Developmental Coordination Disorder in Children: Signs And Best Treatment

Developmental coordination disorder in children affects motor skills, balance, coordination, and the ability to perform everyday activities.

Does your child frequently trip while walking, struggle to catch a ball, find handwriting difficult or need much more time than other children to learn physical activities?

While occasional clumsiness is common during childhood, persistent difficulties with movement and coordination may sometimes indicate Developmental Coordination Disorder in children (DCD).

Developmental Coordination Disorder is a neurodevelopmental condition that affects how children acquire, plan and perform coordinated movements.

It can make everyday activities such as running, jumping, dressing, handwriting, cycling and playing sports more challenging.

These difficulties are not caused by laziness or a lack of effort.

With appropriate assessment, practical support and pediatric physiotherapy, children can develop more effective movement strategies, improve their functional abilities and participate more confidently in everyday activities.

What Is Developmental Coordination Disorder?

Developmental Coordination Disorder is a neurodevelopmental condition in which a child’s ability to learn and perform coordinated motor skills is substantially below what would be expected for their age and opportunities to learn those skills.

It can affect:

• Gross motor skills: Running, jumping, balancing, climbing and playing sports.
• Fine motor skills: Handwriting, using scissors, fastening buttons and handling small objects.
• Motor planning: Organizing the movements needed to complete an activity.
• Daily functioning: Dressing, eating, classroom tasks and independent play.

For example, a child may understand how to catch a ball but struggle to judge its direction, position their hands and coordinate the timing of the movement.

DCD is sometimes called dyspraxia in everyday language.

However, dyspraxia is also used more broadly, so the terms are not always interchangeable in clinical practice.

Importantly, DCD is not caused by poor parenting, low intelligence or a lack of motivation.

Signs of Developmental Coordination Disorder In Children

DCD can look different from one child to another.

Some children mainly experience difficulties with larger movements, while others struggle with handwriting, dressing or tasks requiring precise hand control.

The difficulties often become more noticeable when children encounter increasingly complex activities at home, school and during play.

1. Frequent Tripping and Falling

Some children with DCD experience difficulty coordinating their movements while walking, running or changing direction.

Parents may notice that their child:

• Trips frequently during everyday activities.
• Bumps into furniture or objects.
• Struggles with uneven surfaces.
• Has difficulty changing direction quickly.
• Appears less coordinated when moving through crowded spaces.

Occasional falls are normal during childhood.

Persistent difficulties that affect daily functioning deserve further assessment.

2. Difficulty Running, Jumping and Climbing

Gross motor activities require different muscle groups to work together in a coordinated manner.

Children with DCD may find it difficult to:

• Run smoothly.
• Jump with both feet.
• Hop on one leg.
• Climb playground equipment.
• Walk up and down stairs.
• Maintain balance on one foot.
• Participate in games involving quick movements.

These challenges may become more noticeable during physical education classes or playground activities.

3. Poor Ball Skills

Catching, throwing and kicking require visual tracking, timing, balance and coordinated movement.

A child may struggle to:

• Catch a ball approaching at different speeds.
• Throw accurately towards a target.
• Kick a moving ball.
• Judge the distance between themselves and an object.
• Coordinate their hands and eyes during play.

Repeated difficulty with ball games may cause some children to avoid sports or become frustrated when playing with their peers.

4. Difficulty With Handwriting and Fine Motor Skills

DCD can also affect smaller movements involving the hands and fingers.

Parents and teachers may notice:

• Slow or poorly controlled handwriting.
• Difficulty managing pencil grip.
• Trouble using scissors.
• Difficulty colouring within boundaries.
• Problems assembling small toys.
• Difficulty handling buttons, zips and shoelaces.

These difficulties can affect classroom performance even when a child understands the lesson.

5. Problems With Dressing and Daily Activities

Some children struggle with everyday tasks that require several coordinated movements.

For example, they may find it difficult to:

• Put on clothes in the correct orientation.
• Fasten buttons.
• Tie shoelaces.
• Use a knife and fork.
• Brush their teeth effectively.
• Open food containers.
• Organize their school belongings.

These challenges can affect independence and make routine activities take longer.

6. Difficulty Learning New Movement Skills

Children with Developmental Coordination Disorder may need additional demonstrations, practice and guidance to learn unfamiliar physical activities.

