DCD Assessment
Information Sheet
Developmental Coordination Disorder
Advocacy
Toolkit
What is Developmental Coordination Disorder (DCD)?
DCD is a chronic motor skill disorder seen in children and youth, which significantly affects activities of daily
living, school performance, and leisure activities.1,2
The disorder is diagnosed using DSM-5 criteria:3
A. Acquisition and execution of coordinated motor skills are substantially below
what would be expected given the child’s age and opportunity for skill learning
and use. Difficulties may be seen as clumsiness, inaccuracy, or slowness of
performance of motor skills (e.g., catching a ball, using scissors, printing or
handwriting, riding a bicycle, or participating in sports).
B. The motor skills deficit significantly and persistently interferes with activities of
daily living and impacts school productivity, vocational skills, leisure activities,
and play.
C. The onset of symptoms is in the early developmental period.
D. The motor skills deficit is not better explained by intellectual disability, visual
impairment, or a neurological or medical condition affecting movement.
Why is assessment important?
DCD is a chronic disorder that affects fitness, activities of daily living, academic functioning, social
relationships, and participation in meaningful life activities.1,2,4-6 Children with DCD also report psychological
issues, including significantly higher levels of depression and anxiety, and decreased quality of life than their
typically developing peers.6,7,8 Assessment facilitates the implementation of individualized, evidence-informed
treatment that can improve physical, social, and psychological outcomes for these children.
Who can do the assessment?
DCD is typically diagnosed by a medical doctor or pediatrician (and in some jurisdictions, a psychologist) who
is qualified to examine the specific DSM-5 criteria.1 Comprehensive assessment leading to diagnosis ideally
involves a multidisciplinary health professional team.1,2 Occupational therapists have a key role in assessing
Criteria A and B.
At what age is a DCD diagnosis appropriate?
DCD is usually evident early on in a child’s life but not typically diagnosed before age 5.1 Preschoolers (aged 3
to 5 years) who show significant motor impairments (despite having had ample opportunities for learning and
DCD Advocacy Toolkit | DCD Assessment Information Sheet 1
with other causes of motor delay ruled out) can receive a DCD diagnosis based on the findings from at least
two longitudinal assessments (e.g., repeated administration of the MABC-2 at least 3 months apart).1
Please also refer to the accompanying information sheet, Early Identification and Early Intervention for DCD
(http://bit.ly/2D8IDEY).
How do I assess for DCD?
Assessment should include:1,2
• A thorough medical and developmental history
• Clinical examination
• Motor testing
• Questionnaires
• Discussion with the child and key individuals regarding the impact of the child’s motor skills on daily living
skills, school, leisure and participation.
The following tools are recommended as primary assessment measures for school-age children for suspected DCD:1
Diagnostic Assessment Recommended
Criteria Domain Measures Key Information
Movement Assessment Age range: 3 years to 16 years 11 months
Battery for Children, Subsections: Manual dexterity, ball skills, and
2nd ed. (MABC-2)9 balance (static & dynamic)
A Motor
functioning
Bruininks-Oseretsky Age range: 4 to 21 years
Test of Motor Subsections: Running ability, agility, balance,
Proficiency, 2nd ed. bilateral co-ordination, upper limb speed, and
(BOT-2)10 dexterity, and visual motor control
Developmental Coordina- Age range: 5 to 15 years
tion Disorder Questionnaire Subsections: Control during movement, fine
(DCDQ’07)11 motor skills & handwriting, general coordination
Free download available at www.dcdq.ca
B Activities of
daily living
Movement Assessment Age range: 5 to 12 years
Battery for Children Checklist, Subsections: Movement in a static environment,
2nd ed. (MABC-2 Checklist)10 movement in a dynamic environment, non-
motor factors
C Early onset Parent interview and/or tools Developmental history as part of OT and/or
such as the Listening for DCD physician assessment; a history of motor
Checklist12 or clinical inter- learning challenges should be evident from
view guidelines13 may be used early in life
Medical Neurological exam and Refer to physician to rule out other possible
examination other tests, as required medical or neurological explanations for motor
difficulties14
D
Cognitive IQ testing Not required if no history of challenges with
functioning school functioning/academic achievement1
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The psychometric properties of these measures are described in the Management of DCD Evidence for Practice
(E4P) Synthesis.
What motor performance scores indicate a possible DCD diagnosis?
Cut-off scores1 Children 3-5 years Children 6 years and older
MABC-2 ≤ 5th percentile ≤ 16th percentile; however, if a child scores below the 5th
percentile in one domain (e.g., fine motor, balance) but scores
above the 16th percentile in other domains, a DCD diagnosis
could be made if other diagnostic criteria are met
BOT-2 2 SD below the mean 1 SD below the mean; as above
Where can I learn more?
