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Developmental coordination disorder

Developmental coordination disorder (DCD) is a neurodevelopmental disorder characterized by marked deficits in the acquisition and execution of coordinated motor skills, which substantially and persistently interfere with activities of daily living or academic and occupational productivity, and which are not better explained by intellectual disability, visual impairment, or a neurological condition such as cerebral palsy or muscular dystrophy.^[1]^[2]^[3] Symptoms typically emerge in early childhood during the developmental period and manifest as clumsiness, poor balance, and difficulties with both fine motor tasks (e.g., handwriting, fastening buttons, or using utensils) and gross motor activities (e.g., running, catching a ball, or riding a bicycle).^[4]^[5] The disorder affects 5–6% of school-aged children worldwide, with higher prevalence in males, and often co-occurs with conditions such as attention-deficit/hyperactivity disorder or autism spectrum disorder, complicating differential diagnosis.^[6]^[7] Diagnosis relies on standardized motor assessments and fulfillment of DSM-5 criteria, emphasizing impairments disproportionate to chronological age and overall cognitive ability.^[2]^[3] Although the precise etiology is multifactorial and not fully elucidated, neuroimaging studies indicate atypical brain activation in motor planning regions, supporting a neurobiological basis over purely behavioral or environmental explanations.^[8]^[9] DCD frequently persists into adulthood, impacting employment and independence, yet early intervention through occupational therapy can mitigate functional limitations.^[10]^[4]

Definition and Diagnostic Criteria

Core Diagnostic Features

Developmental coordination disorder (DCD) is defined by substantial deficits in the acquisition and execution of coordinated motor skills, which manifest as performance markedly below that expected for the individual's chronological age and opportunities for skill development and practice.^[11] These impairments typically involve both fine and gross motor domains, including difficulties with precise hand-eye coordination (e.g., handwriting, manipulating small objects, or fastening clothing), balance and postural control (e.g., frequent stumbling or poor stability during locomotion), and whole-body coordination (e.g., catching, throwing, or participating in sports).^[4] Motor output is often characterized by slowness, inaccuracy, excessive variability, and inefficiency, rather than isolated weakness or sensory loss, distinguishing DCD from peripheral neuromuscular conditions.^[12] The core features necessitate that these motor difficulties significantly disrupt everyday functioning, such as academic tasks requiring sustained fine motor control (e.g., prolonged writing leading to illegible output or fatigue), self-care activities (e.g., challenges with dressing or eating independently), and leisure pursuits (e.g., avoidance of physical games due to repeated failures).^[11] Onset occurs during the developmental period, often evident by school entry around age 5-6 years, though retrospective reports may identify subtler delays in infancy, such as prolonged milestones for sitting, crawling, or walking.^[13] Unlike transient clumsiness in typically developing children, DCD symptoms persist and do not resolve with maturation alone, with prevalence estimates around 5-6% in school-aged children meeting full criteria.^[4] Diagnosis requires exclusion of motor impairments attributable to intellectual disability (IQ <70), uncorrected visual deficits, or overt neurological disorders (e.g., cerebral palsy), ensuring the coordination issues are primary and neurodevelopmental in origin.^[11] Associated subtle neurological signs, such as mild hypotonia or joint hypermobility, may coexist but do not explain the full syndrome.^[6] Comprehensive evaluation typically involves standardized motor assessments (e.g., Movement Assessment Battery for Children) alongside clinical observation to quantify deficits against normative data, confirming persistence across contexts and ruling out secondary causes like prematurity-related complications when possible.^[13]

Classification in DSM-5 and ICD-11

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association in 2013, developmental coordination disorder (DCD) is classified as a motor disorder within the broader category of neurodevelopmental disorders. The diagnostic criteria require that the acquisition and execution of coordinated motor skills be substantially below age-expected levels, manifested in clumsiness, slowness, or inaccuracy in tasks such as handwriting, buttoning clothing, or sports participation.^[14] These deficits must significantly interfere with daily activities or academic performance, with onset during the developmental period, and cannot be better explained by intellectual developmental disorder, a neurological condition like cerebral palsy, visual impairment, or attentional/executive function deficits alone.^[14] The disorder carries the code 315.4 (F82) and emphasizes persistent functional impairment rather than isolated skill deficits.^[15] The DSM-5 criteria align closely with prior iterations from DSM-IV but refine the focus on functional impact and exclude cases where motor issues are secondary to other primary conditions, aiming for diagnostic specificity. This classification supports early identification for intervention, as motor impairments must not merely reflect lack of opportunity for practice but represent a core developmental deviation.^[16] In the International Classification of Diseases, Eleventh Revision (ICD-11), implemented by the World Health Organization in 2022, the condition is termed "developmental motor coordination disorder" and coded as 6A04 under neurodevelopmental disorders, specifically within impairments of body functions.^[17] It is characterized by marked delays or impairments in the development of motor coordination that substantially interfere with daily activities, such as self-care, productivity, or play, persisting beyond what is developmentally appropriate.^[16] Diagnosis excludes explanations by intellectual developmental disorder or known neurological diseases, emphasizing the disorder's idiopathic nature and lifelong potential impact unless addressed.^[18] ICD-11's terminology shift to "motor coordination disorder" reflects a harmonization effort with DSM-5 while prioritizing clinical utility and global applicability, though it maintains similar core requirements for interference and exclusionary criteria.^[19] Both systems recognize DCD's prevalence around 5-6% in school-aged children, underscoring its distinction from transient motor delays.^[6] Differences lie primarily in nomenclature and coding structure, with ICD-11 integrating it into a linear hierarchy for broader morbidity statistics.^[11]

Etiology

Genetic and Epigenetic Contributions

Twin studies indicate that developmental coordination disorder (DCD) exhibits moderate to high heritability, with estimates ranging from 50% to 70% based on analyses of monozygotic and dizygotic twins, suggesting a substantial genetic component alongside environmental influences.^[20] Family aggregation studies further support genetic involvement, showing elevated risk among siblings and relatives of affected individuals, consistent with polygenic inheritance patterns observed in other neurodevelopmental disorders.^[21] Genetic correlations exist between DCD and conditions like attention-deficit/hyperactivity disorder (ADHD), where shared etiological factors account for overlapping motor impairments, as evidenced by multivariate twin modeling.^[22] Despite this heritability, genome-wide association studies (GWAS) and candidate gene approaches have not identified specific causal variants or loci strongly linked to DCD, pointing to a complex, multifactorial genetic architecture involving numerous common alleles of small effect rather than rare high-penetrance mutations.^[21] Copy number variations (CNVs) and deletions have been implicated in some cases, particularly those overlapping with motor-related pathways, but replication across populations remains limited.^[20] Comorbidity with autism spectrum disorder (ASD) and ADHD suggests pleiotropic effects from shared genetic risk factors influencing neural development and motor control circuits.^[23] Epigenetic mechanisms, such as DNA methylation, show preliminary associations with DCD traits, with altered methylation patterns at specific loci correlating with motor performance deficits in affected children, potentially mediating gene-environment interactions during early development.^[24] These modifications may influence expression of genes involved in neuronal connectivity and synaptic plasticity, though causal directions and functional impacts require further validation through longitudinal and experimental designs.^[20] Unlike genetics, epigenetic research in DCD is nascent, with most evidence derived from small-scale studies highlighting differential methylation in motor-related pathways rather than disorder-specific signatures.^[25]

Neurological Mechanisms

Developmental coordination disorder (DCD) involves atypical neural processing in motor control networks, with consistent evidence from neuroimaging implicating the cerebellum, basal ganglia, parietal cortex, and frontal regions. Structural MRI studies reveal reduced gray matter volume in the cerebellum and basal ganglia in children with DCD aged 8-12 years compared to typically developing peers, suggesting subcortical contributions to impaired motor coordination.^[26] These regions form interconnected circuits essential for movement initiation, execution, and error correction, where disruptions may underlie difficulties in predictive motor control and adaptation.^[27] Functional MRI (fMRI) research demonstrates altered activation patterns during motor tasks, such as trail-tracing, with children exhibiting DCD showing underactivation in the cerebellum and supplementary motor areas alongside compensatory overactivation in prefrontal regions, indicating inefficient neural efficiency for skilled movements.^[28] Diffusion tensor imaging highlights white matter abnormalities in tracts connecting sensorimotor cortex to subcortical structures, correlating with poorer motor performance and implicating disrupted intra- and inter-hemispheric connectivity.^[29] Resting-state fMRI further reveals atypical functional connectivity between the sensorimotor network and default mode regions like the posterior cingulate cortex and precuneus, potentially contributing to deficits in integrating sensory feedback with motor planning.^[30] Mechanistically, DCD is associated with impairments in forward modeling and efference copy mechanisms, where the cerebellum fails to accurately predict sensory consequences of actions, leading to reliance on slower feedback-based corrections rather than feedforward control.^[31] Basal ganglia dysfunction may disrupt action selection and habit formation, as evidenced by reduced subcortical volumes and altered dopamine-related pathways inferred from motor learning deficits.^[32] Parietal lobe involvement affects visuospatial integration for goal-directed movements, with meta-analyses confirming consistent structural and functional anomalies across these areas, though heterogeneity in study samples limits causal attribution.^[33] These findings underscore a distributed network deficit rather than isolated regional pathology, with ongoing research emphasizing longitudinal imaging to clarify developmental trajectories.^[34]

