Children with developmental coordination disorder, or DCD, have a hard time with movement skills and coordination. This can make things like riding a bike, playing sports, skipping, running, or jumping difficult. Children with DCD may take longer to finish school tasks, such as writing, coloring, or cutting. DCD affects about 5% to 6% of school-aged children. More than 1 million children in the U.S. have the disorder. Physical therapists help children with DCD learn skills and strategies to better participate in school and perform physical or motor activities. Early physical therapy may help prevent secondary conditions such as anxiety, depression, decreased fitness, and obesity.

Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can see a physical therapist directly for evaluation and treatment without a physician’s referral.* To find a physical therapist in your area, visit Find a PT.

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*A referral may still be required by your insurance policy, corporate policies, or state practice laws (some states limit the type of treatment or number of visits without a referral).

On this page

• What Is Developmental Coordination Disorder?
• Signs and Symptoms
• How Is It Diagnosed?
• How Can a Physical Therapist Help?
• Can This Injury or Condition Be Prevented?
• What Kind of Physical Therapist Do I Need?

What Is Developmental Coordination Disorder?

Developmental coordination disorder, or DCD, is a motor control disorder. It causes difficulties with planning, coordinating, and executing movement. DCD is not related to intelligence or other movement disorders such as cerebral palsy.

DCD affects areas of the brain involved in learning, planning, and remembering movements. This means each motor task may seem new, no matter how many times the child performs or repeats it. Movements do not become automatic or feel effective to the child. Children with DCD may struggle to imitate movements or learn new motor skills. They also have a hard time regulating the speed, force, direction, and stability of movements compared with other children their age.

Boys are diagnosed with DCD slightly more often than girls. Children with DCD also may have other conditions, such as:

• Attention deficit hyperactivity disorder
• Learning disability.
• Speech/language impairments.

Self-esteem, behavior, and social or emotional problems may affect their quality of life. Because movement is so hard for them, they may develop poor health. They may have poor fitness, be overweight, and have heart disease due to inactivity.

DCD continues throughout a person’s life. However, physical therapy can help children and teens improve their condition and learn new movement strategies. With guidance, they can find the right physical activities, sports, and jobs that lead to a fulfilling life.

Signs and Symptoms

Parents are often the first to notice signs of DCD in their child. They may see their baby is slower than their peers to learn how to sit up, crawl, or walk. However, sometimes signs and symptoms of DCD are not caught until a child starts school. Teachers may see that the child can’t play at recess or in gym class like other children do. They also may find that it takes the child longer to do schoolwork. Children with DCD may have a hard time making friends or playing with others.

Children with DCD move differently. They may feel like their arms and legs won’t move the way they planned. They want to throw a ball, ride a bike, or play sports, but their body may not remember how. This may make them feel clumsy or awkward, leading to low self-esteem. Because of this, children with DCD may not want to join in activities with other children in gym class or recess.

Children with DCD may have a hard time with:

• Physical activities like running, skipping, jumping, riding a bike, hopping on one foot, or doing jumping jacks.
• Using hand-held tools such as crayons, scissors, or eating utensils.
• Throwing, catching, kicking, or dribbling a ball accurately.
• Following multi-step directions that involve movement or planning. If they make a mistake or can’t do the next step, they will start over rather than adjust and move on.
• Knowing where their body is in space. This can cause them to bump into or trip over objects often.
• Doing everyday tasks such as pouring milk, packing a backpack, or tying their shoes.

How Is It Diagnosed?

Only a physician or similar health care provider can diagnose DCD. Typically, it takes a team of health professionals (including a physical therapist) to help determine if the child’s condition meets all of these criteria:

• The ability to learn and perform motor skills is much lower than that of other children their age.
• The motor skill difficulties greatly and persistently impact age-appropriate activities (such as bathing and dressing) and affect school, work, and play. 
• Symptoms develop when the child is young.
• Difficulties with motor skills are not caused by an intellectual disability, visual impairment, or a neurological condition (such as cerebral palsy or muscular dystrophy). 

How Can a Physical Therapist Help?

Your child's first physical therapy visit will begin with a full check-up called an evaluation. The physical therapist may:

• Ask about your child’s medical history. This will include questions about the mother's pregnancy, the child's birth, and the age they first sat up, crawled, and walked. They also will ask about the child’s general health and any concerns parents have.
• Ask you questions about your child’s activities and how they participate at home, school, and play.
• Observe how your child moves, such as walking, running, or playing.
• Assess your child's muscle strength, tone, flexibility, and balance.
• Test movement skills like skipping or walking in a straight line.
• Screen for other developmental concerns, such as using their hands, vision, language skills, and thinking skills.
• Ask you and your child about your goals for therapy.

Your child’s physical therapist will refer your child to other health care providers as part of a team approach to best address their needs.

Physical therapists help children with DCD improve muscle strength, coordination, motor planning, and balance. They also help them develop skills and strategies to make doing everyday tasks easier and improve physical activity and quality of life. Your child's physical therapy plan may include:

• Task-oriented and task-specific learning. Your child may learn fun new skills like bike riding or jump roping by focusing on the task they want to learn. Your physical therapist may recommend using a three-wheeled bike or training wheels to help your child build confidence while learning new skills.
• Motor planning. Your physical therapist will use techniques to help your child improve how they plan and do tasks requiring movement. They will help your child to develop strategies or problem-solve through challenging activities. They may guide your child to use a “Goal-Plan-Do-Check” or the MATCH strategy to learn new skills.
• Strength, balance, coordination, motor planning, and body awareness exercises. Your physical therapist may provide exercises to increase muscle strength, balance, or body awareness. These exercises can address any deficits that impact your child’s ability to do their desired tasks.
• Strategies to improve participation, physical literacy, and fitness. Your physical therapist may identify games and fun home or community activities to improve strength, reduce or prevent obesity, and improve heart and lung health. Examples include soccer training or martial arts.

Can This Injury or Condition Be Prevented?

The exact cause of DCD is unknown. However, research shows a link to premature birth and low birth weight. Research into why children develop DCD is ongoing. Presently, there are no known ways to prevent DCD.

A physical therapist can work with you and your child to improve your child's movement abilities. They also can help to prevent new problems from developing, such as:

• Poor posture while sitting, standing, or walking.
• Delayed learning of desired or required movement skills.
• Low self-esteem, anxiety, or depression caused by being unable to participate with peers fully.
• Obesity, metabolic, or heart diseases caused by a lack of activity.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and clinical experience to prevent, manage, and treat a variety of conditions or injuries. You may want to consider:

• A physical therapist who is experienced in treating children with developmental disorders. Some physical therapists practice with a pediatric focus and can work with you and your child in your home, at school, or in the community.
• A physical therapist who is a board-certified clinical specialist or who completed a residency or fellowship in pediatric physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to developmental conditions.

You can find physical therapists in your area with specific clinical expertise by using Find a PT, provided by the American Physical Therapy Association.

General tips when you're looking for a physical therapist (or any other health care provider):

• Ask family, friends, or other health care providers to recommend a physical therapist.
• Ask about the physical therapists' experience in helping children with developmental disorders when you contact the clinic for an appointment.
• Be prepared to describe your child’s symptoms in as much detail as possible and say what makes your child’s symptoms better or worse.

The Academy of Pediatric Physical Therapy contributed to this consumer resource. It is for informational purposes only and is not intended to represent the position of APTA Pediatrics.