Development of a movement questionnaire adapted for Japanese culture for elementary school children

AimsCurrent tools to evaluate Developmental Coordination Disorder (DCD) symptoms are not adapted to Japanese cultural and educational contexts. We aimed to develop a new tool, the Developmental Coordination Disorder Checklist (DCDC), that can be applied specifically to elementary school–aged children in Japan, by generating a list of culturally relevant items.MethodsWe designed an 18-item questionnaire that was distributed to parents and teachers of elementary school–aged children. The degree of negative influence on a child’s life from their motor ability was estimated using a visual analogue scale (VAS).ResultsWe analyzed the responses from parents/guardians (n = 1174) and teachers (n = 688) of elementary school children (age range: 75–147 months, 1st–6th grades). An exploratory analysis showed that the DCD items could be divided into three factors: fine motor, gross motor, and catch and throw. Internal consistency reliabilities of each factor and of total DCDC were sufficiently high (all coefficients of Cronbach’s alpha: > 0.75). Inter-rater reliability between parent/guardian and teacher was moderate in each sub-score and total DCDC score. Parents/guardians evaluated the degree of difficulty in the fine motor factor more severely than teachers. Total DCDC score was correlated significantly with VAS value (r = 0.545), with each factor in DCDC proving useful in predicting negative impact on daily life.ConclusionsDCDC is an efficient and culturally relevant assessment tool for DCD symptoms within Japan, particularly for measuring any practical deficits in daily life activities.     

Examining the relationships between attention deficit/hyperactivity disorder and developmental coordination disorder symptoms,and writing performance in Japanese second grade students

The purpose of this study was to explore the relationships between attention deficit/hyperactivity disorder and developmental coordination disorder symptoms and writing performance in Japanese second grade students from regular classrooms. The second grade students (N = 873) in Japanese public elementary schools participated in this study. We examined a variety of writing tasks, such as tracing, copying, handwriting (Hiragana and Katakana), and spelling (Hiragana, Katakana, and Kanji). We employed the Japanese version of the home form ADHD-rating scale (ADHD-RS) and the Japanese version of the Developmental Coordination Disorder Questionnaire (DCDQ-J) to assess the developmental characteristics of the participating children. Seven writing performance scores were submitted to a principal component analysis with a promax rotation, which yielded three composite scores (Spelling Accuracy, Tracing and Copying Accuracy, and Handwriting Fluency). A multiple regression analysis found that inattention predicted Spelling Accuracy and Handwriting Fluency and that hyperactive-impulsive predicted Handwriting Fluency. In addition, fine motor ability predicted Tracing and Copying Accuracy. The current study offered empirical evidence suggesting that developmental characteristics such as inattention and fine motor skill are related to writing difficulties in Japanese typical developing children.     

Age-related validity and reliability of the Dutch Little Developmental Coordination Disorder Questionnaire (LDCDQ-NL)

BackgroundEarly recognition of children at risk of Developmental Coordination Disorder (DCD) is important, but variability in motor development in preschool children affects the validity of instruments to reliably detect children at risk of DCD.AimsTo investigate the age-related validity and reliability of the Dutch version of the Little Developmental Coordination Disorder Questionnaire (LDCDQ-NL).Methods and proceduresTwo hundred and sixty 3- to 5-year old children were recruited in the Netherlands. Parents filled out the LDCDQ-NL and children were assessed with the Movement Assessment Battery for Children-2 Test (MABC-2 Test). Internal consistency of the LDCDQ-NL was determined by Cronbach’s alpha. Construct validity was investigated using factor analysis. Concurrent validity was measured by calculating correlations between the LDCDQ-NL and MABC-2. Receiver Operating Characteristics (ROC) were calculated to assess discriminant validity.Outcomes and resultsInternal consistency of the LDCDQ-NL was 0.91. Factor analysis resulted in three factors (Fine motor skills, Locomotor skills, Ball skills). Correlation between the LDCDQ-NL and MABC-2 Test increased with increasing age. With a sensitivity of 80%, specificity increased with age.Conclusions and implicationsThe LDCDQ-NL is a reliable and valid screening instrument for 4- and 5-year old Dutch children; concurrent and discriminant validity are low for 3-year olds.     

