International clinical practice recommendations on DCD published in March 2019 provide a comprehensive overview of the evidence related to definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD.
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Recommendations on therapeutic approaches
R 22 If an intervention is to be provided then we recommend that activity-oriented and participation-oriented approaches be used as a means to improve general, fundamental, and specific motor skills in individuals with DCD.
Comment: Activity-oriented or participation-oriented approaches are interventions that focus on ADL (including personal care, play, leisure/sports, arts and crafts, and academic, prevocational, and vocational tasks) within the intervention process.
Intervention must also aim to generalize to daily function, activity, and participation across environmental contexts in which the child needs to perform.
Activity-oriented or participation-oriented approaches should involve family, teacher, significant others, and/or environmental support to cascade and promote essential opportunities for practice and generalization. This is necessary to give enough opportunity for motor learning and consolidation of skills.
Formally investigated activity-oriented or participation-oriented approaches, based on this and the previous review, include but are not limited to task-specific training, NTT, and cognitive orientation to daily occupational performance approach (CO-OP).
Activity-oriented or participation-oriented approaches are interventions that focus on ADL (including personal care, play, leisure/sports, arts and crafts, and academic, prevocational, and vocational tasks) within the intervention process. Intervention must also aim to generalize to daily function, activity, and participation across environmental contexts in which the child needs to perform.
Activity-oriented or participation-oriented approaches should involve family, teacher, significant others, and/or environmental support to cascade and promote essential opportunities for practice and generalization. This is necessary to give enough opportunity for motor learning and consolidation of skills.
R23 If handwriting problems are present in children with DCD, we suggest activity-oriented and participation-oriented intervention (including ways to self-evaluate performance) to improve the quality of the handwriting.
R24 If handwriting problems are present in children with DCD, in addition to activity-oriented and participation-oriented handwriting intervention, we suggest teaching keyboarding from early on, to improve the legibility and neatness of schoolwork.
S2 Some interventions that aim to improve body functions and structures may be effective, but there is limited evidence whether body-function-oriented interventions are effective in improving activity and participation in children with DCD.
S3 The following interventions cannot be recommended as empirical support, because their effectiveness is inconclusive, absent, or negative: (1) the evidence is inconclusive for the effectiveness of sensory integration therapy as an intervention for children with DCD; (2) the evidence is inconclusive for the effectiveness of kinesthetic sensitivity training for children with DCD.
Other approaches used in children with DCD (e.g. brain-gym, complementary and alternative therapies) have not been systematically evaluated so cannot be recommended. GCP⇑⇑ R25
R25 Active video games may be recommended as a useful adjunct to more traditional activity-oriented and participation-oriented interventions in children with DCD, in supervised settings or group intervention.
R26 We recommend that physical fitness (e.g. strength, endurance, flexibility) is considered as part of intervention planning.
Blank R, Barnett AL, Cairney J, Green D, Kirby A, Polatajko H, Rosenblum S, Smits-Engelsman B, Sugden D, Wilson P, Vinçon S. International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Dev Med Child Neurol. 2019 Mar;61(3):242-285. doi: 10.1111/dmcn.14132. Epub 2019 Jan 22. PubMed PMID: 30671947. Full text
