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Moving and Sensing — Coordination

Poor Coordination in Children

Young girl throwing a red ball in the air.

Anna Kroncke


Last modified 05 Sep 2023

Published 22 Feb 2022

What is Coordination in Childhood?

Coordination in childhood is a child’s motor abilities, including walking, running, and jumping in a fluid, straight and smooth motion.

We often think of coordinated children as good at sports and aware of their bodies in space. They fall less and have more agile movements.

When a child is not coordinated, we may call their movement clumsy or report motor delays. ‘Clumsiness’ is referred to clinically as a deficit in gross motor skills. The term gross motor refers to large muscle groups such as those used for walking and running. Difficulties walking swiftly and smoothly may also be referred to as “awkward gait.” This term means that the walking movements are jerky and awkward rather than fluid, straight, and coordinated.

Coordination Milestones in Children

A child who struggles with gross motor control has difficulty sending signals from the brain to the limbs to execute effective, fluid movement. Some children have trouble running smoothly but eventually grow out of it.

Typical development 

  • 36 months (3 years): Children who are 36 months of age should be able to walk naturally while rotating the upper body and swinging arms at sides [2]. 
  • 48 months (4 years): By 48 months, children should be able to walk like an adult and run smoothly. 
  • 66 months (5.5 years): By 66 months, children should have a mature running pattern and may enjoy racing peers to show off their skills. 

If your child is still awkward in their movements through kindergarten or first grade, you may have a cause for concern. A physical therapist may be able to work with your child on these skills.

Symptoms of Coordination Problems in Children

  • Poor balance: has challenges running or walking
  • Poor posture: moves awkwardly, slouches or slumps, sits in a folded posture
  • Runs into things or people
  • Trips or falls down a lot; drops things
  • Struggles to participate in P.E. or sports for fear of getting hurt
  • Feels embarrassed about a lack of athletic ability
  • Unable to use both sides of their body effectively during a task
  • Has difficulty stringing beads, tying shoes, or buttoning

Some children have trouble running or walking. They may bump into the walls while running down the hall. They may hit their heads when entering a play tunnel. Children with these challenges generally do not enjoy hopscotch or the monkey bars.

Sometimes they accidentally crash into people at school while in circle time. They might have trouble walking in a single-file line or doing other motor activities in which they are close to peers. They may not understand personal space.

Children who struggle with this skill may be described as ‘bulls in a china shop.’ They may move loudly and clumsily and may fall frequently. Clumsy children are often getting hurt; bumps, bruises, and even more serious injuries may happen more frequently than in children with better coordination.

Sometimes, you may notice these children behave impulsively, not thinking before acting. You may notice your child simply looks funny or awkward when running at the park. 

You may notice that your child doesn’t seem to understand how far away things are and may run into the screen door or fall off of playground equipment. Within a developmental context, difficulty with running smoothly is normal through the toddler years. However, if your child is 4-years-old or older, they should be able to walk like an adult and start to run naturally [2].

Causes of Coordination Problems in Children

  • Cerebral Palsy: a disability of movement, balance, and posture, usually diagnosed at birth or in the first months of life. It is a common motor diagnosis in childhood. CP is caused by challenges in brain function before or in the first year of life. Low birth weight and low muscle tone may occur with CP. 
  • Motor Planning difficulty: the ability to plan and execute gross motor movements. If this is hard for a child, they may appear uncoordinated
  • Depth Perception difficulty: judging the distance in space between the child and other objects in the visual field. Those who struggle with depth perception may fall or run into things a lot
  • Motor Apraxia: physical challenges with gross motor movement. Those with difficulty in motor apraxia are likely to move in a more forced or stilted manner and be less coordinated
  • Developmental Coordination Disorder: challenges with motor coordination, likely including poor handwriting. DCD is a diagnosis related to coordination and defined by motor dyspraxia or learning challenges in the motor domain
  • Visual Impairment: children with a visual impairment may have difficulty with motor coordination 
  • Autism Spectrum Disorder: deficits in social communication and restricted interests or behaviors define autism, which often has motor implications. A child with ASD may have challenges with coordination, but that is not always the case.
  • Attention Deficit Hyperactivity Disorder (ADHD): challenges with hyperactivity, inattention, and impulsivity define ADHD. Sometimes being very active and impulsive can result in clumsy behavior because of the level of activity and movement and challenges with planning and thinking ahead

What to Do About Coordination Problems in Children

Physical therapy and Occupational therapy may be available to your child in school or privately through insurance.