Motor impairments screened by the Movement Assessment Battery for Children-2 are related to the visual-perceptual deficits in children with Developmental Coordination Disorder

This study was to examine to what extent the motor deficits of children with Developmental Coordination Disorder (DCD) verified by the Movement Assessment Battery for Children-2 (MABC-2) are linked to their visual-perceptual abilities. Seventeen children with DCD and seventeen typically developing children (TD) aged 5–10 years screened from a total of 250 children were recruited. The assessments included MABC-2, traditional test of visual perceptual skills (TVPS-R), and computerized test for sequential coupling of eye and hand as well as motion coherence. The results indicated that children with DCD scored lower than TD in MABC-2, and their total scores were highly correlated with manual dexterity component scores. DCD group also showed poor visual-perceptual abilities in various aspects. The visual discrimination and visual sequential memory from the TVPS-R, the sequential coupling of eye and hand, and the motion coherence demonstrated a moderate or strong correlation with the MABC-2 in the DCD rather than the TD group. It was concluded that the motor problems screened by MABC-2 were significantly related to the visual-perceptual deficits of children with DCD. MABC-2 is suggested to be a prescreening tool to identify the visual-perceptual related motor deficits.     

Comorbidity of motor and language impairments in preschool children of Taiwan

Comorbidity of motor and speech/language impairments was investigated in 363 preschool children between the ages of 5 and 6 years (boys: 205, age 6.04 ± 0.48 years; girls: 158, age 5.98 ± 0.53 years). The children were sampled from two municipals of Taiwan, and were determined to present no apparent neurological, musculoskeletal, cardiopulmonary system impairment or mental insufficiency. They were administered with three speech/language tests and a motor test (Movement Assessment Battery for Children, or M-ABC). The results showed a significant correlation between the total score of the motor test and the total score of each of the speech and language tests. Regression analysis that controlled for IQ (C-TONI) further showed that manual dexterity, but not ball skills or balance, of M-ABC was predictive of all scores on the speech and language tests. To determine a deficit on a test, a score at or below the 10th percentile of the norm or a score at or below 1.25 SD from the group mean was established as the cutoff. For the speech/language impairment, a deficit on at least two out of the three tests also applied. Following these criteria, 22 children (6.1%) were identified to have Developmental Speech and Language Disorder (DSLD), and 45 (12.4%) to have Developmental Coordination Disorder (DCD). Comorbid DSLD and DCD were found in six children (1.65%). Chi-square analysis revealed a significant correlation between DSLD and DCD (p < .03). The odds of DSLD was higher (by about three-fold) among the children with DCD than among the children without (0.15 vs. 0.05). Comorbid motor and speech/language impairments in preschool children appear to be a significant clinical condition that requires the attention of the therapeutic community. Manual dexterity, in particular, seems to be an important clue for understanding the shared mechanism of motor and speech/language impairments.     

Movement Assessment Battery for Children-2: Translation,reliability, and validity for Brazilian children

The Movement Assessment Battery for Children 2nd edition (MABC-2) is a well-recognized assessment used to identify children with Developmental Coordination Disorder (DCD). Although researchers and practitioners across Brazil have used the MABC-2 to identify children with motor deficits, its validation for this particular population has yet to be investigated. In this study, we translated all MABC-2 items and validated them with respect to content, construct and criteria validity. The validation process involved 13 experts in Motor Development and a total of 844 children (3–13 years old) from two different states in Brazil. A cross-cultural translation method yielded a Brazilian–Portuguese version of the battery. The expert panel confirmed language clarity and pertinence of the items. High intra- and inter-rater reliability and internal consistency for the MABC-2 was established for Brazilian children. A discriminant analysis confirmed the MABC-2 power (.80) to differentiate children with DCD and those at risk for DCD from typically developing children. Predictive validity was observed for the impairment scores and a percentile main effect was found in the repeated measures ANOVA (ICC: .93 and .73, respectively). Although our data are not representative of the entire country, this study is the first to confirm that the original standardized scores established for the MABC-2 are valid in Brazilian children.     