• Evidence on DCD assessment/diagnosis and management [Evidence for Practice (E4P) Synthesis]: http://
www.childdevelopment.ca/DCDAdvocacyToolkit/DCDAdvocacyToolkitEvidenceforPracticeSummary.aspx
• Advocating for a DCD diagnosis (information sheet): http://www.childdevelopment.ca/DCDAdvocacyToolkit/
DCDAdvocacyToolkitResources.aspx
• Best practices in DCD treatment (information sheet): http://www.childdevelopment.ca/
DCDAdvocacyToolkit/DCDAdvocacyToolkitResources.aspx
• Early Identification and Early Intervention for DCD (information sheet): http://www.childdevelopment.ca/
DCDAdvocacyToolkit/DCDAdvocacyToolkitResources.aspx
• Review of standardized motor assessments: http://www.therapybc.ca/eLibrary/resources.php
• Listening for DCD Interview Guide (CanChild): http://bit.ly/2Ca1qDw
• DCDQ : http://www.dcdq.ca
This document was prepared in March 2018 and will be updated as new evidence emerges.
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References
1. Blank R, Smits-Engelsman B, Polatajko H, Wilson P. European Academy for Childhood Disability (EACD): Recommendations on the definition, diagnosis, and
intervention of developmental coordination disorder (long version). Dev Med Child Neurol. 2012;54:54-93.
2. Chung A, Callanen A. Clinical Review: Developmental Coordination Disorder (Occupational Therapy). CINAHL Information Systems, Rehabilitation Reference
Center, 2016.
3. American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders (5th ed.). 2013. Arlington, VA: APA.
4. Callanen A. Clinical Review, Developmental Coordination Disorder (Physical Therapy). CINAHL Information Systems, Rehabilitation Reference Center, 2017.
5. Magalhaes LC, Cardoso AA, Missiuna C. Activities and participation in children with developmental coordination disorder: A systematic review. Res Dev
Disabil. 2011;32(4):1309-16.
6. Gagnon‐Roy M, Jasmin E, Camden C. Social participation of teenagers and young adults with developmental coordination disorder and strategies that could
help them: Results from a scoping review. Child Care Health Dev. 2016;42(6):840-51.
7. Zwicker JG, Harris SR, Klassen AF. Quality of life domains affected in children with developmental coordination disorder: A systematic review. Child Care Health
Dev. 2013;39(4):562-80.
8. Zwicker JG, Suto M, Harris SR, Vlasakova N, Missiuna C. Developmental coordination disorder is more than a motor problem: Children describe the impact of
daily struggles on their quality of life. Br J Occup Ther. 2018; 81:65-73.
9. Henderson SE, Sugden DA, Barnett AL. Movement Assessment Battery for Children, 2nd ed. London: Pearson, 2007.
10. Bruininks R, Bruininks B. Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition. Minneapolis, MN: NCS, Pearson, 2005.
11. Wilson BN, Crawford SG, Green D, Roberts G, Aylott A, & Kaplan B. Psychometric properties of the revised Developmental Coordination Disorder Questionnaire.
Phys Occup Ther Pediatr. 2009;29(2):182-202.
12. Camden C, Rivard L, Pollock, Missiuna C. Listening for DCD Interview Guide. CanChild. 2013; Available from: http://bit.ly/2Ca1qDw
13. Missiuna C, Pollock N, Egan M, DeLaat D, Gaines R, Soucie H. Enabling occupation through facilitating the diagnosis of developmental coordination disorder.
Can J Occup Ther. 2008;75(1):26-34
14. Harris SR, Mickelson ECR, Zwicker JG. Diagnosis and management of developmental coordination disorder. Can Med Assoc J. 2015;187:659-665.
Access the full Toolkit here
This document was developed by Giovanna Boniface, Stephanie Glegg, Ivonne Montgomery, and Dr. Jill Zwicker with funding support
from a Michael Smith Foundation for Health Research (MSFHR) REACH Award and Sunny Hill Health Centre for Children. Stephanie Glegg
is supported by a CIHR Vanier Canada Graduate Scholarship, the Canadian Child Health Clinician Scientist Program, a UBC Public Scholars
Award and Four-Year Fellowship, and the Sunny Hill Foundation. Dr. Zwicker is a MSFHR Scholar and is funded by the Canadian Child Health
Clinician Scientist Program, BC Children’s Hospital Research Institute, Sunny Hill Foundation, and Canadian Institutes of Health Research.
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