The reliability and validity of the Developmental Coordination Disorder Questionnaire'07 for children aged 4-6 years in mainland China

Social responsiveness in children with developmental coordination disorder

BACKGROUND

Developmental coordination disorder (DCD) is a neurodevelopmental disorder characterized by deficits in performing motor tasks. Research suggests social skills are also altered.

OBJECTIVE

To investigate (1) whether the presence of DCD affects social responsiveness, (2) whether the co-occurrence of autism spectrum disorder (ASD) affects social responsiveness in children with DCD, and (3) whether there is an association between motor performance and social responsiveness in children with DCD.

METHODS

Based on parental reports, children aged 5 to 15.5 years were assigned to one of three groups: DCD only (noASD, n = 67), DCD and suspected ASD (sASD, n = 13), and DCD and confirmed ASD (cASD, n = 22). Parental answers to the Social Responsiveness Scale (SRS-2) and the DCD-Questionnaire (DCD-Q) were compared to norm values using one sample t-tests, and between groups using ANOVA and MANOVA. Pearson correlation coefficients explored the relationship between the SRS-2 and DCD-Q in the total group and per group.

RESULTS

Compared to norm values, difficulties in all areas of social responsiveness were reported in children with DCD, regardless of group (p<0.001). Compared to the noASD group, more unfavorable SRS-2 total T-scores and poorer DCD-Q scores were observed in sASD and cASD groups. Only in the total group, motor performance showed significant weak to moderate associations with the SRS-2 total T-score and all subscales except for 'social motivation' (r=-0.306 to -0.405; p ≤ 0.02).

CONCLUSION

Social responsiveness difficulties are more common in children with DCD and are more severe in the ASD groups. Motor performance and social responsiveness are weak to moderately associated.

CLINICAL TRIAL REGISTRATION NUMBER

NCT05092893 (https://clinicaltrials.gov/study/NCT05092893).

Cross-replicating findings on unique motor impairments of children with ASD using confirmatory factor analysis and a novel SPARK study sample

A series of recent reports have shed light on the pervasive nature of motor impairments in children with ASD (Bhat, 2020, 2021, Bhat et al., 2022), underscoring the importance of providing ASD clinicians efficient and accurate tools for motor screening. The Developmental Coordination Disorder-Questionnaire (DCD-Q) is a widely used motor screening tool, yet scant evidence exists regarding its psychometric properties in children with ASD. In a recent Exploratory Factor Analysis (EFA) of the 15-item DCD-Q in a large sample of children with ASD (SPARK study), we found a 5-factor latent structure that identified unique motor impairments in a large sample of children with ASD (Bhat et al., 2022). In the current study, we extend this work by cross-replicating the EFA findings of unique ASD-related motor issues using Confirmatory Factor Analysis (CFA) in a new, more recent wave of children with ASD from the SPARK study (N = 9721). The fits and interpretability of 11 hypothesis-driven CFA models, including 8 correlated-factors, 1 second-order, and 2 bifactor models were compared. Our findings supported the previous 5-factor model with 2 gross motor subdomains, 1 fine motor domain (similar to the original DCD-Q) and 2 general coordination subdomains. This model demonstrated acceptable fit in the new sample as well as superior fit compared to several other parsimonious correlated-factors models. However, the second-order and bifactor models fit slightly better and supported the presence of a general motor skills factor, although 38% of the common variance in the DCD-Q items remained attributable to the 5 subdomains. Using one of the bifactor models, measurement invariance was also supported for DCD-Q across sex, race, and co-occurring conditions of language disorder and intellectual disability. Only partial invariance was supported when testing DCD-Q scores across different age groups. These findings reveal a more complex dimensional picture of the DCD-Q in children with ASD. Results suggest that the DCD-Q can be used in two ways, total scores adequately assess general motor skills for brief screening and subdomain scores offer unique information on the multidimensional motor problems of children with ASD. If subdomain data are of interest, our findings call into question the practice of relying on 3 original subscales of the DCD-Q when screening for ASD-related motor difficulties, whereas 4 out of 5 subscale scores may better highlight domain-specific motor problems. Future studies should continue to further validate DCD-Q's ability to screen for multidimensional motor problems.