Environmental and Perinatal Influences

Perinatal complications, including preterm birth and low birth weight, have been identified as significant risk factors for developmental coordination disorder (DCD). Studies of cohorts born extremely preterm show that gestational age at birth inversely correlates with DCD risk, with mediation partly through retinopathy of prematurity (ROP) and other neonatal morbidities such as bronchopulmonary dysplasia.^[35] ^[36] Lower gestational age and birth weight independently predict poorer motor outcomes, persisting after adjustment for confounders like sex.^[37] Obstetric events including fetal distress during labor, threatened abortion, and placental abnormalities such as previa or abruption elevate DCD likelihood, independent of genetic factors.^[38] ^[39] Maternal pre-eclampsia associates with increased DCD incidence, potentially via intrauterine growth restriction mechanisms.^[40] Neonatal conditions like pathological jaundice, chronic lung disease, seizures, and white matter disruptions further compound vulnerability.^[39] ^[36] Prenatal environmental exposures contribute to DCD etiology, with maternal tobacco smoking during pregnancy linked to higher odds of motor coordination deficits in offspring.^[41] Second-hand smoke exposure in utero similarly raises suspected DCD risk, though evidence requires replication in larger cohorts.^[42] Air pollution, particularly fine particulate matter (PM2.5), shows dose-dependent associations with DCD, affecting both prenatal and early postnatal periods via neuroinflammatory pathways.^[43] Socioeconomic factors, such as lower family income, correlate with elevated DCD prevalence in school-aged children, potentially reflecting cumulative environmental stressors rather than causation alone.^[44] These influences interact with biological risks, underscoring multifactorial models over singular determinants.^[45] Empirical data emphasize early interventions targeting modifiable perinatal risks to mitigate motor impairments.^[46]

Clinical Presentation

Primary Motor Impairments

Children with developmental coordination disorder (DCD) demonstrate core deficits in the acquisition, control, and execution of coordinated motor actions, manifesting primarily as impairments in gross and fine motor skills that persist beyond what is expected for their chronological age and interfere with daily functioning.^[47] These impairments are not attributable to generalized intellectual disability or primary visual, sensory, or neurological conditions, distinguishing them as intrinsic motor coordination challenges.^[48] Gross motor impairments typically involve difficulties with balance, locomotion, and whole-body coordination, leading to clumsiness in activities such as running, jumping, kicking, or catching balls.^[9] Children affected may exhibit delayed motor milestones, poor postural control, and reduced proficiency in sports or playground tasks requiring dynamic balance and agility, with studies reporting significantly lower scores on standardized gross motor assessments compared to typically developing peers.^[49] For instance, object control tasks like throwing or batting show marked deficits, often quantified by performance below the 15th percentile on tools such as the Movement Assessment Battery for Children.^[50] Fine motor impairments encompass challenges in precise hand-eye coordination and manual dexterity, affecting tasks like handwriting, fastening buttons, using utensils, or manipulating small objects.^[9] These deficits extend to motor planning and sequencing, where children struggle with the ideation and organization of movements, resulting in slow, inaccurate, or effortful performance in self-care activities such as tying shoelaces or drawing shapes.^[51] Research indicates that fine motor difficulties correlate with broader sensorimotor integration issues, though primary impairments remain centered on execution rather than isolated sensory processing.^[48] Both gross and fine motor domains reflect underlying difficulties in motor learning and adaptation, where repetitive practice yields slower skill acquisition than in neurotypical children, as evidenced by longitudinal studies tracking proficiency over time.^[52] These primary impairments form the diagnostic foundation of DCD, with severity varying such that mild cases may primarily affect complex skills, while severe cases disrupt basic mobility and self-maintenance.^[53]

Secondary Sensory and Functional Deficits

Children with developmental coordination disorder (DCD) frequently experience secondary sensory processing impairments that exacerbate motor challenges, including deficits in proprioception and visual-motor integration. Proprioceptive dysfunction, involving reduced accuracy in sensing joint positions and movements, has been documented in multiple joints such as the shoulder, elbow, wrist, and hand, with children with DCD showing greater errors in position sense tasks compared to typically developing peers.^[9] These impairments are evident in both proximal and distal upper limb assessments, contributing to imprecise motor planning and execution.^[54] Visual-motor integration deficits are also prevalent, with systematic reviews indicating lower performance on standardized tests of copying geometric forms and integrating visual cues with motor output, independent of basic visual acuity issues.^[55] Such sensory-motor mismatches correlate with broader perceptual weaknesses, including spatial organization and figure-ground discrimination.^[56] These sensory deficits manifest in functional impairments across daily activities, particularly in fine and gross motor tasks requiring integrated sensory feedback. In activities of daily living (ADL), children with DCD demonstrate delays in self-care skills like dressing, buttoning clothing, and using utensils, with performance on standardized ADL scales lagging 1-2 standard deviations behind age-matched norms.^[57] Handwriting legibility and speed are compromised due to poor visual-motor coordination, leading to slower output and higher error rates in academic settings.^[58] Gross motor functions, such as catching balls or maintaining balance during dynamic tasks, are similarly affected, with vestibular and proprioceptive weaknesses linked to reduced postural stability and increased fall risk.^[59] Participation in leisure and play is restricted, as these children avoid sports or games involving rapid sensorimotor demands, resulting in lower physical fitness and social engagement levels.^[60] Longitudinal data suggest these functional limitations persist into adolescence without intervention, amplifying risks for reduced independence.^[61]

Comorbidities and Consequences

Co-occurring Neurodevelopmental Disorders

Children with developmental coordination disorder (DCD) exhibit high rates of comorbidity with other neurodevelopmental disorders, reflecting shared underlying neurobiological mechanisms such as atypical brain connectivity and genetic factors. Up to 50% of children diagnosed with DCD also meet criteria for attention-deficit/hyperactivity disorder (ADHD), with bidirectional overlap where approximately 50% of children with ADHD display DCD symptoms.^[62]^[11] This co-occurrence, sometimes termed deficits in attention, motor control, and perception (DAMP), amplifies functional impairments in executive function, impulsivity, and fine/gross motor skills.^[62] Autism spectrum disorder (ASD) commonly co-occurs with DCD, with motor coordination deficits observed in up to 79% of ASD cases, though dual diagnoses range from 15% to 46% depending on sample criteria.^[63] Distinguishing ASD-related motor issues from isolated DCD involves assessing whether motor improvements occur with targeted training, as seen more readily in DCD alone.^[62] Screening for ASD is recommended in DCD evaluations due to overlapping sensory processing and social communication challenges.^[11] Specific learning disorders, particularly dyslexia, show significant overlap with DCD, with approximately 33% of children meeting criteria for both in comorbid assessments. This comorbidity exacerbates working memory demands and reading fluency without additive effects on core phonological deficits.^[62] Dysorthography and non-verbal learning disabilities also frequently accompany DCD, contributing to broader academic difficulties.^[62] Developmental language disorders, including specific language impairment, co-occur in a substantial subset of DCD cases, with many children qualifying for DCD based on motor assessments within language-impaired cohorts.^[62]^[11] Toddlers at risk for language delays face elevated DCD likelihood, underscoring the need for integrated screening across motor, linguistic, and cognitive domains in neurodevelopmental evaluations.^[62] Children with developmental coordination disorder (DCD) exhibit elevated rates of internalizing psychological symptoms, including anxiety and depression, compared to typically developing peers, with meta-analyses indicating a moderate effect size for these associations.^[64] These difficulties often stem from repeated experiences of motor failure, which undermine self-efficacy and contribute to heightened state and trait anxiety as well as depressive symptoms.^[65] Low self-esteem is particularly prevalent, arising from chronic clumsiness and perceived incompetence in daily tasks, leading to internalized feelings of inadequacy that persist into adolescence and adulthood.^[62] Comorbid attention-deficit/hyperactivity disorder (ADHD) exacerbates psychological distress in DCD, with affected children showing significantly higher levels of emotional problems and reduced prosocial behaviors.^[66] Longitudinal studies confirm that without intervention, these mental health risks compound over time, increasing susceptibility to mood dysregulation and social withdrawal.^[67] Socially, individuals with DCD face heightened peer victimization, including bullying, due to visible motor impairments that mark them as different or less capable in group activities.^[68] This victimization correlates with poorer peer relationships, fewer friendships, and greater social isolation, as children with DCD are often excluded from play and sports, further eroding self-worth.^[69] Teachers and parents report that these children spend less leisure time with peers and experience marginalization in school settings, perpetuating cycles of rejection and emotional distress.^[70] Qualitative syntheses highlight recurring themes of exclusion and strained interactions, which impair overall psychosocial functioning and quality of life.^[71]

