In this article
Neurodiversity is a term that refers to the natural differences between people and was coined in the late 1990’s by Australian sociologist Judy Singer. Neurodiversity describes the idea that people experience and interact with the world around them in many different ways; there is no one “right” way of thinking, learning, and behaving, and differences are not viewed as deficits. Neuro-divergent people tend to find some things very easy and other things incredibly hard. You may have heard of many of these types of neurodiversity such as.
- Autism, or Autism Spectrum Conditions
- Attention Deficit Hyperactivity Disorder (ADHD), or Attention Deficit Disorder (ADD)
- Dyscalculia
- Dyslexia
- Dyspraxia, or Developmental Coordination Disorder (DCD)*
* There is often confusion about which term to use, dyspraxia or DCD, both are recognised and are used interchangeably, or depending on the professional that you are dealing with. However, the NHS now prefers healthcare professionals to use the term Developmental Coordination Disorder (DCD). As the term dyspraxia is still in more common usage in the UK, and to avoid any confusion throughout this article, we will use the term dyspraxia (DCD).
Approximately 15 – 20% of the UK population has a neurological difference, with around 10% of people in the UK thought to have dyspraxia (DCD), with up to 2% severely affected. Some famous people who have dyspraxia (DCD) include:
- Daniel Radcliffe (Actor)
- Cara Delevingne (Model, Actress and Singer)
- Florence Welch (Singer)
- David Bailey (Photographer)
- Steven Spielberg (Film maker)
- Albert Einstein (Inventor)
- Thomas Edison (Inventor)
In this article we will explain what dyspraxia (DCD) is, and highlight some of its challenges. We will then explore some of the current emerging trends and innovations in diagnosis and treatment, and look at developments in awareness campaigns and advocacy efforts of dyspraxia (DCD).
What is Dyspraxia (DCD)?
Dyspraxia, also known as Developmental Coordination Disorder (DCD), is a neurological condition that affects physical coordination and motor skills, and is commonly associated with difficulties with movement. Neurologically, dyspraxia (DCD) affects the cerebellum this is tucked behind the brainstem, and is small and roughly shaped like a walnut. Interestingly there are more neurons here than in any other part of the brain, its primary role being to coordinate posture, balance, speech and movement.
Those with dyspraxia (DCD) experience misfiring between those neurons controlling their voluntary movements, leading to the physical symptoms. The cerebellum is not the only area of the brain affected, dyspraxia (DCD) can also affect the prefrontal cortex (PFC) in the front part of the brain. This is the area of the brain responsible for how we think. It aids in our decision making and planning, as well as time management and how we regulate our emotions. Medical professionals refer to these as our executive functioning.
The prefrontal cortex is the last area of the brain to fully mature, this generally happens around 25 – 26 years of age and as such, with a condition such as dyspraxia (DCD), it can be underdeveloped or impaired, making life more of a challenge.
Whilst those with dyspraxia (DCD) can struggle with their day-to-day lives, such as in education and work, primarily because they are expected to learn things in the “neuro-typical way”, there are some upsides to living with dyspraxia (DCD). There are many strengths that are associated with this neuro-type, such as big picture thinking, problem solving, tenacity, creativity, an eye for detail, and empathy, these are all qualities associated with having dyspraxia (DCD).
The American Psychiatric Association’s latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), describes the condition as a motor disorder within the broader category of “neurodevelopmental disorders”, as follows “a child with developmental coordination disorder has motor coordination below expectations for his or her chronological age. Difficulties with coordination of either gross or fine motor movements can interfere with academic achievement or activities of daily living.” An additional criterion included in DSM-5 is that the onset of symptoms occurs during the developmental period.
Symptoms of dyspraxia (DCD) vary from person to person. These can include difficulty with everyday tasks such as dressing, writing, and eating, as well as difficulty with fine motor skills such as holding a pencil or using scissors. Other signs of dyspraxia (DCD) may include poor balance, clumsiness, and delayed gross motor skill development. Children with dyspraxia (DCD) may also experience difficulty with social skills and communication, and have issues with planning, organisation, and time management. These motor and coordination difficulties that affect daily life are not the same as having a physical disability which is why dyspraxia (DCD) is known as a hidden disability.
