Is severity of motor coordination difficulties related to co-morbidity in children at risk for developmental coordination disorder?

Dysgraphia Differs Between Children With Developmental Coordination Disorder and/or Reading Disorder

Handwriting deficits, or dysgraphia, are present in several neurodevelopmental disorders. To investigate whether dysgraphia differs according to the associated disorder, we performed a detailed analysis of handwriting in a group of French children with developmental coordination disorders (DCD), reading disorder (RD), or comorbid RD and DCD. Handwriting deficits were investigated at the product (quality of the trace) and the process (movement that generates the trace) levels. Nineteen children with singular RD (among which eight with dysgraphia), 13 children with singular DCD (among which seven with dysgraphia), 16 children with comorbid RD+DCD (among which 11 with dysgraphia), and 20 typically developing children, age 7 to 12, performed the BHK (Brave Handwriting Kinder) test, a standardized assessment of handwriting, on a graphic tablet. Developmental coordination disorders primarily affected handwriting quality, while RD affected slowness and, to a lesser extent, quality. Children with RD, solely or comorbid with DCD, wasted time by lifting and stopping the pen when writing. The comorbidity added to but did not worsen, handwriting difficulties. These results reflect distinct motor impairments and/or strategies in children with DCD or RD. We identified subtypes of dysgraphia and advocated for a fine-grained analysis of the writing process and the assessment of motor and reading skills when studying dysgraphia.

"Picture this from there": spatial perspective-taking in developmental visuospatial disorder and developmental coordination disorder

Introduction

Either Developmental Visuospatial Disorder (DVSD) and Developmental Coordination Disorder (DCD) present with difficulties in visuospatial processing, even though entailing different degrees of impairment. Among the visuospatial domain, spatial perspective taking is essential to interact with the environment and is significantly involved in many daily activities (e.g., environment navigation and spatial orienting). Notwithstanding, no previous studies have investigated this spatial domain in children with DVSD and limited evidence is available regarding DCD. Consistent with a transdiagnostic approach, the first goal of the present study was to compare spatial perspective taking abilities of these groups, also including a control group of not diagnosed peers (ND). Secondly, the role of different fine-motor and visuo-spatial predictors on the spatial perspective taking performance was considered.

Method

A total of 85 participants (DVSD = 26; DCD = 26; ND = 33), aged between 8 and 16 years old, were included in the study. Tasks assessing spatial perspective taking, fine-motor, visual imagery, and mental rotation skills, as well as visuo-spatial working memory were administered.

Results and Discussion

Overall, our results confirmed weaknesses in spatial perspective taking in both clinical groups, with the DVSD obtaining the lowest scores. Similarities and differences in the predictors accounting for the performance in the spatial perspective taking task emerged, suggesting the possible employment of different fine-motor or visuospatial strategies by group. Findings are discussed considering the potential impact they may have both in research and clinical practice.

Motor Adaptation Deficits in Children with Developmental Coordination Disorder and/or Reading Disorder

Procedural learning has been mainly tested through motor sequence learning tasks in children with neurodevelopmental disorders, especially with isolated Developmental Coordination Disorder (DCD) and Reading Disorder (RD). Studies on motor adaptation are scarcer and more controversial. This study aimed to compare the performance of children with isolated and associated DCD and RD in a graphomotor adaptation task. In total, 23 children with RD, 16 children with DCD, 19 children with DCD-RD, and 21 typically developing (TD) children wrote trigrams both in the conventional (from left to right) and opposite (from right to left) writing directions. The results show that movement speed and accuracy were more impacted by the adaptation condition (opposite writing direction) in children with neurodevelopmental disorders than TD children. Our results also reveal that children with RD have less difficulty adapting their movement than children with DCD. Children with DCD-RD had the most difficulty, and analysis of their performance suggests a cumulative effect of the two neurodevelopmental disorders in motor adaptation.

Effectiveness of CO-OP group intervention for children with developmental coordination disorder: single-case experimental design study protocol

INTRODUCTION

With the Cognitive Orientation to daily Occupational Performance (CO-OP) approach, children with developmental coordination disorder learn to use a problem-solving strategy to deal with their motor difficulties and perform daily activities of their choice. Therapists use guided discovery to enable children to find their own solutions. Although CO-OP is recommended in a group setting, studies are needed to support its effectiveness.

