Developmental coordination disorder: associated problems in attention, learning, and psychosocial adjustment

Excessive body weight in developmental coordination disorder: A systematic review and meta-analysis

Evidence on the link between developmental coordination disorder (DCD) and obesity and overweight is mixed. Based on a pre-registered protocol (PROSPERO: CRD42023429432), we conducted the first systematic review/meta-analysis on the association between DCD and excessive weight. Web of Science, PubMed and an institutional database aggregator were searched until the 18th of December 2023. We assessed study quality using the Newcastle-Ottawa Scale and study heterogeneity using Q and I2 statistics. Data from 22 studies were combined, comprising 11,330 individuals out of which 1861 had DCD. The main analysis showed a significant association between DCD and higher body weight (OR:1.87, 95 % CI =1.43, 2.44). Meta-regression analyses indicated that the relationship was mediated by age, with stronger effects in studies with higher mean age (p 0.004). We conclude that DCD is associated with obesity and overweight, and this association increases with age. Our study could help to implement targeted prevention and intervention measures.

Evaluating the impact of virtual reality game training on upper limb motor performance in children and adolescents with developmental coordination disorder: a scoping review using the ICF framework

OBJECTIVE

This scoping review aims to explore published literature testing Virtual Reality (VR) interventions for improving upper limb motor performance in children and adolescents with Developmental Coordination Disorder (DCD). Our primary focus was on the types of VR systems used and the measurement tools employed within the International Classification of Functioning, Disability and Health Children and Youth Version (ICF-CY) domains in these studies.

METHODS

A comprehensive search of six electronic databases up to 11th January 2024 was conducted using predefined terms. Inclusion and exclusion criteria were applied to determine study eligibility, with two authors independently assessing titles, abstracts, and full-text articles.

RESULTS

Out of 788 potential studies, 14 met the eligibility criteria. Studies predominantly utilized non-immersive VR (nVR) systems, for example, commercial platforms such as Nintendo Wii. Most interventions targeted general motor coordination or balance, with only four studies specifically focusing on upper limb motor performance. The Movement Assessment Battery for Children-2 was the predominant assessment tool. However, the use of game scores and trial durations raised concerns about the accuracy of assessments. The majority of studies reported no significant improvement in upper limb motor performance following VR interventions, though some noted improvements in specific tasks or overall outcomes.

CONCLUSION

The findings suggest that, while nVR interventions are being explored for paediatric motor rehabilitation, their impact on enhancing upper limb motor performance in children with DCD is unclear. The variability in intervention designs, outcome measures, and the predominant focus on general motor skills rather than specific upper limb improvements highlight the need for more targeted research in this area.

IMPACT

This review underscores the importance of developing precise and clinically relevant measurement tools in a broader range of VR technologies to optimize the use of VR in therapy for children with DCD. Future research should aim for more rigorous study designs and emerging immersive technologies to maximize therapeutic benefits.

Motor skills and capacities in developmental dyslexia: A systematic review and meta-analysis

In recent decades, the connections between academic skills, such as reading, writing, and calculation, and motor skills/capacities have received increasing attention. Many studies provided evidence for motor difficulties in children and adolescents with dyslexia, prompting the need for a meta-analysis to combine these multiple findings. Therefore, we conducted a meta-analysis using PsycINFO, Pubmed, and SportDiscus as scientific databases. A total of 572 studies were analyzed following several stringent inclusion criteria, resulting in the inclusion of 23 peer-reviewed studies in the final analysis. Our results showed that children and adolescents with dyslexia displayed significant different performances in multiple motor tasks and these differences persisted also when the type of motor task was considered as moderator in the analysis. The present findings are in accordance with the literature that supports a close connection between reading disabilities and difficulties in motor skills/capacities.

Cortical grey matter volume differences in children with developmental coordination disorder compared to typically developing children

Introduction

The cause of Developmental Coordination Disorder (DCD) is unknown, but neuroimaging evidence suggests that DCD may be related to altered brain development. Children with DCD show less structural and functional connectivity compared to typically developing (TD) children, but few studies have examined cortical volume in children with DCD. The purpose of this study was to investigate cortical grey matter volume using voxel-based morphometry (VBM) in children with DCD compared to TD children.