Children with developmental coordination disorder demonstrate a spatial mismatch when estimating coincident-timing ability with tools

Coincident timing or interception ability can be defined as the capacity to precisely time sensory input and motor output. This study compared accuracy of typically developing (TD) children and those with Developmental Coordination Disorder (DCD) on a task involving estimation of coincident timing with their arm and various tool lengths. Forty-eight (48) participants performed two experiments where they imagined intercepting a target moving toward (Experiment 1) and target moving away (Experiment 2) from them in 5 conditions with their arm and tool lengths: arm, 10, 20, 30, and 40 cm. In Experiment 1, the DCD group overestimated interception points approximately twice as much as the TD group, and both groups overestimated consistently regardless of the tool used. Results for Experiment 2 revealed that those with DCD underestimated about three times as much as the TD group, with the exception of when no tool was used. Overall, these results indicate that children with DCD are less accurate with estimation of coincident-timing; which might in part explain their difficulties with common motor activities such as catching a ball or striking a baseball pitch.     

Prevalence of suspected developmental coordination disorder and associated factors in Spanish classrooms

BackgroundDevelopmental Coordination Disorder (DCD) is a multifactorial, neurodevelopmental motor disorder that severely affects the activities of a child’s daily life and classroom performance. The aim of this study was to determine the prevalence of suspected DCD in a sample of Spanish schoolchildren and its association with socio-demographic factors.MethodsWe conducted a cross-sectional study including a random sample of 460 children attending mainstream schools in northwest Spain in 2017. A Developmental Coordination Disorder Questionnaire-European Spanish was used to evaluate suspected DCD prevalence. We performed multivariate logistic and linear regression analysis to determine the socio-demographic variables associated with suspected DCD and problematic motor coordination performance.ResultsThe prevalence of suspected DCD was 12.2%. According to the multivariate analysis, DCD symptoms were significantly associated with males (OR = 3.0), ages above 10 years old (OR = 5.0) and low participation in out-of-school physical activities (OR = 2.3). Preterm birth children were twice as likely to show suspected DCD, although this association was not statistically significant (OR = 2.1).ConclusionsA high percentage of Spanish schoolchildren are at risk for developing DCD. There is a strong connection between suspected DCD and socio-demographic factors. Protocols aimed to detect DCD and intervention programmes in classrooms designed to promote motor coordination skills need to take these factors into consideration.     

Health-related quality of life of children with Developmental Coordination Disorder

BackgroundAlthough Developmental Coordination Disorder (DCD) is primarily a motor disorder, it can also impact emotional and psychosocial functioning of children with this condition. Evidence suggests that children with DCD experience lower quality of life than their peers, but few studies have explicitly examined the health-related quality of life (HRQOL) of these children.AimsTo: (1) describe HRQOL of children with DCD compared to typically-developing children; (2) compare HRQOL from the perspectives of children with DCD and their parents; and (3) explore predictors of HRQOL for children with DCD.MethodsData from the KidScreen-52 and Strength and Difficulties Questionnaire were collected from 50 children with DCD [Mean(SD) age: 9.8 (1.2) years] and their parents and compared to normative data.ResultsChildren with DCD and their parents report significantly lower HRQOL compared to published norms. Caregivers have a significantly lower perception of their child’s HRQOL than their child’s self-report in many domains. Parents of children with DCD report that their children experience significantly more emotional and behavioral disturbances compared to norms. Poor motor function and attentional difficulties predict HRQOL.Conclusion and implicationsDCD appears to contribute to lower perceived HRQOL. Findings inform therapeutic targets for children with DCD, beyond motor skill intervention.     