METHODS AND ANALYSIS

A single-case study design with multiple baselines across participants and four systematic replications will be used. In each of the five groups, four children (aged 8-12 years) will be randomly included at the baseline. The baseline includes 5-8 measurements, and the CO-OP intervention stage is comprised of 10 sessions. The follow-up stage includes five measurements. Prior to baseline, each child in each of the five groups will choose five activities of which three will be carried out during the intervention sessions. Children's performance in each of these activities will be scored using the Performance Quality Rating Scale (PQRS) as the main measure. Three secondary measures will be collected: perceived activity performance using the Canadian Occupational Performance Measure, quality of life using the Kidscreen-27 and spontaneous motor rhythm using a computerised typing task. Graphed data will be analysed visually at the individual level with the Visual Aid Implying an Objective Rule (VAIOR) protocol which provides a colour code based on the level and trend of two consecutive phases, facilitating an objective visual analysis. Statistics will be performed for PQRS scores at the individual level and at the group level.

ETHICS AND DISSEMINATION

The protocol has been approved by the Comité de protection des personnes Sud-Est I (CPP 2021070) and the Comité d'éthique de la recherche avec les êtres humains de l'Université du Québec à Trois-Rivières (CER-22-294-07.03). Results will be published in a peer-reviewed scientific journal.

TRIAL REGISTRATION NUMBER

NCT05231486.

Visuomotor adaptation, internal modelling, and compensatory movements in children with developmental coordination disorder

BACKGROUND

Developmental coordination disorder (DCD) is one of the most prevalent developmental disorders in school-aged children. The mechanisms and etiology underlying DCD remain somewhat unclear. Altered visuomotor adaptation and internal model deficits are discussed in the literature.

AIMS

The study aimed to investigate visuomotor adaptation and internal modelling to determine whether and to what extent visuomotor learning might be impaired in children with DCD compared to typically developing children (TD). Further, possible compensatory movements during visuomotor learning were explored.

METHODS AND PROCEDURES

Participants were 12 children with DCD (age 12.4 ± 1.8, four female) and 18 age-matched TD (12.3 ± 1.8, five female). Visuomotor learning was measured with the Motor task manager. Compensatory movements were parameterized by spatial and temporal variables.

OUTCOMES AND RESULTS

Despite no differences in visuomotor adaptation or internal modelling, significant main effects for group were found in parameters representing movement accuracy, motor speed, and movement variability between DCD and TD.

CONCLUSIONS AND IMPLICATIONS

Children with DCD showed comparable performances in visuomotor adaptation and internal modelling to TD. However, movement variability was increased, whereas movement accuracy and motor speed were reduced, suggesting decreased motor acuity in children with DCD.

Are childhood factors predictive of adult health literacy? A longitudinal birth cohort analysis

Health literacy (HL), defined as the ability of an individual to understand and appraise health information to make informed decisions on their health, helps maintain and improve one's health and thus reduce the use of healthcare services. There is a recognised global effort to address insufficient HL in early life and understand how HL develops. This study examined the association of a range of factors including educational, speech and language ability, health and healthcare engagement, sleep problems, mental health, demographic, environmental, and maternal factors at different childhood stages (from 5 years to 11 years) with later adult HL at age 25. HL was measured using a HL ordinal score (insufficient, limited, or sufficient) derived from the European Literacy Survey Questionnaire-short version (HLS-EU-Q16) within a large UK based birth cohort (Avon Longitudinal Study of Parents and Children: ALSPAC study). Univariate proportional odds logistic regression models for the probability of having higher levels of HL were developed. Results of analysis of 4248 participants showed that poorer speech and language ability (aged 9 years, OR 0.18 95% CI 0.04 to 0.78), internalising in child (age 11 years, OR 0.62 95% CI 0.5 to 0.78), child depression (age 9 years, OR 0.67 95% CI 0.52 to 0.86), and the presence of maternal depression (child age 5, OR 0.80 95% CI 0.66 to 0.96), reduced the odds of sufficient HL when adult. Our results suggest some useful markers to identify children at potential risk of low HL that could be targeted for research into future interventions within school settings, for example, child's speech and language capability. In addition, this study identified child and maternal mental health as factors associated with later development of limited HL and future research should consider what potential mechanisms might explain this link.