The exact causes of dyspraxia (DCD) are not yet known, however, it is believed that both genetic and environmental factors may play a role. Research suggests that dyspraxia (DCD) is caused by an immaturity of neurone development and neural pathways in the central nervous system. Neurones are responsible for providing the brain with information about our physical condition and the environment around us.
Constant repetition of movement allows a more refined, controlled movement in response to a stimulus. If there are immaturities in these neurones and their pathways the result will be difficulties in producing purposeful, co-ordinated and smooth movements. What causes these immaturities in the neurones is yet to be discovered. Dyspraxia (DCD) can be difficult to diagnose, as it can manifest itself in many different ways and is often confused with other conditions, such as attention deficit hyperactivity disorder (ADHD).
Whilst there is no cure for dyspraxia (DCD) itself, there are a number of therapies that can help children and adults to manage their day-to-day activities. These include:
- Being taught ways to carry out activities that they find difficult, such as breaking down difficult movements into smaller parts and practising them regularly
- Adapting tasks to make them easier, such as using special grips on pens and pencils so they are easier to hold
Once dyspraxia (DCD) has been diagnosed, a treatment plan tailored to the individual’s particular difficulties can be made. This plan may involve a variety of specialists, including paediatricians, occupational therapists, and educational psychologists. This treatment plan, combined with extra help and support at school, college or in the workplace, can help the person to manage many of their physical difficulties, and improve their general confidence and self-esteem. However, there is limited availability of treatments available for people with dyspraxia (DCD).
These are some of the reasons why raising the awareness and understanding of dyspraxia (DCD) is important to help support research into the condition to promote better diagnosis, support, and inclusion.
Current State of Dyspraxia (DCD) Awareness and Research
Despite the fact that dyspraxia (DCD) is recognised by the DSM-5, the NHS, the World Health Organisation (WHO), and the Government’s Disability Unit, dyspraxia (DCD) has been described as the “Cinderella of developmental disorders” due to low levels of public awareness.
Many people confuse dyspraxia (DCD) with dyslexia, and although both of these conditions are neurodevelopmental conditions, they are not the same. Dyslexia primarily affects reading and language processing, whereas as we have seen, dyspraxia (DCD) primarily affects physical coordination and motor skills.
People consider dyspraxia (DCD) another form of attention deficit hyperactivity disorder (ADHD), which primarily affects attention and impulse control. This misconception may occur because approximately 1 in 2 people with ADHD will also have dyspraxia (DCD), but these conditions whilst both are neurodevelopmental conditions, each has its own unique set of challenges and symptoms.
Because the onset of symptoms of dyspraxia (DCD) occur during the developmental period, many people believe that it is a condition that a child will grow out of, this is a fallacy as dyspraxia (DCD) is a lifelong condition. As a child with dyspraxia (DCD) grows into adulthood they may have developed strategies to combat symptoms of the condition, or some symptoms may change over time, however a person with dyspraxia (DCD) will continue to experience motor and coordination difficulties that will affect them daily for life.
It is often thought that those with dyspraxia (DCD) are only affected when they participate in physical activities such as sports which require the use of gross motor skills. Dyspraxia (DCD) doesn’t just affect gross motor skills which require whole body movements and involve the large muscles of the body to perform everyday functions, such as standing and walking, running and jumping, and sitting upright, it also affects fine motor skills.
These are the ability to make movements using the small muscles in our hands and wrists. We rely on these skills to do key tasks in everyday life such as holding a pen or pencil for writing or drawing, operating a keyboard, using scissors, rulers, and other tools, getting dressed and brushing our hair and teeth.
In addition, dyspraxia (DCD) affects motor planning skills, these are the skills or abilities needed to work out the plan of action before engaging in a motor activity helping us to move our bodies in the way that we want it to move. Although a person’s time perception, ability to sequence activities, and to organise tasks efficiently can also be affected by dyspraxia (DCD), all of which will affect their everyday life, it does not impact cognitive ability or intellectual potential.
However, it is important to note that no two individuals will have exactly the same experience of dyspraxia (DCD) due to the diverse nature and wide variation in the type, and the severity of symptoms people experience with a condition that operates on a spectrum from mild to severe.