Learning to ride a bicycle, swim, skip or perform a dance routine may require repeated attempts and structured instruction.

Even after learning a movement, they may find it difficult to perform it consistently in different environments.

7. Avoiding Physical Activities

Repeated difficulties during sports, games or playground activities can affect a child’s confidence.

Some children may avoid team sports, prefer sedentary activities or become frustrated when physical tasks are challenging.

Avoidance should not automatically be interpreted as laziness.

It may reflect fatigue, embarrassment, anxiety or previous experiences of struggling during physical activities.

Why Does a Child Develop DCD?

The exact causes of DCD are not fully understood.

Research suggests that differences in neurodevelopmental processes involved in motor planning, coordination, sensory integration and movement control contribute to the condition.

However, there is no single brain abnormality or laboratory test that confirms DCD.

Several factors may be associated with an increased likelihood of motor coordination difficulties.

1. Differences in Neurodevelopment

The brain coordinates movement by integrating information related to posture, balance, timing, sensory feedback and motor planning.

Differences in how these systems develop and work together may contribute to difficulties learning and performing coordinated movements.

2. Genetic and Familial Factors

Motor coordination difficulties may occur more frequently in some families, suggesting that genetic factors contribute to susceptibility.

However, DCD does not have one established genetic cause that explains most cases.

3. Premature Birth and Early Developmental Factors

Children born prematurely or with certain early developmental complications may have an increased risk of motor difficulties.

However, prematurity does not automatically mean that a child will develop DCD. A proper assessment is needed to understand the child’s movement difficulties.

4. Co-occurring Neurodevelopmental Conditions

DCD can occur alongside other conditions, including:

• Attention-deficit/hyperactivity disorder (ADHD).
• Autism spectrum disorder (ASD).
• Specific learning difficulties.
• Speech and language difficulties.

Some children also experience anxiety, reduced self-esteem or difficulties participating in social activities.

These conditions need to be considered individually. Their presence does not automatically explain a child’s motor difficulties.

How Is DCD Different From Normal Childhood Clumsiness?

Children develop movement skills at different rates. Some need more practice to learn to ride a bicycle, catch a ball or manage buttons.

The important difference is whether the difficulties are persistent, substantially below age expectations and interfere with everyday functioning.

Normal variation	Possible DCD-related difficulties
Occasional tripping during play	Persistent difficulties with balance and coordination
Needs some practice to learn a new skill	Needs substantially more practice than expected
Gradually improves with ordinary opportunities	Continues to struggle despite appropriate practice
Manages most age-appropriate daily tasks	Needs extra help with dressing, handwriting or play
Physical difficulties have little impact on participation	Avoids activities or struggles at school and during play

A child should not be diagnosed with DCD simply because they appear clumsy. A comprehensive assessment considers motor performance, daily functioning, developmental history and other possible explanations.

Developmental Coordination Disorder in Children Diagnosis?

DCD is diagnosed through a comprehensive assessment. There is no single test that can independently confirm the condition.

Healthcare professionals consider four main diagnostic criteria.

1. Motor Skills Are Below Age Expectations

The child’s motor coordination must be substantially below what is expected for their age and opportunities to learn and practise the skills.

A standardized motor assessment may help identify difficulties in balance, manual dexterity and ball skills.

Common assessment tools include:

• Movement Assessment Battery for Children, Second Edition (MABC-2): Assesses manual dexterity, aiming and catching, and balance.
• Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2): Evaluates several areas of motor proficiency.
• Developmental Coordination Disorder Questionnaire (DCDQ): A parent questionnaire that helps identify everyday coordination difficulties. It is a screening tool, not a diagnostic test.

2. Motor Difficulties Affect Everyday Life

The difficulties must significantly and persistently interfere with activities such as:

• Dressing and self-care.
• Handwriting and classroom tasks.
• Physical education.
• Sports and recreational activities.
• Play and social participation.

3. Difficulties Begin During Childhood

The movement difficulties must have originated during the developmental period.

Parents may recall early problems with learning physical skills, managing utensils, dressing or participating in playground activities.

Some children do not show obvious difficulties during infancy. Their challenges may become more apparent as movement tasks become increasingly complex.

4. Other Conditions Are Considered

The motor difficulties must not be better explained by another medical, neurological or developmental condition.