Prediction of movement difficulties at 5 years from parent report at 2 years in children born extremely preterm

AIM

To assess the predictive validity of parent-reported gross motor impairment (GMI) at age 2 years to detect significant movement difficulties at age 5 years in children born extremely preterm.

METHOD

Data were from 556 children (270 males, 286 females) born at less than 28 weeks' gestation in 2011 to 2012 in 10 European countries. Parent report of moderate/severe GMI was defined as walking unsteadily or unable to walk unassisted at 2 years corrected age. Examiners assessed significant movement difficulties (score ≤ 5th centile on the Movement Assessment Battery for Children, Second Edition) and diagnoses of cerebral palsy (CP) were collected by parent report at 5 years chronological age.

RESULTS

At 2 years, 66 (11.9%) children had moderate/severe GMI. At 5 years, 212 (38.1%) had significant movement difficulties. Parent reports of GMI at age 2 years accurately classified CP at age 5 years in 91.0% to 93.2% of children. Classification of moderate/severe GMI at age 2 years had high specificity (96.2%; 95% confidence interval 93.6-98.0) and positive predictive value (80.3%; 68.7-89.1) for significant movement difficulties at age 5 years. However, 74.5% of children with significant movement difficulties at 5 years were not identified with moderate/severe GMI at age 2 years, resulting in low sensitivity (25.1%; 19.4-31.5).

INTERPRETATION

This questionnaire may be used to identify children born extremely preterm who at age 2 years have a diagnosis of CP or movement difficulties that are likely to have a significant impact on their functional outcomes at age 5 years.

Motor-related health care for 5-year-old children born extremely preterm with movement impairments

AIM

To (1) determine the proportion of 5-year-old children born extremely preterm (EPT) with movement difficulties including cerebral palsy (CP) and the proportion of these children receiving motor-related health care (MRHC), and (2) describe factors associated with receiving MRHC.

METHOD

Children born before 28 weeks' gestation in 2011 to 2012 in 11 European countries were assessed with the Movement Assessment Battery for Children, Second Edition (MABC-2) at 5 years of age. Information on family characteristics, child health including CP diagnosis, and health care use were collected using parent-report questionnaires. MRHC was defined as visits in the previous year with health care providers (physical and occupational therapists) specialized in assessing/treating motor problems. We analysed receipt of MRHC and associated factors among children at risk of movement difficulties (MABC-2 score 6th-15th centiles), with significant movement difficulties (SMD; ≤5th centile) or with CP.

RESULTS

Of 807 children assessed at 5 years 7 months (SD 4 months; 4 years 7 months-7 years 1 month), 412 were males (51.1%), 170 (21.1%) were at risk of movement difficulties, 201 (24.9%) had SMD, and 92 (11.4%) had CP. Those who received MRHC comprised 89.1% of children with CP, 42.8% with SMD, and 25.9% at risk of movement difficulties. MRHC for children with SMD varied from 23.3% to 66.7% between countries. Children were more likely to receive MRHC if they had other developmental problems or socioemotional, conduct, or attention difficulties.

INTERPRETATION

Efforts are needed to increase MRHC for 5-year-old children born EPT with movement difficulties.

WHAT THIS PAPER ADDS

Children born extremely preterm without cerebral palsy frequently experienced motor difficulties. Most of these children were not receiving motor-related health care (MRHC). Large geographical differences throughout Europe were observed in receipt of MRHC. Socioemotional problems were related to MRHC use.

Emotional and behavioral problems in Japanese preschool children with motor coordination difficulties: the role of autistic traits

