International Journal of Disability, Development and

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What Impact does Developmental Coordination

Disorder have on Daily Routines?

Janet Summers , Dawne Larkin & Deborah Dewey

To cite this article: Janet Summers , Dawne Larkin & Deborah Dewey (2008) What Impact does
Developmental Coordination Disorder have on Daily Routines?, International Journal of Disability,
Development and Education, 55:2, 131-141, DOI: 10.1080/10349120802033485

To link to this article: https://doi.org/10.1080/10349120802033485

Published online: 07 May 2008.

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International Journal of Disability, Development and Education
Vol. 55, No. 2, June 2008, 131–141

What Impact does Developmental Coordination Disorder have on

Daily Routines?
Janet Summersa, Dawne Larkina and Deborah Deweyb,c*
aUniversity of Western Australia, Australia; bUniversity of Calgary, Alberta, Canada; cAlberta Children’s
Hospital, Behavioural Research Unit, Calgary, Alberta, Canada
In order to understand how age and motor difficulties impact on daily routines, this qualitative
International
10.1080/10349120802033485
CIJD_A_303516.sgm
1034-912X
Original
Taylor
202008
55
Deborah.dewey@calgaryhealthregion.ca
DeborahDewey
00000June
and
& Article
Francis
Francis
(print)/1465-346X
2008
Journal of Disability,
(online)
Development and Education

investigation used focus groups and in-depth interviews with Australian and Canadian parents
to examine the daily routines of younger (5 to 7 years of age) and older children (8 to 9 years
of age) with and without Developmental Coordination Disorder (DCD). Parents were asked to
describe the typical school-day routine, one that was not typical and how weekend routines
differed. Daily routines were consistent across families and cultures. Older children were
expected to participate more independently in the daily routine. The level of structure and
assistance provided to children with DCD was greater, and the parents’ expectations of
independent performance were lower. Children with DCD required consistent prompting and
more structure to complete the morning tasks within the allotted time. Children with DCD
were reported to be much happier on weekends and holidays, enjoying the relaxed atmosphere
free of the time pressures and tasks of a school-day routine. The main factors that modified
participation in daily routines were the child’s age and their motor difficulties.
Keywords: daily routines; Developmental Coordination Disorder; children; motor difficulties

Introduction
Humans organise life around regularly occurring and predictable events, such as daily routines
and a weekly work/rest cycle (Zerubavel, 1985). These daily routines, which consist of habituated
activities and tasks (Chapparo & Ranka, 1997; Gallimore & Lopez, 2002), are so commonplace
that individuals seldom consider the contribution of motor competence to their harmonious
functioning. While it is well recognised that parents adapt the daily routine to accommodate
the changing abilities of growing children, these abilities have rarely been explicitly linked to
Developmental Coordination Disorder (DCD) (American Psychiatric Association [APA], 1994).
Although parents of children with movement difficulties such as DCD, dyspraxia, and motor
learning problems have identified that family life is constrained by the motor abilities of the child
(Chesson, McKay, & Stephenson, 1990; Missiuna, Moll, King, & Law, 2007), limited research
has focused on the daily routine.
Family routines evolve over time in response to the external demands of the environment and
the internal dynamics of the family. The routine adapts to accommodate changes in children’s
performance as they get older and increases their ability to participate. Children’s increased
participation in daily routines evolves with biological, emotional, and cognitive development and
is primed by social interaction. Adults set the standard for children’s participation (Coster, 1998;
Valsiner, 1997), and children generally learn these routines through a process of guided partici-
pation (Rogoff, 1993). Activities of daily living, which rely on motor skills, are an essential

*Corresponding author. Alberta Children’s Hospital, Behavioural Research Unit, 2888 Shaganappi Trail,
N. W. Calgary, Alberta T3B 6A8, Canada. Email: Deborah.dewey@calgaryhealthregion.ca

ISSN 1034-912X print/ISSN 1465-346X online

© 2008 Taylor & Francis
DOI: 10.1080/10349120802033485
http://www.informaworld.com
132 J. Summers et al.