Epidemiology

Prevalence and Incidence

Developmental coordination disorder (DCD) has a prevalence of approximately 5% among children, based on a 2024 systematic review and meta-analysis of studies using standardized diagnostic criteria such as the DSM-5 or Movement Assessment Battery for Children.^[72] This estimate aligns with multiple epidemiological surveys indicating rates between 5% and 6% in school-aged populations worldwide, though broader ranges of 2% to 20% appear in less stringent assessments.^[73] ^[11] Prevalence is higher in males, with subgroup analyses showing 7% in boys versus 4% in girls, potentially reflecting sex-based differences in motor development thresholds or referral biases in clinical samples.^[72] Regional variations exist; for instance, a 2024 study in Türkiye reported 2.1% using strict DSM-5 criteria, suggesting methodological differences like sample size or assessment tools may influence estimates.^[74] Incidence data for DCD are limited, as the disorder manifests developmentally in early childhood rather than as discrete new-onset cases, making traditional incidence metrics challenging to apply.^[10] Longitudinal cohorts indicate persistence from preschool ages, with rates stabilizing around 5% by school entry, but no population-level annual incidence figures are widely established due to underdiagnosis and lack of prospective registries.^[75] Early identification efforts, such as screening at ages 4-6, highlight that undiagnosed cases may inflate apparent incidence in later assessments.^[76]

Demographic Variations and Risk Factors

Developmental coordination disorder (DCD) exhibits variations in prevalence across demographic groups, with males consistently showing a higher risk than females. Systematic reviews indicate that male sex is associated with an adjusted relative risk (aRR) of 1.35 (95% CI 1.05–1.73) for DCD, particularly among term-born children, though the male-to-female ratio is often reported as 2:1 or higher in clinical samples.^[36] ^[77] Prevalence estimates hover around 5–6% globally in school-aged children, with limited evidence of significant age-related shifts post-diagnosis, though symptoms may persist into adolescence in 50–70% of cases without intervention.^[72] Data on ethnic and geographic variations remain sparse and inconsistent, with few large-scale studies controlling for socioeconomic confounders. In South African cohorts, possible DCD prevalence was similar across ethnic groups (e.g., 9.9% overall in grade 1 learners, with no significant differences by ethnicity), but rural areas have shown higher incidence rates (18.5%) compared to urban settings (15.6%) in some regional analyses, potentially linked to environmental or access disparities.^[78] ^[79] U.S.-based studies highlight underrepresentation of minority groups in DCD research, limiting generalizability, though preterm cohorts in geographic comparisons (e.g., extremely preterm vs. term) show elevated rates irrespective of location.^[80] ^[81] Key risk factors for DCD include perinatal complications, with preterm birth elevating odds (e.g., 16% prevalence in extremely preterm/extremely low birth weight groups vs. 5% in term controls; OR 3.45, 95% CI 1.47–8.09) and intrauterine growth restriction conferring an aRR of 1.45 (95% CI 1.14–1.85).^[81] ^[36] Other established factors encompass low birth weight, male sex, and certain prenatal conditions such as maternal health issues, while postnatal elements like parental education levels inversely correlate with risk.^[38] In preterm populations, retinopathy of prematurity and maternal factors further mediate increased vulnerability.^[40] Genetic and familial influences are implicated but less quantified, with no single environmental factor dominating causation.^[33]

Assessment and Diagnosis

Screening and Evaluation Methods

Screening for developmental coordination disorder (DCD) typically begins with parent or teacher questionnaires to identify children at risk, as these tools provide efficient initial identification in school or clinical settings. The Developmental Coordination Disorder Questionnaire (DCDQ), a 15-item parent-report measure for children aged 5 to 15 years, assesses motor coordination in areas such as fine motor control, gross motor coordination, and organization/planning, demonstrating adequate predictive validity with sensitivity around 80-90% and specificity of 60-70% when compared to standardized motor tests.^[82] ^[83] For preschoolers aged 3 to 4 years, the Little Developmental Coordination Disorder Questionnaire (Little-DCDQ) serves as a brief screening instrument, showing good reliability and ability to distinguish children with emerging motor difficulties from peers.^[84] These questionnaires align with DSM-5 Criterion A, which requires motor skills to be substantially below age-expected levels given opportunities for learning, but they do not confirm diagnosis alone due to potential subjective bias in reports.^[14] Formal evaluation requires a multidisciplinary approach involving pediatricians, occupational therapists, and psychologists to verify DSM-5 criteria, including interference with daily activities (Criterion B), early onset (Criterion C), and exclusion of other explanations like intellectual disability or neurological conditions (Criterion D).^[14] A comprehensive assessment includes a detailed developmental history, physical examination to rule out medical causes, and standardized norm-referenced motor tests normed for age and sex. The Movement Assessment Battery for Children-Second Edition (MABC-2), widely used for ages 3 to 16 years, evaluates manual dexterity, aiming and catching, and balance, with excellent test-retest reliability (intraclass correlation coefficients of 0.91-0.97 across subscales) and validity in identifying DCD severity.^[85] ^[86] Similarly, the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) measures fine and gross motor skills through tasks like bilateral coordination and strength, offering high internal consistency (Cronbach's alpha >0.80) and utility in quantifying functional impairments.^[87] Observations of real-world performance, such as handwriting or self-care tasks, supplement test scores to assess Criterion B impacts. Differential evaluation emphasizes ruling out comorbidities or mimics, such as cerebral palsy or sensory processing issues, through targeted neurological exams or additional tests like the Peabody Developmental Motor Scales if needed. Canadian Paediatric Society guidelines recommend integrating questionnaire screens with at least one standardized motor assessment for diagnostic confirmation, noting that scores below the 15th percentile on tests like MABC-2 often indicate probable DCD when criteria are met.^[6] Reliability of these methods varies by rater training; interrater agreement for MABC-2 classifications (normal, at-risk, impaired) exceeds 90% with standardized administration, though cultural adaptations may affect norms in non-Western populations.^[88] Early screening around age 5, when school demands highlight deficits, improves outcomes, but underdiagnosis persists due to reliance on self-referral rather than universal protocols.^[89]

Differential Diagnosis Challenges

Diagnosing developmental coordination disorder (DCD) requires distinguishing it from other conditions exhibiting motor impairments, as per DSM-5 criteria which mandate exclusion of intellectual disability, visual or neurological disorders, and primary medical etiologies. A key challenge arises from high comorbidity rates, particularly with attention-deficit/hyperactivity disorder (ADHD) at approximately 50%, where inattention and impulsivity in ADHD can mimic or exacerbate coordination deficits, complicating attribution of motor issues to a primary dyspraxic process rather than secondary attentional lapses. Similarly, autism spectrum disorder (ASD) co-occurs in 4.1%–8.2% of cases, with overlapping pervasive motor deficits such as praxis and gait abnormalities; however, standard assessments like the Movement Assessment Battery for Children-2 (MABC-2) fail to reliably differentiate ASD from DCD due to insufficient sensitivity to subtle kinematic variances, such as gesture imitation or deceleration control.^[4]^[90] Further difficulties stem from the necessity to rule out neurological or genetic conditions mimicking DCD, including cerebral palsy, Chiari malformation, or syndromes like Ehlers-Danlos, which accounted for 29% of alternative diagnoses in one cohort of 111 children initially suspected of DCD. Only 12.5% of research studies incorporate physician-led medical evaluations to exclude such mimics, leading to potential overdiagnosis or misattribution. Assessment relies on multidisciplinary input from developmental pediatricians, occupational therapists, and standardized tools like the Bruininks-Oseretsky Test or Developmental Coordination Disorder Questionnaire (DCDQ), yet clinician awareness remains low—41% among pediatricians and 23% among general practitioners—resulting in under-recognition and delayed intervention.^[91]^[4] These challenges are compounded by the absence of biomarkers or objective neuroimaging signatures specific to DCD, with neural overlaps (e.g., cerebellar involvement in both DCD and ADHD) hindering clear demarcation, though emerging digital kinematic analyses show promise for 71%–78% accuracy in distinguishing DCD from ASD or typically developing peers via machine learning. Cultural and linguistic barriers in standardized testing, along with age-dependent variability in motor presentation, further obscure precise diagnosis, emphasizing the need for comprehensive history-taking and serial evaluations to isolate DCD's intrinsic planning and execution deficits from comorbid or extraneous influences.^[90]

