Physiological characteristics, self-perceptions, and parental support of physical activity in children with, or at risk of, developmental coordination disorder

The multiple mediation impact of adolescents' physical fitness and cognitive perceptions on their objective measures - The Cogni-Action Project

OBJECTIVE

To establish whether physical fitness and cognitive self-perceptions act as mediators in the link between global fitness and cognitive performance measured objectively in adolescents. We also compared differences across sex.

METHODS

A total of 1296 adolescents (50 % girls) from grades 5 to 8 (ages 10-14) participated in this cross-sectional study. The ALPHA-fitness test battery assessed physical fitness, comprising cardiorespiratory, speed-agility, and muscular fitness components. We used the 1-5-point International Fitness Scale for physical fitness self-perception, and the 1-10 scale for cognitive performance self-perception. Objective cognitive performance was assessed using a neurocognitive battery consisting of eight tasks. Using principal component analysis, these tasks were grouped into three domains: attention, working memory, and problem solving. We examined three serial mediation models adjusted for sex, standardized body mass index, maturation, and school vulnerability index.

RESULTS

Physical fitness and cognitive self-perceptions mediated the effects on attention (B = .0027, CI = .0011 to .0047), memory (B = .0025; CI = .0003 to .0055 and B = .0035; CI = .0009 to .0063), and problem-solving (B = -.0137; CI = -.0231 to -.0052 and B = .0072; CI = .0043 to .0106). By sex, boys showed mediation in all domains, while girls only showed mediation in problem-solving.

CONCLUSIONS

Adolescents' perceptions play a crucial and positive mediating role in linking objective measures of physical fitness to cognitive performance outcomes, particularly when self-perceptions of physical fitness and cognition are considered together. Therefore, educating families and school/health environments about the importance of adolescent perceptions, while fostering self-awareness and reinforcing their capabilities, is essential.

Which outcomes are key to the pre-intervention assessment profile of a child with developmental coordination disorder? A systematic review and meta-analysis

BACKGROUND

Purpose of this study was to determine what key aspects of function should be incorporated to make up a pre-intervention assessment profile of a child with Developmental Coordination Disorder (DCD); more specifically, what aspects of functioning are implicated in DCD and what is their relative impact?

METHODS

A systematic review and meta-analysis were conducted, for which Pubmed, Web of Science, Scopus and Proquest were searched (last update: April 2023, PROSPERO: CRD42023461619). Case-control studies were included to determine point estimates for performances on field-based tests in different domains of functioning. Risk of bias was assessed, and level of evidence estimated. Random-effect meta-analyses were performed to calculate the pooled standardized mean differences for domains of functioning and subgrouping was done for clinically relevant subdomains. Heterogeneity was determined with I2.

RESULTS

121 papers were included for analyses. Data of 5 923 children with DCD were included (59.8% boys) and 23 619 Typically Developing (TD) children (45.8% boys). The mean (SD) age of the DCD group was 10.3y (1.2) and 9.3y (1.3) for the TD children. Moderate evidence was found for motor performance, executive functions, sensory processing and perceptions, cognitive functions and sports and leisure activities to be affected in children with DCD.

CONCLUSION

Differences between the two groups varied per domain of functioning. This emphasizes the diversity present within children with DCD and provides a rationale for explaining the heterogeneity in this patient group. Yet, results highlight the potential involvement of all these domains and call for clinicians to be alert not only to examine motor skill difficulties but also other aspects of function. Results indicate the need to develop an individualized pre-intervention multi-dimensional assessment profile for each child with DCD. It also supports the important role that clinicians play in an interdisciplinary team to tackle the difficulties encountered by children with DCD.

Objectively Measured Physical Activity in Children With Developmental Coordination Disorder: A Systematic Review and Meta-analysis

OBJECTIVE

To conduct a systematic review and meta-analysis to understand the difference in objectively measured physical activities (PAs) between children with and without developmental coordination disorder (DCD).

DATA SOURCES

A systematic literature search of 4 databases (PubMed, Science Direct, Web of Science, and Cochrane library) was conducted in July 2023.

