Bridging the Gap – A school-based physiotherapy model for children with DCD

About Bridging the Gap

Developmental Coordination Disorder (DCD) is a neurodevelopmental condition affecting 5–6% of children. It impacts motor proficiency in ways that interfere with everyday activities and participation. Without timely and appropriate support, children with DCD face an increased risk of reduced health and well-being. Yet in Sweden, school-aged children with DCD often lack access to physiotherapy.

Traditionally, physiotherapy services are delivered one-to-one. However, there is growing international support for chronic care models that promote participation, support self-management, and help prevent long-term negative outcomes. Collaborative, tiered service models that focus on participation have been recommended – but such approaches have not yet been tested within Swedish schools.

In Bridging the Gap, we aim to develop a school-based physiotherapy service delivery model using the UK Medical Research Council (MRC) framework for complex interventions. Our overall goal is to increase access to physiotherapy and improve participation in school activities, particularly for children with DCD.

Developing the intervention

In the first phase of the project, we are examining current practices, identifying needs, and building the theoretical foundation for the intervention.

As part of the international “IMPACT for DCD”-initiative, we have surveyed parents to understand the impact of DCD on children and families. We are also studying how familiar DCD is among school and healthcare professionals and conducting a systematic literature review to identify behavior change techniques used in interventions that effectively promote participation in physical activity among children with chronic conditions or neurodevelopmental disorders.

In parallel, we have contributed to the development of a collaborative, tiered school-based physiotherapy model and have evaluated a project in Region Gotland, where a physiotherapist worked in schools during one academic year.

Adaption and testing the intervention

In the next phase of the project, we will adapt and test the intervention within the Swedish context. We aim to identify barriers and facilitators that influence implementation and explore how the model can be adapted to Swedish schools and healthcare systems. We will also investigate whether the model is perceived as useful and acceptable by children, families, and professionals.

Why this matters

The project aims to develop a new model for how support for children with DCD is organized within schools and healthcare services. By offering physiotherapy interventions in the school environment, we can reach children who currently lack access to support and create opportunities for earlier and more equitable access to services. The goal is to promote children's health, well-being, and learning, reduce inequalities, and strengthen the foundations for positive development in both the short and long term.