Management and Interventions

Therapeutic Strategies

Therapeutic strategies for developmental coordination disorder (DCD) primarily emphasize motor-based interventions delivered through occupational therapy (OT) and physical therapy (PT), targeting improvements in coordination, fine and gross motor skills, and functional activities.^[50] These approaches leverage task-oriented training, which focuses on practicing real-world motor tasks to enhance skill acquisition and generalization, supported by meta-analyses showing moderate to large effect sizes on standardized motor assessments and daily activity performance in children with DCD.^[92] Process-oriented interventions, such as sensory-motor training, and activity-oriented methods, including structured play and sports-based programs, have demonstrated efficacy in randomized controlled trials, with benefits persisting beyond immediate post-treatment in high-quality studies.^[93] The Cognitive Orientation to daily Occupational Performance (CO-OP) approach, a client-centered OT strategy, promotes problem-solving and cognitive strategies during goal-directed motor tasks, yielding significant gains in self-reported and observed occupational performance as evidenced by controlled trials involving children aged 7-12.^[94] Routine OT interventions, including fine motor exercises and bilateral coordination activities, improve integration of motor skills, with effect sizes indicating clinical relevance for preschool and school-aged children, though outcomes vary by intervention intensity and duration (typically 8-12 weeks, 1-2 sessions weekly).^[95] Gross-motor-focused PT programs, such as balance and agility training, enhance body functions and participation levels, per quantitative reviews of interventions lasting 10-20 hours total.^[96] Evidence underscores the superiority of active, child-engaged motor learning over passive or non-specific therapies, with meta-analyses confirming transfer to untrained tasks when interventions incorporate variable practice and feedback.^[97] Multidisciplinary teams, integrating OT/PT with parental coaching, amplify retention, as parental involvement reinforces strategy use at home.^[94] However, methodological limitations in some trials, including small sample sizes (often n<50) and heterogeneous DCD criteria, temper generalizability, necessitating individualized plans based on severity assessed via tools like the Movement Assessment Battery for Children.^[98] No pharmacological treatments are established, reflecting DCD's non-degenerative neurodevelopmental etiology.^[92]

Educational and Supportive Measures

Children with developmental coordination disorder (DCD) benefit from individualized education plans (IEPs) or similar accommodations that address motor challenges in academic and physical activities, such as extended time for tasks involving fine motor skills like writing or drawing.^[99] ^[100] These plans often include breaking down instructions into short, clear steps and providing visual aids or note-taking support to reduce cognitive overload from motor demands.^[101] ^[100] In physical education, evidence supports strategies like task-oriented training, where instructors use cues, goal setting, and routines to promote skill acquisition without emphasizing competition, allowing children to focus on personal progress rather than performance deficits.^[102] ^[103] Group-based activities with modified equipment, such as larger balls or simplified rules, enhance participation and self-efficacy, as demonstrated in interventions improving motor competence in school settings.^[102] Product-oriented assessments, evaluating outcomes over process, further reduce anxiety and encourage engagement.^[102] Supportive measures extend to teacher training on DCD awareness and collaboration with occupational therapists for classroom adaptations, such as ergonomic seating or assistive technology like speech-to-text software for writing-intensive subjects.^[101] ^[104] Parental involvement through home-school communication and reinforcement of strategies, like practicing routines for transitions, strengthens generalization of skills.^[99] Cognitive approaches, including the Cognitive Orientation to daily Occupational Performance (CO-OP) method, teach problem-solving for motor tasks, with studies showing sustained improvements in functional participation when integrated into educational settings.^[104] ^[105]

Prognosis

Short-Term and Long-Term Outcomes

Children with developmental coordination disorder (DCD) experience short-term challenges primarily in motor skill acquisition and daily functioning, such as difficulties with dressing, writing, and participating in sports, which impair school performance and peer interactions.^[5] These issues contribute to reduced physical fitness, including lower flexibility, strength, and endurance, due to limited involvement in group activities.^[11] Sociobehavioral problems often arise, with increased risks of anxiety and low self-esteem stemming from perceived clumsiness and exclusion from play.^[11] Delayed diagnosis exacerbates these, leading to immediate psychosocial complications like academic struggles and obesity from sedentary behavior.^[11] In the long term, DCD persists into adulthood in 30–70% of cases, with ongoing motor impairments affecting mobility, handwriting, and executive functioning.^[5] Adults face heightened risks of mental health disorders, including anxiety, depression, and obsessive-compulsive tendencies, alongside social marginalization and lower employment rates due to challenges in manual tasks and estimating distances.^[11]^[10] Educational outcomes are poorer, as evidenced by a longitudinal study of neonatal intensive care recipients where those with probable DCD at age 6.5 had upper secondary school graduation rates of 54.5% by age 19 (versus 78.2% in non-DCD peers) and 81.1% by age 24 (versus 92.8%), with delays particularly pronounced in females.^[106] Comorbidities like attention-deficit/hyperactivity disorder (present in 30–50% of cases) and metabolic syndrome further compound risks for cardiovascular disease and reduced quality of life.^[11]^[5] Prognosis varies, with early intervention improving motor and psychological outcomes, though many require lifelong support.^[11]

Factors Influencing Persistence

Severity of initial motor impairments is a primary predictor of DCD persistence. Longitudinal research identifies two distinct developmental pathways: one leading to resolution and another to ongoing deficits, with persistent cases characterized by greater early severity in fine and gross motor skills, poorer perceptual-motor integration, and sustained challenges in daily activities.^[107] Children exhibiting more profound coordination difficulties, such as in handwriting or ball skills, demonstrate lower rates of remission by adolescence, with motor problems continuing in 50-70% of severe cases into adulthood.^[108] Comorbid neurodevelopmental conditions substantially increase the likelihood of persistence. Co-occurrence with attention-deficit/hyperactivity disorder (ADHD) correlates with exacerbated outcomes, including reduced physical activity levels and higher rates of academic and social impairments persisting over 20 years.^[109] Similarly, associated reading difficulties, hyperactivity, and social communication deficits predict non-resolution, as these amplify avoidance of motor-demanding tasks and hinder adaptive strategies.^[110]^[111] Psychosocial and environmental factors further modulate persistence. Low perceived physical competence and motivational deficits in childhood foster sedentary behaviors, perpetuating skill gaps through reduced practice opportunities.^[112] Socioeconomic indicators, such as lower maternal education, indirectly influence continuity by limiting access to interventions, while early occupational therapy targeting motor and self-efficacy skills can promote partial remission in milder cases.^[109] Without such supports, persistence rates climb, affecting employment and independence in adulthood.^[113]

History

Early Descriptions and Terminology Evolution

The earliest clinical descriptions of what is now recognized as developmental coordination disorder (DCD) emerged in the late 19th and early 20th centuries, focusing on congenital impairments in motor skill acquisition without evident neurological damage. In 1900, James Collier reported cases of "congenital maladroitness," characterizing children who exhibited persistent difficulties in coordinated movements despite normal intelligence and absence of paralysis or sensory loss.^[15] By 1937, Samuel Orton included such motor praxis deficits among six common developmental anomalies, emphasizing delays in skilled movements like writing or tool use that were not attributable to intellectual impairment.^[15] These accounts laid groundwork by distinguishing inherent motor clumsiness from acquired or pathological conditions, though lacking standardized criteria. Mid-20th-century terminology shifted toward syndromic labels reflecting presumed subtle neurological underpinnings. In 1966, the concept of "minimal brain dysfunction" was proposed to encompass coordination deficits, hyperactivity, and perceptual issues in children without overt brain lesions, influencing pediatric neurology but criticized for its vagueness and overinclusivity.^[114] Sasson Gubbay advanced the field in 1975 with his monograph The Clumsy Child, coining "clumsy child syndrome" for school-aged children displaying apraxic (planning) and agnosic (perceptual) motor errors—such as poor ball skills or handwriting—while exhibiting normal muscle tone, strength, and sensation; he estimated prevalence at 5-6% based on clinical observations.^[115] ^[116] This term gained traction for its descriptive accuracy but was later seen as pejorative, prompting exploration of related labels like "developmental dyspraxia," defined as a praxis breakdown impairing voluntary motor execution across daily activities.^[114] By the late 20th century, efforts to unify terminology culminated in "developmental coordination disorder" to prioritize empirical motor impairment over speculative etiology. The DSM-III-R (1987) introduced "specific developmental disorder of motor skills," but the DSM-IV (1994) formalized DCD with criteria requiring significant coordination deficits interfering with academic or daily function, excluding better explanations like intellectual disability or medical conditions; this aligned with international consensus statements emphasizing prevalence around 6% and persistence into adulthood.^[11] Dyspraxia persisted in clinical use, often synonymously with DCD, but the latter gained preference for its neutrality and focus on observable coordination failures rather than inferred brain mechanisms, reducing diagnostic overlap with conditions like sensory integration disorders.^[114] This evolution reflected growing emphasis on verifiable motor assessments over anecdotal "clumsiness," though debates on term interchangeability continue in pediatric literature.^[12]