STUDY SELECTION

Studies that met the following criteria were considered classified children with DCD based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), DSM-IV-Text Revision, or DSM-V diagnosis criteria, evaluated PA using objective measurements and provided the amount of time spent in PA and/or sedentary behavior, included a control group of typically developing children, and written in English.

DATA EXTRACTION

Data extracted from all included studies were: first author's surname and publication year, study design, country, total sample size, the measure of PA, the intensity of PA, categories of PA level, and main finding(s).

DATA SYNTHESIS

Twelve articles met the inclusion criteria for the systematic review, 10 of which were included in the meta-analysis. The overall mean difference in moderate-to-vigorous PA (MVPA) between 2 groups was -0.17 (95% CI, -0.25 to -0.09), (I2=48.7%, P=.029). A subgroup analysis by age (ie, school-aged vs. preschool) showed a significant pooled effect size with no heterogeneity in school-aged children (ie, 6-14y) (standardized mean difference=-0.27, 95% CI, -0.38 to -0.16, I2=43.1%, P=.08).

CONCLUSIONS

Children with DCD spent significantly less time participating in MVPA, particularly those aged between 6 and 14 years. These findings highlight the need for increased awareness among parents and physicians regarding insufficient participation in PA among children with DCD.

Post-term Birth and Developmental Coordination Disorder: A Narrative Review of Motor Impairments in Children

A prevalent long-term medical condition in children that is rarely understood and acknowledged in educational contexts is developmental coordination disorder (DCD), which is one of the most prevalent conditions in school-aged children. Mild-to-severe abnormalities in muscle tone, posture, movement, and the learning of motor skills are associated with motor disorders. Early detection of developmental abnormalities in children is crucial as delayed motor milestones during infancy might indicate a delay in both physical and neurological development. To overcome the current condition of motor impairment, obstructing their risk factors is important to prevent the development of disability, which is already determined in the prenatal and perinatal period. Concerning the relationship with gestational age, the majority of the studies reported a relationship between DCD and preterm children. However, the entire range of gestational age, including post-term birth, has not been studied. The risk of developmental consequences such as cognitive impairments, major mental diseases, attention-deficit/hyperactivity disorder, autism spectrum disorder, and other behavioral and emotional problems increases in post-term birth, according to prior studies. Thus, this review aims to provide an overview of information linking post-term birth to children's motor impairment, with a focus on DCD. A thorough systemic review was conducted on online databases, and only a few studies were found on the association with post-term children. Insufficient evidence made it necessary to examine more post-term cohorts in adolescence to fully determine the long-term health concerns and develop therapies to mitigate the detrimental effects of post-term deliveries.

Physical Fitness in Children With Developmental Coordination Disorder: A Systematic Review

OBJECTIVE

To synthesize evidence about physical fitness levels in children with developmental coordination disorder (DCD) compared with typically developing (TD) children.

METHODS

We searched four databases (PubMed, Scopus, Web of Science, and PsycINFO) for cross-sectional, case-control, and cohort studies comparing physical fitness between children with and without DCD. We assessed the methodological quality of the studies with the Newcastle-Ottawa Scale (NOS). We calculated Cohen's d effect sizes to provide clinical evidence of group differences in aerobic capacity, anaerobic capacity, muscle strength, body composition and flexibility.

RESULTS

We included 32 studies for qualitative synthesis after applying eligibility criteria. All selected studies ranged from moderate to high research quality. Effect sizes in favor of typically developing children over children with DCD were large for aerobic capacity (d = 1.15), anaerobic capacity (d = 0.90), and muscle strength (d = 0.79), and small for body composition (d = 0.43) and flexibility (d = 0.21) outcomes.

CONCLUSION

Children with DCD presented significantly lower physical fitness than their typically developing peers, particularly in aerobic and anaerobic capacity and in muscle strength.