component of the daily routine, and research has reported that children with DCD have difficulties
with activities of daily living such as dressing, personal hygiene, cutting, eating and playing
(Mandich, Polatajko, & Rodger, 2003; May-Benson, Ingolia, & Koomar, 2002; Missiuna et al.,
2007; Rodger et al., 2003; Rosenblum, 2006; Summers, Larkin, & Dewey, 2008; Watkinson et
al., 2001; Wright & Sugden, 1996). Efficient performance of daily activities requires competent
motor functioning, yet children with DCD are known to have difficulties with the sequencing of
motor tasks, the timing of tasks and the speed with which they perform motor tasks (Dewey &
Tupper, 2004; Geuze, Jongmans, Schoemaker, & Smits-Engelsman, 2001; Williams, 2002).
These limitations may be reflected in their participation in the family routine. Further, the cultural
expectations of adults regarding their children’s motor behaviour (Cintas, 1995; Hopkins &
Westra, 1989) may influence the approaches and strategies used to guide the daily routine. To the
best of our knowledge, however, no studies have investigated cultural differences in the daily
routines of children with DCD.
The view that family routines are influenced by children’s motor competence, biological
development, and cultural expectations guided the present study. To obtain a comprehensive
understanding of the impact of DCD on the family routine, it was essential to explore for typi-
cally developing children, parents’ perceptions of family routines and their age-appropriate
expectations of performance (Harkness & Super, 1983; Rogoff, 1993; Tudge et al., 2006).
Although a number of studies have investigated the construction of routines in families who have
a child with a disability (Gallimore, Weisner, Kaufman, & Bernheimer, 1989; Kellegrew, 2000;
Larson, 2006; Segal, 1998, 2000), limited information is available on how the daily routine is
constrained by the impairments in motor abilities associated with DCD. As biological develop-
ment influences children’s ability to participate in families’ routines, we investigated how chil-
dren’s participation in family routines changed among younger (5 to 7 years of age) and older
children (8 to 9 years of age). Further, we investigated whether cultural differences existed in the
approaches and strategies used to guide the daily family routine in Australia and Canada.

Method
Design
A qualitative approach using focus groups (Krueger, 1994) and in-depth interviews (McCracken,
1988) was chosen to examine parents’ perspectives of the family routines of children with DCD
and typical children. This approach provided a richer source of contextual information about
family routines than was obtainable through questionnaires and quantitative research designs, and
allowed us to explore the impact of children’s motor problems, age and country of residence on
family routines. The conceptual framework that guided the exploration of routines was based on
an ecocultural model. Such a model assumes that human performance cannot be isolated from the
social and cultural context in which it occurs (Valsiner, 1997) and that family routines are a means
by which parents shape their children’s activity and development to reflect cultural characteristics
(Gallimore et al., 1989; Gallimore & Lopez, 2002).

Participants
Approval for the study was obtained from the university human ethics committees in Australia
and Canada, and participants provided informed consent. Participants were Australian and
Canadian parents of younger (5 to 7 years of age) and older (8 to 9 years of age) children. Purpo-
sive sampling was used to obtain participants. Parents of typically developing children came from
school and community contacts. Parents of children with DCD were located through therapists,
clinics and programs that specialised in children with motor difficulties. Each parent was familiar
 Impact of DCD on Daily Routines 133

