Childhood Motor Skill Disorders

Childhood motor skill disorders affect a child’s ability to perform everyday physical tasks, such as writing, tying shoelaces, or catching a ball. These challenges go beyond simple clumsiness and may interfere with academic performance, social participation, and self-esteem. Often linked to neurological development, these disorders require early recognition and supportive intervention. Understanding the types, causes, and signs of childhood motor skill disorders helps create strategies for children to thrive.

Childhood Motor Skill Disorders and Dyspraxia

Childhood motor skill disorders are developmental conditions that impact a child’s ability to plan, coordinate, and execute physical movements. These challenges can affect fine motor skills (like handwriting) and gross motor skills (like jumping or running). One of the most recognized motor skill disorders is dyspraxia, also known as Developmental Coordination Disorder (DCD). 

Dyspraxia is a brain disorder where neural messages are not fully processed. It affects the coordination of large movements (gross motor skills) and smaller movements (fine motor skills). Gross motor skills include the ability to walk, ride a bicycle, or play sports, and fine motor skills could include writing or fastening a button ^[1]. 

The disorder affects movement. Therefore, many children with dyspraxia appear clumsy. Dyspraxia impacts people’s ability to think of and execute movements (motor planning). In other words, a child with dyspraxia struggles to plan and act out physical movements.

The condition begins in childhood and affects nearly 1 in 20 primary school-age children. Doctors generally diagnose the condition only after age 5, as coordination issues may only become noticeable as a child ages. Children born with the disorder typically reach developmental milestones later than their peers ^[1]. 

Signs and Symptoms of Dyspraxia

Dyspraxia symptoms can vary widely based on a child’s age and developmental stage. While typical signs are associated with the condition, these often present differently across early childhood, preschool, later childhood, and adolescence. It’s important to note that no two individuals will experience dyspraxia similarly. Most children display a unique combination of symptoms, which may evolve as they grow and face new motor and coordination challenges ^[2].

Early Childhood Years

In the early developmental stages, children with dyspraxia may reach milestones more slowly than their peers. These delays can become noticeable in physical, speech, and self-care abilities. For example, a child with dyspraxia may take longer to:

• Sit, stand, crawl, or walk
• Speak, including answering questions at the same speed as peers, repeating sequences (sounds or words), or having a limited vocabulary
• Learn potty training or self-feeding

Preschool Ages

As children enter preschool, dyspraxia symptoms often become more apparent in social, behavioral, and motor skill contexts. At this stage, children may exhibit challenges related to:

• Fidgeting and needing to move constantly
• Unusual behaviors
• Keeping friends
• Being hesitant or slow
• Concentrating and focusing
• Learning new skills quickly
• Bumping into objects, falling, and dropping things
• Misunderstanding spatial concepts like “in,” “out,” “around,” “behind,” and “in front of”

They may also struggle with the following: 

Fine Motor Skills

• Holding a pen or pencil, writing, fastening buttons, using utensils, using scissors, coloring or drawing, copying from a blackboard, tying shoes, or getting dressed

Gross Motor Skills

• Playing catch, jumping, kicking a ball, skipping, or walking
• Following multi-step instructions, such as “put the toy in the box, then wash your hands,” which may confuse a child with dyspraxia due to difficulty with sequencing or memory

Later Childhood Years

As children grow older, many earlier difficulties persist, impacting academic performance and daily functioning. Caregivers and educators may begin to notice:

• Disorganization
• Unusual or awkward postures
• Frequent temper tantrums
• Avoidance of sports and physical activities leads to a decline in fitness
• Difficulty eating or drinking in a socially appropriate way
• Challenges following or remembering instructions
• Trouble filtering out background noise or distractions
• Difficulty with academic tasks such as math and writing
• Learning more effectively in one-on-one settings than in group classrooms

Adolescence

Some individuals are not diagnosed with dyspraxia until adolescence, but a retrospective review of their developmental history typically reveals earlier symptoms. During adolescence, the condition may present with a range of cognitive, emotional, and motor challenges, including ^[4]:

• Slower acquisition of new skills
• Impulsivity and poor time management
• Limited awareness of situational risks
• Difficulty with spatial awareness, including proximity to people or objects, depth perception, and estimating weight or distance
• Challenges with driving due to poor coordination and judgment
• Struggles to follow multi-step instructions, remember dates or names, and recall recent events
• Frequently losing or misplacing items
• Heightened stress, irritability, and difficulty adjusting to changes
• Social awkwardness, increased vulnerability to bullying, and lack of awareness about online and social media risks
• Mental health concerns such as anxiety or depression, along with persistent fatigue
• Ongoing issues with concentration, language, and sensory processing

Causes of Dyspraxia

The exact cause of dyspraxia is unknown, but research suggests the condition could result from an issue in how neurons in the brain develop, affecting the brain’s ability to send messages to the muscles in the body. This can make planning and carrying out coordinated movements challenging ^[3]. 

