coordination Disorder. Reviewed December 9, 2016. Accessed September 27, 2017.
Smits-Engelsman BCM, Blank R, Van Der Kaay, AC, et al. Efficacy of interventions to improve motor performance in children with developmental coordination disorder: a combined systematic review and meta-analysis. Developmental Medicine and Child Neurology. March 2013;55(3):229-237.
Wilson PH, Ruddock S, Smits-Engelsman B, Polatajko H, Blank R. Understanding performance deficits in developmental coordination disorder: a meta-analysis of recent research. Developmental Medicine and Child Neurology. March 2013; 55(3):217-228.
Last updated: 09/22/2021