with the child’s daily routines and at least one of the child’s parents was a citizen of Australia or
Canada.
Information on family routines was collected on 87 children born in Australia or Canada who
were not more than two weeks premature. There were 34 Australian and 15 Canadian typical chil-
dren, and 29 Australian and nine Canadian children with DCD (for more detail, see Summers
et al., 2008). Parents reported that the typical children had no diagnosed neurological or behav-
ioural disorder, were enrolled in regular classes at school, had not repeated a grade or received
any educational intervention and had no known condition that would affect their performance of
daily routines. Parents of children with DCD were located through therapists (e.g., occupational
therapists, physiotherapists), clinics and intervention programmes that specialised in treating
children with motor difficulties. Therapist, clinic, programme and parents’ reports indicated that
the children with DCD had no known neurological (e.g., cerebral palsy), neuromuscular (e.g.,
muscular dystrophy) or pervasive developmental disorders (e.g., autism or Asperger syndrome)
and that none of the children had been diagnosed with Attention Deficit Hyperactivity Disorder
(ADHD) or psychological disturbance. Some of the children, however, had repeated a grade or
received intervention for language or specific learning difficulties. The children with DCD had
been assessed by their various therapists or programs on standardised norm-referenced measures
of motor performance such as the McCarron Assessment of Neuromuscular Development, the
Developmental Test of Visual–Motor Integration, the Bruininks–Oseretsky Test of Motor
Proficiency, and the Movement Assessment Battery for Children, and been found to display
performance below the average range (-1SD) on at least one of these measures. The practitioners’
clinical observations of these children also noted problems in motor performance and motor
performance levels below that of their peers.

Procedure
Parents of either typically developing children or children with DCD participated in either an
individual interview or a focus group. Forty-two parents participated in one of 12 focus groups,
six for parents of typically developing children and six for parents of children with DCD.
Individual interviews were conducted with parents who were unable to arrange their schedules to
attend a focus group. To sensitise the parents to observe detailed aspects of the daily routine, they
were given an outline of the main questions that would be asked and asked to monitor the daily
routines of their children. The principal investigator initiated the focus groups and interviews,
which ranged from 60–90 minutes and were audio-taped and video-taped, with the latter used in
place of an assistant moderator (Kreuger, 1994). The focus groups and interviews took place in
various locations (i.e., clinic offices, childcare centres, schools, family homes) based on the avail-
ability of space and parents’ preferences. In all cases, parents were interviewed in the absence of
their children.

Data Collection
For both the focus groups and the interviews, the principal investigator used semi-structured and
open-ended questions—e.g., Please tell me about your family’s typical school day routine. Does
your typical family routine change on weekends?—in order to elicit broad contextual and
unprompted information, followed by specific questions and probes about performance of family
routines. The questions investigated daily routines in which the parents were asked to describe a
“typical school day routine”, one that was “not typical” for a school day and how weekend
routines differed. Following each interview or focus group, detailed field notes were made by the
principal investigator to record the experiences, feelings and thoughts that emerged (Patton,
134 J. Summers et al.

1990). Analysis of group data from the focus groups and interviews was ongoing throughout the
study, and the questions used in subsequent focus groups and interviews were modified in
response to the emerging data. Interviews with Australian families of typically developing chil-
dren and children with DCD were continued until saturation was reached and variation identified.
Canadian families were interviewed at this point and cultural differences between Australian and
Canadian families in terms of daily family routines were investigated.

Data Management and Data Analysis

Interviews were transcribed verbatim and NUD*IST software was used to assist with data
management and data analysis. Each phrase was analysed separately by individual case (interview
or focus group), and then cross-case analysis was used to group responses to questions. The anal-
ysis was conducted in two stages. A content analysis was conducted first to identify, code, and
categorise the primary patterns from the data into a manageable classification (Agar, 1996; Patton,
1990). To verify the classification, a second person coded the data separately. Initially the content
was organised as descriptive data that addressed questions concerning routines. Interpretation
sought to understand the daily routines of the children and the actions used to carry out those
routines. This was followed by an inductive analysis that identified emerging categories, patterns,
and themes (Agar, 1996; Patton, 1990). The categories were scrutinised to determine consistency
and contradictions, to uncover the multiple perspectives of individuals and to develop an under-
standing of their experience and interactions. Trustworthiness of the study findings were
augmented by collection of sufficient data for saturation to occur, an audit trail that documented
the conceptual development of the research, verification of data by participant review, and an audit
of transcripts by experienced researchers and clinicians.

Results
Differences between younger and older children with and without DCD in Australia and Canada
were explored within the context of family routines. These are reported below within three
separate categories: first, the typical school day routine; second, the non-typical school day; and
third, the weekend routine. Names used in quotes have been altered but do reflect the gender of
the child.