Dyspraxia also appears to have a strong genetic connection, as children with dyspraxia often have a parent with the condition. Complications during pregnancy and birth, such as premature birth (before 37 weeks of gestation) or a low birth weight (less than 4 pounds), may also increase the risk ^[1].

Other factors include maternal drug or alcohol use during pregnancy and a family history of developmental coordination disorders. Dyspraxia is four times more common in people born male than in people born female. It is a lifelong condition that begins in childhood and can persist into adulthood ^[3][4]. 

How Does Dyspraxia Affect Daily Life?

Dyspraxia affects young people in different ways, including academically, socially, and emotionally, in terms of self-esteem. The long-term prognosis for children with dyspraxia varies based on the severity of the condition and the support they receive. While dyspraxia is a chronic condition, many symptoms can improve with the proper treatments. 

Academic Performance

Because dyspraxia impacts concentration and memory, it often affects academic performance. Teachers may have to repeat instructions, and affected children might struggle to complete tasks at the same rate as their peers. This frequently leads to lower academic marks, and a child with dyspraxia may require additional educational assistance, such as an individualized education plan (IEP) ^[5]. 

Social Interactions

Children with dyspraxia are often socially awkward, and they may be more likely to be victims of bullying. This can render it difficult to make and keep friends. It is common for those with this condition to avoid team games, leaning toward social isolation instead. 

Self Esteem

Due to struggles with academics and social interactions, children with dyspraxia may develop low self-esteem. These reasons are likely multifaceted, including links to physical impairments, coordination difficulties, limited socialization, and mental health concerns, all of which may negatively impact self-confidence and self-esteem ^[6]. 

Long Term Prognosis

As children with dyspraxia become adults, the condition continues to present challenges. While larger muscle movements may improve with age, smaller ones remain problematic. Adults with dyspraxia may continue to struggle with tasks requiring coordination, such as driving or typing. Organizational skills or multitasking can also be challenging.

Challenges with social interactions, such as interpreting non-verbal signals and self-esteem issues, may persist long-term. However, many adults become adept at masking or working around these difficulties. Persistent effort to manage motor and cognitive challenges can lead to mental fatigue and stress ^[7]. 

Diagnosing Dyspraxia

While symptoms of dyspraxia often emerge in early childhood, they can be challenging to detect, as children naturally develop at different rates. As a result, dyspraxia is typically not diagnosed until after the age of five. Even if a child exhibits several signs outlined in clinical guides, this does not automatically indicate a diagnosis. Some children may develop specific skills more slowly than their peers.

Dyspraxia is one of several motor skill disorders in various subtypes related to motor, cognitive, and visual-motor abilities ^[8]. Therefore, a comprehensive professional assessment is essential to determine whether there is an underlying concern.

Diagnosing dyspraxia requires a multidisciplinary approach. An occupational therapist or developmental neuropsychologist should assess the child’s motor skills, while a pediatrician should help rule out other neurological conditions that might present with similar symptoms. These professionals must evaluate whether the child’s challenges reflect a genuine motor coordination disorder ^[1].

Key areas of assessment include:

• Fine motor skills (how the brain controls smaller muscle movements)
• Gross motor skills (how the brain controls large muscle movements)
• Visual motor coordination (how the brain controls sight related to movement)
• Sensory profiling (how the brain responds to sensory stimuli)
• Medical and developmental history (when and how the child started crawling, walking, speaking, etc.)
• Intellectual abilities
• Social or behavioral issues

Professionals utilize a range of assessments to diagnose dyspraxia, so caregivers should inquire about the specific evaluations offered before scheduling an appointment. A comprehensive assessment should address all relevant areas of functioning, which often requires a multidisciplinary team, including occupational therapists, psychologists, and pediatricians, to ensure thorough evaluation. Following this process, a diagnosis of dyspraxia may be made if the child meets the following criteria ^[9]:

• Symptoms developed in early childhood
• Fine and gross motor skills are not at the same level as a child’s peer group
• Lack of motor skills negatively impacts quality of life
• Other disorders with overlapping symptoms are ruled out

Treatment of Dyspraxia

Although dyspraxia cannot be cured, targeted interventions can effectively manage its symptoms. Common treatments include occupational therapy, physiotherapy, and speech and language therapy. Early intervention is associated with better long-term outcomes, making timely support crucial. Since symptoms vary widely in type and severity, treatment plans should be personalized by qualified healthcare professionals to address each child’s unique needs and help them build essential motor and coping skills.

