Written by the Inclusive Developmental and Therapy Center therapy team · medically reviewed by Dr Muhammad Suffyan, MB BS (GMC 8023727) · Last reviewed July 2026
Every child trips over their own feet now and then. Dyspraxia — the everyday name for Developmental Coordination Disorder, or DCD — is different. The clumsiness is there most days, across several kinds of task, and it gets in the way of ordinary things: getting dressed, eating, writing, catching a ball. It is one of the most common reasons a bright child struggles at school.
The difficulty is not in the muscles. It is in the planning — working out which movements to make, in what order, then repeating them smoothly next time. Therapists call this motor planning, or praxis. Your child has to think their way through a movement other children stopped thinking about long ago. That is why the same task takes longer, and why it leaves them so tired.
DCD is commoner than most families realise. The international clinical practice recommendations put the most-quoted figure at around 5 to 6 per cent of school-age children, and note it is identified more often in boys. It rarely travels alone, either: ADHD is the condition found alongside it most often, followed by dyslexia, autism and language difficulties. So if your child is clumsy and restless, that is two things worth checking — not one explaining the other away.
It helps to know what DCD is not. It is not verbal or speech apraxia, which affects the muscles used for talking; a child can have one without the other. It is not caused by cerebral palsy, a muscle disease or uncorrected vision — those are ruled out before anyone uses the word. There is no routine school screening for coordination in Pakistan, so DCD is usually spotted late, often once handwriting has to keep pace with the class and cannot. Our centre is on MPS Road in Model Town, Multan, and families come to us from across South Punjab.
What does dyspraxia (DCD) look like in a child?
- Babies and toddlers — slow to sit, crawl or walk, or skipped crawling and shuffled instead
- Babies and toddlers — struggled with stacking blocks, shape sorters, a spoon or a cup
- Pre-school — clumsy and accident-prone: bumping into furniture, tripping, knocking cups over
- Pre-school — late or awkward at running, jumping, hopping, climbing and stairs compared with children the same age
- Pre-school — dressing takes a long time, and clothes end up inside out, back-to-front or muddled
- Pre-school — poor balance: hard to stand on one leg, or stay steady on a bike, a scooter or a kerb
- School age — handwriting is messy, slow and tiring, and letters still take real effort to form
- School age — fiddly tasks are a daily battle: buttons, zips, shoelaces, cutlery, a bottle lid
- School age — struggles to learn new physical skills: riding a bike, swimming, the moves in PE
- School age — hard to copy from the board, loses their place, and written work lags far behind what they can tell you out loud
- Any age — tires more quickly than other children, because movement takes so much concentration
- Any age — avoids sport, playground games and drawing; low confidence, and reluctance to go in on PE days
What can I do at home, starting this week?
- Pick one goal your child actually wants — pouring their own water, tying a lace, riding a bike. The best-supported approaches to DCD work on the specific task the child cares about, not on general exercises.
- Break it into small steps and teach the last step first: let your child finish the bow or pull the zip the final inch, so every attempt ends in a success. Add a step backwards each week.
- Say the movement out loud before doing it — goal, plan, do, check. Putting words to a movement helps, because words reach the exact part their brain is working at.
- Practise little and often. Ten focused minutes most days beats an hour on a Sunday; repetition is what makes a movement start to run by itself.
- Remove needless hurdles: elastic or Velcro laces, a chunky pencil grip, a sloped writing surface or a stack of books, a non-slip mat under the plate, chunky cutlery, a wide-mouthed cup.
- Sit them well before you ask for handwriting — feet flat on the floor or on a box, hips and knees at right angles, table at about elbow height. A stable body makes a steady hand far easier.
- Find a physical activity they enjoy and can do at their own pace — swimming, cycling, climbing, dancing — so movement feels like fun rather than a test with an audience.
- Praise the effort and the plan, not the neatness, and keep comparisons with siblings, cousins and classmates out of it entirely.
- Allow more time and less rush for dressing, eating and packing the school bag. Hurrying a child with DCD reliably makes the movement worse, not faster.
- Talk to the class teacher: fewer copying tasks, extra time, a printed worksheet instead of the board, and marks for what was written rather than how neat it is. Ask what they notice, too — a teacher’s account of school is part of how DCD is assessed.
- Ask a paediatrician to check what DCD is not — vision, hearing, muscle tone, any neurological cause — before anyone settles on a label. In Multan that can be a private paediatric clinic or a hospital paediatric department.
Dyspraxia is a difference in how the brain organises movement, not a limit on who your child can become. With sensible adaptations and steady practice, children with DCD get noticeably more capable — and the confidence tends to come back along with the skill.