A review of five tests to identify motor coordination difficulties in young adults

Difficulties with low motor competence in childhood and adolescence, such as that seen in Developmental Coordination Disorder (DCD), often persist into adulthood. Identification of DCD at all ages is particularly challenging and problematic because of the diversity of motor symptoms. Many tests of motor proficiency and impairment have been developed for children up to 12 years of age. Whilst identification of DCD is important during childhood, it is of equal importance to identify and monitor the impact of this impairment as an individual grows and develops. Currently there is no test specifically designed to support diagnosis and monitor change in the age range 16–30 years. In this article we review five tests that have been used to assess motor competence among young adults (Bruininks–Oseretsky Test of Motor Proficiency-2, McCarron Assessment of Neuromuscular Development, Movement Assessment Battery for Children-2, Tufts Assessment of Motor Performance and the Zurich Neuromotor Assessment). Key issues relevant to testing motor skills in older populations, such as the inclusion of age appropriate skills, are explored. While the BOT-2 provided the most evidence for valid and reliable measurement of Criterion A of the diagnostic criteria for DCD among this age group, no test adequately evaluated Criterion B. Further evaluation of motor skill assessment among the young adult population is needed.     

Psychometric properties of the DCD-Q-07 in children ages to 4–6

It is important to identify Developmental Coordination Disorder (DCD) early in a child's life to allow for proper and timely intervention and support, and to reduce the negative secondary consequences associated with this condition. In this study we assessed the psychometric properties (construct validity, concurrent validity, reliability and test accuracy) of the Developmental Coordination Disorder Questionnaire (DCD-Q-07) in preschool children. A community-based sample of children ages 4–6 (n = 181) were screened for motor difficulties using the Movement Assessment Battery for Children (M-ABC-2). Use of the M-ABC-2 resulted in the identification of 29 children below the 15th percentile, which we classified as probable DCD. Parents of these children concurrently completed the DCD-Q-07 to report their child's motor performance. The DCD-Q-07 demonstrated high internal consistency for both the full scale (alpha = 0.881) and each subscale: control during movement (alpha = 0.813), fine motor and handwriting (alpha = 0.869) and general coordination (alpha = 0.728). Moderate correlations (r = 0.47–0.63) were also seen between the subscales on the DCD-Q-07, the strongest correlation being between control during movement and general coordination (r = 0.63). Based on published age and sex cut points, the DCD-Q-07 showed poor sensitivity (20.7%) but high specificity (92.1%) against the M-ABC-2. Overall agreement with the M-ABC-2 was low using ROC analysis (area under the curve = 0.654). Although it is important to screen for DCD in young children, the DCD-Q-07 may not be the best choice as a screening tool for DCD in preschool children ages 4–6 due to its low test accuracy.     

Mild impairments of motor imagery skills in children with DCD

It has been hypothesized that the underlying mechanism of clumsy motor behaviour in children with Developmental Coordination Disorder (DCD) is caused by a deficit in the internal modelling for motor control. An internal modelling deficit can be shown on a behavioural level by a task that requires motor imagery. Motor imagery skills are suggested to be related to anticipatory action planning, but motor imagery and action planning have not been tested within the same child. In the present study, action planning and motor imagery skills were assessed in 82 children between 7 and 12 years of age. Twenty-one of these children met the criteria for DCD, which was assessed by the McCarron Assessment of Neuromuscular Development and 56 of these children were used in the control group. Motor imagery was tested by a mental rotation task of hands that were shown from a back and palm point of view. The results show that motor imagery is affected in children with DCD but only in conditions with complex task constraints (i.e., rotation of hand stimuli presented in palm view). These results provide partial support for the internal modelling deficit hypothesis. We were not able to elicit motor planning deficits in this group, however, and argue that more complex planning tasks may be needed to identify such deficits.     

Motor skill learning in children with Developmental Coordination Disorder

Children with Developmental Coordination Disorder (DCD) are characterized as having motor difficulties and learning impairment that may last well into adolescence and adulthood. Although behavioral deficits have been identified in many domains such as visuo-spatial processing, kinesthetic perception, and cross-modal sensory integration, recent studies suggested that the functional impairment of certain brain areas, such as cerebellum and basal ganglia, are the underlying causes of DCD. This review focuses on the “motor learning deficits” in DCD and their possible neural correlates. It presents recent evidence from both behavioral and neuroimaging studies and discusses dominant neural hypotheses in DCD. Given the heterogeneity of this disorder, a successful intervention program should target the specific deficits on an individual basis. Future neuroimaging studies are critical steps in enhancing our understanding of learning deficits in DCD.     