Occupational Therapy

Occupational therapy is one of the best treatments for dyspraxia. It helps develop skills for daily life and can assist in learning new ways of doing things and reaching performance-related goals.

Physiotherapy

Physical therapists help individuals learn how to improve movement through exercise, which can improve coordination, energy levels, strength, and muscle tone.

Psychology

Psychologists can help your child manage stress, social skills, and mental health. Cognitive behavioral therapy (CBT) has been found to assist in changing the way individuals think and behave, even if they are suffering from dyspraxia. 

Speech and Language Therapists

Speech and language therapists help children who struggle with forming certain sounds, stuttering, and other language-related problems. This form of therapy can help children communicate more effectively.

How to Support Children with Dyspraxia

Caregivers and educators can play a key role in supporting children with dyspraxia by establishing structured routines and breaking tasks into manageable steps. Visual aids, such as charts or checklists, can assist with daily activities and reinforce consistency. Incorporating physical activities that focus on coordination, without emphasizing competition, can also be beneficial.

To build confidence, it is essential to focus on effort rather than outcomes and to offer consistent encouragement. Social development can be supported by facilitating structured playdates and teaching social cues through guided activities like turn-taking games.

In educational settings, teachers can offer accommodations such as extended time for assignments, adaptive writing tools (like pencil grips or lined paper), and access to keyboards for written tasks. Regular communication with occupational therapists and other specialists ensures a coordinated approach. Above all, patience and consistent encouragement are essential to helping children with dyspraxia thrive.

Other Motor Skills Disorders

Several childhood conditions share symptoms with dyspraxia, making an accurate diagnosis essential. A healthcare professional can help rule out other possibilities and identify the appropriate support. The following are common childhood motor skills or neurological disorders that may overlap with or be mistaken for dyspraxia:

• Cerebral Palsy: Characterized by muscle stiffness, weakness, or involuntary movements, cerebral palsy is caused by abnormal brain development or brain injury. Unlike dyspraxia, it directly affects motor control due to structural changes in the brain
• Muscular Dystrophy: This condition involves progressive muscle weakening and wasting. It differs from dyspraxia in that it affects the muscles, not the brain’s ability to plan movement.
• Spinal Muscular Atrophy (SMA): SMA causes muscle weakness resulting from nerve dysfunction. Unlike dyspraxia, it affects the communication between nerves and muscles rather than motor coordination.
• Attention-Deficit Hyperactivity Disorder (ADHD): ADHD presents with inattention, impulsivity, and hyperactivity. It often co-occurs with dyspraxia but is primarily a disorder of executive functioning and behavior regulation, not movement planning.
• Autism Spectrum Disorder (ASD): Children with ASD may have poor motor coordination, but these symptoms are secondary to challenges in communication, sensory processing, and social interaction.
• Childhood Apraxia of Speech (CAS): CAS is a motor planning disorder specific to speech. Children with CAS struggle to plan and coordinate the movements needed for speech, but generally do not show motor impairments in other areas of the body.
• Dyslexia: Dyslexia is a learning disorder primarily affecting reading and language processing. It differs from dyspraxia, as it does not involve motor coordination difficulties.

Proper diagnosis is essential for determining which condition is present, as treatments and interventions vary depending on the underlying cause.

Key Takeaways

Dyspraxia, also known as Developmental Coordination Disorder (DCD), is a neurological condition that affects a child’s ability to plan and execute fine and gross motor movements. It can impact everything from handwriting and coordination to speech and organizational skills. While dyspraxia affects movement and sometimes cognitive processing, it is not related to intelligence, and many individuals with dyspraxia have average or above-average intellectual abilities.

The condition typically appears in early childhood and persists throughout life. It can interfere with academic performance, social development, and emotional well-being, often leading to frustration and low self-esteem. Because many motor skill disorders share overlapping symptoms, obtaining an accurate diagnosis from a multidisciplinary team of healthcare professionals is essential.

Although dyspraxia cannot be cured, early intervention and targeted therapies, such as occupational, speech, and physiotherapy, can significantly improve a child’s abilities and quality of life. With the proper support, children with dyspraxia can thrive in and out of the classroom.