Key Research Milestones

The concept of persistent motor coordination deficits in children without obvious neurological pathology was first systematically described in the early 20th century as "congenital maladroitness," highlighting delays in skilled movements despite normal intelligence.^[117] By the 1960s, researchers like Gubbay employed the descriptor "clumsy" for children exhibiting motor acquisition difficulties, laying groundwork for empirical studies on prevalence and characteristics.^[118] A pivotal advancement occurred in 1975 when Sasson Gubbay published The Clumsy Child: A Study of Developmental Apraxic and Agnostic Ataxia, coining "clumsy child syndrome" to denote a specific developmental disorder marked by impaired praxis and spatial awareness, affecting 5-6% of schoolchildren based on clinical observations.^[116] This work shifted focus from anecdotal reports to structured evaluations, emphasizing exclusion of medical causes and integration with cognitive assessments. In October 1994, the London (Ontario) Consensus formalized "developmental coordination disorder" (DCD) as the preferred term, unifying disparate labels like dyspraxia and clumsy child syndrome, while the DSM-IV introduced diagnostic criteria requiring marked motor impairment impacting daily functioning, onset in childhood, and non-attribution to other disorders.^[119]^[120] The 2006 Leeds Consensus refined diagnostic tools, endorsing standardized assessments like the Movement Assessment Battery for Children (developed in 1992) for quantifying motor deficits and supporting prevalence estimates of 1.8-6% across populations.^[119] DSM-5 in 2013 reclassified DCD under neurodevelopmental disorders, prompting a surge in research—publications doubled from 308 in 2013 to 640 by 2021—emphasizing neuroimaging (e.g., fMRI revealing cerebellar and basal ganglia anomalies) and longitudinal outcomes.^[118] In 2019, international clinical practice recommendations synthesized evidence for refined criteria, assessment protocols, and task-oriented interventions, underscoring persistent challenges in adult transition.^[121]

Controversies

Diagnostic Validity and Over/Under-Diagnosis Debates

Developmental coordination disorder (DCD) is diagnosed according to DSM-5 criteria, which require motor skills substantially below those expected for the individual's age, significantly interfering with daily activities or academic/occupational performance, onset during developmental period, and exclusion of intellectual disability or other neurological/medical conditions as primary explanations.^[11] These criteria emphasize functional impairment over isolated motor deficits, with quantitative assessments often using cutoffs at or below the 15th percentile on standardized motor tests, as employed in 97% of research studies reviewed for clinical and research purposes.^[122] Diagnostic validity is supported by tools like the Developmental Coordination Disorder Questionnaire (DCDQ), which demonstrates adequate predictive accuracy for identifying motor skill deficits in children, with studies validating its use across populations including those with autism spectrum disorder comorbidities.^[83] ^[123] Despite this, debates persist regarding DCD's nosological distinctiveness, particularly its overlap with conditions like ADHD and autism, where motor impairments may not fully differentiate from DCD-specific profiles, raising questions about whether DCD represents a unique entity or a dimension of broader neurodevelopmental motor variance.^[124] Critics argue that the diagnosis's validity hinges on establishing familial aggregation, biological markers, and course stability akin to other psychiatric disorders, yet empirical support remains mixed, with some analyses questioning the specificity of "specific" developmental disorders like DCD due to heterogeneous etiologies and exclusionary criteria that may artifactually define boundaries.^[125] Screening instruments such as the MobiScreen show high diagnostic validity in preschoolers, but reliability can vary with observer subjectivity and cultural adaptations, underscoring the need for multimodal assessments combining parent reports, clinical observations, and performance tests.^[126] Under-diagnosis predominates in discussions, with DCD affecting 5-6% of school-aged children—comparable to ADHD prevalence—yet remaining under-recognized due to limited awareness among educators, primary care providers, and psychiatrists, leading to missed interventions and persistent adult sequelae.^[4] ^[127] In the UK, systemic failures in identification and support exacerbate this, with children often dismissed as "clumsy" despite evidence of lifelong impacts on employment and mental health.^[128] Adult under-diagnosis is particularly acute, as psychiatrists infrequently consider DCD in presentations of anxiety or executive dysfunction, despite its persistence into adulthood in up to 50-70% of cases.^[10] ^[129] Over-diagnosis concerns are less substantiated but arise in debates over pathologizing mild motor delays, where environmental factors like reduced physical education or screen time might mimic criteria without underlying neurodevelopmental deficits, though prevalence studies using strict functional impairment thresholds mitigate this risk.^[3] Professional (un)awareness contributes to diagnostic inconsistencies, with surveys indicating gaps in training that perpetuate under-identification over inflation.^[130]

Causal Attribution Disputes

The etiology of developmental coordination disorder (DCD) remains incompletely understood, with researchers attributing symptoms to a heterogeneous mix of factors including genetic predispositions, perinatal complications, and neurological immaturity, yet lacking consensus on primary mechanisms.^[11] Proposed neurological bases involve under-activation in motor learning regions, abnormalities in parietal, frontal, and cerebellar cortices, and altered white matter connectivity, as evidenced by functional MRI studies showing atypical brain activation patterns during motor tasks.^[11] Genetic influences are hypothesized due to familial clustering and shared vulnerabilities with other neurodevelopmental conditions, though specific genes have not been identified, complicating attribution.^[11] Perinatal risks such as prematurity, low birth weight, and neonatal admission have been associated with increased likelihood, but recent causal modeling in large cohorts indicates only male sex and neonatal ward admission exert direct effects, while factors like preterm birth and maternal smoking show no such causality after adjustment.^[131]^[132] Disputes center on whether DCD arises primarily from centralized brain-based deficits in information processing—such as internal modeling deficits impairing predictive motor control—or from decentralized dynamical systems failures in perception-action coupling, where environmental interactions and self-organization play key roles.^[133]^[134] The information processing framework, emphasizing executive function impairments and frontoparietal network delays, garners support from neuroimaging of reduced sensory-motor tract connectivity and higher executive deficit rates (up to 41% in affected children), but critics argue it relies on weak empirical data and overlooks coordination variability, advocating dynamical perspectives that highlight degraded affordance perception without invoking isolated neural lesions.^[133]^[134] These debates reflect broader tensions in prioritizing reductionist neurocognitive models over holistic, interactionist ones, with much evidence remaining correlational rather than establishing temporality or necessity.^[134] Further contention involves the extent to which DCD constitutes a discrete motor entity versus a manifestation of overlapping neurodevelopmental comorbidities, such as attention-deficit/hyperactivity disorder or dyslexia, potentially inflating causal attributions to shared genetic or maturational pathways without isolating DCD-specific origins.^[11] While sensorimotor pathway disruptions are frequently implicated as core, the heterogeneity of presentations—ranging from pure coordination deficits to co-occurring cognitive-motor integration issues—undermines unified causal models, with ongoing research emphasizing multifactorial interplay but sparse direct evidence for any single pathway.^[133]^[131] This uncertainty persists despite advances in brain imaging and cohort studies, highlighting the need for longitudinal designs to disentangle bidirectional influences between early risks and persistent motor impairments.^[11]

