DCD OSCE — assessment counselling and school plan

Station objectives

1. Elicit motor developmental history and functional impact. [1]
2. Screen for neurological red flags that exclude simple DCD. [4]
3. Use screening/quantification tools correctly without over-calling diagnosis. [7] [1]
4. Counsel without shame and set task-oriented goals. [1] [5]
5. Plan school adaptations and activity that protect fitness/participation. [9]

Candidate brief

You are the doctor in a paediatric outpatient clinic. Station A is 10 minutes with parent and child. Station B is 8 minutes focused on explanation and planning after assessment supports DCD. [1]

Station A — Assessment

Setup: 8-year-old boy. Teacher letter: slow writing, PE avoidance, “doesn’t try.” Parent: buttons and cutlery always hard. No regression. Optional twist: examiner may inject Gowers-like rising if you fail to check. [1] [4]

Expected actions:

• Ask about self-care, handwriting, PE, play, bullying, mood and what the child wants to improve. [1]
• Examine tone, power, reflexes, gait, coordination; check for Gowers in boys with rising difficulty. [4]
• Observe a short functional task (writing sample/buttoning) if appropriate. [1]
• Screen ADHD/learning concerns and vision. [1]
• Propose DCDQ screen and standardised motor testing as needed; do not diagnose from teacher letter alone. [7] [1]
• If red flags appear, convert to CK/neurology pathway. [4]

Station B — Counselling and plan

Setup: Exam normal. Functional impact clear. Motor testing substantially below age. Parent tearful: “So he is lazy?” [1]

Expected actions:

• Name developmental coordination disorder in plain language; reject laziness narrative. [1]
• Explain criteria briefly without jargon overload. [1]
• Set 2–3 functional goals with child input. [1]
• Refer for task-oriented OT/PT; mention Goal–Plan–Do–Check idea if asked. [5]
• School plan: extra time, reduced copying, keyboard options, inclusive PE adaptations. [1]
• Prescribe successful physical activity; mention fitness/weight risk without scolding. [9]
• Address possible ADHD/learning comorbidity and follow-up owner/date. [4] [1]
• Do not invent a drug for core DCD. [1]

Marking anchors

Clear pass: red flags checked; criteria used; tools not over-called; task-oriented + school plan; compassionate accurate language. [1] [5]
Borderline: kind tone but process-only therapy only, or no school adaptations. [5]
Fail: misses progressive weakness pathway; diagnoses from handwriting alone; blames child; invents DCD medication; no follow-up loop. [1] [4]

Debrief pearls

• DCD is common (~5–6%) and under-recognised. [4]
• Task-oriented practice beats process-only as the core plan. [5]
• Participation and fitness are part of the medical outcome. [9]
• Shame is already in the room — name the motor system problem early. [1]