Understanding factors that influence physical activity behavior in people with developmental coordination disorder (DCD): a mixed-methods convergent integrated systematic review

This systematic review synthesizes the literature on physical activity amongst people with DCD using the COM-B framework. The review questions were: (1) what is the Capability (C), Opportunity (O) and Motivation (M) for physical activity and (2) what does physical activity behavior (B) look like? A mixed-methods systematic review was conducted by searching eight databases (PubMed, APA PsycINFO, EMBASE, Scopus, Child Development and Adolescent Studies, Cochrane Library, Web of Science, CINAHL) up to July 2023. Data were extracted, thematically analyzed, and mapped to the COM-B model. The quality of studies was assessed with the Joanna Briggs Institute (JBI) critical appraisal tool. The protocol was registered with PROSPERO (CRD42022319127). Forty-three papers, 42 of which related to children, were included. Fifteen aligned with physical activity behavior, nine with physical capability, thirteen with psychological capability, one with social opportunity, one with physical opportunity, one with reflective motivation and three with automatic motivation. Pre-school-aged children with DCD engage in comparable levels of physical activity behavior, but differences emerge from 6 years of age. Characteristics of DCD result in reduced physical capability and less varied participation in physical activity. This impacts psychological capability, whereby lower self-perceptions result in a negative feedback loop and reduce the motivation to participate. Barriers relating to social opportunities may result in poor reflective and automatic motivation, although there is evidence that interventions can enhance enjoyment in the short term.

Parental support for physical activity and children's physical activities: a cross-sectional study

BACKGROUND

Physical activity (PA) in school-aged children is imperative for physical and mental development. However, there has been reduced PA among children in recent years owing to environmental changes, resulting in declining physical strength and athletic ability. Although parents' and children's PA has been found to be correlated, the specific parental caregiving attitudes associated with children's actual levels of PA during school-age years remain unknown. Therefore, this study aimed to examine the relationship between parental support for PA and children's levels of PA.

METHODS

In 2017, a self-reported questionnaire survey was administered to 1,515 third-grade students (8-9 years old) and their caregivers in Nagoya, Aichi, a major metropolitan area in Japan. The main items surveyed included the attitudes of children and parents towards PA and the children's actual PA level. Multiple regression analysis was conducted with parental involvement related to PA as the explanatory variable and children's PA as the objective variable.

RESULTS

In total, 717 children with valid responses were included in the analysis. The mean age of the children was 9.08 ± 0.33 years; 366 (51.0%) were boys, and 351 (49.0%) were girls. For moderate-to-vigorous and vigorous PA, PA levels tended to be significantly higher in children whose parents provided logistic support such as enrolling their children in a sports club. However, for moderate PA and walking, PA levels tended to be significantly higher in children whose parents used community resources. Modeling and limiting sedentary activities were not associated with children's PA.

CONCLUSIONS

The results of this study suggest that direct parental assistance for PA such as logistic support encourages children to engage in moderate-to-vigorous PA; in addition, parental use of community resources may encourage children to engage in moderate and light PA such as walking. Conversely, indirect and negative involvement such as modeling and limiting sedentary activities were not associated with children's PA. Therefore, logistic support may need to be strengthened to encourage moderate-to-vigorous and vigorous PA, which is important for children's health.

Associations of preterm and early-term birth with suspected developmental coordination disorder: a national retrospective cohort study in children aged 3-10 years

BACKGROUND

This study analyzed the motor development and suspected developmental coordination disorder of very and moderately preterm (< 34+0 gestational age), late preterm (34+0-36+6 gestational week), and early-term (37+0-38+6 gestational week) children compared to their full-term peers with a national population-based sample in China.

METHODS

A total of 1673 children (799 girls, 874 boys) aged 3-10 years old were individually assessed with the Movement Assessment Battery for Children-second edition (MABC-2). The association between gestational age and motor performance of children was analyzed using a multilevel regression model.

RESULTS

The global motor performance [β =  - 5.111, 95% confidence interval (CI) =  - 9.200 to - 1.022; P = 0.015] and balance (β =  - 5.182, 95% CI =  - 5.055 to - 1.158; P = 0.003) for very and moderately preterm children aged 3-6 years old were significantly lower than their full-term peers when adjusting for confounders. Late preterm and early-term children showed no difference. Moreover, very and moderately preterm children aged 3-6 years had a higher risk of suspected developmental coordination disorder (DCD) (≤ 5 percentile of MABC-2 score) when adjusting for potential confounders [odds ratio (OR) = 2.931, 95% CI = 1.067-8.054; P = 0.038]. Late preterm and early-term children showed no difference in motor performance from their full-term peers (each P > 0.05).