References

[1]
Current Perspectives on Developmental Coordination Disorder (DCD)
Children with DCD display motor difficulties which persist into adulthood and cannot be better explained by a medical or neurological condition (APA, 2013). The ...
[2]
International clinical practice recommendations on the definition ...
Jan 22, 2019 · DCD, according to the DSM-52 is defined by the following four criteria: (1) acquiring and execution of coordinated motor skills is far below ...
[3]
An Investigation of Developmental Coordination Disorder ...
There are four criteria in the DSM-5 that should be met to warrant a diagnosis of DCD: (a) Acquisition and execution of coordinated motor skills are below what ...
[4]
Diagnosis and management of developmental coordination disorder
Developmental coordination disorder is a common neuromotor condition, affecting about 5%–6% of school-aged children.
[5]
Developmental coordination disorder and dysgraphia: signs and ...
Jul 8, 2019 · The motor signs encountered in DCD include difficulty executing coordinated motor actions, and fine and gross motor disorders, resulting in ...
[6]
Assessment, diagnosis, and management of developmental ...
Sep 20, 2021 · Developmental coordination disorder (DCD) is a neurodevelopmental condition that affects 5% to 6% of school-aged children.<|separator|>
[7]
Developmental Coordination Disorder - CanChild
Developmental Coordination Disorder (DCD) is a motor skills disorder that affects five to six percent of all school-aged children.Causes & Identification · Assessment & Diagnosis · Educational Materials
[8]
New trends in developmental coordination disorder - Frontiers
Jan 26, 2023 · Developmental coordination disorder (DCD) is a motor development disorder characterized by inadequate motor performance, which affects ...<|separator|>
[9]
Children with developmental coordination disorders: a review of ...
May 23, 2024 · Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder that impairs a child's ability to perform coordinated motor movements ...
[10]
Developmental coordination disorder in adults: A case series of a ...
Finally, an additional criterion included in DSM-5 is that the onset of symptoms occurs during the developmental period; while highlighting that DCD remains a ...
[11]
Developmental Coordination Disorder (Dyspraxia) - StatPearls - NCBI
Feb 24, 2024 · Developmental coordination disorder (DCD), or dyspraxia, is a neurodevelopmental disorder characterized by poor motor coordination and difficulty learning ...Introduction · History and Physical · Evaluation · Differential Diagnosis
[12]
Developmental coordination disorder: A review and update
DCD is a neuromotor disability in which a child's motor coordination difficulties significantly interfere with activities of daily living or academic ...
[13]
Children with developmental coordination disorders: a review of ...
May 22, 2024 · Children with DCD often exhibit clumsiness, lack of balance and coordination, and struggle with everyday tasks such as grasping objects, ...Introduction · Assessment of children with... · Rehabilitation for children with...
[14]
Developmental Coordination Disorder - PsychDB
Mar 29, 2021 · DSM-5 Diagnostic Criteria. Criterion A. The acquisition and execution of coordinated motor skills is substantially below that expected given the ...
[15]
Developmental Coordination Disorder DSM-5 315.4 (F82)
Diagnostic Criteria. The acquisition and execution of coordinated motor skills is substantially below that expected for the patient's age and opportunities for ...
[16]
Developmental Coordination Disorder (DCD): Relevance for Clinical ...
DSM 5: Developmental Coordination Disorder. (A) the acquisition and execution ... The ICD-11 “Developmental Motor Coordination Disorder” lists symptoms ...
[17]
Healthcare Professionals - Dyspraxia DCD America
Sep 8, 2025 · Summary of DSM-5 Diagnostic Criteria for Developmental Coordination Disorder 315.4 (F82). A. Motor skills are substantially below age ...
[18]
DCD Diagnosis in ICD | Cadabam's Child Development Centre - CDC
The code is 6A04: Developmental motor coordination disorder. ICD-11 aims to provide more detail and clinical utility. Cadabam's Child Development Center is ...
[19]
Developmental coordination disorder: Clinical features and diagnosis
Nov 1, 2024 · Developmental coordination disorder (DCD) is characterized by ... "Developmental motor coordination disorder" is the preferred term in ...
[20]
Advances in Genetics and Epigenetics of Developmental ...
Jun 11, 2023 · This review provides an overview of the current knowledge in genetic research on DCD, highlighting the importance of continued research into the underlying ...
[21]
Genome-Wide Association Study of Motor Coordination - Frontiers
It is also widely accepted that genetics play a major role in an individual's risk for developing DCD, although no specific genes or molecular pathways have ...
[22]
DCD and ADHD: A genetic study of their shared aetiology
The aim of the present investigation was to examine the extent to which the shared aetiology is due to common genetic factors to both disorders. We also ...
[23]
A meta-analysis of genetic effects associated with ... - Nature
Feb 20, 2023 · A meta-analysis of seven twin studies of clinically diagnosed ASD in child and adolescent samples yielded a grand heritability (h2) estimate of ...
[24]
association between DNA methylation and motor performance - PMC
Sep 9, 2025 · Epigenetic modifications in developmental coordination disorder: association between DNA methylation and motor performance. Fangfang Huang ...
[25]
Epigenetic modifications in developmental coordination disorder
The mechanisms underlying DCD have not been clearly defined, but evidence suggests that they may involve the interaction of genetic and environmental factors.
[26]
Subcortical brain structure in children with developmental ...
Aug 13, 2021 · The current study investigated cortical and subcortical volumes in 37 children with DCD, aged 8 to 12 years, and 48 controls of a similar age.
[27]
Neural Signature of DCD: A Critical Review of MRI Neuroimaging ...
Our results indicate that several brain areas are unquestionably linked to DCD: cerebellum, basal ganglia, parietal lobe, and parts of the frontal lobe.
[28]
Brain activation associated with motor skill practice in children with ...
Using functional magnetic resonance imaging, we mapped brain activity associated with skilled motor practice of a trail-tracing task in 7 children with DCD and ...
[29]
Neural Basis and Motor Imagery Intervention Methodology Based on ...
Jan 22, 2021 · Brain function analyses using MRI for children with DCD involve the following: (1) fMRI; (2) diffusion tensor imaging (DTI); or (3) voxel-based ...
[30]
Children with developmental coordination disorder show altered ...
Children with DCD demonstrate altered functional connectivity between the sensorimotor network and the posterior cingulate cortex (PCC), precuneus, and the ...
[31]
Developmental Coordination Disorder: State of the Art and Future ...
Developmental coordination disorder (DCD) is a common neurodevelopmental condition characterized by disabling motor impairments being visible from the first ...2. Planning And Monitoring... · 2.4. Efference Copy And... · 5. Neural Correlates Of Dcd...<|separator|>
[32]
Cerebellar and brainstem differences in children with developmental ...
Jul 28, 2022 · It is posited that DCD may be related to the central nervous system pathology, particularly the parietal lobe, basal ganglia, and the cerebellum ...
[33]
A Combined Systematic Review and Meta-Analysis of Recent Findings
The latest neuroimaging research suggests disruptions to both neural structure and functional activation patterns in children with DCD. A recent review by ...Introduction · Methods · Results · Discussion
[34]
Brain Imaging Increases Our Understanding of Developmental ...
Mar 26, 2015 · This review will focus on neuroimaging techniques and summarize current knowledge gained from brain imaging studies on motor impairment in children with DCD.
[35]
Perinatal risk factors for developmental coordination disorder in ...
Jan 1, 2023 · The risk of DCD in children born extremely preterm was multifactorial and associated with gestational age largely mediated by ROP, ...
[36]
Early factors associated with risk of developmental coordination ...
Apr 18, 2022 · Neonatal morbidities, including seizures, prolonged jaundice, disruption of brain white matter, retinopathy of prematurity, and bronchopulmonary ...
[37]
Perinatal and neonatal predictors of developmental coordination ...
Perinatal variables significantly associated with DCD were male sex, lower gestational age and lower birth weight, but only male sex and low birth weight ...
[38]
https://www.sciencedirect.com/science/article/abs/pii/S0891422220301293
[39]
The prenatal, perinatal and neonatal risk factors for children's ...
Maternal age, threatened abortion, fetal distress during labor, preterm birth, chronic lung disease and newborn pathological jaundice were related with DCD.
[40]
Perinatal risk factors for developmental coordination disorder in ...
Jan 1, 2023 · Pre-eclampsia was significantly associated with DCD in our study. This condition has been shown to increase the risk of intrauterine growth ...
[41]
Mothers' prenatal tobacco smoke exposure is positively associated ...
Mar 27, 2020 · Prenatal tobacco smoke exposure is a potential risk factor for developmental coordination disorder (DCD) in children, but evidence on the ...
[42]
Prenatal second-hand smoke exposure and the risk of suspected ...
Nov 8, 2022 · Maternal active smoking during pregnancy has been confirmed as a risk factor for developmental coordination disorder (DCD) (21). However, the ...
[43]
Association of developmental coordination disorder with early-life ...
Jan 30, 2023 · In general, both prenatal and postnatal PM2.5 exposure was associated with elevated risks of DCD. Specifically, for each IQR increase in PM ...
[44]
338 family income as an environmental risk factor for children with ...
In this sample, family income was shown to be an environmental risk factor for DCD in children aged 6 to 11 years.
[45]
The prenatal, postnatal, neonatal, and family environmental risk ...