Consistency of Family Routines

The study findings revealed that overall the activities and tasks that constituted the daily routines
were consistent across families and countries. The structure of the family, daily rhythms, work
patterns (especially those of the mother) and personal preferences, however, had an influence
on the order in which family routines were performed and the expectations of the child’s
performance.

Typical School-day Routine

Before School Routine. For all children the morning routine was characterised by being the most
structured and regular in its requirements and sequence. Expectations for the morning routine on
a typical school day focused on self-maintenance, with productivity and leisure taking a lesser
role. Time was an important factor in this routine and influenced what and how tasks were
achieved. The time frame to complete the tasks involved in the morning routine varied among
families, and the school-day morning routines tended to follow a set pattern. The minimum
expectation was that typical children would get themselves dressed, toileted, eat breakfast, clean
 Impact of DCD on Daily Routines 135

their teeth and pack their school bag; a parent generally made lunch for school. A common expec-
tation was that children first complete these essential tasks and then, if time permitted, engage in
leisure activities such as watching television. Older children were expected to complete these
independently without direction, whereas younger children received assistance with some of the
tasks and required some direction and prompting to successfully complete the morning routine.
Older children also had more responsibilities than younger children; they were expected to do
small chores such as make their beds, pack their lunch into their school bags or assist with the
care of younger siblings. “We have a wee 9 month old and she helps with her, she helps me get
her dressed and holds her while I have a shower.” Age differences were also noted in the time of
waking. Younger children were more likely to sleep later and be woken by a parent, whereas older
children more often woke spontaneously. The following quote sums up the morning routine of a
younger child:
Generally he’s a little bit harder to wake up … he comes down by himself … we organise his break-
fast … then he does everything independently with some directions—“go brush your teeth.” … He
gets himself dressed and he will want to go and turn the television on.
In contrast, this quote is an example of the typical morning routine of an older child:
I find now, that she is dressed and got her shoes on; she’s had her breakfast, packed her bags. She
doesn’t make her lunch; I make it. She’s tidied her room and then if she’s done all those chores (I do
have to help her with her hair because it does have to be put up and she can’t do that) then she can
watch TV.
The before school routine for children with DCD, like typical children, was the most struc-
tured, and the tasks that constituted the morning routine were similar. For both younger and older
children with DCD, however, a daily unchanging routine was seen as essential to accomplish the
tasks required to get ready and out the door for school; “I have to have the routine and direction
otherwise we just don’t get out the door, with him just not organising himself to get ready for
school, get dressed and have his breakfast”. The level of structure and assistance provided to both
younger and older children with DCD was greater than that provided to typical children and the
parents’ expectations of the level of independent performance less. Many younger and older chil-
dren with DCD did not appear to be able to proceed independently without constant parental guid-
ance and those with the most difficulty, particularly younger children, required actual assistance.
Parents frequently reported that, without a consistent and high level of structure, their child would
not complete the morning tasks within the allotted time frame. Implementing a high level of struc-
ture enabled the parents (usually the mother) to focus on the needs of the child with DCD and, if
needed, attend to other children in the family.
A parent of a 7-year-old Australian boy with DCD said:
I’ve got two older children but they just do their own thing, and I have to spend all my time on him,
they get themselves up, dressed, ready and out the door, and I’ll spend a whole hour on Nic. You have
to do everything for him, make his breakfast, put his clothes out for him, you have to turn the shower
on for him, you have to drag him to the shower, get him undressed, put him in the shower, get him
out of the shower, dry him, make sure he’s finished his breakfast, then put his socks, his jocks and
everything on for him, because he just won’t do it.
The slow performance of the tasks involved in the morning routine by children with DCD contrib-
uted to the time pressures that exist for all families and imposed extra demands on the family:
“You have to harass him to go and get dressed for school; I mean he’s quite capable of dressing
himself, he’s just very very slow.”
Parents of younger and older children with DCD developed a number of different strategies
to cope with the time pressures of the morning routine. Most parents laid out the clothes for their
children even when they knew that it was something that they should “get away from”:
136 J. Summers et al.

Some of the things that I have fallen into is selecting the clothes that he will wear, and giving
them to him to put on, just to expedite the process, so I know that it is something I need to get
away from … right now it just er, the morning progress is quite tedious.

