Internalising symptoms in Developmental Coordination Disorder: The indirect effect of everyday executive function

Paediatric motor difficulties and internalising problems: an integrative review on the environmental stress hypothesis

The current study aims to provide an in-depth analysis and extension of the Environmental Stress Hypothesis (ESH) framework, focusing on the complex interplay between poor motor skills and internalising problems like anxiety and depression. Using an integrative research review methodology, this study synthesises findings from 38 articles, both empirical and theoretical, building upon previous foundational works. The hypothesis posits that poor motor skills serve as a primary stressor, leading to internalising problems through various secondary stressors. A rigorous comparison of data was conducted, considering study design, findings, and methodologies-while exploring variables such as age, sex, and comorbidities. The study also enhances the ESH framework by including intrapersonal stressors and introducing resource buffers, including optimism and familial support as additional influencing factors. This multi-level approach yields a more nuanced and comprehensive ESH framework, highlighting the need for future studies to consider variables that intersect across multiple domains and how the relationship between poor motor skills and internalising problems may vary across different life stages.

The relationship between executive function and the association of motor coordination difficulties and social communication deficits in autistic children

Background

Motor coordination difficulties could contribute to social communication deficits in autistic children. However, the exploration of the mechanism implicated in these claims has been limited by the lack of potential confounders such as executive function (EF).

Methods

We investigated the role that EF plays in the relationship between motor coordination and social communication in a school-aged autistic population via a structural model in a statistically robust manner. The results of questionnaires, including the Developmental Coordination Disorder questionnaire, the Behavior Rating Inventory of Executive Function, and the Social Responsiveness Scale, were collected to measure motor coordination, social communication deficits, and EF.

Results

A total of 182 autistic children (7.61±1.31 years, 87.9% boys) were included in the final analysis. In the model with EF as a mediator, the total effect (β=-0.599, P<0.001) and the direct effect (β=-0.331, P =0.003) of motor coordination function on social communication were both significant among autistic children without intellectual disability (ID), as were indirect effects through EF (β=-0.268, P<0.001).

Conclusion

EF partially mediates the motor coordination and social communication correlation among autistic children. We suggest that motor coordination should be included in the routine evaluation of autistic surveillance and rehabilitation procedures.

Investigating the Mediating Role of Executive Function in the Relationship Between ADHD and DCD Symptoms and Depression in Adults

This study was designed to test the effects of Attention Deficit Hyperactivity Disorder (ADHD) and Developmental Co-ordination Disorder (DCD) on depression levels and investigate the mediating role of executive function (EF) in adults. Adults with ADHD, DCD, and ADHD + DCD (N = 139) completed self-report measures of ADHD, DCD, depression, and EF. There were distinct profiles of EF across diagnostic groups, and higher depression symptoms in adults with ADHD + DCD than DCD alone. All EF domains were predicted by ADHD symptoms, and several by DCD symptoms. ADHD and DCD symptoms, and most EF domains, predicted depression symptoms. Overall EF difficulties fully mediated the relationships between ADHD/DCD and depression symptoms. Several specific EF domains relating to behavioural regulation and metacognition also showed full/partial mediating effects. The mediating role of EF difficulties between these neurodevelopmental conditions and depression symptoms has implications for their understanding and treatment, suggesting that targeting EF may be important for preventing co-occurring depression.

Relationships between motor skills and executive functions in developmental coordination disorder (DCD): A systematic review

BACKGROUND

Individuals with developmental coordination disorder (DCD) experience motor skill and executive function (EF) difficulties that challenge their daily activities.

AIM/OBJECTIVE

This systematic review aims to provide an in-depth analysis of the relationships between motor skills and EFs in studies among individuals with DCD.

MATERIAL AND METHODS

We conducted a systematic search of eight electronic databases for articles (published 1994-2021) reporting on quantitative studies that estimated relationships between motor skills and EFs when assessing children, adolescents and adults with DCD. Motor skills and EFs were assessed via reliable and validated assessment tools. Two reviewers independently screened the articles. We evaluated the quality of the selected articles according to EPHPP guidelines and the methodological quality of the assessments from these studies using the COSMIN checklist and reported results following the PRISMA-P checklist. This systematic review was registered in PROSPERO (CRD42019124578).

RESULTS

A total of 30,808 articles were screened. Eleven articles met the inclusion criteria and were reviewed. Findings from nine studies demonstrated weak to strong correlations between aspects of motor skills and EFs.

CONCLUSIONS AND SIGNIFICANCE

Limited evidence supports the relationships between motor skills and EFs among individuals with DCD. Occupational therapists should consider the possibility of this relationship and give more consideration to these components when planning intervention for individuals with DCD.

The relationship between executive function, neurodevelopmental disorder traits, and academic achievement in university students

Difficulties with executive function have often been identified in individuals with various neurodevelopmental disorders such as Autism Spectrum Disorder (ASD), Attention-Deficit Hyperactivity Disorder (ADHD), and Developmental Co-ordination Disorder (DCD). Additionally, in childhood and adolescence, executive functioning is an important predictor of academic achievement. However, less research has explored these relationships in adult students, and those with a high level of neurodevelopmental disorder traits but no clinical diagnosis. Therefore, the current study aimed to assess whether ASD, ADHD, and DCD traits can predict academic achievement in university students, and whether traits of these neurodevelopmental conditions moderate the relationship between executive function and academic achievement. Both neurotypical students and those with a clinical diagnosis of a neurodevelopmental disorder were able to participate, with the majority being neurotypical. Participants completed four self-report questionnaires and provided a measure of academic achievement based on their university assignment results. Traits of ASD, ADHD, and DCD alone did not predict achievement, however, traits of ADHD and DCD significantly moderated the relationship between executive function and academic achievement. ASD traits did not significantly moderate this relationship. Implications and suggestions for future research are also discussed.

Sensory Modulation in Children with Developmental Coordination Disorder Compared to Autism Spectrum Disorder and Typically Developing Children

Developmental Coordination Disorder (DCD) is one of the least studied and understood developmental disorders. One area that has been minimally investigated in DCD is potential issues with sensory modulation. Further, in other neurodevelopmental disorders (e.g., autism spectrum disorder (ASD)) sensory modulation is related to many other challenges (e.g., social issues, repetitive behaviors, anxiety); however, such potential relationships in children with DCD have been largely unexplored. The purpose of this study is to explore sensory modulation differences in DCD and to understand the relationships between sensory modulation and social emotional measures, behavior, and motor skills in DCD in comparison to ASD and typically developing (TD) peers. Participants (aged 8-17) and their caregivers (DCD, N = 26; ASD, N = 57; and TD, N = 53) completed behavioral and clinical measures. The results indicated that 31% of the DCD group showed sensory modulation difficulties, with the DCD group falling between the ASD and TD groups. In the DCD group, sensory modulation was significantly associated with anxiety, empathic concern, repetitive behaviors, and motor skills. Data are compared to patterns seen in ASD and TD groups and implications for interventions are discussed.