Can the movement assessment battery for children-test be the "gold standard" for the motor assessment of children with Developmental Coordination Disorder?

Developmental Coordination Disorder (DCD) is an important risk factor in the development of children that can have a significant academic and social impact. This reinforces the need for its timely identification using appropriate assessment methods and accurate screening tests. The commonly used standardized motor test for the DCD identification is the Movement Assessment Battery for Children-Test (M-ABC Test) (Henderson & Sugden, 1992). The aim of the present study was to examine if the M-ABC Test can be considered to be the “gold standard” for the motor assessment of children with the aforementioned disorder. For that purpose, a critical review of the extant literature regarding M-ABC Test's psychometric properties was conducted. Neither the test manual nor the studies reviewed provide support for the reliability and validity of the M-ABC Test results in children with DCD. Until sufficient evidence for its technical adequacy is accumulated, the M-ABC Test should not be used in isolation for children with DCD.     

The risk of reduced physical activity in children with probable Developmental Coordination Disorder: a prospective longitudinal study

The aim of the current study was to test the hypothesis that children with probable Developmental Coordination Disorder have an increased risk of reduced moderate to vigorous physical activity (MVPA), using data from a large population based study. Prospectively collected data from 4331 children (boys = 2065, girls = 2266) who had completed motor coordination testing at 7 years and accelerometry at 12 years were analysed from the Avon Longitudinal Study of Parents and Children (ALSPAC). Probable DCD (p-DCD) was defined, using criteria based on the DSM IV classification, as those children below the 15th centile of the ALSPAC Coordination Test at seven years who had a functional impairment in activities of daily living or handwriting, excluding children with a known neurological diagnosis or IQ < 70. Secondary exposure variables consisted of subtests from the ALSPAC Coordination test (manual dexterity, ball skills and balance). Objective measurement of the average daily minutes of MVPA was recorded as ≥3600 counts per minute (cpm) using actigraph accelerometry. Boys with p-DCD were less physically active than boys without DCD (mean difference in MVPA 4.36 cpm, t = 2.69; p = 0.007). For boys, targeting skill (bean bag toss) was related to increased MVPA, after adjustment for confounding factors including neonatal, family and environmental factors as well as Body Mass Index at age seven and 12 years (β = 0.76, t = 3.37, p < 0.001, CI 0.32-1.20). There was no difference in level of MVPA in girls with and without p-DCD (mean difference 1.35 min, t = 0.97, p = 0.31), which may reflect the low levels of MVPA of girls in this cohort. Our findings suggest that the presence of movement difficulties, particularly poor targeting (bean bag toss/ball skills), at a young age is a potential risk factor for reduced MVPA in boys.     

Physical fitness in children with Developmental Coordination Disorder: Measurement matters

Children with Developmental Coordination Disorder (DCD) experience considerable difficulties coordinating and controlling their body movements during functional motor tasks. Thus, it is not surprising that children with DCD do not perform well on tests of physical fitness. The aim of this study was to determine whether deficits in motor coordination influence the ability of children with DCD to perform adequately on physical fitness tests. A case–control study design was used to compare the performance of children with DCD (n = 70, 36 boys, mean age = 8y 1mo) and Typically Developing (TD) children (n = 70, 35 boys, mean age = 7y 9mo) on measures of isometric strength (hand-held dynamometry), functional strength, i.e. explosive power and muscular endurance (Functional Strength Measurement), aerobic capacity (20 m Shuttle Run Test) and anaerobic muscle capacity, i.e. muscle power (Muscle Power Sprint Test). Results show that children with DCD were able to generate similar isometric forces compared to TD children in isometric break tests, but were significantly weaker in three-point grip strength. Performance on functional strength items requiring more isolated explosive movement of the upper extremities, showed no significant difference between groups while items requiring muscle endurance (repetitions in 30 s) and items requiring whole body explosive movement were all significantly different. Aerobic capacity was lower for children with DCD whereas anaerobic performance during the sprint test was not. Our findings suggest that poor physical fitness performance in children with DCD may be partly due to poor timing and coordination of repetitive movements.     