The morning time frame did not leave time for play for both younger and older children with
DCD. Only those few children who rose before the morning routine commenced were reported
to have free time to choose to play or watch television. Play was a distraction that parents
attempted to control because it interfered with the morning routine. A common strategy used
with typical children was to reward them with time to play or watch television once they had inde-
pendently completed all expected tasks associated with the morning routine. The use of such a
strategy was not expressed by the parents of children with DCD.
Overall, both older and younger children with DCD required significant structure and
assistance to successfully complete the morning routine. Some age differences were noted. Older
children with DCD were beginning to display more independence with some aspects of the morn-
ing routine such as personal hygiene and dressing; however, they continued to be very slow in
carrying it out and continued to require parental prompting.

After School Routine. The after school routine was characterised by its regularity from week
to week, and the expectation that the structure and specific content would change with the
seasonal fluctuations in recreational activities. The order in which the activities and tasks were
undertaken varied between families and from day to day, and depended on the working
patterns of the mother and the children’s activities. Most children had at least one evening
when they attended an organised activity. Almost all children engaged in one after school
activity, with older children engaging in more organised activities (sport and club) than
younger children.
After school it was expected that children needed time to wind down (“veg out” or “zone
out”); however, this was forgone if a friend had been invited or there was an organised activ-
ity to attend. Homework and any chores were done either before or after the evening meal.
Younger children’s homework was mainly reading; older children generally had an addi-
tional 30 minutes of homework a week to be done over several nights. Regular chores
included unpacking their school bag, setting the table and clearing the dishes. In Australia,
bathing was frequently part of the daily evening routine. In Canada, however, many children
did not bathe daily: “every second day I’ll say why don’t you go and have a bath and she’ll
go have a bath”. A winding down time was part of the bedtime routine; there was an expecta-
tion that children would engage in quiet activities and once in bed this was followed by a
period of reading or being read to. Bedtime was associated with the age of the child; in
Australia it was between 7.30 and 8.30 p.m.; however, in Canada it was reported to be later,
8.00–9.00 p.m.
The after school routine for children with DCD was more structured and there was less flex-
ibility as the routine was determined by the programs they attended or the type of remedial prac-
tice they did. Some children with DCD were described as being very tired after their day at
school; “He gets very tired so by the end of the day he will be more than happy to have some after-
noon tea and lie on the couch until dinner time.” While typical children were involved in seasonal
recreation team sporting activities (e.g., soccer, football, T-ball, hockey), children with DCD
were more often involved in individual activities such as swimming or martial arts. Parents of
children with DCD noted that such activities had the potential to develop coordination and also
reduced the “comparison factor”. Parents also reported using parks and encouraging outdoor and
playground activities such as ball play, play on playground equipment and cycling to promote
development of motor skills.
 Impact of DCD on Daily Routines 137

Adapting to a Non-typical Day

A non-typical day occurred when a child had to get up early or leave home early because of an
appointment, because the parent had to leave for work early or because of a sports carnival or a
dress-up day at school. Typical children were more accepting of alterations to the daily routine,
although a few 6-year-old children were reported to be “out of sorts” and complain about such
changes. In contrast, parents of children with DCD reported that their children had difficulty
adjusting to changes in routines:
We try to keep it [the routine] the same everyday because he doesn’t cope well with change, he falls
apart, he just doesn’t seem to know what to do. So there will be lots of tears and confusion and it just
doesn’t go well. (Parent of 6-year-old boy with DCD)
Even older children with DCD had difficulty coping with change in the routine: “any change [in
the routine] she will react negatively to, even at 9 she will have a full blown tantrum” (parent of
9-year-old girl with DCD). To reduce the stress associated with changes in routine and to help the
child cope, parents worked hard at informing and preparing the child for the change:
One parent of an eight-year-old boy with DCD said:
On those days [when the typical routine is not followed] we have to talk about what the plan is and
we have to go into great detail step by step and talk it through, and then review that several times
throughout the day about OK we’ve done this and this is coming up next and so he’s ready for it. And
even then it’s a lot of coaxing him through what it is actually, to do what it is that’s different, you
know its a lot of coaxing step by step.
Some parents of children with DCD did report that their children coped with changes to their
routine, describing them as adaptable, flexible and “going with the flow”. However, probing
revealed that it was not always the child who was adaptable but that the child’s apparent coping
was a result of the parent’s responsiveness to the changed situation. “I think that he is adaptable
but we tend to change things to take into account that he can’t do things.”

