What is Dyspraxia (Developmental Coordination Disorder)?
Dyspraxia, formally known as Developmental Coordination Disorder (DCD), is a neurodevelopmental disorder characterized by the inability to plan, organize, and execute coordinated movements in the absence of any known neurological condition or intellectual impairment. 1
Core Definition and Clinical Features
Dyspraxia affects motor coordination with marked impact on both academic and day-to-day living activities. 2 The disorder manifests as:
- Motor planning and sequencing deficits: Problems primarily involve motor sequencing and selection, distinguishing it from general coordination difficulties 3
- Functional impairment: Affects a child's ability to learn motor skills and perform everyday activities efficiently and effectively 4
- Persistent nature: While some individuals learn to cope with motor difficulties over time, the majority retain them into adulthood 1
Prevalence and Recognition
- Affects 5-15% of school-aged children, making it more prevalent than autism spectrum disorder 4
- Commonly co-occurs with other neurodevelopmental disorders: Including intellectual disability (27-45%), speech disorders (33-82%), and autism spectrum disorder (3-9%) 5
- Often underdiagnosed: Awareness remains poor despite high prevalence rates 4
Clinical Presentation Across the Lifespan
Early Childhood
- Gross and fine motor delays are prominent during infancy and toddlerhood 5
- Speech and language delays/disorders predominate in early years 5
- Hypotonia and motor/speech delays are common early neurologic features 5
School-Age Children
- Learning difficulties are ubiquitous regardless of IQ, especially in mathematics and language comprehension 5
- Cognitive deficits typically occur in sustained attention, executive function, memory, and visuospatial perception 5
Adults
- Gender differences in presentation: Women report significantly greater gross motor and non-motor difficulties with greater impact on activities and participation, while men report significantly greater fine motor difficulties 2
- Age-related variations: Emerging adults (16-25 years) report significantly greater non-motor difficulty than older adults 2
- Persistence into adulthood impacts motor, emotional, and behavioral status 4
Distinction from Related Conditions
Critical differentiation: Dyspraxia should not be confused with:
- Cerebral palsy: A permanent disorder of movement and posture attributed to nonprogressive disturbances in the developing fetal or infant brain 5
- Dyskinesia: Involuntary, abnormal, irregular, and purposeless movements (such as tardive dyskinesia or paroxysmal kinesigenic dyskinesia) 6, 7
- Dysmetria: Impaired ability to measure distance in muscular movements, a cardinal sign of cerebellar dysfunction 8
Clinical Implications and Assessment
- Early identification is crucial: Children with significant functional impairment should be identified and assessed as early as possible 1
- Formal neuropsychological testing is strongly recommended for all children 5
- Screening tools exist: The Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC) is available for adults in further and higher education settings 9
- Reassessment at transition periods (primary to secondary school, secondary to postsecondary) is recommended 5
Long-Term Impact
Failure to address motor and commonly associated comorbid features may have major consequences in adult life, including: