What Is Developmental Coordination Disorder?
Developmental Coordination Disorder — DCD — is a condition affecting motor coordination that significantly impacts a child’s ability to perform everyday tasks. It is sometimes called dyspraxia, though these terms have slightly different origins and emphases. DCD is recognised in diagnostic manuals as a neurodevelopmental condition — it is not caused by laziness, lack of trying, or poor parenting.
DCD affects approximately 5 to 6 percent of school-age children, making it one of the most common neurodevelopmental conditions. Despite this, it is frequently misunderstood and under-identified. Children with DCD are often labelled as clumsy, careless, or immature — labels that are both inaccurate and damaging.
What Causes DCD?
DCD is believed to involve differences in how the brain plans, sequences, and executes motor movements. Motor planning — the ability to imagine, organise, and carry out a new or complex movement — is a central challenge. This is why children with DCD often struggle most with novel motor tasks: they can learn a specific skill with enough practice, but applying it in a new context or learning a new movement is consistently difficult.
DCD frequently co-occurs with other neurodevelopmental conditions including ADHD, autism, dyslexia, and language disorder. It is important to consider the whole child rather than viewing DCD in isolation.
How DCD Affects Daily Life
The impact of DCD extends well beyond being clumsy on the sports field. It touches every aspect of daily life.
Self-Care
Dressing, managing fastenings (buttons, zips, shoelaces), using cutlery, brushing teeth, and managing personal hygiene can all be challenging for children with DCD. These tasks require precisely the kind of coordinated, sequenced movements that are difficult for them. Morning routines become stressful for children and families alike.
Handwriting
Handwriting is one of the most common referral reasons for children with DCD. Writing requires the coordination of posture, shoulder stability, wrist control, finger manipulation, and visual-motor integration — all simultaneously. Children with DCD often write slowly, with great effort, and produce output that does not reflect their intelligence or understanding.
Physical Education and Sport
PE and sports present significant challenges. Ball skills, team games, swimming, and gymnastics all require the kind of motor coordination and motor planning that are affected by DCD. Children with DCD are often the last picked for teams and may begin to avoid physical activity altogether — with significant implications for physical health and emotional wellbeing.
Social and Emotional Impact
The social and emotional impact of DCD should not be underestimated. Children with DCD often know they are struggling. They see their peers manage tasks they find impossibly difficult. Many develop anxiety, low self-esteem, and school refusal. Peer relationships can suffer when children cannot participate fully in sports and physical play.
The OT Approach to DCD
Occupational therapy is the primary professional support for children with DCD. The OT assessment identifies the specific motor planning, coordination, and sensory processing difficulties underlying the child’s challenges. From this, an individualised intervention plan is developed.
Task-Oriented Approaches
Modern evidence-based practice for DCD focuses on teaching specific functional skills the child needs — rather than generalised motor exercises. We practise the actual task (e.g., shoe tying, handwriting, catching a ball) using motor learning principles: breaking tasks into steps, providing clear demonstration, giving the right amount of practice, and offering feedback that helps the child feel what the correct movement is like.
Cognitive Strategies
Approaches like the Cognitive Orientation to daily Occupational Performance (CO-OP) teach children to solve their own motor problems using a “Goal, Plan, Do, Check” framework. This empowers children to analyse what is going wrong in their movement and generate their own solutions — a profoundly effective approach that generalises across settings.
Sensory Integration
Where sensory processing difficulties are contributing to the motor planning challenges, sensory integration therapy addresses the underlying neurological processing that supports coordinated movement.
What Families Can Do at Home
- Allow extra time for tasks that are difficult — rushing increases anxiety and reduces performance
- Break new skills into small steps and teach one step at a time
- Celebrate effort and persistence, not just achievement
- Find activities your child enjoys and is good at — swimming, art, music — to build confidence
- Communicate with school so teachers understand the condition and can make appropriate accommodations
- Avoid comparing your child to siblings or peers
Getting Support in Malta
DCD is not always well understood in general healthcare settings in Malta, and families sometimes wait a long time before accessing appropriate support. An occupational therapy assessment can identify DCD and begin intervention without waiting for a formal medical diagnosis. Early support matters — both for skill development and for protecting the child’s self-esteem and wellbeing.
If you’re concerned about your child’s development, contact us at +356 99872936 or visit wonderkids.mt to book an assessment.