Identifying developmental coordination disorder: consistency between tests

In the absence of a gold standard to identify the presence of developmental coordination disorder in children, it is useful to examine the consistency of different tests used in physical and occupational therapy. This study examined three measures of motor skills to determine whether they consistently identified the same children. In total, 379 children participated in this study. The final matched samples consisted of 202 children ranging in age from 8 to 17 years: 101 met criteria for DCD and 101 children did not show any evidence of DCD. The results indicated that the overall agreement between the Bruininks Oseretsky Test of Motor Proficiency (BOT), the Movement Assessment Battery for Children (M-ABC) and the Developmental Coordination Disorder Questionnaire (DCDQ) was less than 80%. The difference in structure and style of administration between the BOT and the M-ABC appears to contribute to their tendency to identify different children. This study emphasizes the need for therapists to use clinical reasoning to examine multiple sources of information about a child's abilities.     

Multidisciplinary Assessment of Children with Developmental Coordination Disorder: Using the ICF Framework to Inform Assessment

The aim of this study was to describe relationships in young children with motor coordination problems between measures of motor, functional, self-efficacy, and communication administered by a multidisciplinary team and the fit of these measures within the framework of the International Classification of Functioning, Disability and Health (ICF) (). Sixty children, 40 males and 20 females, with mean age 72.5 months (SD = 11.4 months) referred to a university physiotherapy clinic met the inclusion criteria for developmental coordination disorder (DCD). Each measure provided a different perspective of performance when considered within the framework of the ICF. The findings suggest caution when using the Movement Assessment Battery for Children (M-ABC) for the purpose of diagnosis with young referred children, since 25 of the 60 children scored > 15th percentile, despite demonstrating motor deficits at home and school. Further research is needed to address assessment at the participation level. Viewing children from the multiple perspective of each discipline highlights the range of challenges faced by children with DCD.     

General movements of preterm infants in relation to their motor competence between 5 and 6 years

BackgroundThe criteria for identification of children with high risk of cerebral palsy are well documented, but the early identification of children at highest risk of minor motor deficits remains less clear.AimTo analyze the correlation between the quality of general movements (GMs) from term to twenty weeks postterm age and the motor competence between 5 and 6 years of age.MethodsIn the group of 45 preterm infants, the quality of GMs was assessed using Prechtl's method. The Movement Assessment Battery for Children (M-ABC) was used to test motor competence between 5 and 6 years of age. The correlations between GMs and M-ABC results were analyzed.ResultsDuring writhing period, the sensitivity of GMs to identify children with definite motor problem was 0.86 for total impairment, 0.67 for manual dexterity, 0.89 for ball skills and 0.92 for balance. During fidgety period, the sensitivity was higher than during the writhing period: 1.00 for total impairment, 1.00 for manual dexterity, 1.00 for ball skills and 0.83 for balance, respectively. The specificity was low at both ages (total scoring 0.24 at term and 0.21 at 3 months corrected age).ConclusionThe sensitivity of GMs to identify children with definite motor problems is higher at the fidgety than at the writhing period. The specificity of GMs at the term and fidgety age to predict later motor abilities is low.     

Self-efficacy profile in daily activities: Children at risk and with developmental coordination disorder

AimThe objectives of this study were: 1) to compare the perceptions of self-efficacy in the daily activities (self-care, schoolwork, and leisure) of boys and girls with DCD, or in children at risk for DCD (r-DCD) and in typical children (TD); 2) to investigate if a self-efficacy assessment could be a support tool in the establishment of children with the DCD profile.MethodsChildren between 6 to 8 years old (N=115: 35 with DCD, 40 with r-DCD, 40 with TD) were assessed using the Movement Assessment Battery for Children (MABC-2) and the Perceived Efficacy and Goal Setting System (PEGS). A two-way MANOVA showed significant effect for the perceived self-efficacy group.ResultsThe Bonferroni post hoc test indicated that in the self-care, schoolwork, leisure, and general self-efficacy dimensions the children with DCD presented significantly lower scores compared to children with r-DCD and TD (p < 0.001). A similar result was observed for r-DCD children in comparison with TD (p < 0.001). The discriminate analysis showed that perceived self-efficacy in leisure activities was the variable that most contributed to the discrimination of the groups.ConclusionThe judgment of children with DCD and r-DCD on the effectiveness of the execution of schoolwork and leisure activities may have been influenced by the motor skill difficulties showed by the children.     