Prenatal second-hand smoke exposure and the risk of suspected developmental coordination disorder in preschoolers: A nationwide retrospective cohort study in China

Prenatal exposure to second-hand smoke (SHS) is associated with increased neurodevelopmental problems in children, however, its impact on the risk of developmental coordination disorder (DCD) in preschoolers have not been studied thoroughly. Herein, we probed this association based on a nationwide retrospective cohort study of 149,005 preschoolers in China. We divided the objects into the prenatal SHS-exposed group or the no prenatal smoke exposed group (NS-exposed group). Preschoolers were assessed for motor proficiency by the Chinese version of Little Developmental Coordination Disorder Questionnaire (LDCDQ). Multivariable logistic regression was used to evaluate the associations. The prevalence of prenatal SHS exposure was 23.89%. Generally, the prevalence of suspected DCD was significantly higher in prenatal SHS-exposed group (16.38% VS. 14.19%, P < 0.001). With the increase of age, the mean total scores of LDCDQ of both boys and girls increased gradually; and the prevalence of suspected DCD in girls was higher than that in boys in the same age group. After adjusting for covariates, prenatal SHS exposure had the negative association with the total score of LDCDQ and increased the risk of suspected DCD. Our results suggest a need for interventions designed to reduce maternal SHS exposure during pregnancy, early screen for DCD and increase targeted movement and coordination skill training for vulnerable children.

Analysis of Piano Performance Characteristics by Deep Learning and Artificial Intelligence and Its Application in Piano Teaching

Deep learning (DL) and artificial intelligence (AI) are jointly applied to concrete piano teaching for children to comprehensively promote modern piano teaching and improve the overall teaching quality. First, the teaching environment and the functions of the intelligent piano are expounded. Then, a piano note onset detection method is proposed based on the convolution neural network (CNN). The network can analyze the time-frequency of the input piano music signal by transforming the original time-domain waveform of the piano music signal into the frequency distribution varying with time. Besides, it can detect the note onset at a stable state after 8 × 104 iterations. Moreover, an intelligent piano teaching method is designed to teach Jingle Bells for 40 preschool children aged 4-6 years. Finally, a questionnaire survey is performed to investigate the teaching situation, including the learning interest and learning effect of children and learning feedback from parents. The results show that 80% of children like smart music scores, 82% of children like intelligent piano lessons with games, and 84% of children can learn actively in the intelligent piano class. Besides, 85% of parents believe that their children are more interested in learning piano. In general, the intelligent piano teaching method effectively combines DL with AI to realize the overall optimization of piano performance. It is widely favored by preschool children and their parents and plays an important role in improving the interest of preschool children in piano learning.

Discrepancies between Parent and Teacher Reports of Motor Competence in 5–10-Year-Old Children with and without Suspected Developmental Coordination Disorder

Parents and teachers have knowledge of children’s daily motor performance yet may make different judgments about the levels of competence observed at home and school. The current study aimed to examine the discrepancies between parent and teacher reports using the Movement ABC-2 Checklist and the Developmental Coordination Disorder Questionnaire (DCDQ) on children with and without suspected Developmental Coordination Disorder (DCD). The Movement ABC-2 Test was administered to 1276 children aged 5–10 years in China. The Movement ABC-2 Checklist and DCDQ were completed by both parents and teachers of all children. A total of 172 children achieving a score below the 15th percentile on the Movement ABC-2 Test were identified as children with suspected DCD. Both parents and teachers showed suitable agreement in judging children’s motor competence but low sensitivity in identifying children with DCD. Parent scores of children’s motor competence were more closely associated with test performance scores compared to teacher scores. Teachers tended to over-rate children’s motor competence. The motor difficulties identified by parents were associated with low Movement ABC-2 Test scores on Manual Dexterity and Balance components, while motor difficulties identified by teachers were associated with the Balance component only. The results demonstrated discrepancies between parent and teacher reports, suggesting the importance of using a range of measures to identify and describe motor difficulties in children.

