A guide for parents

Katie Cleary
Senior Paediatric Physiotherapist

As a Paediatric physiotherapist, one of the most rewarding aspects of our role is helping children overcome challenges related to Developmental Coordination Disorder (DCD), formerly known as motor dyspraxia. This neurodevelopmental condition affects your child’s ability to plan and execute coordinated movements, impacting their daily activities and overall quality of life.

Did you know, DCD affects between 5-15% of Australian Primary School age children! That’s 2-3 in every classroom! Typically we see these children who may struggle with ball skills, handwriting, self care activities e.g. tying shoelaces and bike riding/sports.
Children with DCD have been shown to have difficulties controlling their posture and with their awareness of objects or their body in space. They appear to have difficulties planning movements (e.g. sitting down on a chair or figuring out how to jump), with the timing and amount of force needed during movement, e.g., using too much or too little force to pick things up, being late reaching to catch a ball.

What causes DCD?

The exact cause of DCD remains elusive, but it is generally understood to result from disruptions in the brain’s motor planning systems. Factors contributing to DCD may include:

• Genetic Predisposition: There’s evidence suggesting that DCD can run in families, pointing to a possible genetic component
• Neurological Factors: Differences in brain areas responsible for motor control, such as the cerebellum and motor cortex, have been observed in children with DCD.
• Environmental Influences: Conditions like premature birth, low birth weight, or prenatal exposure to harmful substances may also play a role.

Children with DCD struggle with ‘motor planning’

Motor planning is the process of conceiving, planning, and executing movement sequences. It involves:

1. Idea Generation: Developing a plan for a specific movement.
2. Planning: Organising the steps needed to execute the movement.
3. Execution: Carrying out the planned actions accurately.

What does DCD look like at home and school for your kids?

DCD at home:

• Dressing difficulties- doing up buttons, turning clothes the right way out, putting on shoes, doing up laces
• Slowness to achieve motor skills
• Difficulty using feeding utensils and other kitchen items
• Inability to ride a bike
• Difficulty manipulating small items such as lego
• Frustration, even tantrums, when unable to complete a task
• Easily fatigued
• Poor social skills
• Meltdowns and anxiety after masking at school
• Frequent trips, falls, bumps, bruises

DCD at school

• Difficulty with handwriting or using rulers and scissors
• Dressing difficulties – doing up buttons, turning clothes the right way out, putting on shoes
• Bumping into furniture
• A messy, disorganised desk, difficulty locating items
• Frequent falling or tripping
• Being ‘off task’ or ‘easily distracted’ when in actual fact they are finding the activity difficult
• Expressions of frustration, and Needing constant attention and support.
• Social isolation; the child may retreat to the library, veranda or computer room
• Unwillingness to be physically active
• Less vigorous activity
• Less often playing on large playground equipment, and
• Less time engaged in positive social interactions.

How do I get my child assessed for DCD?

At Ocean Kids Health, our Physiotherapy team will ask you questions about your childs’ motor skills and challenges, then ask you to complete some checklists. We will then complete a standardised Motor Assessment Movement Assessment Battery for Children (Movement ABC). This assessment evaluates a child’s motor skills across three key areas:

1. Manual Dexterity: Assesses fine motor skills, such as using scissors and drawing.
2. Ball Skills: Evaluates abilities related to handling balls, including catching and throwing.
3. Balance: Measures static and dynamic balance through activities like walking on a line and hopping.

Following this assessment, we will then provide your child with a provisional diagnosis if necessary – which needs to be confirmed by your child’s Doctor or Paediatrician to rule out other factors and conditions which may be causing their coordination problems. We then use evidence based practice to help your child improve their coordination and achieve their goals – including tasks practice and cognitive approaches. If you’re not a Victorian local, you can see your Paediatric Physiotherapist, Occupational Therapist or Paediatrician for an assessment and diagnosis for your child.

Our practical tips for parents for managing DCD at home

1. Balance and Coordination Exercises: Activities like walking on a line, balancing on one foot, or using a balance board help improve core stability and spatial awareness. Use fun props, like balance beams or wobble cushions, to keep children engaged.
2. Crossing the Midline Activities: Helping your child to reach across their body to reach for toys by playing on their tummy, kneeling and standing can help improve coordination.
3. Fine Motor Skill Activities: To enhance hand-eye coordination and grip strength, we recommend tasks such as threading beads, using tweezers, or manipulating playdough. These activities can make everyday tasks like writing or buttoning a shirt easier.
4. Structured Physical Play: Create obstacle courses and engage children in playground games suited to their abilities. Simple activities, such as crawling under a tunnel or jumping over small obstacles, help practice motor skills in a supportive setting.
5. Repetition and Consistency: Regular practice is crucial for reinforcing motor skills. We encourage short bursts of daily exercises to build confidence and proficiency, ensuring that children have a consistent routine.
6. Use of Visual and Verbal Cues: To guide children through tasks, try and use visual aids and break actions into smaller, manageable steps. Visual schedules or step-by-step diagrams can simplify complex movements and make them more approachable.
7. Sensory Integration Activities: Activities that stimulate the senses, like swinging or playing with textured materials, can improve sensory-motor integration and overall coordination.
8. Encouraging Active Play: Encourage your child to participate in activities like swimming or cycling, adapting them to your child’s abilities. These activities help improve motor skills while fostering enjoyment and self-confidence.

Conclusion

DCD is a very common condition affecting over 10% of Australian Children and often goes undiagnosed. Early recognition and assessment for DCD can set your child up for success in primary school and beyond by building their confidence to move! Our goal as a Paediatric Physiotherapists and Paediatric Exercise Physiologists is to create a supportive and motivating environment that helps children with DCD reach their full potential and thrive in their everyday activities. Please reach out for an assessment if you think your child may have DCD and need supports. We’re here to help!

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