There has been little research on whether younger children with developmental coordination disorder (DCD) symptoms have an increased risk for emotional and behavioral problems. This study examined whether coordination difficulties are associated with emotional and behavioral problems (emotional symptoms, conduct problems, hyperactivity/inattention, peer problems, reduced prosocial behavior) in preschool children and the role of autistic traits in this association. Data (N = 1042, age 58-71 months) were analyzed from the Tama Children's Survey (TCS). The Little Developmental Coordination Disorder Questionnaire (LDCDQ) was used to measure coordination difficulty symptoms. Information was obtained on emotional/behavioral problems using the Strengths and Difficulties Questionnaire (SDQ) and on autistic traits with the Social Responsiveness Scale (SRS). Higher autistic traits were based on SRS cutoff scores (53.5 for boys and 52.5 for girls). Logistic regression analysis was used to assess associations between the variables. In adjusted models, children with probable DCD (pDCD) were significantly more likely to score above the clinical thresholds on all SDQ emotional/behavioral domains. However, nearly all of these associations became nonsignificant after including autistic traits in the analysis. Additional analyses showed that children with pDCD with higher autistic traits had significantly increased odds for emotional problems (odds ratio [OR]: 4.47, 95% confidence interval [CI]: 1.52-13.19), hyperactivity/inattention (OR: 3.74, 95% CI: 1.45-9.64), peer problems (OR: 15.81, 95% CI: 5.96-41.99), and total difficulties (OR: 28.78, 95% CI: 7.23-114.57), compared to children with pDCD alone. These results indicate that the increased risk of emotional/behavioral difficulties in preschool children with pDCD might be mediated by autistic traits.

Rapid automatic naming and phonological awareness deficits in preschool children with probable developmental coordination disorder

Children with developmental coordination disorder (DCD) have been reported to have a higher risk of dyslexia than children with typical development (TD). Phonological awareness (PA) and rapid automatic naming (RAN) are known to be predictive of children's reading development. The present study examined PA and RAN in preschool children with and without probable DCD in Taiwan. In total, 704 children aged 5-6 years old from 25 preschools in Taichung City were included as participants. The probable DCD children performed more poorly than the children with TD on the PA and the RAN tests. Put in deficit terms, 22% of the children with TD, but 48% of the probable DCD children, had a single or dual PA/RAN deficit. Furthermore, it was manual dexterity that bore the unique relationship with RAN. Automatic visual perceptual-motor coordination may be the common processing component that underlies RAN and probable DCD. The early visual perceptual-motor profile of probable DCD children has not been well recognized before.

A comparison of characteristics, developmental disorders and motor progression between children with and without developmental coordination disorder

BACKGROUND AND AIM

Children with Developmental Coordination Disorder (DCD) have difficulty in the development of motor coordination and with learning new motor skills. Studies demonstrate that children with DCD differ in terms of the nature and severity of their motor difficulties, the incidence of co occurring conditions and family background. However, little is known whether these profiles may relate to motor progression over time. The aim of this study was to describe the profiles of children with and without DCD and track motor progression over time.

METHOD

The characteristics of thirty-four 7-14 year old children (M = 10.07, 85.3% boys) with and without DCD were compared and their motor progression monitored over a two academic years. DCD was identified using DSM5 criteria. The Movement Assessment Battery for Children-2 (MABC-2) was used to classify children as TD (≥25th percentile), having moderate motor coordination difficulties (6-16th percentile) or severe motor coordination difficulties (≤ 5th percentile). The Kaufman Brief Intelligence Test - 2 (KBIT-2) was used to measure full scale IQ. Parent questionnaires were used to gather information on socio economic status and co occurrence of other developmental disorders. We used ANOVA to assess whether there were differences in characteristics between the TD children, children with severe motor coordination difficulties and children with moderate motor coordination difficulties. Linear mixed effect modelling was used to estimate any change in motor performance over time and whether this differed between the three groups of children.

RESULTS

Children with severe motor coordination difficulties had distinct profiles in motor and non-motor domains, lower IQ and a greater likelihood of having associated characteristics of 2 or more developmental disorders. We found significant differences between the poor motor performance of the severe group compared to the other two groups. Longitudinal analyses revealed stable, persistent and lower motor competence for the severe group. The rate of change in motor proficiency for the typical and severe groups was similar. However, the group with moderate motor difficulties gained on average more points per week compared to the typical group and achieved motor scores in the typically developing range over time.

CONCLUSIONS

This is one of the first studies to compare the characteristics and rate of motor progression of children with and without DCD using different motor proficiency cut off scores. The children with severe motor coordination difficulties progressed at the same rate as typically developing peers but remained in the severe group over time, whereas the children with moderate motor coordination difficulties caught up to TDC. The results indicate that different intervention may be required according to the nature and severity of the characteristics in both the motor and non-motor domains of children with DCD.