Effectiveness of a Summer Camp Intervention for Children with Developmental Coordination Disorder

ABSTRACT

Background: Developmental coordination disorder (DCD) significantly affects a child's motor abilities and negatively impacts their self-efficacy and participation in physical activity. Using a task-specific approach and cognitive strategies in a group setting, we designed a summer camp intervention for children with DCD. Aims: Our purpose was to examine the effectiveness of the summer camp in meeting child-chosen functional motor goals and increasing self-efficacy and participation. Methods: This mixed methods study examined performance and satisfaction of child-chosen goals, self-efficacy, and participation of 11 children before and after the camp. Survey and interview data from three children and nine parents were collected to supplement quantitative findings. Results: Statistically significant improvement in performance and satisfaction of child-chosen goals was noted. While no measureable changes in self-efficacy and participation were observed, parents and children reported positive benefits to camp participation, including the confidence to try new activities, being with other children with DCD, and learning more about the disorder. Conclusion: The intensive, group-based summer camp may offer a valuable alternative to improve the functional skills of children with DCD, while providing other notable benefits.     

Ecosystemic Needs Assessment for Children with Developmental Coordination Disorder in Elementary School: Multiple Case Studies

ABSTRACT

This study explored the needs of children with developmental coordination disorder (DCD) from an ecosystemic viewpoint as part of a theory-driven program evaluation process. A multiple case study needs assessment was conducted. Participants included ten children with DCD, their parents (n = 12), teachers (n = 9), and service providers (n = 6). Data collection involved semi-structured interviews, validated questionnaires, and a review of the children's records. The results support the relevance of using an ecosystemic model to assess the needs of children with DCD in their life and social contexts. More specifically, the results highlight the need to provide additional services at school, such as occupational therapy and special education, as well as information and training regarding DCD for parents and teachers. The results also point to the relevant variables to consider in an intervention program based on theory-driven evaluations. This study shows how employing an ecosystemic frame of reference provides a better understanding of the needs of children with DCD. Future research should document the ecosystemic profiles and evolution of the needs of children with DCD with a larger sample from diverse socioeconomic backgrounds using a longitudinal study design.     

Comparing Activity Patterns,Biological, and Family Factors in Children with and Without Developmental Coordination Disorder

ABSTRACT

The association between motor proficiency and moderate to vigorous physical activity (MVPA) suggests children with developmental coordination disorder (DCD) may be susceptible to inactivity-related conditions such as cardiovascular diseases. The aim of this study was to compare children with and without DCD on physical activity patterns, activity types, body composition, strength, and cardiovascular fitness. Additionally, factors potentially influencing MVPA were also explored. Eighteen children (7–11 years) with and without DCD (n = 9/group) participated. Motor coordination, physical activity, strength, cardiovascular fitness, body mass index (BMI), and family factors were measured. Children with DCD participated in significantly less MVPA and had higher BMIs and decreased strength and cardiovascular fitness. Strength, activity type, and family factors correlated significantly with MVPA for children with DCD. The results suggest that strength, activity types, parent perception of their child's motor abilities, and parent activity participation should be considered to maximize health benefits associated with MVPA for children with DCD.     

Cross-cultural adaptation,reliability and predictive validity of the Italian version of Developmental Coordination Disorder Questionnaire (DCDQ)

BackgroundDevelopmental coordination disorder (DCD) is a motor disorder of unclear etiology that severely interferes with a child's ability to perform daily motor tasks. As a useful alternative to a time-consuming motor test and specialist evaluation, parents or teachers can complete motor questionnaires. A tool used worldwide to screen motor performance in 4- to 14-year-old children is the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07).AimsTo describe how we translated the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07) and adapted it to the Italian population and to test its preliminary psychometric properties in Italian children.MethodsParents of a clinical group of 26 children (5–11 years old) with a diagnosis of DCD and 52 matched controls completed the DCDQ translated into Italian and adapted for cross-cultural purposes according to current guidelines. Twenty-four parents of typically developing children randomly selected completed the questionnaire twice to examine test–retest reliability.ResultsThe internal consistency value (Cronbach alpha) for the Italian DCDQ was 0.94. The Italian DCDQ achieved moderate-to-high test–retest reliability (ICC) for 14/15 items and a good diagnostic performance for identifying children with DCD (sensitivity 88% and specificity 96%).ConclusionsThe Italian DCDQ is a valid screening tool for assessing motor performance in 5- to 11-year-old children that merits research in a larger sample.     

