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.     

Self-Concept of Boys with Developmental Coordination Disorder

Children with Developmental Coordination Disorder (DCD) experience difficulties in motor coordination. During the last decade there has been increasing interest in the psychosocial aspects of children with motor coordination difficulties. To date, the majority of studies have focused on the perceived competence and global self-worth of children with DCD. This study examined the self-concept in academic and nonacademic domains of 30 boys (aged 7 to 12 years) with DCD. Results indicated that boys with DCD had significantly poorer self-concept for physical abilities and peer relations when compared to normative mean values. Severity of motor difficulties was significantly related to self-concept for physical abilities and reading. Self-concept plays an integral role in the holistic management of children with DCD.     

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.     

Psychometric Properties of the Revised Developmental Coordination Disorder Questionnaire

The Developmental Coordination Disorder Questionnaire (DCDQ) is a parent-completed measure designed to identify subtle motor problems in children of 8 to 14.6 years of age. The purpose of this study was to extend the lower age range to children aged 5 to 7 years, revise items to ensure clarity, develop new scoring, and evaluate validity of the revised questionnaire. Additional items with improved wording were generated by an expert panel. Analyses of internal consistency, factor loading, and qualitative/quantitative feedback from researchers, clinicians, and parents were used to select 15 items with the strongest psychometric properties. Internal consistency was high (alpha =. 94). The expanded questionnaire was completed by the parents of 287 children, aged 5–15 years, who were typically developing. Logistic regression modeling was used to generate separate cutoff scores for three age groups (overall sensitivity = 85%, specificity = 71%). The revised DCDQ was then compared to other standardized measures in a sample of 232 children referred for therapy services. Differences in scores between children with and without DCD (p <. 001) provide evidence of construct validity. Correlations between DCDQ scores and Movement Assessment Battery for Children (r =. 55) and Test of Visual-Motor Integration (r =. 42) scores support concurrent validity. The results provide evidence that the revised DCDQ is a valid clinical screening tool for DCD.     

Early motor development of blind children

OBJECTIVES: The purpose of this study was to assess the characteristic motor developmental pattern in blind children in Israel. METHODOLOGY: The study compared the developmental data concerning 10 motor skills of 40 blind children to a control group of sighted children and to the motor developmental milestones of the Bayley Developmental Scale and the Revised Denver Developmental Screening Test. RESULTS: The motor development of blind children was delayed, the delay being significant in all 10 motor skills that were examined. This delay emphasizes the major importance of vision as a sensory input modality for the process of sensory- motor development. CONCLUSION: An adequate stimulating environment and proper parental handling could potentially shorten the motor developmental delay but probably not eliminate it entirely.     

Psychometric Properties of the Canadian Little Developmental Coordination Disorder Questionnaire for Preschool Children

ABSTRACT

Aims: Test the psychometric properties and cut-off scores for the Canadian Little Developmental Coordination Disorder Questionnaire (Little DCDQ), which screens for coordination difficulties in children aged 3 to 4 years. Methods: Parents of children with typical development (n = 108) and children at risk for motor problems (n = 245) completed the questionnaire. A subgroup (n = 119) of children was tested with the Movement Assessment Battery for Children-2 (MABC-2) and the Beery–Buktenica Developmental Test of visual-motor integration (VMI) to determine motor impairment (MI). Results: Test-retest reliability (r = 0.956, p < .001) and internal consistency (Cronbach's alpha = 0.94) were high. Construct validity was supported by a factor analysis and significant difference in scores of children who were typically developing and were at risk. Concurrent validity was evaluated for the children who received standardized motor testing, with significant difference between children with and without MI. Discriminant function analysis showed that all 15 items were able to distinguish the two groups. The questionnaire correlated well with the MABC-2 and VMI. Validity as a screening tool was assessed using logistic regression modeling (X²(5) = 25.87, p < .001) and receiver operating curves, establishing optimal cut-off values with adequate sensitivity. Conclusions: The Little DCDQ is a reliable, valid instrument for early identification of children with motor difficulties.     