Methods

This cross-sectional study was part of a larger randomized-controlled trial (ClinicalTrials.gov ID: NCT02597751) that involved various MRI scans of children with/without DCD. This paper focuses on the anatomical scans, performing VBM of cortical grey matter volume in 30 children with DCD and 12 TD children. Preprocessing and VBM data analysis were conducted using the Computational Anatomy Tool Box-12 and a study-specific brain template. Differences between DCD and TD groups were assessed using a one-way ANOVA, controlling for total intracranial volume. Regression analyses examined if motor and/or attentional difficulties predicted grey matter volume. We used threshold-free cluster enhancement (5,000 permutations) and set an alpha level of 0.05. Due to the small sample size, we did not correct for multiple comparisons.

Results

Compared to the TD group, children with DCD had significantly greater grey matter in the left superior frontal gyrus. Lower motor scores (meaning greater impairment) were related to greater grey matter volume in left superior frontal gyrus, frontal pole, and right middle frontal gyrus. Greater grey matter volume was also significantly correlated with higher scores on the Conners 3 ADHD Index in the left superior frontal gyrus, superior parietal lobe, and precuneus. These results indicate that greater grey matter volume in these regions is associated with poorer motor and attentional skills.

Discussion

Greater grey matter volume in the left superior frontal gyrus in children with DCD may be a result of delayed or absent healthy cortical thinning, potentially due to altered synaptic pruning as seen in other neurodevelopmental disorders. These findings provide further support for the hypothesis that DCD is related to altered brain development.

Study protocol to examine the effects of acute exercise on motor learning and brain activity in children with developmental coordination disorder (ExLe-Brain-DCD)

INTRODUCTION

Developmental coordination disorder (DCD) is one of the most prevalent pediatric chronic conditions. Without proper intervention, significant delays in motor skill performance and learning may persist until adulthood. Moderate-to-vigorous physical exercise has been proven to improve motor learning (adaptation and consolidation) in children with or without disorders. However, the effect of a short bout of physical exercise on motor adaptation and consolidation in children with DCD has not been examined. Furthermore, the role of perceptual-motor integration and attention as mediators of learning has not been examined via neuroimaging in this population.

OBJECTIVES

Therefore, the primary aims of this project will be to compare children with and without DCD to (a) examine the effect of acute exercise on motor learning (adaptation and consolidation) while performing a rotational visuo-motor adaptation task (rVMA), and (b) explore cortical activation in the dorsolateral- and ventrolateral-prefrontal cortex areas while learning the rVMA task under rest or post-exercise conditions.

METHODS

One hundred twenty children will be recruited (60 DCD, 60 controls) and within-cohort randomly assigned to either exercise (13-minute shuttle run task) or rest prior to performing the rVMA task. Adaptation and consolidation will be evaluated via two error variables and three retention tests (1h, 24h and 7 days post adaptation). Cortical activation will be registered via functional near-infrared spectroscopy (fNIRS) during the baseline, adaptation, and consolidation.

DISCUSSION

We expect to find exercise benefits on motor learning and attention so that children with DCD profiles will be closer to those of children with typical development. The results of this project will provide further evidence to: (a) better characterize children with DCD for the design of educational materials, and (b) establish acute exercise as a potential intervention to improve motor learning and attention.

Exploring the presence and impact of sensory differences in children with Developmental Coordination Disorder

BACKGROUND

Children with Developmental Coordination Disorder (DCD) can experience sensory differences. There has been limited exploration of these differences and their impact on children with DCD.

AIMS

i) To explore the presence and impact of sensory differences in children with DCD compared to children without DCD; ii) To examine whether sensory differences are related to motor ability, attention deficit hyperactivity disorder (ADHD), or autistic traits.

METHOD

Parents of children (8-12 years) with (n = 23) and without (n = 33) DCD used standardised questionnaires to report on their children's sensory differences, autistic traits, and ADHD traits. Motor abilities were assessed through the Movement Assessment Battery for Children-2. Data were explored both categorically (between-groups) and dimensionally.

RESULTS

Children with DCD had significantly higher levels of sensory differences than children without DCD. Sensory differences also had a significantly greater impact on daily activities for children with DCD. Higher levels of ADHD and autistic traits, but not motor ability, were significant independent predictors of higher levels of sensory difference.