Knowledge to Practice in Developmental Coordination Disorder: Utility of an Evidence-Based Online Module for Physical Therapists

ABSTRACT

Aims: Developmental coordination disorder (DCD) is a chronic condition with potential negative health consequences. Therapists working with children with DCD need access to tailored, synthesized, evidence-based information; however a knowledge-to-practice gap exists. The aim of this study was to develop and evaluate the utility of an evidence-based online DCD module tailored to physical therapists’ (PTs) needs. Methods: Guided by the Knowledge to Action framework, we interviewed PTs working with children with DCD (n = 9) to identify their information needs. Their recommendations, along with synthesized DCD research evidence, informed module development. These PTs as well as others (n = 50) evaluated the module's usefulness. Results: The module incorporated important content areas including: (1) identification; (2) planning interventions and goals; (3) evidence-based practice; (4) management; and (5) resources. Case scenarios, clinical applications, interactive media, links to resources, and interactive learning opportunities were also embedded. PTs perceived the module to be comprehensive and useful and provided feedback to improve module navigation. Conclusions: Involving end-users throughout the development and evaluation of an online PT DCD module contributed to its relevance, applicability, and utility. It will be important to evaluate whether use of this module improves the quality of services provided by PTs.     

A crucial role of altered fractional anisotropy in motor problems of very preterm children

BackgroundVery preterm children (<32 weeks of gestation) are characterized by impaired white matter development as measured by fractional anisotropy (FA). This study investigates whether altered FA values underpin the widespread motor impairments and higher incidence of developmental coordination disorder (DCD) in very preterm children at school-age.MethodsThirty very preterm born children (mean (SD) age of 8.6 (0.3) years) and 47 term born controls (mean [SD] age 8.7 [0.5] years) participated. Motor development was measured using the Movement Assessment Battery for Children. A score below the 15th percentile was used as a research diagnosis of DCD. FA values, as measure of white matter abnormalities, were determined for 18 major white matter tracts, obtained using probabilistic diffusion tensor tractography.ResultsLarge-sized reductions in FA of the cingulum hippocampal tract right (d = 0.75, p = .003) and left (d = 0.76, p = .001), corticospinal tract right (d = 0.56, p = .02) and left (d = 0.65, p = .009), forceps major (d = 1.04, p < .001) and minor (d = 0.54, p = .02) were present in very preterms, in particular with a research diagnosis of DCD. Reduced FA values moderately to strongly related to motor impairments. A ROC curve for average FA, as calculated from tracts that significantly discriminated between very preterm children with and without a research diagnosis of DCD, showed an area under curve of 0.87 (95% CI 0.74–1.00, p = .001).ConclusionsThis study provides clear evidence that reduced FA values are strongly underpinning motor impairment and DCD in very preterm children at school-age. In addition, outcomes demonstrate that altered white matter FA values can potentially be used to discriminate between very preterm children at risk for motor impairments, although future studies are warranted.     

The rCBF brain mapping in adolescent ADHD comorbid developmental coordination disorder and its changes after MPH challenging

BackgroundComorbid developmental coordination disorder (DCD) in the patients with attention-deficit hyperactivity disorder (ADHD) often complicated the treatment strategy. Methylphenidate (MPH) improves the coordination problem in patients with ADHD.AimThe study intended to investigate the pathophysiology and the mechanisms of MPH in comorbid DCD of the adolescents with ADHD.MethodsBrain images using technetium-99m ethyl cysteinate dimmer (^99mTc-ECD) single photon emission computed tomography (SPECT) were done in 10 drug-naïve adolescents with ADHD without DCD and 5 adolescents with ADHD comorbid DCD. The baseline rCBF and changes of rCBF after 10 mg MPH challenge between two groups were compared using statistical parametric mapping (SPM99) analysis.ResultsLower rCBF of bilateral frontal lobe, inferior parental lobe, and increased rCBF of right posterior cingulate gyrus, anterior lobe of cerebellum were found in ADHD comorbid DCD group compared to ADHD without DCD group. Decreased rCBF in the right occipital, inferior temporal lobe was found in ADHD comorbid DCD group after MPH while ADHD alone group revealed increased rCBF in bilateral occipital lobe.ConclusionsThe results help us understand the pathophysiology of DCD in ADHD adolescents. The different rCBF response to MPH provides a clue for future intervention of DCD in ADHD adolescents.     