Use of the motor performance checklist to study motor outcomes in 5-year-olds

Aim:   To report findings about the Motor Performance Checklist (MPC) for 5-year-olds, a simple 12-item instrument for assessing gross and fine motor skills, in a research study of neurodevelopmental outcomes after neonatal events.
Methods:   We trained 10 examiners to use the MPC in a study of the outcomes of neonatal jaundice and dehydration in 339 5-year-old children. We compared MPC scores with those on the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R), the Beery–Buktenica Developmental Test of Visual-Motor Integration-Fourth Edition (VMI-4), and a standard neurological examination, and compared failure rates on each MPC item across examiners. Parent concerns about their child's development were addressed using the Parent Evaluation of Developmental Status (PEDS).
Results:   Children who 'failed' the MPC had 7–10 points lower mean scores on the WPPSI-R subscales ( P  = 0.001), 9–10 points lower mean scores on the VMI-4 subscales ( P  = 0.001), and were almost twice as likely to have a 'questionable' neurological examination score (adjusted OR 1.86, 95% CI 1.00–3.53, P  = 0.005). On the PEDS, only the concern about the use of arms and hands was significantly associated with MPC failure. We found significant sex differences on four of the 12 MPC items. We also found differences in failure rates by different examiners.
Conclusions:   MPC scores correlated with other measures of neurodevelopment. Because of different failure rates across examiners, examiner terms need to be included if it is used in research studies.     

Fine motor function and oral-motor imitation skills in preschool-age children with speech-sound disorders

Preschool-aged children with speech-sound disorders may be at risk for associated deficits in fine motor function. The objectives of this study were 2-fold: (1) to determine whether abnormalities in fine motor function could be detected in 2- to 5-year-old children with speech-sound disorders and (2) to determine whether there was a correlation between abnormal oral-motor imitation skills and abnormal fine motor function. Thirty-two children with speech-sound disorders (6 female, 26 male) were prospectively evaluated from July 2003 to July 2005, and the Peabody Developmental Motor Scales and the Kaufman Speech Praxis Test for Children were administered. The presence of abnormal oral-motor imitation skills as measured by the Kaufman Speech Praxis Test was associated with below-average fine motor performance. This finding has important implications for evaluation and treatment of preschool children with severe speech-sound disorders.     

Growth and motor performance in preterm children at 8 years of age

At 8 years of age 41 preterm and 24 term children were followed up in a long-term prospective study of 46 unselected infants born before 35 completed weeks of gestation and of 26 term infants. The two groups were comparable in physical growth and there was no significant difference between them in motor performance, as evaluated with the Test of Motor Impairment. Only minor motor problems were found (in 22% of the preterm and 17% of the term group). In the preterm group, motor impairment was correlated to birthweight. The preterm children had less developed postural control and manifested more compensatory movements during the balance tasks than the term children.     

Limited motor performance and minor neurological dysfunction at school age

Aim: To investigate the relationship between motor performance and minor neurological dysfunction (MND) at school age. Methods: Two hundred and fifty‐three children (158 boys, 95 girls; mean age 8 years and 7 months) of whom 167 children received mainstream education and 86 children special education were neurologically examined according to Touwen. Special attention was paid to the severity of MND (simple or complex form) and type of dysfunction. Motor performance was assessed with the Movement Assessment Battery for Children (MABC), a parental questionnaire (Developmental Coordination Disorder Questionnaire; DCD‐Q) and a teacher’s questionnaire (Motor Observation Questionnaire for Teachers; MOQ‐T). Results: Total scores of MABC, DCD‐Q and MOQ‐T were strongly related to the severity of MND and to dysfunctional coordination and fine manipulation. Mild dysfunction in posture and muscle tone was only weakly related to limited motor performance. Children with a MABC score < 5th percentile showed significantly more often complex MND than children with scores between the 5th and 15th percentile or >15th percentile (54% vs 17% and 10%). Conclusion: Limited motor performance is related to the severity and type of MND. Coordination problems and fine manipulative disability are strongly related to poor motor performance, mild dysfunctions of posture and muscle tone to a lesser extent.     

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.     

Motor impairment and low achievement in very preterm children at eight years of age

Aim

To examine the concurrence of motor impairment and academic underachievement in a group of very preterm children at 8 years of age.

Methods

All surviving children with a gestational age less than 30 weeks, admitted to the neonatal intensive care unit between 1987 and 1997, were prospectively enrolled in developmental follow-up. Children with a neurosensory disability or a low intelligence score (FSIQ ≤ 75 points) were excluded. At 8 years of age the Bruininks Oseretsky Test of Motor Proficiency and standardised tests of academic achievement were administered to a sample of 323 very preterm children.

Results

One hundred and one (31.3%) of these very preterm children were identified as having Developmental Coordination Disorder (DCD). Of the children with DCD, 54.4% also had underachievement in literacy and/or numeracy. As the severity of motor impairment increased so too did the severity and complexity of underachievement. Significantly fewer children with motor impairments participated in after-school sporting activities. Children with DCD required more mechanical ventilation support during their hospital admission.