CONCLUSIONS

Our findings have important implications for understanding motor impairment in children born at different gestational ages. Very and moderately preterm preschoolers have an increased risk of DCD, and long-term follow-up should be provided for early detection and intervention.

On the Parental Influence on Children's Physical Activities and Mental Health During the COVID-19 Pandemic

Background

While neighborhood safety and stranger danger have been mostly canonized to play a part in parents' physical activity (PA) avoidance, less is known about the impact of parental stress and perceived risk on children's PA avoidance and consequently on children's level of PA and wellbeing. Understanding the contributors to children's wellbeing during pandemic disease is the first critical step in contributing to children's health during epidemic diseases.

Methods

This study employed 276 healthy children, aged 10-12 years, and their parents. Data were collected in October and November 2020, about 9 months after the local closing of schools due to the coronavirus disease 2019 (COVID-19) pandemic. Parents and children answered a separate set of questions. Besides the demographic information, the parents responded to questions on their stress level, perceived risk of COVID-19, and PA avoidance for children. Children responded to questions on their PA and wellbeing in the last week. Data were analyzed using SmartPLS and IBM SPSS 22.

Results

The result of the study supported the four directional research hypotheses of the sequential study model. As hypothesized, parents' stress and perceived risk levels of COVID-19 negatively affected children's PA. The PA level was shown to predict children's wellbeing and mental health. Housing type, parents' job security, number of siblings, number of members living together in-home, and history of death or hospitalization of relatives or family members due to COVID-19 were found to be associated with parents' stress and children's mental health.

Conclusion

This study sheds light on parents' role in children's wellbeing and mental health during the COVID-19 pandemic. Parents with higher stress and high restrictive behaviors might put their children at risk of mental disorders in the end.

Association of Gestational Age at Birth With Subsequent Suspected Developmental Coordination Disorder in Early Childhood in China

IMPORTANCE

It remains unknown whether children born at different degrees of prematurity, early term, and post term might have a higher risk of developmental coordination disorder (DCD) compared with completely full-term children (39-40 gestational weeks).

OBJECTIVE

To differentiate between suspected DCD in children with different gestational ages based on a national representative sample in China.

DESIGN, SETTING, AND PARTICIPANTS

A retrospective cohort study was conducted in China from April 1, 2018, to December 31, 2019. A total of 152 433 children aged 3 to 5 years from 2403 public kindergartens in 551 cities of China were included in the final analysis. A multilevel regression model was developed to determine the strength of association for different gestational ages associated with suspected DCD when considering kindergartens as clusters.

MAIN OUTCOMES AND MEASURES

Children's motor performance was assessed using the Little Developmental Coordination Disorder Questionnaire, completed by their parents. Gestational age was determined according to the mother's medical records and divided into 7 categories: completely full term (39 to 40 weeks' gestation), very preterm (<32 weeks), moderately preterm (32-33 weeks), late preterm (34-36 weeks), early term (37-38 weeks), late term (41 weeks), and post term (>41 weeks).

RESULTS

A total of 152 433 children aged 3 to 5 years (mean [SD] age, 4.5 [0.8] years), including 80 370 boys (52.7%) and 72 063 girls (47.3%), were included in the study. There were 45 052 children (29.6%) aged 3 years, 59 796 (39.2%) aged 4 years, and 47 585 (31.2%) aged 5 years. Children who were born very preterm (odds ratio [OR], 1.35; 95% CI, 1.23-1.48), moderately preterm (OR, 1.18; 95% CI, 1.02-1.36), late preterm (OR, 1.24; 95% CI, 1.16-1.32), early term (OR, 1.11; 95% CI, 1.06-1.16), and post term (OR, 1.17; 95% CI, 1.07-1.27) were more likely to be classified in the suspected DCD category on the Little Developmental Coordination Disorder Questionnaire than completely full-term children after adjusting for the same characteristics. Additionally, there was no association with suspected DCD in younger (aged 3 years) early-term and postterm children by stratified analyses.

CONCLUSIONS AND RELEVANCE

In this cohort study, every degree of prematurity at birth, early-term birth, and postterm birth were associated with suspected DCD when compared with full-term birth. These findings have important implications for understanding motor development in children born at different gestational ages. Long-term follow-up and rehabilitation interventions should be considered for children born early and post term.

