Dyspraxia (DCD)

What it is

Developmental coordination disorder, often called dyspraxia in the UK: motor coordination well below what is expected for age, affecting everyday tasks.

Common experiences

May affect handwriting, dressing, cooking, driving, balance, and organization. Many people build strong workarounds.

What helps

Occupational therapy, breaking skills into steps, extra practice time, assistive tools, and patience.

Across life

Children may be late to ride a bike, tie shoes, or catch a ball and seem clumsy. Adults may find driving, cooking, handwriting, and spatial planning hard. Fatigue and low confidence are common.

Evaluation and treatment

A pediatrician, occupational therapist, or physiotherapist assesses motor skills and daily-life impact and rules out other medical causes. Occupational therapy focuses on practical skills and strategies.

Myth vs fact

Myth: it is just clumsiness that children outgrow. Fact: DCD often continues into adulthood, though strategies and tools help.

Full chapter

Definitions and terminology

In the DSM-5-TR, developmental coordination disorder (DCD) is diagnosed when motor skills are well below what is expected for a person's age and chances to learn, showing up as clumsiness, slowness, or inaccuracy. The difficulties must begin in the early developmental period, persist, and significantly interfere with daily living, school, work, or leisure, and they must not be better explained by intellectual disability, vision problems, or a neurological condition affecting movement. The ICD-11 calls it developmental motor coordination disorder. Dyspraxia is a common name, especially in the UK, and international recommendations use DCD as the diagnostic term (Blank et al., 2019). DCD is different from childhood apraxia of speech, a separate motor speech disorder, although the two can occur together (American Speech-Language-Hearing Association, 2007).

How common it is and what causes it

The DSM-5-TR reports that DCD affects about 5 to 6 percent of children aged 5 to 11 and is identified more often in boys than in girls. Its causes are not fully understood. Studies point to differences in brain networks involved in planning and controlling movement (Zwicker et al., 2012), and children born very preterm or at very low birth weight have higher rates of DCD (Edwards et al., 2011). Research suggests that people with DCD may have particular difficulty predicting the results of their own movements and using executive functions to plan and adjust actions (Wilson et al., 2013). DCD is not caused by laziness, lack of practice, or low intelligence.

How DCD looks across ages

Early signs can include delays in sitting, crawling, or walking, and later in learning to dress, use cutlery, ride a bike, catch a ball, or tie shoelaces. School-age children may seem clumsy, avoid games and sport, struggle with handwriting, and take much longer than peers to learn new motor skills. Teens and adults may find driving, cooking, using tools, packing, and keeping a tidy workspace demanding, and many describe tiring easily because everyday movements take so much concentration (Missiuna et al., 2008).

Everyday impact

DCD can affect fine motor tasks such as handwriting, buttons, zips, and keyboard use; whole-body skills such as balance, stairs, sport, and cycling; and planning and organizing tasks such as cooking, packing a bag, and finding your way around. It can limit participation in games and social activities, which in turn affects friendships and fitness. In a UK population study, secondary school students with probable DCD had poorer educational outcomes on average (Harrowell et al., 2018), which shows how much unrecognized motor difficulty can affect learning.

Not just clumsiness

DCD involves difficulty learning, planning, and automating movement sequences, not just a lack of strength or practice. A skill that others pick up in a few tries may need many repetitions, and a skill that is mastered one day can feel hard the next. Understanding DCD as a difference in how movement is planned helps explain why effort alone does not fix it, and why strategies that break skills into steps and practice real tasks help.

Co-occurring differences

DCD often occurs with ADHD (Kadesjo & Gillberg, 1999). Motor coordination difficulties are also common in autistic children, with most children in one study showing definite or borderline motor impairment (Green et al., 2009), and motor difficulties are common alongside language disorders (Hill, 2001). DCD often occurs with dyslexia, dyscalculia, and dysgraphia too (Blank et al., 2019). A thorough assessment looks at attention, language, learning, social communication, and mental health, not movement alone.