Jul 2, 2020 · The results confirmed that male sex, BMI score, preterm birth, and some prenatal conditions are significant risk factors for DCD.
[46]
Preterm Birth and Developmental Coordination Disorder: What Do ...
Oct 2, 2023 · Recent findings indicate that preterm birth is associated with a greater risk of DCD, with increasing severity of impairment observed with decreasing ...
[47]
Developmental coordination disorder - PubMed
Developmental coordination disorder (DCD) is a neurodevelopmental disorder that affects children's ability to execute coordinated motor actions.
[48]
Motor Skills and Visual Deficits in Developmental Coordination ... - NIH
Dec 15, 2022 · The main motor deficits described in the DSM-V are voluntary gaze control during movement, dependent motor training/learning, cognitive/motor ...
[49]
Developmental coordination disorder: a review and update - PubMed
Developmental coordination disorder (DCD) is a neuromotor disability in which a child's motor coordination difficulties significantly interfere with activities ...
[50]
Motor-Based Interventions in Children with Developmental ...
May 26, 2025 · Children with DCD exhibit a broad spectrum of coordinated motor skill difficulties, encompassing both gross and fine motor skills. This is ...
[51]
Perspective: Acknowledging complexity to advance the ... - Frontiers
Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder characterized by difficulties in motor learning, execution, and coordination ( ...<|control11|><|separator|>
[52]
Motor skill learning in children with Developmental Coordination ...
Apr 11, 2013 · Children with Developmental Coordination Disorder (DCD) are characterized as having motor difficulties and learning impairment that may last ...
[53]
Developmental Coordination Disorder (Dyspraxia) - PubMed
Feb 24, 2024 · Developmental Coordination Disorder (DCD), or dyspraxia, is a neurodevelopmental disorder characterized by poor motor coordination and difficulty learning ...
[54]
Assessment of Upper Limb Proprioception in Children with ...
Conclusion: This study documents that DCD is associated with a dysfunction of position sense. Furthermore, the proprioceptive dysfunction affected both proximal ...<|separator|>
[55]
Systematic Review of Visual Motor Integration in Children with ...
Jul 22, 2021 · ... Visual Motor Integration,” and “developmental coordination disorder,” respectively. ... integration difficulties underpin motor dysfunction ...
[56]
Cognitive, perceptual, and motor profiles of school-aged children ...
Developmental coordination disorder (DCD) is a heterogeneous condition. Besides motor impairments, children with DCD often exhibit poor visual perceptual ...
[57]
Activities of Daily Living in Children With Developmental ...
Daily living skills and developmental coordination disorder . In: Cermak. SA ... Developmental coordination disorder: a review of research on subtypes and ...
[58]
Activities of daily living in children with developmental coordination ...
... daily living skills like dressing, personal ... Quality of life domains affected in children with developmental coordination disorder: A systematic review.
[59]
Impacts of Developmental Coordination Disorder on Postural ...
Apr 30, 2024 · Several studies have demonstrated balance impairments in children with developmental coordination disorder (DCD).
[60]
Developmental Coordination Disorder Clinical Practice Guideline ...
Developmental Coordination Disorder. Developmental coordination disorder ... daily living skills, school productivity, leisure and play, 3) symptoms ...
[61]
(PDF) Activities of Daily Living in Children With Developmental ...
Aug 7, 2025 · PDF | Children with developmental coordination disorder (DCD) face evident motor difficulties in daily functioning ... functional impairments ...
[62]
Developmental Coordination Disorder and Most Prevalent ... - NIH
Jul 21, 2022 · Attention Deficit/Hyperactivity Disorder (ADHD) is one of the main developmental disorders whose prevalence is estimated to be around 4–9% of ...
[63]
Children with developmental coordination disorder show altered ...
Common comorbidities include Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), learning disorders, and specific language ...
[64]
Internalising symptoms in developmental coordination disorder: a ...
There is growing evidence that DCD is associated with greater levels of internalising symptoms (i.e. depression and anxiety).Missing: impacts | Show results with:impacts<|separator|>
[65]
Physical and Mental Health of Children with Developmental ... - NIH
They also report significantly more symptoms of depression, state, and trait anxiety than their peers (36). Retrospectively, adults with DCD have described the ...
[66]
Psychosocial wellbeing, parental concerns, and familial impact of ...
Dec 30, 2023 · Children with DCD were rated significantly higher for emotional and peer problems, and significantly lower for prosocial behaviours.
[67]
Mental health outcomes of developmental coordination disorder in ...
Previous research has shown that children with DCD have an increased risk of mental health difficulties compared with their peers.
[68]
The Relationship Between Bullying and Self-Worth in Children With ...
Furthermore, children with movement problems such as developmental coordination disorder (DCD) are considered at risk of both victimization and low self-worth.
[69]
Psychosocial wellbeing, parental concerns, and familial impact of ...
Developmental Coordination Disorder (DCD) is a neurodevelopmental condition ... bullying and impair participation in social play, thereby reducing ...
[70]
Physical and Mental Health of Children with Developmental ...
Teachers report that school-aged children with DCD have fewer friends and are more socially isolated than their peers (14, 15), and tend to report lower self- ...
[71]
A systematic review and meta-ethnography of qualitative research
Mar 4, 2021 · This neurodevelopmental disorder Developmental Coordination Disorder (DCD) affects between 5% to 6% of the paediatric population [1] and is ...
[72]
The prevalence of developmental coordination disorder in children
Sep 26, 2024 · The prevalence of children with DCD was found to be 5%. A subgroup analysis showed that prevalence was 7% [95% confidence interval (CI) 4%–10%] and 4% (95% CI ...
[73]
The current state of Developmental Coordination Disorder (DCD) in ...
The most common co-occurring diagnoses were childhood apraxia of speech and other speech-language disorders (24.6%), ADHD (23.1%), and anxiety (18.8%). Most ...
[74]
Prevalence and associated factors of developmental coordination ...
Jul 15, 2024 · Of the 198 children interviewed, 49 met the diagnostic criteria for DCD. The prevalence of DCD in Türkiye was found to be 2.1%.
[75]
Rates of Developmental Coordination Disorder in Children Born ...
Dec 16, 2020 · The rates of DCD in very preterm children reduced from 47.9% at 5 years of age, to 28.5% at 7 years and 27.8% at 13 years of age (OR per year of ...
[76]
Developmental Coordination Disorder | Physical Therapy
Aug 1, 2003 · With a more precise definition of DCD, the current prevalence is estimated to be between 5% and 8% of all school-aged children,5,9–11 with more ...
[77]
Risk factors in early life for developmental coordination disorder
Dec 20, 2020 · Preterm birth is a risk factor for developmental coordination disorder (DCD). In term-born children, male sex was consistently associated with DCD.
[78]
PREVALENCE OF DCD IN CHILDREN IN GRADE 1 The distribution ...
The prevalence of DCD has primarily been documented within the pediatric population, with a prevalence of 5-6% (Blank et al., 2019).
[79]
[PDF] Multi-scale social-economic-environmental inequities lead to ...
Rural areas (18.5%) had a higher DCD incidence rate than urban areas (15.6%). Geographical Detector revealed strong interactions between factors affect- ing DCD ...
[80]
[PDF] The Relationship Between Demographics and Early and Later Motor ...
Feb 28, 2023 · Even with at-risk minority populations, there are only a few studies examining the potential differences in race/ethnicity in relation to DCD.Missing: variations | Show results with:variations
[81]
Developmental coordination disorder in geographic cohorts of 8 ...
The prevalence of DCD was 16% in the EP/ELBW group and 5% in the comparison group (odds ratio 3.45; 95% confidence interval [CI] 1.47-8.09%). Academic outcomes ...
[82]
Predictive validity of the Developmental Coordination Disorder ...
May 13, 2024 · This study demonstrated that the DCDQ has adequate diagnostic accuracy, suggesting it can help screen children with motor skill deficits.
[83]
Predictive validity of the Developmental Coordination Disorder ...
The Developmental Coordination Disorder Questionnaire (DCDQ) has been used to screen children who probably have developmental coordination disorder (DCD).
[84]
The Developmental Coordination Disorder Questionnaire: Parent ...
The Little Developmental Coordination Questionnaire is a parent report measure that screens for motor coordination difficulties in 3- and 4- year old children.DCDQ - DCDQ · Little DCDQ-CA · FAQ · Spanish
[85]
Reliability and responsiveness of the Movement Assessment Battery ...
The MABC-2 Test is a reliable and valid measure to assess motor competence in children with DCD. The MID and MDC scores provide the reference point for ...
[86]
Validity and reliability of the movement assessment battery second ...
Apr 28, 2022 · The MABC-2 test can be considered a valid and reliable motor skill assessment tool for children with and without motor impairment.
[87]
[PDF] DCD Assessment Information Sheet
The most commonly used assessments are the Movement Assessment Battery for Children-2 (MABC-2)18 and the Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2) ...
[88]
Interrater Reliability of the Movement Assessment Battery for Children
In this study, we showed that the M-ABC provides a robust means of classifying children into the normal, at-risk, or definitely impaired category. The errors ...Method · Results · Discussion
[89]
Assessment & Diagnosis - CanChild
The M-ABC assesses a child's fine motor ability, their performance with ball skills, and their balance, and is intended specifically to identify children with ...
