Bright Futures in Practice: Physical Activity

DEVELOPMENTAL COORDINATION DISORDER

Physical Activity Supervision

Children and adolescents with DCD have no physiological barriers to being physically active. Therefore, health professionals can follow the physical activity screening and assessment guidelines listed in the Early Childhood, Middle Childhood, and Adolescence chapters. But health professionals need to keep in mind that children and adolescents with motor coordination problems, whether or not they have been diagnosed with DCD (or developmental dyspraxia, minimal cerebral dysfunction, or sensory integration problems), probably have psychological barriers that keep them from being physically active.

Interview Questions

Children in early childhood (ages 1–4) whose gross motor skills and fine motor skills (e.g., those used for running, climbing, and drawing and for self-care activities such as dressing, tying shoelaces, and buttoning shirts) develop later than usual may have DCD.

Interview Questions for the Parent

Does your child avoid physical activity?

Does your child feel uncomfortable when participating in group physical activities? If so, which ones?

Does your child often trip, fall down, or bump into things?

Children in middle childhood (ages 5–10) who avoid physical activities that require hand-eye coordination, or who experience difficulty with handwriting, catching or throwing a ball, balancing on one foot, or riding a bike, may have DCD.

Interview Questions for the Child

What do you like about physical education class at school? What do you dislike?

What is your favorite type of physical activity (for example, sports, dancing, or games)?

Do you participate in any of these activities with your friends or family? Do you think you are good at any of them?

Do you think you are as good at physical activ-ities as other children your age?

Do you ever get frustrated when participating in physical activities with your friends?

Adolescents (ages 11–21) who avoid or never participate in physical activity with others or whose motor skill performance is below that of their peers may have DCD. Games and organized sports highlight their difficulties. They become frustrated and avoid activities that require motor skills.

Interview Questions for the Adolescent

What do you like about physical education class at school? What do you dislike?

What is your favorite type of physical activity (for example, sports, dancing, or games)?

Do you participate in any of these activities with your friends or family? Do you think you are good at any of them?

Do you think you are as good at physical activities as other adolescents your age?

Do you ever get frustrated when participating in physical activities with your friends?

Counseling

Health professionals can help children and adolescents with DCD increase their physical activity levels and develop behaviors that will help them remain physically active throughout their lives by encouraging them to participate in activities that they enjoy and that do not require much hand-eye coordination or the ability to focus their attention. These activities include hiking, running, biking, skating, swimming, yoga, aerobic exercise, and some types of martial arts such as tai chi.

Children and adolescents with DCD and their families need to know that motor coordination problems will not disappear with time or without special effort. The most successful intervention strategies are those that are developmentally appropriate and that involve small incremental challenges. It is important to identify physical activities that children and adolescents with DCD enjoy and can continue to participate in throughout their lives.

Children and adolescents with DCD usually have low self-esteem. Competitive activities should be avoided. Emphasis should be placed on finding activities in which these children and adolescents can succeed.

Referral

Schools are an excellent community resource for families. To ensure that physical activity issues and concerns are addressed in the child's or adolescent's school, specific goals, objectives, and supports can be incorporated into their Individualized Education Plan (IEP). The IEP was established through Part B of the Individuals with Disabilities Education Act (IDEA).

Children and adolescents whose motor coordination problems make it difficult for them to function at home or at school should be referred to a health professional, such as a pediatric neurologist, to rule out neurological problems (e.g., cerebral palsy), and to an occupational therapist for treatment.

References

American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.
Cantell MH, Smyth MM, Ahonen TP. 1994. Clumsiness in adolescence: Educational, motor, and social outcomes of motor delay detected at 5 years. Adapted Physical Activity Quarterly 11(2):115–129.