Sofia G. Monastiridi, Ermioni S. Katartzi, Maria G. Kontou, Thomas Kourtessis, Symeon P. Vlachopoulos


Developmental Coordination Disorder (DCD) is an impairment in the development of motor coordination creating varied problems and difficulties in children’s and adolescent’s daily life activities. As a result, the avoidance of participating in physical activity leads in low levels of fitness and also in secondary social and emotional problems. Fitness levels in children and adolescents with DCD have been recognized as an important factor which influences their performance in daily activities and has a positive impact on their health-related quality of life (HRQOL). Surveys showed that every domain in HRQOL (motor, cognitive, emotional, social) is significantly lower in children with DCD compared to their peers. These data showed that intervention is very important for improving motor skill performance and HRQOL, too, in children and adolescents with DCD. The present study aimed to systematically review the literature published in peer reviewed journals and to summarize information about possible relationships between intervention approaches focused on physical fitness and exercise, participation in physical activity and HRQOL, in children and adolescents with DCD. Studies which examined the effect of fitness and exercise intervention programs on motor competence and HRQOL in children and adolescents with DCD were also, included. The review of the literature has shown that several intervention programs developed for DCD population, focusing to improve motor ability, derived from occupational therapy, physiotherapy, medicine, dietetics and education scientific areas. Generally, the present review focused on two basic approaches in clinical practice regarding intervention programs for DCD individuals: task-oriented and process-oriented approach. The task-oriented approach aims to improve the performance of a specific skill and on the other hand the process-oriented approach aims to identify the underlying processes or dysfunctions which the individual has not developed adequately according to his/her age, although they are considered to be necessary for successful performance and acquisition of motor skills. Children and adolescents with DCD seemed to report poorer ΗRQOL than their typically developing peers. However, HRQOL in children and adolescents with DCD needs further investigation. In addition, there is a need of research in interventions focused on fitness and exercise programs with an ultimate goal to improve motor ability and HRQOL too; through participation in such interventions children and adolescents with DCD, may be possible to break the negative cycle of physical activity avoidance, reversing it to a positive one. It is concluded that, there are possible positive relationships between fitness and exercise intervention programs, motor competence and HRQOL in children and adolescents with DCD. Future research should focus on examining whether and how such interventions may eliminate functional constraints leading to an engagement in the positive cycle of physical activity, with a further improvement in HRQOL in DCD population.


Article visualizations:

Hit counter



motor ability, physical activity, process-oriented intervention

Full Text:



Alexandratos, K., Barnett, F., & Thomas, Y. (2012). The Impact of Exercise on the Mental Health and Quality of Life of People with Severe Mental Illness: A Critical Review. February 201. British Journal of Occupational Therapy, 75(2):48-60. doi: 10.4276/030802212X13286281650956.

American Psychiatric Association (APA), (2013). DSM-5: Diagnostic and Statistical Manual of Mental Disorder (Fifth Edition), Washington DC.

Atlantis, E, Chow, C.M., Kirby, A., & Singh, M.F. (2004). An effective exercise-based intervention for improving mental health and quality of life measures: a randomized controlled trial. Preventive Medicine, 39(2):424-34. https://doi.org/10.1016/j.ypmed.2004.02.007

Au, K,. Chan, M.W.M., Lee, L., Chen, T.M.K. Chau R.M.W., & Pang, M.Y.C. (2014). Core stability exercise is as effective as task-oriented motor training in improving motor proficiency in children with developmental coordination disorder: a randomized controlled pilot study. Clinical Rehabilitation, 28(10) 992–1003. doi: 10.1177/0269215514527596.

Barnhart, R.C., Davenport, M.J., Epps, S.B., & Nordquist, V.M. (2003). Developmental coordination disorder. Phyical Therapy, 83:722–30.

Bart, O., Podoly, T., & Bar-Haim, Y. (2010). A preliminary study on the effect of methylphenidate on motor performance in children with comorbid DCD and ADHD. Research in Developmental Disabilities, 31:1443–7. doi: 10.1016/j.ridd.2010.06.014.

Bhayanil, K. & Singaravelan, R.M. (2012). Effectiveness of core stability training programme on improving task specific physical activity in developmental coordination disorder children. Romanian Journal of Physical Therapy, 18(30):33.

Brown, J., Bowling, A. & Flynn, T. (2004). Models of quality of life: a taxonomy, overview and systematic review of the literature. (Project Report) European Forum on Population Ageing Research. 113 p.

