AimThese international clinical practice recommendations (CPR) for developmental coordination disorder (DCD), initiated by the European Academy of Childhood Disability (EACD), aim to address key questions on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD relevant for clinical practice.MethodKey questions in five areas were considered through literature reviews and formal expert consensus. For recommendations based on evidence, literature searches on ‘mechanisms’, ‘assessment’, and ‘intervention’ were updated since the last recommendations in 2012. New searches were conducted for ‘psychosocial issues’ and ‘adolescents/adults’. Evidence was rated according to the Oxford Centre for Evidence‐Based Medicine (level of evidence [LOE] 1–4) and transferred into recommendations. For recommendations based on formal consensus, two meetings of an international, multidisciplinary expert panel were conducted with a further five Delphi rounds to develop good clinical practice (GCP) recommendations.ResultsThirty‐five recommendations were made. Eight were based on the evidence from literature reviews (three on ‘assessment’, five on ‘intervention’). Twenty‐two were updated from the 2012 recommendations. New recommendations relate to diagnosis and assessment (two GCPs) and psychosocial issues (three GCPs). Additionally, one new recommendation (LOE) reflects active video games as adjuncts to more traditional activity‐oriented and participation‐oriented interventions, and two new recommendations (one GCP, one LOE) were made for adolescents and adults with DCD.InterpretationThe CPR–DCD is a comprehensive overview of DCD and current understanding based on research evidence and expert consensus. It reflects the state of the art for clinicians and scientists of varied disciplines. The international CPR–DCD may serve as a basis for national guidelines.What this paper adds Updated international clinical practice guidelines on developmental coordination disorder (DCD).Refined and extended recommendations on clinical assessment and intervention for DCD.A critical synopsis of current research on mechanisms of DCD.A critical synopsis of psychosocial issues in DCD, with implications for clinical practice.The first international recommendations to consider adolescents and adults with DCD.

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ABBREVIATION DCD Developmental coordination disorderAIM Developmental coordination disorder (DCD) is a significant disorder of childhood, characterized by core difficulties in learning fine and ⁄ or gross motor skills, and the attendant psychosocial problems. The aim of the meta-analysis presented here (the first on DCD since 1998) was to summarize trends in the literature over the past 14 years and to identify and describe the main motor control and cognitive deficits that best discriminate children with DCD from those without.

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ABBREVIATIONSCO-OP Cognitive orientation to daily occupational performance DCD Developmental coordination disorder NTT Neuromotor task training AIM The aim of this study was to review systematically evidence about the efficacy of motor interventions for children with developmental coordination disorder (DCD), and to quantify treatment effects using meta-analysis.METHOD Included were all studies published between 1995 and 2011 that described a systematic review, (randomized) clinical trial, or crossover design about the effect of motor intervention in children with DCD. Studies were compared on four components: design, methodological quality, intervention components, and efficacy. Twenty-six studies met the inclusion criteria for the review. Interventions were coded under four types: (1) task-oriented intervention, (2) traditional physical therapy and occupational therapy, (3) process-oriented therapies, and (4) RESULTSThe overall effect size across all intervention studies was d w =0.56. A comparison between classes of intervention showed strong effects for task-oriented intervention (d w =0.89) and physical and occupational therapies (d w =0.83), whereas that for process-oriented intervention was weak (d w =0.12). Of the chemical supplements, treatment with methylphenidate was researched in three studies (d w =0.79) and supplementation of fatty acids plus vitamin E in one study (no effect). The post hoc comparison between treatment types showed that the effect size of the task-oriented approach was significantly higher than the process-oriented intervention (p=0.01) and comparison (p=0.006). No significant difference in the magnitude of effect size between traditional physical and occupational therapy approaches and any of the other interventions emerged.INTERPRETATION In general, intervention is shown to produce benefit for the motor performance of children with DCD, over and above no intervention. However, approaches from a task-oriented perspective yield stronger effects. Process-oriented approaches are not recommended for improving motor performance in DCD, whereas the evidence for chemical supplements for children with DCD is currently insufficient for a recommendation.Children with developmental coordination disorder (DCD) are identifiable by the difficulties they have in performing fine and gross motor tasks, which affect their performance in the classroom and in activities of daily living.1 According to the DSM-IV, 2 in DCD the level of motor coordination is below that expected given the child's chronological age and intelligence, and may lead to problems in activities of daily living and ⁄ or academic performance.3 The estimated prevalence of children with DCD is between 6 and 13% of all school-aged children, 4 with some reports finding that males experience a higher incidence than females.5 Forty per cent of the children diagnosed as having delayed motor development before starting school continue to have this problem 10 years later. 6 These figures indicate that DCD is not a condition that exists on...

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Taken together, results support the hypothesis that children with DCD show differences in brain structure and function compared with typically developing children. Behaviourally, these differences may affect anticipatory planning and reduce automatization of movement skill, prompting greater reliance on slower feedback-based control and compensatory strategies. Implications for future research, theory development, and clinical practice are discussed.