International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder.
Rainer Blank, Anna L Barnett, John Cairney and 8 others
PMID 30671947WHAT IT FOUND
Diagnose DCD only after age 5 unless severe.
Use MABC-2 or BOT-2 with a 16th centile cut-off. Prioritize activity-oriented interventions like task-specific training. Sensory integration therapy lacks evidence. Screen for ADHD and anxiety, as co-occurrence is common and impacts outcomes.
Key findings
01A formal diagnosis of DCD under age 5 is recommended only for severe cases, requiring two assessments at least 3 months apart.
02Activity-oriented and participation-oriented approaches, such as task-specific training and Neuromotor Task Training, are recommended over body-function-oriented interventions like sensory integration therapy.
03The 16th centile (1SD) on the MABC-2 or BOT-2 is the recommended cut-off for diagnosis, as the fifth centile misses many children with moderate DCD.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The guidelines are based on expert consensus and systematic reviews, not new primary clinical trials. Evidence for interventions in adolescents and adults is sparse, with no specific intervention studies identified in the scoping review for this group. Standardized motor tests have sensitivity below 90%, meaning some children with DCD may be missed. There is a lack of data on optimal intervention intensity, duration, and dose. Cost-effectiveness data for different treatment approaches are missing.
Declared interests
The document states it was developed under the umbrella of the European Academy of Childhood Disability. No specific funding sources or commercial conflicts of interest are disclosed in the provided text, though it notes supervision by the Association of the Scientific Medical Societies in Germany (AWMF).
The easy way to misread this
Do not use sensory integration therapy as a primary intervention for improving daily activities, as the guidelines state evidence for its effectiveness is inconclusive. Also, do not diagnose DCD in children under 5 based on a single assessment, as normal motor development variability makes early diagnosis unreliable.