Caçola P., & Killian M. (2018). Health-related quality of life in children with Developmental Coordination Disorder: Association between the PedsQL and KIDSCREEN instruments and comparison with their normative samples. Research in Developmental Disabilities, 75:32-39. DOI: 10.1016/j.ridd.2018.02.009.

Cairney, J., Hay, J.A., Faught, B.E., & Hawes, R. (2005). Developmental coordination disorder and overweight and obesity in children aged 9–14 y. International Journal of Obesity, 29:369–372.

Cairney, J., Hay, J.A., Faught, B.E., Mandigo, J., & Flouris, A. (2005). Developmental coordination disorder, self-efficacy toward physical activity and participation in free play and organized activities: Does gender matter? Adapted Physical Activity Quarterly, 22:67–82.

Cairney, J., Hay, J.A., Veldhuizen, S., &Faught, B.E. (2010). Comparison of VO2 maximum obtained from 20 m shuttle run and cycle ergometer in children with and without developmental coordination disorder. Research in Developmental Disabilities, 31:1332–1339.

Cantell, M., Crawford, S.G., & Doyle-Barker, P.K. (2008). Physical fitness and health indices in children, adolescents and adults with high and low motor competence. Human Movement Science, 27, 344–362.

Cantell, M., Smyth, M., & Ahonen, T. (1994). Clumsiness in adolescence: Educational, motor, and social outcomes of motor delay detected at 5 years. Adapted Physical Activity Quarterly, 11,115-129.

Cermak, S. and Larkin, D. (2002). Developmental Coordination Disorder, Thomson Learning, Inc., 2002.

De Vreede, P.L., Van Meeteren, N.L., Samson, M.M., Wittink, H.M., Duursma, S.A., &Verhaar, H.J. (2007). The effect of functional tasks exercise and resistance exercise on health-related quality of life and physical activity. A randomised controlled trial. Gerontology, 53(1):12-20. https://doi.org/10.1159/000095387

Dewey, & Volkovinskaia (2018). Health-related quality of life and peer relationships in adolescents with developmental coordination disorder and attention-deficit-hyperactivity disorder. Published in Developmental Medicine and Child Neurology, 60(7):711-717. doi: 10.1111/dmcn.13753.

Dunford, C. (2011). Goal-oriented group intervention for children with developmental coordination disorder. Physical Occupation Therapy in Pediatrics, 31(3):288-300. doi: 10.3109/01942638.2011.565864.

Engel-Yeger, B. & Hanna Kasis, A. (2010) The relationship between developmental co-ordination disorders, child’s perceived self-efficacy and preference to participate in daily activities. Child: Care, Health and Development, 36(5):670-7. doi: 10.1111/j.1365-2214.2010.01073.x.

Farhat, F., Masmoudi, K., Hsairi, I., Smits-Engelsman, B.C.M., Mchirgui R., Triki C., & Moalla, W. (2015). The effects of 8 weeks of motor skill training on cardiorespiratory fitness and endurance performance in children with developmental coordination disorder. Applied Physiology, Nutrition, and Metabolism, 40(12), 1269-1278, https://doi.org/10.1139/apnm-2015-0154.

Fayers, P., & Sprangers, M.A. (2002). Understanding self-rated health. The Lancet, 359(9302), 187-188. DOI: 10.1016/S0140-6736(02)07466-4.

Flapper, B.C. & Schoemaker, M.M. (2008). Effects of methylphenidate on quality of life in children with both developmental coordination disorder and ADHD. Developmental Medicine and Child Neurology, 50, 294–299. doi: 10.1111/j.1469-8749.2008.02039.x.

Flapper, C.T., & Schoemaker, M. (2013). Developmental Coordination Disorder in children with specific language impairment: Co-morbidity and impact on quality of life. Research in Developmental Disabilities, 34, 756–763. https://doi.org/10.1016/j.ridd.2012.10.014.

Fong, S.M., Chung, W.Y., Chowa, P.Y., Maa, W.W. & Tsang, W.N. (2013). Differential effect of Taekwondo training on knee muscle strength and reactive and static balance control in children with developmental coordination disorder: A randomized controlled trial. Research in Developmental Disabilities, 34, 1446–1455. doi: 10.1016/j.ridd.2013.01.025.