Moderate-to-vigorous physical activity and sedentary behavior in children with and without developmental coordination disorder: Associations with fundamental movement skills

BACKGROUND

There is a pandemic of physical inactivity in children. Compared to children with typical development (TD), those with developmental coordination disorder (DCD) are less physically active. Mastery of movement skills such as fundamental movement skills (FMS) are potential correlates of physical activity.

AIMS

To examine the associations of FMS with moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) in children with DCD and TD.

METHODS AND PROCEDURES

This cross-sectional study included 172 children with DCD (n = 73; boys = 49) or TD (n = 99; boys = 48) aged 6-10 years. Five components of FMS (running, jumping, throwing, catching, kicking) were assessed using process- and product- oriented approaches using the Test of Gross Motor Development-second edition. The time spent in MVPA and SB was measured using accelerometers.

OUTCOMES AND RESULTS

Children with DCD had significantly poorer performance in FMS proficiency in terms of specific movement patterns (jumping and catching) and outcomes (running, jumping, catching, and kicking) when compared to children with TD. MVPA and SB were significantly associated with certain process-oriented FMS assessments in children, which was moderated by motor coordination status and sex. Movement patterns of catching (odds ratio = 1.686, p < .05) was a significant predictor of children's attainment of the MVPA guideline.

CONCLUSIONS AND IMPLICATIONS

It is important to develop FMS patterns and ball skills in early childhood, particularly for children with DCD, to combat physical inactivity and its related health problems.

Gender, Physical Self-Perception and Overall Physical Fitness in Secondary School Students: A Multiple Mediation Model

Background: Physical self-perception is often related with better physical fitness perception in adolescents. Moreover, it is an important social cognitive perspective to provide suitable mental health in this population. However, this relationship is unequal between boys and girls. The physical fitness is a marker of health in young population. The aims of the present study were the following: (1) to compare physical self-perception and self-reported overall physical fitness (OPF) between boys and girls (gender) and body mass index (BMI) status, and (2) to determine the mediating role of all physical self-perception subscales (except physical condition) and BMI status in the link between gender and OPF in adolescent students. Methods: This cross-sectional study consisted of 85 adolescent students of secondary school between 12 and 17 years of age; 41 were boys (M_age = 14.6, SD = 1.7) and 44 were girls (M_age = 14.4, SD = 1.6). Adolescent participants completed all clinical characteristics by body composition measures (age, body weight, body height, and BMI). Physical self-perception was assessed by the physical self-perception profile (PSPP) whereas the international fitness scale (IFIS) was used to predict the self-reported OPF of adolescents in the present study. Results: Gender (boys and girls) differed significantly in all PSPP subscales and OPF, whereas the BMI status (underweight = 19 students, normal weight = 53 students, overweight/obese = 13 students) showed significant differences in all clinical characteristics, physical condition (PSPP), and OPF. A multiple mediation analysis was performed using bias corrected bootstrap. This multiple mediation analysis revealed that all PSPP subscales were significant mediators between gender and OPF: attractive body (p = 0.013), sport competence (p = 0.009), physical strength (p = 0.002), and self-confidence (p = 0.002). The total direct effect of gender on OPF was significant (p = 0.002). Moreover, the multiple mediation estimated a completely standardized indirect of X on Y for attractive body (effect = 0.109), sport competence (effect = 0.066), physical strength (effect = 0.130), and self-confidence (effect = 0.193). Conclusions: These findings contribute to understanding the link between gender and OPF in adolescent students and the mediation of physical self-perception and OPF in this relationship. In addition, strategies focused to improve self-confidence and physical self-perception are necessary in female adolescent students, because boys showed better physical self-perception in all PSPP subscales. Girls are a risk group because they report low physical self-confidence with their respective insecurity feelings and psychological disorders. Thus, personal physical self-perception must be considered as an important social cognitive perspective to provide suitable mental health in children and adolescents.

Exploring associations between neuromuscular performance, hypermobility, and children's motor competence

OBJECTIVES

To evaluate if neuromuscular performance and hypermobility are factors associated with children's motor competence.

DESIGN

Cross-sectional observation study.

