By Pathways.org

Developmental Coordination Disorder (DCD) is a common diagnosis for children with motor skill and sensory processing difficulties in the absence of other conditions and learning issues. This disorder affects 5-6 percent of school-aged children and is more commonly diagnosed in boys.1

Children with DCD have trouble with both fine and gross motor movements. Very often, parents may describe their child having these motor difficulties:

• Clumsiness-child frequently bumps into other objects or people, trips, and drops things
• Difficulty walking, standing or balancing
• Problems playing sports or riding a bicycle
• Difficulty with daily living activities-getting dressed, feeding themselves, tying shoes
• Poor posture
• Messy handwriting
• Difficulty learning and applying new motor skills2

Sometimes, there is a sensory component to the disorder. Children with sensory processing/integration differences can have trouble integrating all the information received from their senses to produce coordinated motor movements and perform everyday activities.3 If a child is over reactive to sensory information, they are more sensitive to sensory stimuli than their typically developing peers. Warning signs for over reactive children may include:

•Avoids sensory environments with loud noises and too many bright colors
• Seems fearful or very distracted
• Avoids being touched or engaging in activities with lots of tactile input4

Children who are under reactive to sensory information have difficulty perceiving sensory stimuli, which can also affect their behavior and ability to perform daily activities. Warning signs for under reactive children may include:

• Difficulty discriminating odors and tastes
• Using too much force when picking up objects
• Being unaware to pain caused by cuts and bruises
• Engages in sensory seeking behaviors-rough housing or activities with lots of motion such as swinging4

Studies show children who have DCD with a sensory component can have difficulty receiving, processing and integrating visual and vestibular feedback, which contribute to our sense of balance. In one study, children with DCD and typically developing children were asked to stand on their non-preferred leg so researchers could evaluate their balance abilities. The children with DCD showed poorer postural control and were less able to adjust to changes in posture due to slower hamstring muscle contraction and differences in processing sensory information. Balancing requires the use of multiple sensory systems, as well as proper muscle responses and movement strategies. As a way of compensating for differences in muscle contraction, visual, and vestibular feedback, the DCD group swayed their hips to maintain their balance instead of using their legs and ankles to stabilize themselves.3

Differences in sensory processing and motor skill difficulties can extend to children’s everyday activities and affect their ability to learn new motor movements needed for playing on a playground, participating in sports, or daily self care.5 Activities that require making multiple movements at once and using different senses to coordinate movements can be difficult for children with DCD. To view a checklist to help identify sensory areas of concern, see our Sensory Motor Checklist. Parents can use this to track their concerns and discuss them with their healthcare professional.

Physical and occupational therapy are two common forms of treatment used to help children improve their motor skills. Treatment approaches vary depending on the child’s motor abilities and whether there is a sensory component to their diagnosis. Physical therapists may work with children to build muscle strength needed for improving balance and motor movements. One study found that a strength training program also helped a young child process their proprioceptive sense, body position sense, which improved their motor skills and confidence. Common occupational therapy treatments for DCD include taking more of a task specific and cognitive approach to focus on the child’s motor learning.1 Cognitive approaches to therapy may provide children opportunities to practice holding their attention and using working memory to improve their problem solving and motor task strategy. A child’s treatment plan varies depending on their needs, and therapists can decide which approach would be the most beneficial.6

Medical professionals can ask parents or caregivers additional questions about a child’s everyday behaviors and activities to help diagnose DCD. If parents have concerns about their child’s sensory processing/integration, most pediatric physical and occupational therapy clinics offer free screenings. An early referral and early intervention can help children reach their fullest potential.

About Pathways.org
Pathways.org is a national not-for-profit dedicated to maximizing children’s development by providing free tools and resources for medical professionals and families. Medical professionals can contact Pathways.org to receive free supplemental materials to give away at well child visits and parent classes.
View our Sensory Integration/Processing Brochure to provide parents with information on how children use their senses and warning signs of a sensory processing/integration issue. For a free package of brochure to give away to families, please email friends@pathways.org.
[1] Kaufman L, Schilling D. Implementation of a Strength Training Program for a 5-Year-Old Child With Poor Body Awareness and Developmental Coordination Disorder. 2007; 87(4): 455-467.
[2] Causes and Identification: Causes of Developmental Coordination Disorder. CanChild. McMaster University. https://canchild.ca/en/diagnoses/developmental-coordination-disorder/causes-identification
[3] Fong S., Ng S., Yiu B. Slowed muscle force production and sensory organization deficits contribute to altered postural control strategies in children with developmental coordination disorder. 2013; 34: 3040-3048.
[4] Red Flags. Sensory Processing Disorder Foundation. http://www.spdfoundation.net/about-sensory-processing-disorder/redsflags/
[5] Jelsma D, Et al. Short-term learning of dynamic balance control in children with probable Developmental Coordination Disorder. Research in Developmental Disabilities. 2015; 38: 213-222.
[6] Barnhart R, Et al. Developmental Coordination Disorder. Journal of the American Physical Therapy Association. 2003; 83:722-731.