Diagnosis - Developmental co-ordination disorder (dyspraxia) in children

Talk to a GP, health visitor or special educational needs co-ordinator (SENCO) if you think your child has developmental co-ordination disorder (DCD).

They may refer your child to another healthcare professional who can do an assessment.

This could be:

• a paediatrician – a doctor specialising in the care of babies and children who will usually be based locally (community paediatrician)
• a paediatric occupational therapist – a healthcare professional who can assess your child's functional abilities in daily activities, such as handling cutlery and getting dressed
• a paediatric physiotherapist – a healthcare professional who can assess your child's movement (motor) skills
• an educational psychologist – a professional who assists children who are having difficulty progressing with their education because of emotional, psychological or behavioural factors

Other doctors who may be involved in this process include a neurodevelopmental paediatrician or a paediatric neurologist.

These are paediatricians who also specialise in the development of the central nervous system, which includes the brain, nerves and spinal cord.

A neurodevelopmental paediatrician may work at a child development centre or local health clinics.

Occasionally, a neurologist is needed to help rule out other conditions that affect the brain and nervous system (neurological conditions), which may be causing your child's symptoms.

It's important to get a correct diagnosis so you can develop a better understanding of your child's problems and appropriate support can be offered.

Getting a diagnosis can also help reduce the stress experienced by both parents and children with DCD.

Assessment

The diagnosis of DCD is usually made by a paediatrician, often in collaboration with an occupational therapist.

Generally, a paediatrician is involved in diagnosis and an occupational therapist is involved in both diagnosis and treatment.

For a diagnosis to be made, it's essential for the child to have what is called a norm-referenced assessment of their motor skills. This may be done by an occupational therapist, physiotherapist or paediatrician.

Children with suspected DCD are usually assessed using a method called the Movement ABC, which involves tests of:

• gross motor skills – their ability to use large muscles that co-ordinate significant body movements, such as moving around, jumping and balancing
• fine motor skills – their ability to use small muscles for accurate co-ordinated movements, such as drawing and placing small pegs in holes

Your child's performance in the assessment is scored and compared with the normal range of scores for a child of their age.

There also needs to be evidence that the child's mental ability is within the normal range for their age.

Sometimes your child may also have an assessment of their mental ability by a psychologist, or if they're very young, by a paediatrician.

The healthcare professional doing the assessment will take your child's medical history into account. This includes any problems that may have happend during their birth and any delays reaching developmental milestones.

Your family medical history, such as whether any family members have been diagnosed with DCD, will also be considered.

Once the assessment process is complete, the healthcare professionals involved will produce a report on your child's condition.

Diagnostic criteria

For a diagnosis of DCD to be made, your child will usually need to meet all of the following criteria:

• their motor skills are significantly below the level expected for their age and opportunities they have had to learn and use these skills
• their lack of motor skill significantly and persistently affects their day-to-day activities and achievements at school
• their symptoms first developed during an early stage of their development
• their lack of motor skills isn't better explained by long-term delay in all areas (general learning disability) or rare medical conditions, such as cerebral palsy or muscular dystrophy

DCD should only be diagnosed in children with a general learning disability if their physical co-ordination is more impaired than would be expected for their mental (cognitive) ability.

Although DCD may be suspected in the pre-school years, it's not usually possible to make a definite diagnosis before a child is aged 5.