METHODS

Data was collected on 60 children aged 6-12 years; motor competence was determined using the Movement Assessment Battery for Children-2 test, with children classified into 3 groups (Typically Developing n=30; 'At Risk' of low motor competence (LMC) n=9; LMC n=21). Neuromuscular performance was determined utilising the Resistance Training Skills Battery for Children (RTSBc), 5-repetition maximum (5RM) leg press and Biodex dynamometry to assess isometric and isokinetic peak torque of the knee flexors and extensors. Hypermobility was measured using the Beighton and Lower Limb Assessment Score.

RESULTS

Between-groups MANCOVA revealed typically developing children scored significantly higher on the RTSBc than those 'at risk' of LMC (p=0.021) and those in the LMC group (p<0.001). 5RM scores also differed between groups, with typically developing children achieving significantly higher scores than the LMC group. No differences were found between groups for isometric or isokinetic measures of strength. Sequential regression analysis revealed neuromuscular performance variables explained 44.7% of the variance in motor competence, with RTSBc (p<0.001) and 5RM (p=0.019) emerging as positive significant predictors. Hypermobility failed to explain significant variance in motor competence beyond that explained by neuromuscular performance.

CONCLUSIONS

Neuromuscular performance of children varies according to levels of motor competence, with those with LMC performing poorly on tasks requiring multi-joint movement. Furthermore, neuromuscular performance predicted almost half the variance observed in motor competence and highlights a novel intervention strategy.

The effect of parental logistic support on physical activity in children with, or at risk of, movement difficulties

OBJECTIVES

In a sample of children with, or at risk of, movement difficulties, (1) To test the direct effects of children's perceptions of parents' logistic support for physical activity on children's physical activity-related self-perceptions and on children's physical activity levels, and (2) To explore the indirect relationship between children's perceptions of parents' logistic support for physical activity and children's physical activity levels through children's physical activity-related self-perceptions.

DESIGN

Cross-sectional observation study.

METHODS

Data were collected from 120 children aged 6 to 12 years; movement proficiency levels were determined using the movement assessment battery for children-2 test. Children's perspectives of parental support for physical activity were captured using the Activity Support Scale for Multiple Groups child report. Children's self-perceptions towards physical activity were reported with the Children's Self- perceptions of Adequacy in and Predilections for physical activity, and time spent in physical activity were measured using accelerometers.

RESULTS

There was no significant direct effect between perceived levels of parents' logistic support for physical activity and children's physical activity. A significant indirect relationship between these variables was discovered, with higher perceived levels of parent logistical support for physical activity predicting stronger perceptions of adequacy (i.e., confidence) toward physical activity participation among children, which in turn was associated with increased physical activity minutes.

CONCLUSIONS

The results demonstrate that irrespective of a child's movement ability, children's perceptions of parents' logistic support for physical activity indirectly and positively predicts children's physical activity levels, via children's confidence for physical activity.

A school-based physical activity intervention for children with developmental coordination disorder: A randomized controlled trial

BACKGROUND

Children with developmental coordination disorder (DCD) have lower physical activity (PA) than children with typical development (TD). PA and fundamental movement skills (FMS) are positively associated so interventions that promote FMS of children with DCD are recommended.

AIM

To examine the effects of a school-based FMS training program on motor functions, PA and other psychological outcomes.

METHODS AND PROCEDURES

A total of 131 primary children were allocated to FMS training groups (DCD-FMS n = 35, TD-FMS n = 29), which received FMS training (eight weekly 40-min sessions), or to control groups (DCD-C n = 34, TD-C n = 33), which received conventional physical education lessons. Outcome measures, including accelerometer-assessed PA, motor functions, and self-perceived competence and enjoyment, were measured at baseline, 1-week (immediate effect), 3-months (short-term effect) and 12-months (longer-term effect) after the intervention.

OUTCOMES AND RESULTS

FMS training resulted in improved FMS proficiency and increased PA and enjoyment of activity participation in children. In particular, the DCD-FMS group reported greater enjoyment over time. Some effects were also evident for both short- and longer-term.

CONCLUSIONS AND IMPLICATIONS

The findings suggest that a school-based FMS training program has the potential to promote physical and psychological health in children with DCD in the long run.