Fong, S.M., Guo, X., Cheng, Y.T.Y., Liu, K.P.Y., Tsang, W.N., Yam, T.T., Chung, M.Y., & Macfarlane, D.J. (2016). A Novel Balance Training Program for Children with Developmental Coordination Disorder. Medicine (Baltimore., 95(16):e3492. doi: 10.1097/MD.0000000000003492.

Gabbard, C., Caçola, P., & Bobbio, T.G. (2009). Studying motor development: A biological and environmental perspective. In: Baig, A. & Kahraman, E. (Eds.) Environmentalism: Environmental strategies, and environmental sustainability. (p.p. 8). Nova Science Publishers.

Haga, M. (2009). Physical fitness in children with high motor competence is different from that in children with low motor competence. Physical Therapy, 89(10), 1089–1097. doi: 10.2522/ptj.20090052.

Jelsma, D., Geuze, R.H., Mombarg, R., & Smits-Engelsman, B.C.M. (2014). The impact of Wii Fit intervention on dynamic balance control in children with probable Developmental Coordination Disorder and balance Problems. Human Movement Science, 33, 404–418. doi: 10.1016/j.humov.2013.12.007.

Kane, K., & Bell, A. (2009). A Core Stability Group Program for Children with Developmental Coordination Disorder: 3 Clinical Case Reports. Pediatric Physical Therapy, 21(4):375-82. doi: 10.1097/PEP.0b013e3181beff38.

Karras, H.C., Morin, D.N., Gill, K. Izadi-Najafabadi, S., & Zwicker J.G. (2019). Health-related quality of life of children with Developmental Coordination Disorder. Research in Developmental Disabilities, 84, 85-95. doi: 10.1016/j.ridd.2018.05.012.

Katartzi, E., & Vlachopoulos, S. (2011). Motivating children with developmental coordination disorder in school physical education: The self-determination theory approach. Research in Developmental Disabilities 32, 2674–2682. doi: 10.1016/j.ridd.2011.06.005.

Kaufman, B.B., & Schilling, D.L. (2007). Implementation of a Strength Training Program for a 5-Year-Old Child with Poor Body Awareness and Developmental Coordination Disorder. Physical Therapy, 87(4), 455-67. https://doi.org/10.2522/ptj.20060170.

Kordi, H., Kakhki, S., &Hossini, A. (2016). The effect of strength training based on process approach intervention on balance of children with developmental coordination disorder. Arch Argent Pediatrics, 114(6), 526-533. doi: 10.5546/aap.2016.eng.526.

Li, Y.C., Wu, S.K, Cairney, J., & Hsieh, C.Y. (2011). Motor coordination and health-related physical fitness of children with developmental coordination disorder: A three-year follow-up study. Research in Developmental Disabilities, 32, 2993–3002. doi: 10.1016/j.ridd.2011.04.009.

Maciejewski, M.L., Patrick, D.L., & Williamson, D.F. (2005). A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. Journal of Clinical Epidemiology, 58(6), 568-78 https://doi.org/10.1016/j.jclinepi.2004.10.015

Mandich, A.D., Polatajko, H.J., Macnab, J.J., & Miller, L.T. (2001). Treatment of Children with Developmental Coordination Disorder: What is the Evidence? Physical and Occupational Therapy in Pediatrics, 20(2-3), 51-68.

Mathiowetz, V., & Haugen, J.B. (1995). Motor behavior research: implications for therapeutic approaches to central nervous system dysfunction. The American Journal of Occupation Therapy, 48(8), 733-45.

McIntyre, F., Chivers, P., Larkin, D., Rose, E., & Hands, B. (2015). Exercise can improve physical self-perceptions in adolescents with low motor competence. Human Movement Science, 42, 333-343. doi: 10.1016/j.humov.2014.12.003.

McMath, T. (1980). The clumsy child: A cause for concern. Physical Education Review, 3, 50–63.

Menz, M.S., Hatten, K., & Grant-Beuttler, M. (2013). Strength Training for a Child with Suspected Developmental Coordination Disorder. Pediatric Physical Therapy, 25(2):214-23. doi: 10.1097/PEP.0b013e31828a2042.

Mitchell, T. & Barlow, C. (2011). Review of the Role of Exercise in Improving Quality of Life in Healthy Individuals and in Those with Chronic Diseases. Current Sports Medicine Reports, 10(4), 211-216. doi: 10.1249/JSR.0b013e318223cc9e.