Assessment may consider:

• Cerebral palsy.
• Muscular dystrophy.
• Neuromuscular conditions.
• Significant visual impairment.
• Intellectual disability.
• Other neurological conditions.

A neurological examination and appropriate vision assessment may help identify alternative explanations.

What about children under five?

DCD can be suspected during the preschool years, but a formal diagnosis is generally approached cautiously because motor development varies considerably at this age.

International recommendations suggest diagnosing children under five only when impairment is severe and supported by at least two motor assessments separated by at least three months. (Blank et al., 2019)

How Can Paediatric Physiotherapy Help Children With DCD?

Pediatric physiotherapy helps children develop functional movement skills, balance, coordination and confidence.

Treatment should focus on activities that matter in the child’s everyday life rather than simply improving isolated muscle strength.

The physiotherapist first assesses the child’s movement difficulties and then develops an individualized program based on meaningful goals.

1. Improving Balance and Postural Control

Balance helps children maintain stability while standing, walking, running and participating in games.

Physiotherapy activities may include:

• Standing on one foot.
• Walking along a marked pathway.
• Stepping over low obstacles.
• Controlled changes in direction.
• Reaching for objects while standing.
• Practicing balance during age-appropriate play.

These activities help children develop better postural control during functional movement.

2. Developing Motor Planning and Coordination

Motor planning involves organizing the movements required to complete an activity.

A child with DCD may understand what they want to do but struggle to perform the movements in the correct order.

Physiotherapists may use:

• Obstacle courses.
• Stepping sequences.
• Jumping patterns.
• Ball games.
• Movement imitation.
• Age-appropriate coordination challenges.

Activities are introduced gradually, with demonstrations, feedback and repeated opportunities to practise.

3. Improving Gross Motor Skills

Gross motor activities involve larger muscle groups and coordinated movements of the arms, legs and trunk.

Depending on the child’s needs, therapy may focus on:

• Running.
• Jumping and hopping.
• Climbing.
• Stair negotiation.
• Throwing and catching.
• Kicking a ball.
• Learning to cycle.

Practicing meaningful activities helps children develop skills they can use outside the clinic.

4. Building Strength and Physical Endurance

Some children with DCD demonstrate reduced physical fitness or muscular endurance, particularly when they avoid physical activities.

A physiotherapist may incorporate age-appropriate strengthening and endurance activities, including:

• Squatting during play.
• Step-ups.
• Modified animal walks.
• Climbing activities.
• Repeated sit-to-stand movements.
• Walking and cycling activities.

Strengthening should address identified needs and support functional performance. It should not replace practising the actual movement skills the child finds difficult.

5. Improving Hand-Eye and Foot-Eye Coordination

Children may struggle to coordinate their movements with visual information.

Activities may include:

• Catching and throwing different-sized balls.
• Kicking a stationary ball.
• Rolling a ball towards a target.
• Stepping towards visual markers.
• Following simple movement sequences.

These activities help children practice timing, visual tracking and movement control.

6. Using Task-Specific Motor Training

Task-specific training means practicing the actual activity the child wants to improve.

For example:

• If a child struggles to climb stairs, therapy includes appropriate stair practice.
• If catching a ball is difficult, sessions include graded catching activities.
• If jumping is challenging, the physiotherapist practices the movement in manageable stages.

This approach allows children to practice meaningful activities and apply what they learn to everyday situations.

A 2025 systematic review and meta-analysis of randomized trials found that motor-based interventions can improve standardized motor skills and activity performance in children with Developmental Coordination Disorder.

Task-oriented approaches showed benefits across several motor outcomes, although improvements in participation and psychosocial outcomes were not consistently demonstrated (Gao et al., 2025)

7. Setting Individualized Physiotherapy Goals

Treatment should reflect what the child and family want to achieve.

Examples of functional goals include:

• Climbing stairs more independently.
• Catching a ball during playground activities.
• Riding a bicycle.
• Improving balance while running.
• Completing dressing tasks with less assistance.
• Participating more comfortably in physical education.

The 2026 American Physical Therapy Association clinical practice guideline emphasizes individualized examination, evidence-based intervention and meaningful activity and participation outcomes for children with coordination difficulties (Sargent et al., 2026)

Physiotherapy vs Occupational Therapy for DCD

Both pediatric physiotherapy and occupational therapy can support children with DCD. Their roles may overlap, particularly when movement difficulties affect several areas of daily life.