Weekend Routine
The weekend routine was characterised by its variability. Unless there was a sporting or other
commitment, the pressure of getting ready on time was reduced. The children were often allowed
to stay up later and sleep in; however, they were often out of bed before their parents. Daily
routine tasks often stayed the same but the timing and order was different and the atmosphere
more relaxed. Children were involved in family domestic activities such as shopping, and some
older children had extra domestic jobs. Families usually did some leisure activity together. Many
typical older children were involved in sporting activities on a Saturday or Sunday. They were
motivated and there were no reported difficulties in getting ready for and participating in these
events.
Children with DCD were reported to be much happier at weekends and holidays. These chil-
dren and their parents reported that they enjoyed a relaxed atmosphere free of the time pressures
and set tasks of a school-day routine: [weekends are] “easier really, John just loves not having the
routine of having to head off somewhere in the morning”. When the pressures of time were
removed and these children could wake and get up in their own time, most could dress without
assistance. The children had few commitments; sporting events were not a feature for these chil-
dren. For those children with DCD who were involved in organised weekend sporting activities,
participation was somewhat stressful:
His dad and he and his brother all do karate on Saturday mornings and he finds it hard … he whines
before he goes to it. Then he’ll say to me afterwards when I ask how it was, he says “Kind of good.”
“So you enjoyed it?” “No not really good, just kind of good.
138 J. Summers et al.

Although typical children liked to laze around in their pyjamas, this behaviour was more
commonly reported for children with DCD. “Saturday is probably his favourite day because
that’s his day he stays in pyjamas all day and probably doesn’t get dressed ‘til 2 or 3 in the
afternoon and I’m quite happy with that.” Children with DCD enjoyed the lack of routine at
the weekend and this was in contrast to their need for routine during the school week. The
change in atmosphere was reflected in the description of these children’s responses to week-
days versus weekends. Terms used to describe weekday mornings such as “stressful” and
“drama” were replaced by “loves” and “relaxed” for weekend mornings. When the pressure
of time was removed, such as on the weekend, many children with DCD could demonstrate a
higher level of independence than during the week. For example, some children would get
their own breakfast, choose their own clothing and dress themselves. This increased indepen-
dence at the weekend was clearly demonstrated by the two children who required the most
assistance during the week. The parent of the 6-year-old said, “He’s started sometimes to
dress himself, it’s quite surprising really”. A dependent 8-year-old boy was independent at
the weekend: “He gets up, gets himself dressed, [and] does his own hair. He gets up when
he’s ready, sleeps in until 9.30 … He can go to the cupboard and get cereal and milk and
stuff.”

Discussion
There were many similarities across cultures, age groups and levels of motor competence
in the daily routines of families; however, these three factors modulated the structure and
rhythm of the daily routine. Parents used many different strategies to guide the family routine.
Age-related expectations influenced the child’s participation in daily family routines. Typical
younger children were learning the social requirements that supported participation to a level
described by parents as basic independence. Basic independence was supported by parental
actions that consisted of minimal physical assistance such as tying shoelaces, direct supervision
related to quality of performance and task completion, and direction and prompting particularly
related to the temporal aspects of the routine. Typical older children had an established routine,
increased performance expectation and decreased tangible support from parents that reflected
their greater capacity. Children with motor difficulties generally needed much more structural
support and temporal prompting than their same-aged peers in order to engage in the family
routine.
Cultural differences in the approaches and strategies used by Australian and Canadian parents
to guide children’s participation in daily routines were few. Further, only negligible differences
were noted in routine expectations. The need to adjust routines to suit seasonal changes in orga-
nised activities especially sport occurred in both cultures. The colder Canadian winter had an
influence on self-maintenance activities of Canadian children relative to Australian children as
they were required to manage hats, gloves and more complex and bulky clothing than was needed
in Australia.
The morning routine was the least flexible in all families because it was constrained by
time. Segal (1998) also observed this phenomenon in families of children with Attention
Deficit Disorder who identified that time for getting to school or work required enabling
strategies and routine adaptations. Children with DCD needed more time prompts, partly
because they were slower to perform the essentials tasks. Pressure of time was greater for
working mothers, and to sustain the routine two opposing strategies were reported: either
expecting a high level of independence that would free them to do another task or providing
more assistance to the child. This latter strategy was most often used with children with
DCD.
 Impact of DCD on Daily Routines 139