Self-Regulatory Skill Among Children with and without Developmental Coordination Disorder: An Exploratory Study

Aim: Children with developmental coordination disorder (DCD) experience difficulty learning and performing everyday motor tasks due to poor motor coordination. Recent research applying a cognitive learning paradigm has argued that children with DCD have less effective cognitive and metacognitive skills with which to effectively acquire motor skills. However, there is currently limited research examining individual differences in children's use of self-regulatory and metacognitive skill during motor learning. This exploratory study aimed to compare the self-regulatory performance of children with and without DCD. Methods: Using a mixed methods approach, this study observed and compared the self-regulatory behavior of 15 children with and without DCD, aged between 7 and 9 years, during socially mediated motor practice. Observation was conducted using a quantitative coding scheme and qualitative analysis of video-recorded sessions. This paper will focus on the results of quantitative analysis, while data arising from the qualitative analysis will be used to support quantitative findings. Results: In general, findings indicate that children with DCD exhibit less independent and more ineffective self-regulatory skill during motor learning than their typically developing peers. In addition, children with DCD rely more heavily on external support for effective regulation and are more likely to exhibit negative patterns of motivational regulation. Conclusions: These findings provide further support for the notion that children with DCD experience difficulty effectively self-regulating motor learning. Implications for practice and directions for future research are discussed.     

Motor Planning and Gait Coordination Assessments for Children with Developmental Coordination Disorder

Aims: The purposes were to examine construct validity of the Motor Planning Maze Assessment (Maze) and three items from the Functional Gait Assessment (FGA) that were modified for children (pediatric modified FGA, pmFGA), by comparing performance of children with DCD and age matched peers with typical development (TD); the construct validity of total scores of the Dynamic Gait Index (DGI) and the FGA. Methods: Twenty pairs of children with DCD and TD, age from 5 to 12 years, participated in this study. Children in both groups were tested on the Maze, pmFGA, DGI, and FGA. Paired t-tests and agreement tables were used to compare the motor performances between two groups. Results: The DCD group showed higher summary scores in the Maze (p < 0.001) and demonstrated significantly fewer steps (p ≤ 0.001) while doing the pmFGA items than the TD group. However, the FGA quality scores demonstrated minimal differences between the two groups on all three items. Children with DCD showed significantly lower DGI and FGA total scores (p < 0.001) than the TD group. Conclusion: The Maze, DGI, and FGA tests are easily applied in clinical settings and can differentiate motor planning and gait coordination between children with DCD and with TD.     

Adaptation and Extension of the European Recommendations (EACD) on Developmental Coordination Disorder (DCD) for the UK context

ABSTRACT

Background: Developmental Coordination Disorder (DCD) affects the learning and performance of everyday motor skills. It commonly co-occurs with other developmental disorders and a range of associated psycho-social impairments. Recent evidence-based guidelines on diagnosis, assessment, and intervention provide valuable information for practitioners. However these are directed primarily at German-speaking countries and focus on work with children. Aim: The aim of this project was to consider the application of these guidelines in the UK and to extend them for use with adults with DCD. Methods: Individuals with DCD, parents, and professionals from a wide range of disciplines were invited to two workshops to discuss and debate the guidelines, to adapt them for the UK and produce dissemination materials. Results: A working definition of DCD was agreed, minor revisions were made to the guidelines to reflect the UK context, an extension for adults was compiled and a series of leaflets was produced to disseminate this information to health and education professionals, parents, and employers. Conclusions: This work will raise awareness of the condition across different professional groups. It provides information to help those working with children and adults with DCD in the UK to assist in the process of diagnosis, assessment, and intervention.     

A Service Delivery Model for Children with DCD Based on Principles of Best Practice

ABSTRACT

Aims. In this perspective article, we propose the Apollo model as an example of an innovative interdisciplinary, community-based service delivery model for children with Developmental Coordination Disorder (DCD) characterized by the use of graduated levels of intensity and evidence-based interventions that focus on function and participation. Methods. We describe the context that led to the creation of the Apollo model, describe the approach to service delivery and the services offered. Results. The Apollo model has 5 components: first contact, service delivery coordination, community-, group-, and individual-interventions. This model guided the development of a streamlined set of services offered to children with DCD, including early-intake to share educational information with families, community interventions, inter-disciplinary and occupational therapy groups, and individual interventions. Following implementation of the Apollo model, wait-times decreased and the number of children receiving services increased, without compromising service quality. Conclusions. Lessons learned are shared to facilitate development of other practice models to support children with DCD.     