Pediatric physiotherapy	Occupational therapy
Balance and postural control	Handwriting and fine motor skills
Running, jumping and hopping	Dressing and self-care
Gross motor coordination	Using cutlery and classroom tools
Ball skills and functional movement	Hand function and task adaptations
Physical fitness and movement confidence	Independence in everyday activities

Some children benefit from both therapies.

For example, physiotherapy may address balance and playground movement, while occupational therapy supports handwriting, dressing and classroom tasks.

How Can DCD Affect a Child’s Confidence and School Life?

DCD can affect more than physical movement.

Children who repeatedly struggle with tasks their classmates find easy may become frustrated or lose confidence.

Some may avoid sports, group games or activities involving handwriting because they worry about making mistakes.

At school, difficulties may affect:

• Completing written work within the allotted time.
• Participating in physical education.
• Managing school materials.
• Changing clothes for sports.
• Joining playground games.
• Completing practical classroom activities.

Teachers can help by allowing additional time, adapting tasks where appropriate, providing clear demonstrations and encouraging participation without unnecessary comparisons.

Emotional wellbeing should also be considered. Persistent anxiety, withdrawal or low self-esteem may need additional support.

Parents Support For a Child With DCD at Home

Parents can create opportunities for movement practice without turning every activity into a formal exercise session.

Encourage Regular Physical Play

Offer enjoyable activities such as cycling, swimming, dancing, ball games and playground play, adapted to the child’s abilities.

The goal is participation rather than competition.

Break Activities Into Smaller Steps

A complicated task can feel overwhelming.

For example, learning to tie shoelaces can be divided into smaller movements and practiced gradually.

Allow Extra Time

Children with DCD may need more time to complete tasks involving coordination.

Avoid rushing them or repeatedly taking over activities they are trying to learn.

Use Clear Demonstrations

Visual demonstrations and simple instructions can help children understand unfamiliar movements.

Some children benefit from practicing one movement at a time before combining several steps.

Encourage Without Comparing

Comparing a child’s physical abilities with siblings or classmates may reduce confidence.

Recognize individual progress and encourage activities the child enjoys.

Can Developmental Coordination Disorder Improve With Age?

DCD can continue into adolescence and adulthood, but this does not mean that a child’s abilities cannot improve.

With appropriate support and regular practice, children can learn more effective ways to perform everyday activities.

The degree of progress varies according to individual difficulties, associated conditions, intervention and opportunities for practice.

Treatment should focus on practical outcomes such as:

• Greater independence when dressing.
• Improved handwriting and classroom participation.
• Better balance during play.
• Increased confidence in physical activities.
• Improved ability to learn new movement skills.

The aim is not necessarily to make every child perform exactly like their peers.

It is to help them participate more independently and confidently.

When Should Parents Seek an Assessment?

Parents should consider seeking professional advice when a child consistently struggles with coordination and these difficulties interfere with everyday activities.

Signs that deserve assessment include:

• Frequent falls or persistent clumsiness.
• Difficulty running, jumping or balancing.
• Trouble learning age-appropriate physical skills.
• Poor handwriting or fine motor coordination.
• Problems dressing or using cutlery independently.
• Avoidance of physical activities because of repeated difficulty.
• Motor challenges affecting school participation or confidence.

Important: Sudden onset of clumsiness, new weakness, loss of previously acquired motor skills, significant pain or new walking difficulties should not automatically be attributed to DCD.

These symptoms need prompt medical assessment.

Conclusion

Developmental Coordination Disorder affects how children learn, plan and perform everyday movements.

Difficulties with balance, handwriting, ball skills, dressing and physical activities can make ordinary childhood tasks more challenging.

Although DCD may continue into later childhood and adulthood, appropriate assessment and intervention can help children develop practical movement strategies and improve their participation.

Pediatric physiotherapy focuses on functional movement, balance, coordination, strength and task-specific practice.

Occupational therapy, school support and family involvement may also be important.

Most importantly, a child who appears clumsy is not necessarily lazy or unwilling to try.

Understanding their movement difficulties and providing the right support can help them become more confident and independent.

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