Prevalence and Cognitive Profiles of Children With Comorbid Literacy and Motor Disorders

There is a high prevalence of comorbidity between neurodevelopmental disorders. Contemporary research of these comorbidities has led to the development of multifactorial theories of causation, including the multiple deficit model (MDM). While several combinations of disorders have been investigated, the nature of association between literacy and motor disorders remains poorly understood. Comorbid literacy and motor disorders were the focus of the two present studies. In Study 1, we examined the prevalence of comorbid literacy and motor difficulties relative to isolated literacy and motor difficulties in a community sample (N = 605). The prevalence of comorbidity was five times greater than expected by chance alone, implying some relationship between difficulties. In Study 2, we examined the cognitive profiles of children with literacy and motor disorders amongst a subsample of children from Study 1 (N = 153). Children with literacy disorder had deficits in phonological processing, selective attention, and memory whilst children with motor disorder had deficits in visuospatial processing and memory, suggesting the disorders should be considered to have both independent and shared (memory) cognitive risk factors. Children with comorbid literacy and motor disorder demonstrated an additive combination of these deficits. Together, these findings are consistent with predictions from the MDM.

International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder - Chinese (Mandarin) translation

目的

本国际临床指南由欧洲残疾儿童学会（the European Academy of Childhood Disability，EACD）牵头制定，旨在解决发育性协调障碍（developmental coordination disorder，DCD）的定义、诊断、评估、干预以及与社会心理方面的临床应用关键问题。

方法

本指南针对五个领域的关键问题，通过文献综述和专家团队的正式讨论达成共识。为保证指南的循证基础，以“机制”、“评估”和“干预”为检索词, 对2012年更新以来提出的最新建议以及新增的“社会心理问题”和“青少年/成人”为检索词进行检索。根据牛津大学循证医学中心证据等级 (证据水平 [level of evidence, LOE]1–4) 将结果进行分类，最终转化为指南建议。并由国际、多学科专家小组举行了两次会议，5个回合的Delphi 专家问卷调查，制定了高质量临床应用实践 (good clinical practice，GCP) 。

结果

本指南共制定35条建议。其中8条以文献综述为依据 (3 条涉及“评估”，5条涉及“干预”)； 22 条在 2012 年指南的基础上进行了更新；其他为涉及诊断、评估 (3条GCP) 及社会心理问题 (2 条 GCP) 的新建议。此外，其中有1条(LOE)新建议提出视频游戏可作为以活动和参与为导向的传统干预措施的辅助手段，并针对青少年和成人DCD提出了 2 条新建议 (1 条 GCP，1 条 LOE)。

结论

本指南是基于当前的研究证据和专家共识对DCD进行全面概述。它反映了不同学科临床和科研人员的最新科技水平。本国际指南可作为各国制定指南的基础。

The contribution of motor functions to academic achievement in primary school: State of the art and future directions

This review is intended to point out the role played by motor skills proficiency in the academic achievement of typically and atypically developing pupils who are attending primary school. First, the interplay between motor and cognitive development will be presented. Next, the cognitive phenotype, not yet deeply investigated, of a neurodevelopmental condition associated with the atypical development of motor functions (known as Developmental Coordination Disorder) will be illustrated. Thus, the contribution of motor functions to academic learning and the impact of motor difficulties for pupils attending primary school will be discussed. In addition, the importance of developing observational tools to be used in educational settings and the need for effective interventions designed to empower motor functioning and academic achievement of atypically developing pupils with motor deficits will be highlighted. Finally, future directions within the educational agencies for the early detection of the atypically developing motor trajectories and their treatment will be traced.

What Can We Do to Promote Mental Health Among Individuals With Developmental Coordination Disorder?

Purpose of the Review

It is well-documented that individuals with DCD experience mental health problems, in both psychosocial and psychiatric domains. In this review, we propose a series of diverse options to improve mental health among individuals with DCD.

Recent Findings

Despite recognition of mental health problems in DCD, relatively little work has been done to develop effective interventions. There is an urgent need for action in this matter. We present and discuss options based on a societal perspective (awareness and understanding), parental perspective (access to services and resources), and child perspective (participation).

Summary

In order to improve mental health, interventions must take into account multiple levels in a complex framework that includes community, family, and the individual. While more research on intervention effectiveness is necessary, researchers, practitioners, and community advocates can use existing initiatives as a starting point to address the urgent need for improving mental health in DCD.