Wellbeing and mental health

Reviews link poor motor coordination in childhood with higher rates of anxiety, low mood, and behavior difficulties (Cairney et al., 2010). Adults with suspected DCD in one study reported more symptoms of anxiety and depression and poorer general wellbeing than adults without DCD (Kirby et al., 2013). Young adults in a Canadian study described frustration, fatigue, and the stress of being misunderstood, alongside strengths such as determination and creative problem solving (Missiuna et al., 2008). Recognition, practical supports, and people who understand protect wellbeing. If you are struggling emotionally, the Crisis help page lists where to turn.

Persistence across life

DCD often continues into adulthood. In a ten-year follow-up study, many children identified as clumsy still had motor difficulties as teenagers (Losse et al., 1991). Parents and young adults describe major transitions, such as learning to drive, moving out, starting work, and living independently, as especially demanding, and many take longer or need practical strategies to manage them (Kirby et al., 2011).

Getting assessed

The international recommendations call for assessment that combines developmental and medical history, standardized testing of motor skills, and evidence of how the difficulties affect everyday activities, and for ruling out other medical causes (Blank et al., 2019). A widely used motor test is the Movement ABC-2 (Henderson et al., 2007). In practice, assessment may involve a pediatrician, occupational therapist, or physiotherapist. Services for adults are less common, so you may need to seek out an occupational therapist or clinician with experience in DCD in adulthood. The aim is to understand strengths and needs, not only to assign a label.

Support that works

The recommendations favor task-oriented, goal-directed approaches that practice the real activities a person wants or needs to do, rather than general exercise alone (Blank et al., 2019). A systematic review and meta-analysis found that interventions focused on practicing real tasks improved motor performance (Smits-Engelsman et al., 2013). One example, developed in Canada, is the CO-OP approach, which teaches people a goal-plan-do-check strategy for solving their own motor performance problems (Polatajko & Mandich, 2004). Breaking skills into steps, extra practice time, and assistive tools such as keyboards, adapted utensils, and organizing apps all help.

School and the classroom

A school-based occupational therapy model developed in Ontario, called Partnering for Change, has therapists work with teachers and families to support children with DCD in everyday classroom routines rather than only in separate sessions (Missiuna et al., 2012). Useful classroom supports include typing instead of handwriting, extra time, reduced copying from the board, clear step-by-step instructions, adapted physical education that focuses on personal progress, and help with organizing a bag and desk.

Adults, work, and daily life

Adults with DCD often manage by building routines and using tools: voice and keyboard input instead of handwriting, apps for organizing and reminders, step-by-step checklists, labeled storage, automatic or adapted equipment, and extra time for new motor tasks such as driving lessons. At work, useful adjustments include a keyboard-based workflow, a predictable workspace, and written instructions. The Toolkit page offers a task breaker and a visual schedule builder.

School, work, and rights

A student with DCD may be eligible for services under Section 504 or the IDEA in the United States if the condition affects learning, and eligibility depends on educational impact and local rules; the ADA applies at work. In the UK, the Equality Act 2010 requires reasonable adjustments, and in Canada provincial and territorial human rights codes require accommodation to the point of undue hardship. Laws and eligibility vary, so confirm locally, and see the Resources page.

Identity and being understood

DCD is not clumsiness that people should simply try harder to overcome, and it says nothing about intelligence or character. People with DCD are often told they are careless, lazy, or unsporty. Naming it helps people ask for the right supports and helps others respond with patience rather than judgment.

For families, teachers, and colleagues

Believe that everyday movement can be effortful and tiring. Break tasks into steps, allow extra time, offer alternatives to handwriting and timed motor tasks, and avoid public comparisons in sport and handwriting. Celebrate effort and personal progress. Parents can look for activities such as swimming, cycling, climbing, or martial arts that fit the child's interests and allow progress at their own pace. The Resources page lists the Dyspraxia Foundation and other organizations.