Mombarg, R., Jelsma, D., & Hartman, E. (2013). Effect of Wii-intervention on balance of children with poor motor performance. Research in Developmental Disabilities, 34, 2996–3003. doi: 10.1016/j.ridd.2013.06.008.

Newell, K. (1986). Constraints on the development of coordination. In: Wade, M.G., & Whiting, H.T.A. (Eds.), Motor development in children: Aspects of coordination and control (pp. 341-360). Dordrecht, The Netherlands: Nihjoff

Peens, A, Pienaar, A.E., & Nienaber, A.W. (2008). The effect of different intervention programmes on the self-concept and motor proficiency of 7- to 9-year-old children with DCD. Child Care Health Dev, 34, 316–28. doi: 10.1111/j.1365-2214.2007.00803.x.

Polatajko, H.J., & Cantin, N. (2005). Developmental coordination disorder (dyspraxia): an overview of the state of the art. Seminars in Pediatric Neurology, 12(4), 250-8. https://doi.org/10.1016/j.spen.2005.12.007.

Polatajko, H.J., Kaplan, B.J., & Wilson, B.N. (1992). Sensory Integration Treatment for Children with Learning Disabilities: Its Status 20 Years Later. Occupational Therapy Journal of Research, 12(6), 323-341. doi: 10.1177/153944929201200601.

Raustorp A., Pangrazi R.P., Stahle A. (2004). Physical activity level and body mass index among schoolchildren in south-eastern Sweden. Acta Paediatrica, 93:3, 400-404.

Raz-Silbiger, S., Lifshitz, N., Katz, N., Steinhart, S., Cermak, S.A., & Weintraub, N. (2015). Relationship between motor skills, participation in leisure activities and quality of life of children with Developmental Coordination Disorder: Temporal aspects. Research in Developmental Disabilities, 38, 171–180. doi: 10.1016/j.ridd.2014.12.012.

Rejeski, W.J., & Mihalko, S.L. (2001). Physical activity and quality of life in older adults. The Journals of Gerontology Series A Biological Sciences and Medical Sciences, 2, 23-35.

Rivilis, I., Hay, J., Cairney, J., Klentrou, P., Liu, J., & Faught, B. E. (2011). Physical activity and fitness in children with developmental coordination disorder: A systematic review. Research in Developmental Disabilities, 32, 894–910. doi: 10.1016/j.ridd.2011.01.017.

Rubin, K. H., & Coplan, R. J. (2004). Paying attention to and not neglecting social withdrawal and social isolation. Merri/1-Palmer Quarterly, 50, 506-534.

Schmidt, R.A. (1975). A schema theory of discrete motor skill learning. Psychological Review, 82(4), 225-260. http://dx.doi.org/10.1037/h0076770.

Singer, R.N., Hausenblas, H.A., & Janelle, C.M. (Eds.). (2001). In: Tenenbaum G., Eklund R. Handbook of sport psychology (2nd ed.). Hoboken, NJ, US: John Wiley & Sons Inc.

Smits-Engelsman B.C.M., Blank R., Van Der Kaay A.C., Mosterd-Van Der Meijs R., Vlugt-Van Den Brand E., Polatajko H.J. & Wilson P.H. (2013). Efficacy of interventions to improve motor performance in children with developmental coordination disorder: a combined systematic review and meta-analysis. Developmental Medicine & Child Neurology 2013, 55: 229–237. doi: 10.1111/dmcn.12008.

Smits-Engelsman B.C.M., Jelsma. D., & Ferguson, G.D. (2017). The effect of exergames on functional strength, anaerobic fitness, balance and agility in children with and without motor coordination difficulties living in low-income communities. Human Movement Science, 55, 327-337. doi: 10.1016/j.humov.2016.07.006.

Smoll, F.L. (1974). Motor impairment and social development. American Corrective Therapy Journal, 28, 4–7.

Spirduso, W.W., & Cronin, D.L. (2001). Exercise dose-response effects on quality of life and independent living in older adults. Medicine and Science in Sports and Exercise, 33(6), S598-S608.

Stephenson, E.A. & Chesson, R.A. (2008). ‘Always the guiding hand’:parents’ accounts of the long-term implications of developmental co-ordination disorder for their children and families. Child: Care, Health and Development, 34, 335–343. doi: 10.1111/j.1365-2214.2007.00805.x.