A comparison of using the DSM-5 and MABC-2 for estimating the developmental coordination disorder prevalence in Korean children

BACKGROUND

Previous literature has shown inconsistency in the prevalence of developmental coordination disorder (DCD). The Movement Assessment Battery for Children, Second Edition (MABC-2) is often used for DCD prevalence studies, although the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) recommends four criteria.

AIMS

The purpose of this study was to compare the prevalence of DCD in Korean children using the DSM-5 and MABC-2.

METHODS

A total of 548 Korean elementary school students (mean age: 8.5 years ± 4.5 months) completed this study procedure. All four criteria defined by the DSM-5 were used to classify children with DCD. MABC-2 test scores were used to classify students into four subgroups: high-risk DCD, mild-risk DCD, probable DCD and typical development.

RESULTS

Cohen's kappa revealed that the estimates of DCD prevalence were not significantly different between MABC-2 and DSM-5. When DSM-5 criteria were applied, 60 children out of 548 were classified as probable DCD (10.94%) compared to 70 children with probable DCD (12.77%) when MABC-2 was used.

CONCLUSIONS

DCD prevalence based on DSM-5 is not significantly different from MABC-2, though it tends to estimate less than MABC-2. Future studies should consider our findings when selecting an assessment tool.

International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder

AIM

These international clinical practice recommendations (CPR) for developmental coordination disorder (DCD), initiated by the European Academy of Childhood Disability (EACD), aim to address key questions on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD relevant for clinical practice.

METHOD

Key questions in five areas were considered through literature reviews and formal expert consensus. For recommendations based on evidence, literature searches on 'mechanisms', 'assessment', and 'intervention' were updated since the last recommendations in 2012. New searches were conducted for 'psychosocial issues' and 'adolescents/adults'. Evidence was rated according to the Oxford Centre for Evidence-Based Medicine (level of evidence [LOE] 1-4) and transferred into recommendations. For recommendations based on formal consensus, two meetings of an international, multidisciplinary expert panel were conducted with a further five Delphi rounds to develop good clinical practice (GCP) recommendations.

RESULTS

Thirty-five recommendations were made. Eight were based on the evidence from literature reviews (three on 'assessment', five on 'intervention'). Twenty-two were updated from the 2012 recommendations. New recommendations relate to diagnosis and assessment (two GCPs) and psychosocial issues (three GCPs). Additionally, one new recommendation (LOE) reflects active video games as adjuncts to more traditional activity-oriented and participation-oriented interventions, and two new recommendations (one GCP, one LOE) were made for adolescents and adults with DCD.

INTERPRETATION

The CPR-DCD is a comprehensive overview of DCD and current understanding based on research evidence and expert consensus. It reflects the state of the art for clinicians and scientists of varied disciplines. The international CPR-DCD may serve as a basis for national guidelines.

WHAT THIS PAPER ADDS

Updated international clinical practice guidelines on developmental coordination disorder (DCD). Refined and extended recommendations on clinical assessment and intervention for DCD. A critical synopsis of current research on mechanisms of DCD. A critical synopsis of psychosocial issues in DCD, with implications for clinical practice. The first international recommendations to consider adolescents and adults with DCD.

The impact of developmental coordination disorder on educational achievement in secondary school

BACKGROUND

Developmental coordination disorder (DCD) is a common developmental disorder but its long term impact on health and education are poorly understood.

AIM

To assess the impact of DCD diagnosed at 7 years, and co-occurring developmental difficulties, on educational achievement at 16 years.

METHODS

A prospective cohort study using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). National General Certificate of Secondary Education (GCSE) exam results and Special Educational Needs provision were compared for adolescents with DCD (n=284) and controls (n=5425).

RESULTS

Adolescents with DCD achieved a median of 2 GCSEs whilst controls achieved a median of 7 GCSEs. Compared to controls, adolescents with DCD were much less likely to achieve 5 or more GCSEs in secondary school (OR 0.27, 95% CI 0.21-0.34), even after adjustment for gender, socio-economic status and IQ (OR 0.6, 95% CI 0.44-0.81). Those with DCD were more likely to have persistent difficulties with reading, social communication and hyperactivity/inattention, which all affected educational achievement. Nearly 40% of adolescents with DCD were not in receipt of additional formal support during school.