Dyspraxia (DCD) is classed as a disability, falling under the Equality Act 2010, and this places a duty on especially education and employment to make reasonable adjustments. However according to the Chartered Institute of Personnel and Development (CIPD) only half (52 per cent) of employers said there is a general awareness across the workforce about what neurodiversity is and why it is important.
In education, Ofsted reports and independent studies have highlighted that there are no clear process for identifying students with dyspraxia (DCD), and that dyspraxia (DCD) is often under-identified in schools, particularly in girls, who may present with less obvious physical symptoms, and that 69% of teachers had not received any specific training about dyspraxia (DCD). Training on neurodevelopmental disorders, including dyspraxia, is not always a mandatory part of teacher education, and professional development courses often focus more on dyslexia or ADHD.
24 October 2024 the Government published a paper entitled Support for neuro-divergent children and young people. The paper acknowledges the limited research in the area of neuro-divergence, but does bring together many of the recent research papers and studies in this area. The paper looks at neuro-divergence across a number of conditions, but amongst its findings is the recognition that systemic barriers such as inconsistencies in healthcare and education provision, directly affect the access, level and quality of care for neuro-divergent children and young people.
They reference research that shows that demographic factors including gender, socio-economic background and ethnicity can affect the likelihood of diagnosis. It is however clear from their list of research references that dyspraxia (DCD) remains a Cinderella condition in the field of neuro-divergence study as there are no specific studies on dyspraxia (DCD) referenced.
Recent research into the psychosocial wellbeing, parental concerns, and familial impact of children with developmental coordination disorder highlighted that children with dyspraxia (DCD) face a heightened risk of poor psychosocial outcomes. Parents reported concerns for their child, that is non-participation and social withdrawal, that are not targeted in existing dyspraxia (DCD) intervention modalities and emphasised the impact of dyspraxia (DCD) on the whole family unit, including that dyspraxia (DCD) significantly increases parental care load and causes financial strain.
Wellbeing in dyspraxia is a research project by Professor Kate Wilmut and Dr Clare Rathbone of Oxford Brookes University, looking into wellbeing in adults diagnosed with dyspraxia (DCD) compared to those with undiagnosed dyspraxia (DCD).
Possible Disrupted Biological Movement Processing in Developmental Coordination Disorder aimed to identify whether the Mirror Neuron System (MNS) differed between children with and without dyspraxia (DCD) during action observation, action execution and during a non-action baseline. They concluded that when learning new motor tasks, children with dyspraxia (DCD) might find it easier if there isn’t any distracting movement going on around them. They may also benefit from consciously directing their attention to the motor task they are trying to learn.
Previous research has highlighted that children with dyspraxia (DCD) tend to have lower maths performance compared to their neuro-typical peers. However, until now, no studies have examined the maths performance of adults with dyspraxia (DCD), a crucial gap in understanding this condition’s lifelong impact. A recent research team led by Dr Anna-Stiina Wallinheimo, lead author of the study and Research Fellow in Cognitive Psychology, at the University of Surrey, investigated the influence of cognitive (working memory) and emotional (maths anxiety) factors on the maths performance of adults with and without dyspraxia (DCD).
Adults with dyspraxia (DCD) demonstrated lower working memory and maths performance and reported higher levels of maths anxiety compared to adults without dyspraxia (DCD). Given the lifelong nature of dyspraxia (DCD) and the crucial importance of strong numeracy skills for everyday activities, such as financial planning, cooking, and time management, the insights gained from this research will undeniably make an invaluable contribution to the existing literature. Dr Judith Gentle, co-author of the study and Senior Lecturer in Psychology at the University of Surrey, said “This research not only advances our understanding of the cognitive challenges faced by adults with Dyspraxia but also underscores the need for tailored educational approaches.”
As we have highlighted, dyspraxia (DCD) is often overshadowed particularly in the field of research, by other neurological conditions such as dyslexia, autism and ADHD. The reason for this may be because dyspraxia (DCD) symptoms do not present with overt cognitive deficits, and may therefore have a lesser impact on academic performance, the priority measurement in education, so available research funding is often targeted into areas improve education outcomes.