Cross-cultural validation of the Arabic version of the Developmental Coordination Disorder Questionnaire DCDQ'07, in a Lebanese sample of children

BACKGROUND

The revised version of the Developmental Coordination Disorder Questionnaire (DCDQ'07) is a parent questionnaire designed to identify Developmental Coordination Disorder in 5-15-year-old children.

AIM

The aim of this study was to carry out the translation and cross-cultural adaptation of the DCDQ'07, to examine psychometric properties, and to define the cut-off scores of the Arabic-Lebanese version of the questionnaire (DCDQ-AL).

METHOD

38 parents of children with and without motor difficulties participated in the translation and cross-cultural phase. As for the validation phase and the study of the psychometric properties, a total of one hundred and twenty-four typically developing children (N=124) aged between 5 and 15 years were recruited through schools in different districts across Lebanon, whereas the clinical sample (N = 56) of children with motor difficulties was recruited via psychomotor rehabilitation centers in Beirut and psychomotor therapists working in private clinics across the country. This study used the Movement Assessment Battery for Children - second edition (MABC-2) motor test developed to classify children according to their degree of motor impairment.

RESULTS

For test-retest reliability and inter-rater reliability, excellent Intraclass Correlation Coefficients (ICC) were shown with values of 0.94 and 0.9, respectively. The internal consistency value for the DCDQ-AL was high (Cronbach's alpha = 0.947). Correlations between the DCDQ-AL scores and Movement Assessment Battery for Children (MABC-2) show adequate convergent validity (ρ = 0.65, p < .001). Differences in DCDQ-AL scores between children with and without motor difficulties (p < .001) provide clear evidence of discriminative validity. The Lebanese cut-offs are very similar to the Canadian version, except for the 5-7 age band. The DCDQ-AL shows a sensitivity of 0.91 and specificity of 0.77. The adapted questionnaire showed solid psychometric properties, allowing us to conclude that the DCDQ-AL can be used to support a diagnosis of DCD.

CONCLUSION

The results provide evidence that the DCDQ-AL is a valid clinical screening tool for DCD that can assist Arabic speaking professionals in screening children aged 5-15 years old who are at risk of having DCD.

Early identification of children with/at risk of developmental coordination disorder: a scoping review

AIM

To summarize current evidence for early identification and motor-based intervention for children aged 5 years and younger with/at risk of developmental coordination disorder (DCD).

METHOD

Using scoping review methodology and after duplicates were removed, 11 115 peer-reviewed articles and grey literature were independently screened by two authors. Data from 103 included records were extracted and synthesized by both assessors. One author entered the relevant data into tables, while the other author double-checked the entries.

RESULTS

Records included peer-reviewed studies, guidelines, conference presentations, and theses/dissertations. Most literature pertained to early identification (n=78), with fewer studies targeting intervention (n=22) or covering both topics (n=3). Literature was summarized in two main categories: (1) assessments for diagnostic criteria A and B; and (2) motor-based interventions for young children with/at risk of DCD. This article highlights the findings related to assessments, while a companion article summarizes the intervention literature.

INTERPRETATION

Emerging evidence shows that children, especially those at greatest risk of DCD, may be identified before formal school entry. Earlier identification will allow for earlier intervention, which may help to improve the developmental trajectories of children with/at risk of DCD and prevent secondary consequences of the disorder. It is recommended that health care providers explicitly use the term 'at risk of DCD'.