Imagine a boy of seven — a composite example, not a real child — who knows more about dinosaurs than anyone in his class, yet dreads PE and comes home with his jumper inside out. His handwriting is a quiet daily upset, and his report card says he is careless. A paediatrician checked his vision, hearing and muscle tone; all were fine. Then his parents chose three goals with him — a shoelace, a bottle lid, and writing his name without his hand aching — and worked on those exact tasks a few minutes a day, with a pencil grip, elastic laces, and a teacher who stopped asking him to copy from the board. Within a term the daily battles had eased. He still finds some things tricky. He no longer thinks he is stupid.
An illustrative, general example — not a real child. Every child is unique; the only way to know what yours needs is a proper assessment.What the research tells us
Everything we do is grounded in published research, not just opinion. Here are a few findings from trusted, independent sources:
The international clinical practice recommendations on DCD advise that a formal diagnosis below the age of five is made only where impairment is severe, and that a child should be assessed on at least two occasions three months or more apart. They also confirm that DCD commonly occurs alongside other neurodevelopmental conditions, ADHD most frequently of all.
— Blank et al., Developmental Medicine & Child Neurology (2019). View sourceA Cochrane review of task-oriented interventions for children with DCD found the trials carried out so far too few and too varied for confident conclusions, and called for better-designed research. We would rather say that than overstate it: goal-focused, task-specific practice is the best-supported approach we have, not a guarantee.
— Miyahara et al., Cochrane Database of Systematic Reviews (2017). View source
Other areas we help with
Dyspraxia (DCD): questions parents ask
Is he just clumsy, or is this something more?
Most children are clumsy at some point and it passes. Dyspraxia (DCD) is different: the difficulty is there most days, shows up across several kinds of task, and gets in the way of dressing, eating, writing or playing. If it is affecting daily life or school, have it looked at. Clumsiness can also come from sensory processing difficulties, where a child’s sense of where their body is in space is less reliable. Our printable motor skills observation checklist gives you somewhere to record it properly over a fortnight before you go.
At what age can dyspraxia be diagnosed?
DCD is usually diagnosed from about five years of age. International clinical guidance advises a formal diagnosis below five only where the difficulty is severe, and that a child be assessed on at least two occasions three months or more apart, because young children develop at very different rates. You do not have to wait for a diagnosis to start the practical help at home.
Can my child have dyspraxia and ADHD or dyslexia at the same time?
Yes, and it is common. International guidance notes that DCD frequently occurs alongside ADHD, dyslexia, autism and language difficulties. So if your child is both clumsy and restless, or both clumsy and behind with reading, treat that as two things to look at rather than one cancelling out the other. Our page on dysgraphia and handwriting difficulty covers the writing side in more detail.
Is it because he does not practise enough, or is not trying hard enough?
No. DCD means coordination well below what you would expect for a child’s age even when there has been plenty of chance to learn and practise. Parents often arrive having been told bacha sust hai — the child is lazy — or that he just needs to try harder. Usually the opposite is true: children with DCD work harder at movement than anyone around them realises, which is why they tire so fast.
Is DCD the same as speech apraxia?
No. DCD, or dyspraxia, affects planning and coordinating body movement. Verbal or speech apraxia affects the movements needed for talking. They are different difficulties, a child can have one, both or neither, and they are assessed by different professionals. This page is about the movement and coordination kind.
Who assesses dyspraxia, and where do I start in Multan?
Assessment is a team job. A paediatrician rules out vision, hearing, muscle and neurological causes; a therapist assesses motor skills against what is typical for the age; and the class teacher describes how your child manages at school. In Multan, start with a paediatrician for the medical checks. On our side we look at the day-to-day skills — our free 2-minute developmental check is a sensible first step.
What would you actually do with my child?
We start from what is not working in real life — a shoelace, a spoon, a school jotter — and build that exact skill in small repeated steps, with the plan said out loud before the movement. We also change the task where changing it helps: grips, seating, elastic laces, less copying. Our free hands and handwriting home program shows the kind of activities involved.
Do I need a diagnosis before bringing my child to you?
No. You do not need a diagnosis, a referral or a report to talk to us — just tell us what you have noticed. If mealtimes or self-care are also hard, our free home program for fussy eating and gentle toilet training guide are there to use in the meantime. And if we think your child needs a professional we do not have on staff, we will tell you so plainly.
Worried about your child? Let’s talk.
A short, friendly conversation is the best first step. Call, text or WhatsApp us — we’ll listen and guide you, with no pressure.
MPS Road, Block A Model Town, Multan (near Bloomfield Hall School, Street No. 2) · Mon–Sat, 10 AM – 7 PM