CONCLUSIONS

DCD has a significant impact on educational achievement and therefore life chances. Co-occurring problems with reading skills, social communication difficulties and hyperactivity/inattention are common and contribute to educational difficulties. Greater understanding of DCD among educational and medical professionals and policy makers is crucial to improve the support provided for these individuals.

Coordination difficulties in preschool-aged children are associated with maternal parenting stress: A community-based cross-sectional study

BACKGROUND

Although coordination difficulties are sometimes observed even in children in the general population, no empirical studies have examined the impact of these difficulties on parenting stress.

AIMS

The aim of this study was to elucidate the relationship between coordination difficulties and parenting stress in a community-based sample of preschool-aged children and their mothers.

METHODS

The study included 1691 families. Mothers with 4- or 5-year-old children completed questionnaires about parenting stress and children's coordination difficulties, as well as traits associated with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

RESULTS

The results of hierarchical multiple regression analyses showed that coordination difficulties, and ADHD and ASD traits were each independent predictors of parenting stress. Among the significant predictive factors, impaired general coordination, as well as hyperactivity-impulsivity, showed a strong impact on parenting stress. In addition, a gender difference was observed in the manner in which coordination difficulties influenced parenting stress.

CONCLUSIONS

Coordination difficulties in preschool-aged children in the general population increased maternal parenting stress (as did ADHD and ASD traits). This highlights the need to provide support for mothers who have children with coordination difficulties, even when there is no clinical diagnosis.

Are behaviour problems in extremely low-birthweight children related to their motor ability?

AIM

To investigate whether behaviour problems are independently related to mild motor impairment in 11-13-year-old children born preterm with extremely low birthweight (ELBW).

METHODS

The cross-sectional study included 48 (27 males) non-disabled, otherwise healthy ELBW children (<1000 g) and 55 (28 males) term-born peers. Parents reported behaviour using the Child Behaviour Checklist (CBCL). Children completed the Movement Assessment Battery for Children (Movement ABC).

RESULTS

Extremely low birthweight children had poorer behaviour scores (CBCL Total Problem T score: mean difference = 5.89, 95% confidence interval = 10.29, 1.49, p = 0.009) and Movement ABC Total Motor Impairment Scores (ELBW group median = 17.5, IQR = 12.3; term-born group median = 7.5, IQR = 9, p < 0.01) than term-born peers. Behaviour was related to motor score (regression coefficient 2.16; 95% confidence interval 0.34, 3.97, p = 0.02) independent of gender, socio-economic factors or birthweight. Motor score had the strongest association with attention (ρ = 0.51; p < 0.01) and social behaviours (ρ = 0.50; p < 0.01).

CONCLUSION

Behaviour problems of otherwise healthy 11- to 13-year-old ELBW children are not related to prematurity independent of their motor difficulties. Supporting improved motor competence in ELBW preteen children may support improved behaviour, particularly attention and social behaviours.

Atypical within- and between-hemisphere motor network functional connections in children with developmental coordination disorder and attention-deficit/hyperactivity disorder

Developmental coordination disorder (DCD) and attention-deficit hyperactivity disorder (ADHD) are highly comorbid neurodevelopmental disorders; however, the neural mechanisms of this comorbidity are poorly understood. Previous research has demonstrated that children with DCD and ADHD have altered brain region communication, particularly within the motor network. The structure and function of the motor network in a typically developing brain exhibits hemispheric dominance. It is plausible that functional deficits observed in children with DCD and ADHD are associated with neurodevelopmental alterations in within- and between-hemisphere motor network functional connection strength that disrupt this hemispheric dominance. We used resting-state functional magnetic resonance imaging to examine functional connections of the left and right primary and sensory motor (SM1) cortices in children with DCD, ADHD and DCD + ADHD, relative to typically developing children. Our findings revealed that children with DCD, ADHD and DCD + ADHD exhibit atypical within- and between-hemisphere functional connection strength between SM1 and regions of the basal ganglia, as well as the cerebellum. Our findings further support the assertion that development of atypical motor network connections represents common and distinct neural mechanisms underlying DCD and ADHD. In children with DCD and DCD + ADHD (but not ADHD), a significant correlation was observed between clinical assessment of motor function and the strength of functional connections between right SM1 and anterior cingulate cortex, supplementary motor area, and regions involved in visuospatial processing. This latter finding suggests that behavioral phenotypes associated with atypical motor network development differ between individuals with DCD and those with ADHD.