Physical therapy addresses gross motor movements, which are big movements like walking and running.

Occupational therapy addresses fine motor coordination and control as well as sensory differences and needs. Sensory differences refer to being less or more sensitive to sensory stimuli like light, sound, touch, taste, smell, and movement.

DO Encourage activities such as martial arts, yoga, dance, swimming, or gymnastics. These sports might best be initiated at a beginner level with lots of individual support. Just as you can strengthen your core by doing exercise, your child can too. They may not be a stellar athlete but can build more confidence and strength.

Keep in mind that some children will not care as much about athletics, and this preference is okay. It may be that your child simply dislikes P.E. class and prefers to stay away from baseball. If they are finding a sense of belonging in academics, chess club, card clubs, or student council, the child may not need to worry about sports as much. In this case, it will be important to ensure that your child is healthy physically and has good self-esteem.

Other activities to promote your child’s coordination

  • Lacing cards
  • Ball activities (playing catch, throwing a ball up and catching, tossing against a wall and catching, standing in a line with multiple people and passing it over/ under)
  • Obstacle courses
  • Shuffling and passing out cards
  • Placing noodles or beads on a string
  • Playing Twister

When to Seek Help for Coordination Problems in Children

Some children may have ‘comorbid concerns,’ which means that the motor challenges are related to problems in other areas. Examples of comorbid concerns are reading or writing, solving puzzles, and understanding nonverbal social cues.

Some children who are clumsy may also be very active and impulsive, not thinking before they leap. These children may get hurt more frequently and can even be more prone to have a concussion, which can cause further difficulty by damaging the brain.

Children with fine motor coordination issues often have trouble writing, puzzles, tying their shoes, and any activity requiring them to manipulate small objects and pieces, such as buttons, zippers, cutting, and beads. Finally, children with poor coordination or body awareness may fail to assess and pay attention to social cues.

For example, children may back away if your child gets too close, and that social ‘hint’ may go unnoticed. Because those cues are not regarded and adhered to, your child may be left out of social interactions. In many cases, these children who lack social boundaries also get in trouble at school for accidentally hurting other children, violating personal space, or being off-task during group activities.

If your child is experiencing these challenges, it is important to seek the help of a professional. 

Professional Resources for Coordination Problems in Children

  • Physical Therapist: to assess and treat gross motor coordination; to help with large muscle groups and movement
  • Occupational Therapist: to assess and treat fine motor skills and sensory integration needs
  • Psychologist or Neuropsychologist: to consider symptoms in a mental health context, conducting evaluations as necessary for related concerns with social or attention skills. Can treat or refer to appropriate treatments.

Similar Conditions to Coordination Problems

Sometimes, in addition to ASD or ADHD, learning disabilities can co-occur with motor coordination challenges.

  • Specific Learning Disability in reading / Dyslexia (Educationally Identified Disabilities: may be diagnosed clinically as well, challenges with reading that have underlying visual processing deficits
  • Specific Learning Disability in writing / Dysgraphia (Educationally Identified Disabilities: may be diagnosed clinically as well, challenges with writing due to visual or motor processing deficits
  • Specific Learning Disability in math / Dyscalculia (Educationally Identified Disabilities: may be diagnosed clinically as well, challenges with mathematics may relate to visual-spatial deficits

References on Coordination Problems

[1] Barton, Erin. Educating Young Children with Autism Spectrum Disorders.


[2] Linder Ed.D., Toni & Petersen-Smith Ph.D., Ann (2008) Administration Guide for TPBA2 & TPBI2 (Play-Based Tpba, Tpbi, Tpbc). Paul H. Brookes, Inc.

[3] Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.

[4] Trawick-Smith, Jeffrey (2013). Early childhood development: A multicultural perspective.