Conclusions

This study demonstrated that a significant proportion of children born very preterm find both motor and academic skills difficult in early school years.     

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.     

A Group Motor Skills Program for Children with Coordination Difficulties: Effect on Fundamental Movement Skills and Physical Activity Participation

Aims: Children with coordination difficulties are at risk of low levels of physical activity (PA) participation. This intervention examined the effects of a multidisciplinary program that emphasized parent participation on motor skill performance and PA. Methods: Ten boys (5–7 years) completed a group program consisting of conditioning exercises and activities designed to address child-selected goals. Motor proficiency and PA participation were assessed before and after the program using the Test of Gross Motor Development (TGMD-2) and triaxial accelerometers, respectively. Rating scales captured child and parent perceptions of performance for each child's goals. Results: TGMD-2 subtest raw scores, age equivalent and percentile scores improved, along with parent ratings of their child's performance. Six children reported skill improvements. On average, moderate to vigorous PA improved by 10 min per day although these gains were not significant. Time spent in sedentary activities was unchanged. None of the children met the Canadian PA and sedentary behaviour guidelines. Conclusions: The results support effectiveness of a group program to improve gross motor performance and levels of PA in children with coordination difficulties. Gains in both of these domains also have the potential to impact quality of life and reduce health risks associated with inactivity.     

Predictive value of early motor evaluation in preterm very low birth weight and term small for gestational age children

Background

Motor problems are common in children born preterm or small for gestational age.

Aim

To study the predictive value of early motor assessments for later motor skills.

Subjects

Twenty-eight children born preterm with very low birth weight (VLBW: birth weight ≤ 1500 g), 57 children born small for gestational age (SGA: birth weight < 10th centile) at term and 77 term-born controls with normal birth weight.

Methods

The psychomotor development index (PDI) of the Bayley Scales of Infant Development was used as a measure of motor skills at age one, the Peabody Developmental Motor Scales (PDMS) at age five and the Movement Assessment Battery for Children (Movement ABC) at age 14. Low/borderline low scores were defined as < − 2SD/− 1SD (PDI) or < 5th/15th centile (PDMS; Movement ABC).

Results

In the VLBW group, motor problems in adolescence were identified both by low PDI (sensitivity: 0.80; 95%CI:0.38-0.96) and PDMS scores (sensitivity: 0.83; 95%CI:0.44-0.97). In the SGA and the control group sensitivity was poor for low PDI and moderate for low PDMS scores. However, in the SGA group, sensitivity increased when borderline low PDMS scores were used as cut-off (sensitivity: 0.75; 95%CI:0.41-0.93). Specificity of PDI and PDMS was high in all three groups.

Conclusions

Both PDI and PDMS may be valuable tools for early identification of motor problems in VLBW children, whereas PDMS best predicted motor problems in the two other groups. In all three groups, a normal motor examination at 1 and 5 years was highly predictive of normal motor skills at age 14.     

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.     

Longitudinal motor development of "apparently normal" high-risk infants at 18 months, 3 and 5 years

Background: Motor development appears to be more affected by premature birth than other developmental domains, however few studies have specifically investigated the development of gross and fine motor skills in this population. Aim: To examine longitudinal motor development in a group of “apparently normal” high-risk infants. Setting: Developmental follow-up clinic in a perinatal centre. Study design: Longitudinal observational cohort study. Subjects: Fifty-eight infants born less than 29 weeks gestation and/or 1000 g and without disabilities detected at 12 months. Outcome measures: Longitudinal gross and fine motor skills at 18 months, 3 and 5 years using the Peabody Developmental Motor Scales. The HOME scale provided information of the home environment as a stimulus for development. Results: A large proportion (54% at 18 months, 47% at 3 years and 64% at 5 years) of children continued to have fine motor deficits from 18 months to 5 years. The proportion of infants with gross motor deficits significantly increased over this period (14%, 33% and 81%, p<0.001), particularly for the ‘micropreemies’ (born <750 g). In multivariate analyses, gross motor development was positively influenced by the quality of the home environment. Conclusions: A large proportion of high-risk infants continued to have fine motor deficits, reflecting an underlying problem with fine motor skills. The proportion of infants with gross motor deficits significantly increased, as test demands became more challenging. In addition, the development of gross and fine motor skills appears to be influenced differently by the home environment.     

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.     

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.