This may also be because of the lack of public awareness of dyspraxia (DCD), meaning that there is less advocacy and demand for research. However, there is some funding available to further research into dyspraxia (DCD). The Waterloo Foundation (TWF) is an independent grant-making Foundation created in 2007, and based in Cardiff, Wales. In 2025, they will be inviting applications for research projects aimed at advancing the understanding and treatment of Dyspraxia or motor coordination difficulties in general.
Emerging Trends in Dyspraxia (DCD) Awareness
Occupational therapists play a huge role in the diagnosis and treatment for children and adults with dyspraxia (DCD). There is strong evidence emerging to support the use of Cognitive Orientation to Occupational Performance (CO-OP) in dyspraxia (DCD) treatment. CO-OP is an evidenced based client centred, performance based problem solving approach that enables skill acquisition through a process of strategy use and guided discovery. CO-OP focuses on teaching the child and family how to use cognitive strategies to improve occupational performance of tasks (motor-based) that impact on their daily lives.
A key component of the CO-OP is that the child chooses the goal and is therefore motivated to complete it. While CO-OP has been applied with several other groups with motor disorders, such as children with cerebral palsy, studies have been limited to small numbers in dyspraxia (DCD), however, CO-OP is beginning to be used in the NHS for dyspraxia (DCD) treatment.
Dyspraxia Magazine are dedicated to raising awareness, reducing misinformation, offering dyspraxia (DCD) support, and providing valuable resources backed by research to empower individuals and their families. By publishing experiences of people who live with the condition, they highlight everyday issues. Recent articles include:
- I’m not just “lazy”
- Tory MP Tom Hunt’s Voting Challenge Highlights Dyspraxia
- Historic Day for Dyspraxia Awareness as Two Dyspraxic MPs Secure Seats in Parliament
- Changing the Narrative on Verbal Dyspraxia
- Diary of a Dyspraxic Mother – Entry 2
Dyspraxia Magazine also published the recent news that after approximately 40 years of supporting individuals with dyspraxia (DCD) and raising awareness, the Dyspraxia Foundation announced closure amid financial challenges, in another blow to advocacy and awareness. The Dyspraxia Foundation’s Facebook page has also been closed. Dyspraxia Awareness Week was created by the Dyspraxia Foundation to raise awareness about dyspraxia (DCD) and to educate people on how to support people with dyspraxia (DCD). There is no news to date on whether this initiative will continue in 2025 or about which organisation might take over running the awareness week.
Chrysalis Dyspraxia Awareness is a new non-profit organisation based in Ripon, Yorkshire, that aims to raise awareness of dyspraxia (DCD), providing talks to communities, schools, college, universities, medical professionals, and businesses throughout the UK.
The Brain Charity helps people with all forms of neurological conditions and provides practical help on all aspects of living with dyspraxia (DCD)
Movement Matters is committed to making research accessible to non-scientific communities, in particular, families, individuals with dyspraxia (DCD), and anyone else who might benefit from this information.
Researchers at Manchester Metropolitan University have created videos to help to support children with dyspraxia (DCD), these videos are of four different everyday tasks being carried out successfully by another child such as tying shoelaces, using cutlery, buttoning a shirt and cup stacking. These were filmed from a point-of-view, or first-person perspective, using head cams. While watching the videos, the participants in the study were encouraged to imagine that they were watching themselves perform the movements that they observed.
Twenty-eight children, aged 7 – 12 years, took part in the study. The team found that children with dyspraxia (DCD) who had previously struggled with the tasks, showed a significant improvement after practising with the videos, led by their parents, four times a week over a four-week period. Now researchers hope to develop a video library of common tasks such as opening packets and using a ruler and make them accessible online to parents of children with dyspraxia (DCD).
A key finding was that, for children who were unable to tie their shoelaces at the start of the study, there was an 89% success rate with those in the group which had used the videos to learn this skill, compared to only a 44% success rate in the control group who had just physically practiced, which is the conventional treatment.
Organisations such as Inclusive Employers champion a broad range of diversity and inclusion issues including dyspraxia (DCD) in the workplace. Unions such as the GMB and UCU offer guidance on the law and neurodiversity at work, and the business social media site Linked In has published articles offering insights and advice on dyspraxia (DCD) in the workplace.