Sources

1. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).
2. World Health Organization. International Classification of Diseases, 11th Revision (ICD-11), section on developmental motor coordination disorder.
3. Blank, R., et al. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine & Child Neurology, 61(3), 242-285.
4. American Speech-Language-Hearing Association. (2007). Childhood apraxia of speech [Technical report].
5. Zwicker, J. G., Missiuna, C., Harris, S. R., & Boyd, L. A. (2012). Developmental coordination disorder: A review and update. European Journal of Paediatric Neurology, 16(6), 573-581.
6. Edwards, J., et al. (2011). Developmental coordination disorder in school-aged children born very preterm and/or at very low birth weight: A systematic review. Journal of Developmental & Behavioral Pediatrics, 32(9), 678-687.
7. Wilson, P. H., Ruddock, S., Smits-Engelsman, B., Polatajko, H., & Blank, R. (2013). Understanding performance deficits in developmental coordination disorder: A meta-analysis of recent research. Developmental Medicine & Child Neurology, 55(3), 217-228.
8. Missiuna, C., Moll, S., King, G., Stewart, D., & Macdonald, K. (2008). Life experiences of young adults who have coordination difficulties. Canadian Journal of Occupational Therapy, 75(3), 157-166.
9. Harrowell, I., Hollen, L., Lingam, R., & Emond, A. (2018). The impact of developmental coordination disorder on educational achievement in secondary school. Research in Developmental Disabilities, 72, 13-22.
10. Kadesjo, B., & Gillberg, C. (1999). Developmental coordination disorder in Swedish 7-year-old children. Journal of the American Academy of Child & Adolescent Psychiatry, 38(7), 820-828.
11. Green, D., et al. (2009). Impairment in movement skills of children with autistic spectrum disorders. Developmental Medicine & Child Neurology, 51(4), 311-316.
12. Hill, E. L. (2001). Non-specific nature of specific language impairment: A review of the literature with regard to concomitant motor impairments. International Journal of Language & Communication Disorders, 36(2), 149-171.
13. Cairney, J., Veldhuizen, S., & Szatmari, P. (2010). Motor coordination and emotional-behavioral problems in children. Current Opinion in Psychiatry, 23(4), 324-329.
14. Kirby, A., Williams, N., Thomas, M., & Hill, E. L. (2013). Self-reported mood, general health, wellbeing and employment status in adults with suspected DCD. Research in Developmental Disabilities, 34(4), 1357-1364.
15. Losse, A., et al. (1991). Clumsiness in children: Do they grow out of it? A 10-year follow-up study. Developmental Medicine & Child Neurology, 33(1), 55-68.
16. Kirby, A., Edwards, L., & Sugden, D. (2011). Emerging adulthood in developmental co-ordination disorder: Parent and young adult perspectives. Research in Developmental Disabilities, 32(4), 1351-1360.
17. Henderson, S. E., Sugden, D. A., & Barnett, A. L. (2007). Movement Assessment Battery for Children, Second Edition (Movement ABC-2). Pearson.
18. Smits-Engelsman, B. C. M., et al. (2013). Efficacy of interventions to improve motor performance in children with developmental coordination disorder: A combined systematic review and meta-analysis. Developmental Medicine & Child Neurology, 55(3), 229-237.
19. Polatajko, H. J., & Mandich, A. (2004). Enabling Occupation in Children: The Cognitive Orientation to daily Occupational Performance (CO-OP) Approach. CAOT Publications ACE.
20. Missiuna, C., et al. (2012). Partnering for Change: An innovative school-based occupational therapy service delivery model for children with developmental coordination disorder. Canadian Journal of Occupational Therapy, 79(1), 41-50.
21. Equality Act 2010 (United Kingdom).

Citations are listed so you can verify claims and read further. Guidance is revised over time, so check for newer editions.