Strategies for coping with changes to routine were common across all families and differed
only slightly with age. If the regular flow of the routine was to be disrupted parents typically gave
their child plenty of warning and explained the reasons for change; reminded them at regular
intervals prior to the disruption; and took responsibility for reorganising tasks and the temporal
rhythm so that the routine was completed successfully. These adaptations could require parents
taking on some of the child’s tasks, giving more direction, time prompts and assistance. Typical
children generally could adapt to changes in daily routines. However, children with DCD were
much less amenable to change and needed more reminders and assistance to accomplish daily
tasks when the daily routine was altered.
The conclusions drawn from this study are limited by purposive sampling and the socio-
economic status of the parents who were predominantly well educated, middle class and married
or living with a partner. The perspective of parents from more diverse cultures than Australia and
Canada could contribute to a broader view of cultural variation in daily routines. Although the
study suggests that DCD has a significant impact on daily family routines, we cannot definitively
conclude this based on the findings reported here. Longitudinal prospective studies are needed to
strengthen the credibility of these findings. Future studies could examine in greater detail the
increased participation of children with DCD in family routines as they develop, and examine
whether interventions designed to improve functional skills have an impact on children’s
participation in family routines.
Most studies that have examined children with DCD have focused on these children’s impair-
ments in coordination, and few have specifically investigated in a detailed manner how the
impairment in motor coordination impacts the daily routines of the family (Missiuna et al., 2007).
This qualitative investigation suggests that the motor impairments of children with DCD signifi-
cantly interfere with these children’s participation in the daily family routine. This contention is
supported by statements of parents that siblings that were younger than the child with DCD, as
well as older siblings, were much more independent in terms of their participation in the family
routine. Postural control and motor coordination were identified by parents of children with DCD
as two significant factors that impacted the participation of these children (Summers et al., 2008).
Additional constraints noted by these parents included the difficulties that the children with DCD
had with the organisation and timing of the activities that made up the routine. This study also
revealed that older typical children were more independent than younger children in their partic-
ipation in daily routines and that this reduced demands and stresses on parents. Although older
children with DCD were growing in independence, like the younger cohort with DCD, they gener-
ally needed much more parental support and assistance than their same-aged peers in order to
successfully complete daily family routines, particularly on school days. This parental support
and assistance reduced the burden of the daily before and after school routines for both children
with DCD and their parents. When the temporal pressures of the daily routine were reduced on
weekends and children with DCD were able to set their own time frame and structure, they were
more successful in participating in the family routine, which in turn contributed to a more relaxed
and harmonious household.
The next step in this research is to examine how children with DCD view their participation
in family routines, what parts of the routines they find enjoyable and what parts are viewed as
challenging. Such research could assist us in developing a better understanding of these children’s
perceptions of the impact of their motor difficulties on the performance of daily routines and
could assist us in developing family-based interventions that could create environments in the
home that would promote learning and active participation in family routines. A second direction
for research is in the area of longitudinal prospective studies that examine how participation in
daily routines by children with DCD change for early school age to adolescence and what factors
promote increased participation.
140 J. Summers et al.

Acknowledgement
This paper was based on data collected by Janet Summers for her Ph.D. but regrettably she died
before she was able to publish the results of her research. There was no research funding for this
study, and no restrictions have been imposed on free access to, or publication of, the research
data.

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