Validity of the Developmental Coordination Disorder Questionnaire’ 07 and Its Association with Physical Activity in Young Children with Developmental Disabilities

OBJECTIVES The purposes of the current study were to examine the construct and predictive validity, and reliability of the developmental coordination disorder questionnaire’ 07 (DCDQ’ 07) for young children with developmental disabilities (DD).METHODS 135 parents of young children with DD completed an online questionnaire which consisted of demographic information, the DCDQ’ 07, and a physical activity behavior questionnaire. A one-way analysis of variance was conducted to evaluate motor difficulties across different types of young children with DD. Exploratory factor analysis and Cronbach’s alpha were used to examine construct validity and reliability of the DCDQ’ 07. Moreover, hierarchical multiple regression analysis was used to examine the association between the DCDQ’ 07 scores and physical activity behaviors in young children with DD.RESULTS The one-way analysis of variance indicated that the DCDQ’ 07 scores were significantly different across different types of young children with DD = 6.66, p <0.001). The exploratory factor analysis revealed a three-factor solution, accounting for 64.34% of the variance of the DCDQ’ 07. Internal consistencies of the three factors were acceptable. One factor, control during movement, was a significant predictor for physical activity behaviors in young children with DD (β = 0.37, p < 0.01).CONCLUSIONS The DCDQ’ 07 may be a reliable and valid measure in examining motor difficulties in young children with DD. To promote physical activity behaviors in young children with DD, teaching and reinforcing motor skills need to be encouraged.

Mothers' prenatal tobacco smoke exposure is positively associated with the occurrence of developmental coordination disorder among children aged 3-6 years: A cross-sectional study in a rural area of Shanghai, China

INTRODUCTION

Prenatal tobacco smoke exposure is a potential risk factor for developmental coordination disorder (DCD) in children, but evidence on the relationship between DCD in children and tobacco smoke exposure in women is limited in China. We conducted a cross-sectional study to understand the prevalence of prenatal tobacco smoke exposure among mothers and the prevalence of DCD among children and to explore if mothers’ prenatal tobacco smoke exposure is positively associated with the occurrence of DCD among children.

METHODS

During 2018, we sampled 8586 children aged 3–6 years and their mothers in Songjiang district, Shanghai. DCD in children was identified by MABC-2 screening combined with pediatrician confirmation. Prenatal tobacco smoke exposure among mothers was classified into firsthand smoke (FHS) and secondhand smoke (SHS) exposure. SAS 9.2 software was applied to calculate the prevalence of DCD in children, the prevalence of prenatal FHS and SHS exposure in mothers and to analyze the differences by chi-squared test and logistic regression.

RESULTS

Among the 8586 women, the prevalence of prenatal FHS and SHS exposure was 0.94% and 20.79%, respectively. The prevalence of DCD in children was 6.65%, which was significantly higher in boys (7.64%) than in girls (5.51%), and children aged 3 years (9.77%) had a higher prevalence of DCD than children aged 4, 5 or 6 years (7.44%, 5.27% and 4.28%, respectively). In comparison with children whose mother was not exposed to prenatal FHS or SHS, the odds of having DCD was higher in children whose mother was exposed to prenatal FHS (OR=4.42; 95% CI: 2.62–7.44) and SHS (OR=1.77; 95% CI: 1.47–2.14), even after adjustment for potential confounders.

CONCLUSIONS

The occurrence of DCD among children is positively associated with prenatal tobacco smoke exposure among the mothers. It is crucial to implement tobacco control measures to decrease the prevalence of smoking among pregnant women and SHS exposure at home as well as in the work environment.

ABBREVIATIONS

DCD: developmental coordination disorder, ADHD: attention deficit hyperactivity disorder, FHS: firsthand smoke, SHS: secondhand smoke, MABC-2: movement assessment battery for children-2nd edition, GATS: global adult tobacco survey, SD: standard deviation, OR: odds ratio, CI: confidence interval, DAGs: directed acyclic graphs.