Identification of emotional and behavioral problems by teachers in children with developmental coordination disorder in the school community

Current evidence on the co-occurrence of Developmental Coordination Disorder (DCD) and psychosocial problems mainly concerns parent-reported information, but rarely includes teacher information. The aim of this study was (1) to investigate the teachers’ identification of emotional and behavioral problems in children with DCD and (2) to examine the performance of the teacher version of the Strengths and Difficulties Questionnaire (SDQ-T) compared with the Teacher Report Form (TRF) in children with DCD. We assessed primary school children (202 boys, 200 girls, range 4–10.8 years, mean age 7.2 years) for DCD following the DSM IV-TR criteria. Emotional and behavioral problems were measured with the TRF (n = 327) and the SDQ-T (n = 361). DCD was established in 23 (5.7%) children, 16 boys and 7 girls (mean age 7.0 years). Children with DCD had a higher proportion of clinical scores on both the TRF Total Problem Scale (TRF TPS) and SDQ-T Total Difficulties Score (SDQ-T TDS). Children with DCD had increased odds on the TRF domains Thought (odds ratio, OR: 5.39), Externalizing (OR: 4.12) and Internalizing (OR: 4.42) problems, and on all SDQ-T-domains and Total Difficulties score (OR: 7.30). In the DCD group the SDQ-T TDS correlated strongly (Spearman's rho 0.80) with the TRF TPS and demonstrated a moderate agreement (Cohen's Kappa 0.53). In conclusion, teachers identified significantly more emotional and behavioral problems in children with DCD compared with their peers. The SDQ-T showed moderate agreement with the TRF in identifying emotional and behavioral problems in children with DCD.     

Impaired visuo-motor sequence learning in Developmental Coordination Disorder

The defining feature of Developmental Coordination Disorder (DCD) is the marked impairment in the development of motor coordination (DSM-IV-TR, American Psychiatric Association, 2000). In the current study, we focused on one core aspect of motor coordination: learning to correctly sequence movements. We investigated the procedural, visuo-motor sequence learning abilities of 18 children with DCD and 20 matched typically developing (TD) children, by means of the serial reaction time (SRT) task. Reaction time measurements yielded two important findings. Overall, DCD children demonstrated general learning of visuo-motor task demands comparable to that of TD children but failed to learn the visuo-motor sequence. Interestingly, a sequence recall test, administered after the SRT task, indicated some awareness of the repeating sequence pattern. This suggests that the sequence learning problems of DCD children might be located at the stage of motor planning rather than sequence acquisition.     

Gesture production in school vs. clinical samples of children with Developmental Coordination Disorder (DCD) and typically developing children

Dyspraxia, a difficulty in executing an operationalised act, has been associated with Developmental Coordination Disorder (DCD). However, issues relating to the area such as comparisons across modalities, comparisons of school vs. clinical populations, and developmental delay vs. pathology have not been addressed in the same, comprehensive study. In the current study, therefore, familiar gesture production in DCD was addressed in a comprehensive manner to follow-up outstanding issues from previous studies: The production of familiar gestures and praxis imagery in a school (n = 26) vs. clinic sample (n = 19) of children with DCD was examined in relation to typically developing age matched (n = 24) all aged from 9 to 11 years, and two groups of younger children within the age ranges of 5-6 (n = 23) and 4-5 (n = 26) years. Overall, children with Developmental Coordination Disorder showed an impaired ability to produce familiar gestures compared to their typical peers, and this was dependant on the type of gesture and presentation modality. Differences were found between school and clinic samples of children with DCD, suggestive of the recruitment of different underlying mechanisms in the two samples. The results have a bearing on our understanding of the relationship of developmental dyspraxia to DCD, as well as of the issue of developmental delay vs. pathology.