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Resting-state fMRI was used to examine motor networks of children with DCD and ADHD.

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DCD and ADHD exhibited atypical within- and between-hemisphere motor network connections.

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Neuromuscular development was associated with functional connection strength in DCD, but not ADHD.

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Resting-state fMRI can identify shared and distinct neural mechanisms that underlie ADHD and DCD.

Study of clinical characteristics in young subjects with Developmental coordination disorder

BACKGROUND

Developmental Coordination Disorder (DCD) is a chronic neurological disorder observed in children. DCD is characterized by slowness in activities and motor impairment that affects the children's daily living and academic achievements, and later their professional and social behavior. Our aim in this work was to report characteristics frequencies in a group of children with DCD and to propose a subtyping of DCD characteristics.

METHODS

Thirty three clinical DCD characteristics, the mostly reported in the literature, were assessed in 129 patients, boys and girls aged from 4years to 18years, and their subtyping was proposed. The statistical analyses were carried out with the Chi square, the t-test and the correlation for the statistical differences, and with the Ward clustering method for subtyping.

RESULTS

We found that there were 3.17 boys for one girl, all patients were characterized as slow, 47% were left-handers or ambidextrous, 36% and 26% had orofacial and verbal dyspraxia, respectively, 83% were found anxious, and 84% were described as being clumsy.

CONCLUSIONS

It appears from these results that a child with DCD expresses more than a single difficulty. Three subtypes emerged from the statistical analysis in this study: (1) clumsiness and other characteristics except language difficulties; (2) self-esteem and peer relation without clumsiness and language difficulties; (3) language difficulties and orofacial dyspraxia.

The relationship between manual coordination and mental health

Motor coordination impairments frequently co-occur with other developmental disorders and mental health problems in clinically referred populations. But does this reflect a broader dimensional relationship within the general population? A clearer understanding of this relationship might inform improvements in mental health service provision. However, ascertainment and referral bias means that there is limited value in conducting further research with clinically referred samples. We, therefore, conducted a cross-sectional population-based study investigating children's manual coordination using an objective computerised test. These measures were related to teacher-completed responses on a behavioural screening questionnaire [the Strength and Difficulties Questionnaire (SDQ)]. We sampled 298 children (4-11 years old; 136 males) recruited from the general population. Hierarchical (logistic and linear) regression modelling indicated significant categorical and continuous relationships between manual coordination and overall SDQ score (a dimensional measure of psychopathology). Even after controlling for gender and age, manual coordination explained 15 % of the variance in total SDQ score. This dropped to 9 % after exclusion of participants whose SDQ responses indicated potential mental health problems. These results: (1) indicate that there is a clear relationship between children's motor and mental health development in community-based samples; (2) demonstrate the relationship's dimensional nature; and (3) have implications for service provision.

What is the evidence of impaired motor skills and motor control among children with attention deficit hyperactivity disorder (ADHD)? Systematic review of the literature

This article presents a review of the studies that have analysed the motor skills of ADHD children without medication and the influence of medication on their motor skills. The following two questions guided the study: What is the evidence of impairment of motor skills and aspects of motor control among children with ADHD aged between 6 and 16 years? What are the effects of ADHD medication on motor skills and motor control? The following keywords were introduced in the main databases: attention disorder and/or ADHD, motor skills and/or handwriting, children, medication. Of the 45 articles retrieved, 30 described motor skills of children with ADHD and 15 articles analysed the influence of ADHD medication on motor skills and motor control. More than half of the children with ADHD have difficulties with gross and fine motor skills. The children with ADHD inattentive subtype seem to present more impairment of fine motor skills, slow reaction time, and online motor control during complex tasks. The proportion of children with ADHD who improved their motor skills to the normal range by using medication varied from 28% to 67% between studies. The children who still show motor deficit while on medication might meet the diagnostic criteria of developmental coordination disorder (DCD). It is important to assess motor skills among children with ADHD because of the risk of reduced participation in activities of daily living that require motor coordination and attention.