Dyspraxia and Autism: How They Overlap and What Helps

Dyspraxia, also called developmental coordination disorder (DCD), is a lifelong difference in how the brain plans and coordinates movement. It is separate from autism, but the two often occur together, and movement differences are very common in autistic children. Occupational therapy, practical adjustments, and support that values the outcome over the method all help.

If your autistic child struggles with handwriting, buttons, catching a ball, or learning to ride a bike, you may have wondered whether there is something more going on. Sometimes the answer is dyspraxia. Sometimes the movement differences are part of how autism shows up in that child. Often it takes a careful assessment to tell. This article explains what dyspraxia is, how it overlaps with autism, how assessment works when both may be present, and what kinds of support actually help.

What Does Dyspraxia Mean?

The NHS defines it simply: "Developmental co-ordination disorder (DCD), also known as dyspraxia, is a condition affecting physical co-ordination." Our dyspraxia glossary entry gives the short definition. Here is the fuller picture.

DCD and dyspraxia name the same thing in most conversations. Developmental coordination disorder is the formal diagnostic name used in the DSM-5. Dyspraxia is the everyday word many people in the UK use. The NHS explains that most healthcare professionals prefer DCD because "dyspraxia can have several meanings," including movement difficulties that start later in life after a stroke or head injury. We use both here.

It is about planning movement, not strength or effort. A dyspraxic person usually knows what they want their body to do. The difference is in organizing and sequencing the movement so it comes out smoothly. That is why new or multi-step tasks, such as getting dressed in the right order, often take the most effort. This overlaps with what clinicians call motor planning.

It does not reflect intelligence. The NHS says, "Although DCD does not affect how intelligent a child is, it can make it more difficult for them to learn." A child with messy handwriting may have plenty to say. The pen is the barrier, not the thinking.

It often lasts into adulthood. An international consensus on DCD, published by Blank and colleagues in 2019, reports that "in many cases DCD persists well into adolescence," with 50% to 70% of children continuing to have motor difficulties. People build strategies over time, but the underlying difference is lifelong.

How common is it? The same consensus states: "Current prevalence estimates for DCD range from 2% to 20% of children, with 5% to 6% being the most frequently quoted percentage in the literature." The wide range reflects different definitions and testing methods across studies.

What Are the Signs of Dyspraxia?

According to the NHS, "Early developmental milestones of crawling, walking, self-feeding and dressing may be delayed in young children with DCD," and "Drawing, writing and performance in sports are also usually behind what is expected for their age."

In everyday life, that can look like:

- Handwriting that is slow, tiring, or hard to read - Trouble with buttons, zippers, shoelaces, or cutlery long after peers have learned them - Bumping into furniture, tripping, or dropping things often - Finding ball games, bikes, or playground equipment hard - Needing much more practice than others to learn a new physical skill - Avoiding sports or physical play, often because of past frustration

For adults, the NHS describes difficulty with movement, balance, and spatial awareness that "may lead to you bumping into things, falling over, and dropping things." The NHS adds that dyspraxia can also make learning new skills, planning and organizing time, and managing social situations harder.

None of these signs alone means a person has dyspraxia. Plenty of children are a little clumsy. DCD is diagnosed when coordination differences are significant, start early, and get in the way of daily life.

How Do Dyspraxia and Autism Overlap?

Dyspraxia is not a form of autism, and autism is not a form of dyspraxia. They are separate conditions that can occur together. The Blank consensus notes that the older DSM-IV "did not permit a dual diagnosis of DCD with ASD; however, the DSM-5 now permits this co-occurrence." The NHS also lists autism among the conditions that can occur alongside dyspraxia in adults.

Movement differences are common in autism. The CDC lists "Delayed movement skills" among the other characteristics many autistic people have, and notes that autistic people "may also have different ways of learning, moving, or paying attention." A 2010 meta-analysis by Fournier and colleagues pooled studies comparing autistic and non-autistic groups on coordination, arm movements, walking, and balance. It found a large difference between the groups, and the authors concluded that motor coordination differences are pervasive across autism diagnoses.