[90]
Motor Signature Differences Between Autism Spectrum Disorder ...
Dec 7, 2023 · Coupled with machine learning, kinematics recorded from the smart tablet game were able to categorize ASD from TD at 76%, ASD from DCD at 71%, ...<|separator|>
[91]
DIFFERENTIAL DIAGNOSES FOR DEVELOPMENTAL ... - NIH
The diagnosis of developmental coordination disorder (DCD) is based on four criteria outlined in the Diagnostic and Statistical Manual-5th ed. (American ...
[92]
Motor-Based Interventions in Children with Developmental ... - NIH
May 26, 2025 · Children with DCD exhibit a broad spectrum of coordinated motor skill difficulties, encompassing both gross and fine motor skills. This is ...
[93]
A systematic review of high quality randomized controlled trials ...
To identify effective motor training interventions for children with developmental coordination disorder from research graded as high quality (using ...
[94]
Efficacy of the Cognitive Orientation to daily Occupational ...
CO-OP with and without additional parental coaching resulted in improved occupational performance according to children, parents, and external evaluators.
[95]
The Effectiveness of Routine OT Interventions on Motor Skills for ...
Aug 1, 2019 · This study provides evidence as to the effectiveness of occupational therapy interventions on motor skills in fine motor integration and bilateral coordination ...
[96]
Evaluating the Efficacy of Gross-Motor-Based Interventions ... - MDPI
Aug 7, 2024 · This review quantitatively evaluates the effectiveness of gross-motor-based interventions in children with developmental coordination disorder (DCD).
[97]
A Systematic Literature Review and Meta-Analysis in
Task-oriented approaches as well as motor skill training–based interventions have shown beneficial effects in improving motor function in children with DCD.
[98]
Systematic Review to Inform the Developmental Coordination ...
Apr 1, 2025 · Systematically review current evidence on physical therapy (PT) intervention for developmental coordination disorder (DCD) to inform the update to the 2020 DCD ...
[99]
Children with DCD: At home, at school and in the community (Booklet)
Encourage the child to participate in practical activities that will help improve his/her ability to plan and organize motor tasks. For example, setting the ...
[100]
Classroom accommodations for developmental coordination disorder
Provide extra time to complete work. · Give directions slowly and in short sentences. · Pre-teach physical skills in small parts. · Teach specific handwriting ...
[101]
Working with students with developmental coordination disorder
Feb 1, 2024 · Effective teaching for any student with DCD is about building a model of support for the student with open lines of communication.Whole-school approach · Strategies for classroom...Missing: measures | Show results with:measures
[102]
Strategies to Accommodate Children with Developmental ...
Nov 5, 2015 · Therefore, the purpose of this article is to outline five strategies (group instruction, cues for learning, goal setting and routines, product- ...
[103]
Task‐oriented interventions for children with developmental co ...
To assess the effectiveness of task‐oriented interventions on movement performance, psychosocial functions, activity, and participation for children with DCD
[104]
Developmental Coordination Disorder - Cincinnati Children's Hospital
Developmental coordination disorder (DCD) affects how a child plans and carries out movements. Learn about causes, symptoms, diagnosis and treatment.Missing: prevalence | Show results with:prevalence
[105]
[PDF] Developmental Coordination Disorder - Liberty University
The idea is that the learning and application of cognitive strategies will promote enhanced problem-solving skills that can be used to handle motor difficulties ...
[106]
Impact of developmental coordination disorder in childhood on ... - NIH
Developmental coordination disorder (DCD) is related to poorer educational outcomes among children and adolescents. Evidence on this association into adulthood ...Missing: prognosis | Show results with:prognosis
[107]
Two distinct pathways for developmental coordination disorder
This article describes the perceptual motor, educational and social outcome of early motor delay in a group of 17-18 year old Finnish adolescents.
[108]
Full article: Developmental coordination disorder and dysgraphia
Jul 8, 2019 · Studies show DCD persistence of 30–70% in adulthood for individuals who were diagnosed with DCD as children, with direct consequences in the ...
[109]
Effect of childhood developmental coordination disorder on ...
Individuals at risk of Developmental Coordination Disorder (DCD) have low levels of physical activity in childhood due to impaired motor competence; ...Missing: prognosis | Show results with:prognosis
[110]
24-year follow-up of a population-based sample | BMC Psychiatry
Mar 22, 2021 · ADHD+DCD entailed a less favorable outcome in adulthood compared to a non-clinical comparison group and a registry-matched population.
[111]
The impact of developmental coordination disorder on educational ...
Those with DCD were more likely to have persistent difficulties with reading, social communication and hyperactivity/inattention, which all affected educational ...
[112]
Two distinct pathways for Developmental Coordination Disorder
Aug 7, 2025 · Those with this condition may report issues with academic-related tasks, with consequent poor school outcomes despite an average IQ [122, 136] .
[113]
Young Adults With Developmental Coordination Disorder
May 1, 2014 · We conducted a longitudinal study to assess the continuing influence of developmental coordination disorder (DCD) on quality of life and ...
[114]
Dyspraxia or developmental coordination disorder? Unravelling the ...
Dyspraxia has been defined as “a breakdown of praxis [action]” and “the inability to utilise voluntary motor abilities effectively in all aspects of life from ...Missing: evolution | Show results with:evolution
[115]
CLUMSY CHILDREN IN NORMAL SCHOOLS - GUBBAY - 1975
Feb 1, 1973 · Approximately 50 of these clumsy children have been studied in detail and have shown important educational, neurological and ...
[116]
Evaluation of Clumsiness in Children - AAFP
Oct 15, 2002 · In 1975, Gubbay coined the term “clumsy child syndrome” to describe children of normal intelligence who were without an identifiable medical or ...Missing: origin | Show results with:origin
[117]
https://www.dyspraxiamagazine.com/blogs/articles/history-of-dyspraxia
[118]
New trends in developmental coordination disorder - PubMed Central
Jan 27, 2023 · Developmental coordination disorder (DCD) is a motor development disorder characterized by inadequate motor performance, which affects ...
[119]
https://www.pearsonclinical.co.uk/content/dam/school/global/clinical/uk-clinical/files/LeedsConsensus06-movement-abc_2.pdf
[120]
Developmental coordination disorder: Clinical features and diagnosis
Nov 1, 2024 · Developmental coordination disorder (DCD) is characterized by problems with motor coordination that interfere with academic performance and ...<|separator|>
[121]
International clinical practice recommendations on the definition ...
... intervention of developmental coordination disorder (long version). Dev Med ... Two distinct pathways for developmental coordination disorder: persistence and ...
[122]
Clinical and research diagnostic criteria for developmental ...
The review, however, shows that when quantitative criteria were used, nearly all studies (97%) used the 15th centile or – 1 S.D. cut-off score. The additional ...Missing: dyspraxia reliability
[123]
https://onlinelibrary.wiley.com/doi/10.1002/aur.3189
[124]
Is Motor Impairment in Autism Spectrum Disorder Distinct From ...
Only 15.1% of children with ASD held a dual diagnosis of DCD, whereas 58% of children with ASD had a communication disorder (ie, articulation problems, ...
[125]
The case of 'specific' developmental disorders - ResearchGate
Aug 10, 2025 · ... developmental coordination disorder (DCD) and mixed receptive ... Establishment of Diagnostic Validity in Psychiatric Illness: Its Application to ...
[126]
Is screening for motor skill deficits in Tyrolean preschool children ...
Jun 20, 2024 · ... developmental coordination disorder (DCD) and how it evolves over a ... Regarding diagnostic validity, the MobiScreen 4–6 has a very ...
[127]
What is DCD? The underdiagnosed condition as common as ADHD
Sep 22, 2025 · New findings reveal how deeply developmental coordination disorder is impacting the lives of around 5 per cent of UK children.
[128]
Dyspraxia: why children with developmental coordination disorder in ...
Jul 10, 2025 · Dyspraxia: why children with developmental coordination disorder in the UK are still being failed. Published: July 10, 2025 12:03pm EDT.
[129]
DCD in adulthood - Uppsala University
May 7, 2025 · Developmental Coordination Disorder (DCD) is a neurodevelopmental ... Despite its prevalence, DCD remains underrecognized and underdiagnosed, ...
[130]
(Un)awareness of Developmental Coordination Disorder Across ...
May 3, 2023 · Developmental Coordination Disorder (DCD) is a common condition with core difficulties in motor skills. Recent research has identified links ...
[131]
Causal Effects on Early Risk Factors of Developmental Coordination ...
Mar 3, 2025 · Only male sex and neonatal admission to the paediatric ward had a direct causal effect on at risk for DCD and probable DCD.
[132]
Developmental co-ordination disorder (dyspraxia) in children - NHS
It causes a child to perform less well than expected in daily activities for their age, and appear to move clumsily.Missing: prevalence | Show results with:prevalence
[133]
Awareness about developmental coordination disorder - Frontiers
Jan 31, 2024 · Apart from individual factors related to motor skill and fatigue, factors related to the social network, such as lack of support from peers and ...
[134]
Developmental coordination disorder and its cause: The road less ...
We critically review the research literature that seeks to focus on the possible cause of children diagnosed with developmental coordination disorder (DCD).