The University of St Andrews has published information for their staff on recruiting and supporting people with dyspraxia (DCD) in the workplace and has useful tips for making the workplace more inclusive.
Future Directions in Dyspraxia (DCD) Research
Digital technology, apps and Artificial Intelligence (AI) advancements have the potential to transform the lives of people with dyspraxia (DCD). Digital assessment platforms are becoming increasingly prevalent in the diagnosis of neurodevelopmental conditions, they can be designed to assess fine and gross motor skills in those with dyspraxia (DCD), and can accurately measure for example, coordination, balance, hand-eye coordination, and dexterity. This can help with early diagnosis and personalised treatment and support plans.
Virtual Reality (VR) and Augmented Reality (AR) could be adapted to simulate real-life situations to more accurately assess a person’s abilities and difficulties, and, as we have seen with the development of video resources by Manchester Metropolitan University, be used to help to develop a person’s motor skills. Augmented reality headsets could display virtual guides as the person completes tasks.
Artificial Intelligence (AI) could be used to accurately analyse a vast amount of data from a range of sources and to predict personalised developmental trajectories through the use of machine learning models. AI can also be used to assist people with dyspraxia (DCD) to remove fine motor control barriers, and there are more and more applications to support time management and planning, which can benefit all neuro-divergent people.
Assistive devices such as wearable technology could be used to monitor a person’s movement and to provide data. It could also help to provide alerts to the person to help them to correct movements. By tracking real-time recordings of the brain’s bio-signals and combining that with synchronous recordings of what a person is seeing and hearing, the new wearables will tell us more than we have ever known about how the human brain works in the real world.
Technology advancements will also assist the scientific and medical profession to better research and understand the condition. Functional magnetic resonance imaging (fMRI) measures the small changes in blood flow that occur with brain activity, and has become an invaluable tool for studying the brain’s role in dyspraxia (DCD). It allows researchers to explore differences in brain structure and connectivity that may explain the motor difficulties associated with the condition.
There is also growing interest in combining neuroimaging and genetic research to develop a more comprehensive understanding of the biological basis of dyspraxia. It has been thought for many years that dyspraxia (DCD) could be genetic, but there is limited research to prove this hypothesis. Technology advancements could contribute to this body of research.
Interdisciplinary research has been a topic of interest for many decades, perhaps longer and interdisciplinary collaboration, by its very nature, promotes creativity, innovation, and out of the box thinking which can be of immense benefit to the awareness, understanding, diagnosis, treatment and support of dyspraxia (DCD). However, any interdisciplinary research project with team members from different disciplines would need to find a way to integrate the interests of the various researchers.
One barrier to achieving these mutual goals is the disproportionate allocation of resource funding across different disciplines. Fortunately, opportunities for interdisciplinary discussions between academics and neuro-diverse communities are now emerging, especially in the UK and US, such as the International Society for Autism Research Annual Meetings and the It Takes All Kinds of Minds Conference.
Key Predictions for the Future
The International Society of Research and Advocacy for Developmental Coordination Disorder (ISRA-DCD) brings together researchers, clinicians, families, people with dyspraxia (DCD), and organisations globally with an interest in dyspraxia (DCD) to:
- Further, promote, and disseminate knowledge
- Support and facilitate collaboration
- Promote diversity and inclusion
- Increase public awareness
- Facilitate mentorship of current and future generations of researchers
- Encourage and facilitate the practical application of research
- Advocate for services, facilities, and other supports
They hold bi-annual conferences to share knowledge, to promote research into dyspraxia (DCD), and to influence greater recognition and support for the condition. Keynotes from the latest conference can be found here.
The World Economic Forum’s Skills for the 21st Century report indicates that creativity, innovation, problem solving, and entrepreneurial flair will be in demand for the rest of the century. People who are neuro-divergent tend to possess these skills more than their neuro-typical counterparts. However, although neuro-divergent individuals make up a significant portion of the UK population, estimated at around 15%, there is still a widespread lack of understanding and misinterpretation regarding their unique thought processes and the complexities of their conditions. By increasing awareness of neurodiversity, education, employment and society as a whole can harness technological advancements such as AI to remove the stumbling blocks for neuro-diverse people and can benefit from their strengths.