Aquatic Physical Therapy for Children with Developmental Coordination Disorder: A Pilot Randomized Controlled Trial

ABSTRACT

Aquatic therapy is an intervention for children with Developmental Coordination Disorder (DCD) that has not been investigated formally. This was a pilot randomized controlled trial to investigate the feasibility and preliminary effectiveness of an aquatic therapy program to improve motor skills of children with DCD. Thirteen children (mean age 7 years 1 month; 10 males) with DCD were randomly allocated to receive either six sessions of aquatic therapy (once weekly session of 30 min for 6–8 weeks) or to a wait-list (control group). The intervention and measures were demonstrated to be feasible, but barriers, such as limited appointment times and accessibility, were encountered. Analysis of covariance indicated that at posttest, mean scores on the Movement Assessment Battery were higher for children who received aquatic therapy compared to those on the wait-list (p = .057). Similar trends were noted on the physical competence portion of the Pictorial Scale of Perceived Competence and Social Acceptance (p = .058). Participation levels, as measured by a parent questionnaire, showed improvement for both groups. Potential facilitators and barriers to implementation of an aquatic therapy for children with DCD are discussed.     

Travail interprofessionnel et adaptations pédagogiques : qu’en est-il de l’accompagnement des enfants avec un trouble développemental de la coordination (TDC) ?

Purpose of the study

This work aims to question the perception of parents and teachers about the joint work implemented around instructional accommodations that can be proposed to pupils with Developmental Coordination Disorder.

Health Promotion in a Low-income Primary School: Children with and Without DCD Benefit,but Differently

ABSTRACT

Poor motor performance and reduced physical fitness are characteristic of children with Developmental Coordination Disorder (DCD). These features have also been identified more frequently among children living in low socio-economic circumstances. Aims: To evaluate the outcomes of a nine-week health promotion program (HPP) on the motor performance and fitness levels of children (6–10 years) with and without DCD attending a low-income primary school. Methods: The HPP was designed and implemented by undergraduate physiotherapy students using guidelines from the World Health Organization School Health Initiative and their physiotherapy curriculum. Children with DCD (n = 22) and a control group without DCD (n = 19) participated in the evaluation. Motor skill, functional strength, aerobic capacity, and anaerobic power were measured at baseline and after nine weeks. Results: Both groups of children improved on all measures at the conclusion of the HPP. Children with DCD showed greater improvement than the control group in motor performance and the control group showed greater improvement on one of the anaerobic fitness outcomes. Conclusions: A school-based HPP that focuses on increasing opportunities for physical activity may be effective in improving motor performance in children with DCD and can increase fitness levels in general.     

Goal-Orientated Group Intervention for Children with Developmental Coordination Disorder

ABSTRACT

This study measures the effectiveness of a goal-orientated group intervention using concentrated practice schedules for children with developmental coordination disorder (DCD). The study design is repeated measures. The sample comprises eight children with DCD, aged 7–11 years. Outcome measures are the Movement Assessment Battery for Children (MABC), the Canadian Occupational Performance Measure (COPM), Harter's Scale of Perceived Competence/Harter and Pike's Pictorial Scale of Perceived Competence, and clinical observations. The children set goals with the perceived efficacy and goal setting system with parents/caregivers input. The intervention used a goal-oriented approach combining motor learning and cognitive strategies consisting of eight 50-min sessions over 2 weeks. The results show significant improvements in the COPM and MABC scores following intervention but no changes in Harter's scores. Fifty-six goals were identified with 34 met totally, 12 met partially, and 10 remained unmet. A goal-oriented group intervention shows potential as an effective intervention method.     

Is Group-Based or Individual-Based Intervention more Effective for Quality of Life Outcomes in Children with Developmental Coordination Disorder? A Systematic Review

Aims: To examine whether group-based or individual-based treatment programs are more effective for quality of life (QOL) outcomes in children with developmental coordination disorder (DCD). Methods: A systematic search of the literature was conducted, in accordance with the PRISMA guidelines. Quality of the papers was assessed using the Modified Downs and Black Checklist. Peer-reviewed clinical experimental studies of children diagnosed with DCD with any QOL related outcome measure were included, of all years, languages, and approaches of intervention. Results: Sixteen studies were identified for inclusion, of mixed methodological qualities (predominantly low). Improvement of QOL with both group-based and individual-based interventions were shown, though large degrees of heterogeneity were observed in study designs, participants, modes of interventions, durations, and outcome measures utilized. Conclusions: The effectiveness of group-based versus individual-based interventions on QOL of children with DCD is unclear. There is a pressing need for a high quality, powered trials, utilizing the randomized control trial paradigm, comparing both intervention approaches with standardized treatment approaches and outcome measures to determine and compare the effect on QOL of children with DCD.