Children with motor coordination difficulties tend to be less aware of their surroundings

Research from the Federal University of São Carlos emphasizes the need for health and education professionals to consider sensory processing to expand support strategies for childhood dyspraxia.

By Luciana Constantino  |  Agência FAPESP – Developmental coordination disorder (DCD), which is still relatively unexplored, influences how children perceive and respond to environmental stimuli. In other words, children who have difficulty balancing or picking up objects may have difficulty noticing sounds and movements around them, which limits their daily activities.

This connection is one of the findings of a study conducted in a municipality in the interior of the state of São Paulo, Brazil. The study contributes to our understanding of the relationship between motor performance and changes in sensory processing. Although the scientific literature suggests a connection, these conditions are still poorly understood.

DCD, also known as childhood dyspraxia, is primarily characterized by challenges in executing basic and intricate motor skills, including climbing stairs, riding a bike, using scissors, and writing. Sometimes, children with this disorder are considered “clumsy” and “slow.”

The study involved 694 students between the ages of 6 and 11 who were enrolled in public and private schools in São Carlos. Data collection took place between March 2022 and June 2024.

After undergoing tests based on the Movement Assessment Battery for Children, one of the most widely used tests to detect mild to moderate motor difficulties, the children were classified into three groups: 52 with DCD, 137 with possible disorder, and 505 children with expected development.

Caregivers, including parents and family members, completed questionnaires to create sensory profiles. The data they provided allowed for analysis under four processing patterns: explorers, who seek stimuli around them; sensitive, who intensely perceive environmental stimuli; avoiders, who avoid stimuli or sensory situations; and observers, who tend not to perceive them.

The study identified significant differences between the groups in these patterns. Thirty-five percent of children with DCD exhibited the observer pattern. This lower sensitivity to perceiving the environment can hinder learning and participation in everyday activities. In other words, some motor difficulties may be linked not only to coordination but also to how children process sensory information.

Additionally, the sensitive and observer patterns negatively correlate with motor performance; the more prevalent these patterns are, the poorer the performance on motor tasks. The observer pattern emerged as an important predictor, suggesting that difficulty perceiving sensory stimuli may directly contribute to the coordination problems these children experience.

The results were published in the journal European Child & Adolescent Psychiatry.

“When I started my doctorate, I wanted to understand how environmental stimuli affected children with motor difficulties. Little is said about this. I understood that it would be worthwhile to study the subject, since motor and sensory functions go hand in hand. So we decided to work directly with the children,” says Meyene Duque Weber, a physiotherapist, researcher at the Federal University of São Carlos (UFSCar), and the first author of the article.

The physiotherapist received support from FAPESP through a scholarship. 

According to Eloisa Tudella, coordinator of the Center for Studies in Neuropediatrics and Motor Skills at UFSCar and Weber’s advisor, the results are important for alerting families and health and education professionals to motor difficulties in childhood.

“Children with developmental coordination disorder are often labeled as ‘clumsy’ or ‘awkward’ and don’t receive the attention they need. The results of the study reinforce the need for staff to be trained to identify these children and refer them to specialized services. We’ll continue this line of research, with the work of a doctoral student, within an intervention proposal for children identified as having DCD,” Tudella adds, highlighting the ongoing partnership with Professor Jorge Lopes Cavalcante Neto, from Bahia State University (UNEB), who is also an author of the article.

The disorder

Although there are no statistical surveys on the prevalence of DCD, researchers estimate that it affects between 5% and 8% of school-age children worldwide.

The cause is still unknown. The clinical diagnosis of DCD is complex and made by physicians. A multidisciplinary team of physiotherapists and occupational therapists ensures a complete evaluation.

A diagnosis is made based on four factors: motor performance that is substantially below what is expected for one’s age; motor deficits that significantly interfere with age-appropriate daily activities; difficulties that have been present since early childhood; and deficits that are not the result of intellectual or visual impairment or neurological conditions that affect movement. Other emotional and behavioral changes commonly occur alongside DCD, such as attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

Treatment includes occupational therapy and physiotherapy aimed at developing motor coordination.

“The results of the research can help parents, schools, health professionals, and educators to pay attention to more than just motor signs, realizing the importance of conducting an assessment. After all, motor difficulties can have serious consequences in a child’s life, including effects on emotional and mental health. In this sense, a multidisciplinary approach helps in the development of these children,” says Weber.

The physiotherapist points out that, in addition to the case study, she conducted a systematic review of 2,609 studies. Five of these studies were included, and they identified changes in sensory processing in children with DCD. The sensory characteristics that appeared to be most affected were touch, balance, and movement.

The results of the case study were published in the February 2025 issue of Research in Developmental Disabilities.

The article “Sensory processing in Brazilian children with developmental coordination disorder, possible DCD, and typical development: A case-control study” can be read at link.springer.com/article/10.1007/s00787-025-02811-9.