Most autistic kids in one large study screened at risk. In a 2020 study from the SPARK cohort, Anjana Bhat analyzed parent questionnaires for 11,814 autistic children aged 5 to 15. The proportion at risk for a motor impairment "was very high at 86.9%," and children "did not outgrow their motor impairments." Yet "only 31.6% of children were receiving physical therapy services." This was a parent screening questionnaire, not a clinical diagnosis of DCD, and the author notes that no follow-up clinical assessments were done. Even so, the author argues that an autism diagnosis should trigger motor screening.

The overlap is not total. The Blank consensus cites research finding that "79% of children diagnosed with an ASD" had "definite movement impairments consistent with DCD," and also notes that "more than 90% of children with DCD have no ASD." In other words, movement differences are very common in autistic children, but most dyspraxic children are not autistic.

Dual diagnosis is still uncommon. Bhat's study also observes that autistic children "rarely receive a dual diagnosis" of DCD, even though motor differences are widespread. If your child has an autism diagnosis and real movement challenges, it is reasonable to ask whether a motor assessment would help.

Are the Movement Differences the Same in Both?

Not exactly, and this is where research is still developing.

A 2022 study in Autism Research by Kilroy and colleagues compared autistic, dyspraxic, and non-autistic, non-dyspraxic young people aged 8 to 17. The autistic and dyspraxic groups "shared similar patterns of gross and fine motor skills," but differed in skills related to making gestures. The autistic group had more difficulty imitating meaningful gestures and producing gestures on request. The groups were small (33 autistic, 28 dyspraxic, and 35 comparison participants), so this is one piece of a larger picture, not a final answer.

For parents, the practical takeaway is that two children with similar handwriting or ball-skill challenges may need slightly different support depending on what is underneath. That is one reason careful assessment matters.

How Does Assessment Differ When Autism Is Also Present?

There is no single test for dyspraxia. The Blank consensus describes diagnosis by "a medical professional or a multi-professional team," built on a careful history and a standardized motor assessment, and it uses the four DSM-5 criteria:

1. Learning and doing coordinated motor skills is far below what is expected for age, given the chance to learn them. 2. These difficulties significantly interfere with daily activities, school, leisure, or play. 3. The difficulties began early in development. 4. They are not better explained by intellectual delay, visual impairment, or another neurological condition that affects movement.

Several points matter when a child is also autistic.

Autism can affect the testing itself. The consensus notes that "ADHD, ASD, or conduct disorders may interfere with motor performance and testing," which can make results harder to interpret. A loud room, unclear spoken instructions, an unfamiliar examiner, or pressure to perform on the spot can all affect how a child does on the day. Ask whether the assessor can adjust the setting, use visual demonstrations, allow breaks, and take extra time.

Information from several sources helps. The consensus recommends gathering information from self-reports, parents, health and education professionals, and others who know the child. Your observations at home, such as how dressing, meals, and play actually go, are part of the evidence.

Age matters. The NHS says a definite diagnosis "does not usually happen until a child with the condition is 5 years old or more." The Blank consensus recommends that a formal diagnosis under age 5 be made only for severe difficulties, based on at least two motor assessments at least 3 months apart.

Handwriting gets its own look. The consensus says handwriting and keyboarding should be assessed separately from other motor skills, because language is involved. That distinction matters for autistic children whose writing difficulties may have more than one source.

Who to ask. The NHS describes referrals to an occupational therapist, pediatrician, or another health professional for assessment. In the US, start with your child's pediatrician and ask about an occupational therapy or physical therapy evaluation. If your child is in school, you can also ask the school team about a motor evaluation.

What Helps Dyspraxic and Autistic People?

The NHS says, "There's no cure for DCD, but a number of therapies can help children to manage their problems." For adults, it says dyspraxia "can be managed in different ways." The goal is not a different body. It is fewer barriers between a person and the things they want to do.