At the CIPD conference 2023, Carol Buchanan, head of inclusion qualifications at Inclusive Employers outlined to delegates why having a strategic approach to Equality, Diversity and Inclusion (EDI) is vital for its success. She said: “The very first thing organisations do when they’re thinking about doing inclusion work is… awareness raising. A strategic approach would have a “vision”, which will tell you where you are trying to get to and why you are going there, a “strategy”, which will outline a roadmap of how you move forward in the next few years, and a “plan”, which will add detail to how the strategy will be delivered.”
A recent study by Birkbeck University found that 65% of neuro-divergent employees fear discrimination at work, despite organisations increasingly recognising the need for inclusivity and the advantages that diversity brings to the workforce.
Neurodiversity inclusion requires a cultural change, which is happening in some areas, moving from the idea of support provision to enablement provision. But to achieve this requires better understanding and greater recognition of neurodiversity. For neuro-diverse job applicants and employees, significant barriers can be removed by altering policies and practices such as interview and performance review processes. Organisations should regularly assess whether workplace practices place neuro-diverse employees at a disadvantage, whether this amounts to disability discrimination or not, and whether the duty to make reasonable adjustments has arisen.
The Equality Act 2010 defines disability as a physical or mental impairment that has a long-term and substantial negative effect on a person’s ability to do normal daily activities. Dyspraxia (DCD) is a disability; it is life-long and affects daily life. However, there are still instances where dyspraxia (DCD) discrimination occurs such as in the case of AECOM v Mallon [2023], where the claimant had difficulty setting up the username and password to complete an online application for a role at AECOM. He contacted the HR manager to seek a telephone application and explained he had dyspraxia. He was not offered a telephone application. He successfully submitted a tribunal claim that he had not been offered reasonable adjustment.
Organisations should ensure that they have a culture that encourages disabled employees and candidates to disclose their disability and should choose to raise awareness of the positive outcomes of disclosure, such as being able to make reasonable adjustments, and why the monitoring of disadvantaged groups can influence positive action initiatives and equal pay monitoring. Once a disability is disclosed, or the employer could be reasonably expected to know about the disability, the employer is obliged to provide reasonable adjustments.
Neurodiversity is the concept that brain differences are natural variations and that some people’s brains simply work in a different way. In education, students are neuro-diverse, these differences may mean they are diagnosed with one or more neurological conditions within a broad range that includes autism, dyslexia, ADHD and dyspraxia (DCD). Understanding these differences and variations lays the foundation for ensuring that every student has an accessible and comfortable learning environment. It’s equally important for educators to understand the differences between Special Educational Needs and Disabilities (SEND) and neurodiversity.
While SEND and neurodiversity differ, there is an overlap. Some conditions considered neuro-diverse, including ADHD, autism, dyslexia, dyscalculia and dyspraxia (DCD) can also be classified as SEND conditions, however some are not. The Department for Education provides guidance for educators, Understanding Neurodiversity – A Guide to Specific Learning Differences, however more emphasis could be put onto creating more inclusive teaching and learning environments for neuro-divergent students in initial teacher training and qualifications.
Conclusion
As we have seen in this article, neurodiversity has gained more recognition in employment, education and in the wider society over the last few years. However as we have also seen, dyspraxia (DCD) does not appear to encompass the same prevalence as other more high profile conditions such as dyslexia and ADHD. This is surprising as research shows that around 10% of the UK population has dyspraxia (DCD), the same percentage of the population that have dyslexia and almost double the percentage of people who have ADHD. It is therefore surprising that so little is known about it among professionals in child healthcare and education or by employers, or the wider community.
One of the reasons why dyspraxia (DCD) is less well known than dyslexia might be that it is less easily recognised, that early childhood instances may be dismissed as clumsiness, and as children develop they often acquire strategies to help overcome the challenges of dyspraxia (DCD) which conspires to keep the condition hidden. This is why advocacy for raising awareness and for more research into the condition is so important.
Participating in awareness events help to challenge stereotypes and misconceptions about neurological differences. Events such as Neurodiversity Celebration Week, Dyspraxia Awareness Week, SEND Awareness Days encourage active participation from individuals, schools, colleges and workplaces.