Sudgen, D.A. & Chambers, M.E. (1998). Intervention approaches and children with developmental coordination disorder. Pediatric Rehabilitation, 2: 139–147.

Sugden, D.A, & Wright, HC. (1998). Motor coordination disorders in children. London, England: Sage Publications; 131.

Sugden, D.A. & Chambers, M.E. (2003). Intervention in children with developmental coordination disorder. The role of parents and teachers. British Journal of Educational Psychology, 73(4), 545-561. https://doi.org/10.1348/000709903322591235

Sugden, D.A. (2007). Current approaches to intervention in children with developmental coordination disorder. Developmental Medicine and Child Neurology, 49: 467–71. https://doi.org/10.1111/j.1469-8749.2007.00467.x

Sveistrup, H., Burtner, P.A., & Woollacott, M.H. (1992). Two motor control approaches that may help to identify and teach children with motor impairments. Pediatric Exercise Science, 4:249-269.

Tessier, S., Vuillemin, A., Bertrais, S., Boinia, S., Le Bihana, E., Oppertc, J.M., Hercbergb, S., Guillemina, F., & Brianço, S. (2007). Association between leisure-time physical activity and health-related quality of life changes over time. Preventive Medicine, 44(3), 202-8. https://doi.org/10.1016/j.ypmed.2006.11.012

Vuillemin, A., Boini, S, Bertrais, S., Tessier, S., Oppert, J.M., Hercberg, S., Guillemin, F., & Briançon, S. (2005). Leisure time physical activity and health-related quality of life. Preventive Medicine, 41(2), 562-9. https://doi.org/10.1016/j.ypmed.2005.01.006.

Watkinson, E.J., Dunn, J.C., Cavaliere, N., Calzonetti, K., Wilhelm, L., & Dwyer, S. (2001). Engagement in playground activities as a criterion for diagnosing developmental coordination disorder. Adapted Physical Activity Quarterly, 18, 18–34. doi: 10.1123/apaq.18.1.18

Wendel-Vos, G.C.W., Schuit, A.J., Tijhuis, M.A.R., Kromhout, D. (2004). “Leisure time physical activity and health-related quality of life: Cross-sectional and longitudinal associations”. Quality of Life Research, April 2004, Volume 13, Issue 3.

Wilson, P.H., Patrick, M.D., Thomas, M.A., & Maruff, P. (2002). Motor imaginery training ameliorates motor clumsiness in children. J Child Neurol, 17: 491–8. https://doi.org/10.1177/088307380201700704.

Winnie, W.Y.H. and Pang, M.Y.C., (2010). Effects of group-based versus individual-based exercise Training on motor performance in children with developmental Coordination disorder: a randomized controlled pilot study. J Rehabil Med 2010; 42: 122–128.

World Health Organization (2018). Global action plan on physical activity 2018–2030: more active people for a healthier world.

Wuang, Y.P, Wang, C.C. & Huang, M.H (2012). Health-Related Quality of Life in Children with Developmental Coordination Disorder and Their Parents. OTJR: Occupation, Participation and Health, 32 (4), 142-150.

Zwicker, J.G., Harris, S.R. & Klassen, A.F. (2012). Quality of life domains affected in children with developmental coordination disorder: a systematic review. Child: care, health and development, 39, 4, 562–58.doi: 10.1111/j.1365-2214.2012.01379.x.

DOI: http://dx.doi.org/10.46827/ejpe.v0i0.2911


  • There are currently no refbacks.

Copyright (c) 2020 Sofia G. Monastiridi, Ermioni S. Katartzi, Maria G. Kontou, Thomas Kourtessis, Symeon P. Vlachopoulos

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2015 - 2023. European Journal of Physical Education and Sport Science (ISSN 2501 - 1235) is a registered trademark of Open Access Publishing Group. All rights reserved.

This journal is a serial publication uniquely identified by an International Standard Serial Number (ISSN) serial number certificate issued by Romanian National Library (Biblioteca Nationala a Romaniei). All the research works are uniquely identified by a CrossRef DOI digital object identifier supplied by indexing and repository platforms. All authors who send their manuscripts to this journal and whose articles are published on this journal retain full copyright of their articles. All the research works published on this journal are meeting the Open Access Publishing requirements and can be freely accessed, shared, modified, distributed and used in educational, commercial and non-commercial purposes under a Creative Commons Attribution 4.0 International License (CC BY 4.0).