Developmental co-ordination disorder (DCD) - Diagnosing DCD in children

Talk to your 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 professional who can help arrange an assessment.

This could be:

• a paediatrician – a doctor specialising in the care of children and babies, who will usually be based in your local community (community paediatrician)
• a paediatric occupational therapist – a healthcare professional who can assess a child's functional abilities in daily living activities, such as handling cutlery and getting dressed
• a paediatric physiotherapist – a healthcare professional who can assess a child’s motor (movement) skills
• a clinical psychologist – a healthcare professional who specialises in the assessment and treatment of mental health conditions to deal with emotional problems
• an educational psychologist – a professional who assists children who are having difficulty progressing with their education as a result 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 (the brain, nerves and spinal cord).

A neurologist can help rule out other neurological conditions (conditions that affect the brain and nervous system) that 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 so 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 the paediatrician is more involved in the diagnosis and the occupational therapist is involved in both diagnosis and treatment.

For a diagnosis to be made, it is essential for the child to have what is called a norm-referenced assessment of his or her motor ability, which may be carried out by an occupational therapist, a physiotherapist or a paediatrician.

The assessment method most used in the UK is known as the 'Motor ABC'. This will involve tests of your child’s:

• 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 on the assessment is scored and compared with what is 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 his or her age. This may be clear based on reports from the child’s school obtained by a paediatrician, although sometimes the child may also have a standard assessment of mental ability done by a psychologist or, in the case of young children, a paediatrician.

As part of an assessment, your child's medical history (such as any problems that occurred during their birth and whether there have been any delays reaching developmental milestones) and your family medical history (such as whether any family members have been diagnosed with DCD) may also be taken into account.

Once the assessment process is complete, the paediatrician will produce a report on the child's condition in collaboration with other professionals involved.

Diagnostic criteria

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

• your child’s motor skills are significantly below the level expected for their age and opportunities they have had to learn and use these skills
• this lack of motor skill significantly and persistently affects your child’s day-to-day activities and their achievements at school
• your child's symptoms first developed during an early stage of their development
• the lack of motor skills is not better explained by a learning disability or another medical condition, such as cerebral palsy or muscular dystrophy

DCD should only be diagnosed in children with a generalised learning disability if their physical co-ordination is significantly more impaired than their mental abilities.

Although DCD may be suspected in the preschool years, it is not usually possible to establish a definite diagnosis before the age of four or five years because it can be difficult to be certain whether a child has DCD if they still are very young.