Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Developmental coordination disorder: Management and outcome

S Sutton Hamilton, MD
Section Editors
Teresa K Duryea, MD
Carolyn Bridgemohan, MD
Deputy Editor
Mary M Torchia, MD


Motor skills are typically acquired in a continuous, progressive, orderly process [1]. Normal motor function requires the coordination of neurologic, physiologic, and biologic processes including proprioception, vestibular integration, strength, balance, coordination, dexterity, visual-motor ability, and visual ability. Individual and environmental factors, such as motivation, perseverance, opportunity for practice, and encouragement, also play a role. Problems in any of these areas can result in lack of motor skills, or clumsiness.

Developmental coordination disorder (DCD) is characterized by problems with motor coordination that interfere with academic performance and social integration in otherwise healthy children [2-4]. These motor problems typically present in the early school years with difficulty performing simple motor tasks (eg, running, buttoning, or using scissors) and usually persist into adolescence and adulthood [5-7].

The management and outcome of DCD will be discussed in this topic review. The clinical features and diagnosis of DCD are discussed separately. (See "Developmental coordination disorder: Clinical features and diagnosis".)


In this topic, we will use the term "developmental coordination disorder" (DCD) to describe problems in motor coordination that interfere with academic performance and/or socialization. DCD is the preferred term in countries that use the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification [2]. Specific developmental disorder of motor functions (SDDMF) is preferred in countries in which the International Classification of Diseases, 10th revision (ICD-10) has legal status.

The DSM-5 criteria for DCD include [3]:


Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Sep 2016. | This topic last updated: Sep 28, 2015.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
  1. Lipkin PH. Motor development and dysfunction. In: Developmental-Behavioral Pediatrics, 4th, Carey WB, Crocker AC, Coleman WL et al. (Eds), Saunders Elsevier, Philadelphia 2009. p.643.
  2. Blank R, Smits-Engelsman B, Polatajko H, et al. European Academy for Childhood Disability (EACD): recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version). Dev Med Child Neurol 2012; 54:54.
  3. American Psychiatric Association. Developmental coordination disorder. In: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, American Psychiatric Association, Arlington, VA 2013. p.74.
  4. Leeds Consensus Statement (2006). Developmental Coordination Disorder as a Specific Learning Difficulty. Sugden, D. http://www.dcd-uk.org/index.html (Accessed on May 17, 2011).
  5. Losse A, Henderson SE, Elliman D, et al. Clumsiness in children--do they grow out of it? A 10-year follow-up study. Dev Med Child Neurol 1991; 33:55.
  6. Blondis TA, Snow JH, Roizen NJ, et al. Early maturation of motor-delayed children at school age. J Child Neurol 1993; 8:323.
  7. Cantell MH, Smyth MM, Ahonen TP. Clumsiness in adolescence: educational, motor, and social outcomes of motor delay detected at 5 years. Adapted Physical Activity Quarterly 1994; 11:115.
  8. Smits-Engelsman BC, Blank R, van der Kaay AC, et al. Efficacy of interventions to improve motor performance in children with developmental coordination disorder: a combined systematic review and meta-analysis. Dev Med Child Neurol 2013; 55:229.
  9. Mandich AD, Polatajko HJ, Macnab JJ, Miller LT. Treatment of children with Developmental Coordination Disorder: what is the evidence? Phys Occup Ther Pediatr 2001; 20:51.
  10. Hillier S. Intervention for children with developmental coordination disorder: A systematic review. Internet Journal of Allied Health Sciences and Practice 2007; 5.
  11. Missiuna C, Polatajko H. Developmental dyspraxia by any other name: are they all just clumsy children? Am J Occup Ther 1995; 49:619.
  12. Sugden D. Current approaches to intervention in children with developmental coordination disorder. Dev Med Child Neurol 2007; 49:467.
  13. Stephenson EA, Chesson RA. 'Always the guiding hand': parents' accounts of the long-term implications of developmental co-ordination disorder for their children and families. Child Care Health Dev 2008; 34:335.
  14. Missiuna C, Moll S, King G, et al. Life experiences of young adults who have coordination difficulties. Can J Occup Ther 2008; 75:157.
  15. Taft LT, Barowsky EI. Clumsy child. Pediatr Rev 1989; 10:247.
  16. Fox AM, Lent B. Clumsy children. Primer on developmental coordination disorder. Can Fam Physician 1996; 42:1965.
  17. Knuckey NW, Gubbay SS. Clumsy children: a prognostic study. Aust Paediatr J 1983; 19:9.
  18. Kirby A, Edwards L, Sugden D. Emerging adulthood in developmental co-ordination disorder: parent and young adult perspectives. Res Dev Disabil 2011; 32:1351.
  19. Mandich AD, Polatajko HJ, Rodger S. Rites of passage: understanding participation of children with developmental coordination disorder. Hum Mov Sci 2003; 22:583.
  20. Lingam RP, Novak C, Emond A, Coad JE. The importance of identity and empowerment to teenagers with developmental co-ordination disorder. Child Care Health Dev 2014; 40:309.
  21. Sylvestre A, Nadeau L, Charron L, et al. Social participation by children with developmental coordination disorder compared to their peers. Disabil Rehabil 2013; 35:1814.
  22. Missiuna C, Rivard L, Pollock N. Children with Developmental Coordination Disorder: At home, at school, and in the community http://dcd.canchild.ca/en/DCDFAQs/resources/dcdrevised.pdf (Accessed on November 05, 2013).
  23. Wegner LM. Gross Motor Dysfunction: Its Evaluation and Management. In: Developmental-Behavioral Pediatrics, 3rd, Levine MD, Carey WB (Eds), WB Saunders, Philadelphia 1999. p.452.
  24. Poulsen AA, Ziviani JM, Cuskelly M, Smith R. Boys with developmental coordination disorder: loneliness and team sports participation. Am J Occup Ther 2007; 61:451.
  25. McIntyre F, Chivers P, Larkin D, et al. Exercise can improve physical self perceptions in adolescents with low motor competence. Hum Mov Sci 2015; 42:333.
  26. Fong SS, Chung JW, Chow LP, et al. Differential effect of Taekwondo training on knee muscle strength and reactive and static balance control in children with developmental coordination disorder: a randomized controlled trial. Res Dev Disabil 2013; 34:1446.
  27. Fong SS, Tsang WW, Ng GY. Taekwondo training improves sensory organization and balance control in children with developmental coordination disorder: a randomized controlled trial. Res Dev Disabil 2012; 33:85.
  28. Zwicker JG, Missiuna C, Harris SR, Boyd LA. Developmental coordination disorder: a review and update. Eur J Paediatr Neurol 2012; 16:573.
  29. Sugden DA, Chambers ME. Intervention in children with Developmental Coordination Disorder: the role of parents and teachers. Br J Educ Psychol 2003; 73:545.
  30. Jongmans MJ, Linthorst-Bakker E, Westenberg Y, Smits-Engelsman BC. Use of a task-oriented self-instruction method to support children in primary school with poor handwriting quality and speed. Hum Mov Sci 2003; 22:549.
  31. Barnhart RC, Davenport MJ, Epps SB, Nordquist VM. Developmental coordination disorder. Phys Ther 2003; 83:722.
  32. Richardson AJ, Montgomery P. The Oxford-Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder. Pediatrics 2005; 115:1360.
  33. Flapper BC, Houwen S, Schoemaker MM. Fine motor skills and effects of methylphenidate in children with attention-deficit-hyperactivity disorder and developmental coordination disorder. Dev Med Child Neurol 2006; 48:165.
  34. Flapper BC, Schoemaker MM. Effects of methylphenidate on quality of life in children with both developmental coordination disorder and ADHD. Dev Med Child Neurol 2008; 50:294.
  35. Bart O, Daniel L, Dan O, Bar-Haim Y. Influence of methylphenidate on motor performance and attention in children with developmental coordination disorder and attention deficit hyperactive disorder. Res Dev Disabil 2013; 34:1922.
  36. Pless M, Carlsson M, Sundelin C, Persson K. Preschool children with developmental coordination disorder: a short-term follow-up of motor status at seven to eight years of age. Acta Paediatr 2002; 91:521.
  37. Gillberg C, Gillberg IC, Rasmussen P, et al. Co-existing disorders in ADHD -- implications for diagnosis and intervention. Eur Child Adolesc Psychiatry 2004; 13 Suppl 1:I80.
  38. Skinner RA, Piek JP. Psychosocial implications of poor motor coordination in children and adolescents. Hum Mov Sci 2001; 20:73.
  39. Dewey D, Kaplan BJ, Crawford SG, Wilson BN. Developmental coordination disorder: associated problems in attention, learning, and psychosocial adjustment. Hum Mov Sci 2002; 21:905.
  40. Deuel RK. Developmental dysgraphia and motor skills disorders. J Child Neurol 1995; 10 Suppl 1:S6.
  41. Piek JP, Baynam GB, Barrett NC. The relationship between fine and gross motor ability, self-perceptions and self-worth in children and adolescents. Hum Mov Sci 2006; 25:65.
  42. Cairney J, Hay JA, Faught BE, et al. Developmental coordination disorder, generalized self-efficacy toward physical activity, and participation in organized and free play activities. J Pediatr 2005; 147:515.
  43. Gillberg IC, Gillberg C, Groth J. Children with preschool minor neurodevelopmental disorders. V: Neurodevelopmental profiles at age 13. Dev Med Child Neurol 1989; 31:14.
  44. Geuze R, Borger H. Children who are clumsy: five years later. Adapt Phys Activity Q 1993; 10:10.
  45. Shaw L, Levine MD, Belfer M. Developmental double jeopardy: a study of clumsiness and self esteem in children with learning problems. J Dev Behav Pediatr 1982; 3:191.
  46. Sigurdsson E, Van Os J, Fombonne E. Are impaired childhood motor skills a risk factor for adolescent anxiety? Results from the 1958 U.K. birth cohort and the National Child Development Study. Am J Psychiatry 2002; 159:1044.
  47. Kirby A, Williams N, Thomas M, Hill EL. Self-reported mood, general health, wellbeing and employment status in adults with suspected DCD. Res Dev Disabil 2013; 34:1357.
  48. Hill EL, Brown D. Mood impairments in adults previously diagnosed with developmental coordination disorder. J Ment Health 2013; 22:334.
  49. Rivilis I, Hay J, Cairney J, et al. Physical activity and fitness in children with developmental coordination disorder: a systematic review. Res Dev Disabil 2011; 32:894.
  50. Wrotniak BH, Epstein LH, Dorn JM, et al. The relationship between motor proficiency and physical activity in children. Pediatrics 2006; 118:e1758.
  51. Faught BE, Hay JA, Cairney J, Flouris A. Increased risk for coronary vascular disease in children with developmental coordination disorder. J Adolesc Health 2005; 37:376.
  52. Rasmussen P, Gillberg C. Natural outcome of ADHD with developmental coordination disorder at age 22 years: a controlled, longitudinal, community-based study. J Am Acad Child Adolesc Psychiatry 2000; 39:1424.