Occupational therapy. An occupational therapist focuses on everyday tasks: dressing, eating, handwriting, organizing a backpack, getting ready in the morning. The NHS lists occupational therapy and physiotherapy among the supports for adults.

Task-focused approaches. The Blank consensus gives its strongest recommendation to "activity-oriented and participation-oriented approaches," meaning practicing the real skills a person wants to do, in real settings. It names task-specific training, Neuromotor Task Training, and the Cognitive Orientation to daily Occupational Performance approach (CO-OP) as formally studied options.

Goals that fit the person. One of the consensus's principles for intervention is "aiming at functionality, not at normality." That fits an acceptance approach well. If typing works better than handwriting, typing is a success.

Some approaches have weak evidence for DCD. The consensus states that "the evidence is inconclusive for the effectiveness of sensory integration therapy" for children with DCD, and the same for kinesthetic sensitivity training. Sensory supports may still matter for an autistic child's comfort and regulation. They just should not be expected to change motor coordination on their own. Ask any provider what a therapy is meant to achieve and how you will know if it is working.

Practical adjustments at home and school.

- Typing or speech-to-text instead of long handwriting tasks - Extra time for written work, tests, and getting ready - Pencil grips, slant boards, or adapted scissors and utensils - Clothing with fewer fasteners, such as elastic waists and slip-on shoes - Visual, step-by-step instructions for multi-step tasks - Physical activities chosen for enjoyment, such as swimming, hiking, or dance, instead of only team ball sports

Workplace and college adjustments for adults. The NHS says adults can request changes at work, college, or university. Examples include a quiet workspace, written as well as spoken instructions, and extra time for reading or tasks.

How Can Parents Support a Child With Both?

Name the difference kindly. A child who hears "try harder" about handwriting for years may conclude they are lazy. Explaining that their brain plans movement differently can be a relief.

Protect their confidence. Many dyspraxic children start avoiding physical activities after repeated frustration. Look for activities where they can enjoy movement without being compared to others.

Watch the combined load. For an autistic child, a movement task that already takes extra planning gets harder in a loud, bright, or socially demanding setting. Lowering sensory and social demands can free up energy for the motor task.

Celebrate the outcome, not the method. If your child can get dressed using a picture checklist, or write a story by dictating it, they have done the thing. That is the point.

Talk to your child's care team. If you notice movement challenges, raise them. A pediatrician, occupational therapist, or physical therapist can help you decide whether an assessment makes sense.

This article is general information from our community, not medical advice. For questions about your child's development, diagnosis, or therapy options, talk to your child's care team.

For more on how dyspraxia shows up alongside autism, see our page on dyspraxia and DCD as a co-occurring condition.

Sources

NHS. Developmental co-ordination disorder (dyspraxia) in children.

NHS. Developmental co-ordination disorder (dyspraxia) in adults.

Centers for Disease Control and Prevention. Signs and Symptoms of Autism Spectrum Disorder.

Blank, R., Barnett, A. L., Cairney, J., Green, D., Kirby, A., Polatajko, H., Rosenblum, S., Smits-Engelsman, B., Sugden, D., Wilson, P., and Vinçon, S. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine and Child Neurology, 61(3), 242-285.

Bhat, A. N. (2020). Is motor impairment in autism spectrum disorder distinct from developmental coordination disorder? A report from the SPARK study. Physical Therapy, 100(4), 633-644.

Fournier, K. A., Hass, C. J., Naik, S. K., Lodha, N., and Cauraugh, J. H. (2010). Motor coordination in autism spectrum disorders: a synthesis and meta-analysis. Journal of Autism and Developmental Disorders, 40(10), 1227-1240.

Kilroy, E., Ring, P., Hossain, A., Nalbach, A., Butera, C., Harrison, L., Jayashankar, A., Vigen, C., Aziz-Zadeh, L., and Cermak, S. A. (2022). Motor performance, praxis, and social skills in autism spectrum disorder and developmental coordination disorder. Autism Research, 15(9), 1649-1664.