CONCLUSION

Children with DCD experience high levels of sensory differences, which impact on their daily lives. These sensory differences may be a marker for additional neurodivergence in children with DCD. Practitioners should consider the sensory needs of children with DCD.

WHAT THIS PAPER ADDS

This paper provides insight into the sensory features of children with DCD and the impact that sensory differences can have on daily living. Using parent-report, we found that children with DCD had increased sensory differences relative to children without DCD. These included increased hyperresponsiveness, increased hyporesponsiveness, and increased sensory interests, repetitions, and seeking behaviours (SIRS). We also found that sensory differences had a greater impact on daily living for children with DCD compared to children without DCD. Across the whole sample, autistic traits predicted hyperresponsivity and hyporesponsivity patterns; whereas traits of hyperactivity and impulsivity predicted SIRS. Motor abilities did not uniquely predict sensory differences, suggesting that other traits of neurodivergence may contribute to the sensory differences in DCD. Taken together, these findings highlight the necessity of considering sensory needs when supporting children with DCD. They also suggest that if sensory differences are identified in children with DCD, it may be due to the presence of co-occurring neurodivergent traits or conditions.

Differences in Praxis Errors in Autism Spectrum Disorder Compared to Developmental Coordination Disorder

This study aimed to better understand how autism spectrum disorder (ASD) and developmental coordination disorder (DCD) differ in types of praxis errors made on the Florida Apraxia Battery Modified (FAB-M) and the potential relationships between praxis errors and social deficits in ASD. The ASD group made significantly more timing sequencing errors in imitation of meaningful gestures, as well as more body-part-for-tool errors during gesture-to-command compared to the other two groups. In the ASD group, increased temporal errors in meaningful imitation were significantly correlated with poorer affect recognition and less repetitive behaviors. Thus, in ASD, aspects of imitation ability are related to socioemotional skills and repetitive behaviors.

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.

Anthropometric, physical activity, and psychological characteristics of Korean adults with and without developmental coordination disorder (DCD)

Developmental Coordination Disorder (DCD), also known as Dyspraxia, is characterized by movement difficulties in individuals without discernible neurological disorders or identifiable medical conditions. Previous studies from various countries have highlighted disparities in anthropometric, physical activity, and psychological characteristics between children diagnosed with DCD and their typically developing (TD) peers. These differences are influenced by sociocultural norms and geographical locations. However, little attention has been given to scrutinizing analogous differences in adult populations, particularly within Republic of Korea. This study aims to address this knowledge gap by employing a battery of questionnaires to assess anthropometric, physical activity, and psychological traits in a cohort of 377 Korean adults, encompassing those with DCD (n = 54) alongside TD counterparts (n = 323). It was hypothesized that Korean adults with DCD would exhibit higher body mass index and lower ratings in physical activity and psychological characteristics than TD, consistent with the previous studies performed in other countries on children. The results showed no statistically significant differences between the DCD and TD groups in anthropometric characteristics such as weight (kg), height (cm), and body mass index. The prevalence of walking and biking for daily commuting in daily routines within Korean society might have contributed to the mitigation of anthropometric among individuals with/without DCD. Statistically significant differences were found in physical activity levels at work and recreational settings, as shown in physical activity scores and duration. The DCD group also displayed lower scores across several psychological characteristics, including exercise adherence, intrinsic motivation, self-efficacy, physical self-concept, exercise expectations, and intrinsic regulation. These findings underscore the necessity of incorporating sociocultural dynamics when investigating anthropometric, physical activity, and psychological characteristics in adults with DCD. Their perceived difficulties in fine motor skills were also significantly poor than TD. Future research studies are warranted to elucidate the underlying mechanisms driving the observed patterns in this study, thus contributing to a more nuanced comprehension of how DCD manifests within specific sociocultural contexts.

Possible disrupted biological movement processing in Developmental Coordination Disorder

AIM

There is emerging evidence that the Mirror Neuron System (MNS) might contribute to the motor learning difficulties characteristic of Developmental Coordination Disorder (DCD). This study aimed to identify whether MNS activity differed between children with and without DCD during action observation, action execution and during a non-action baseline.

METHODS

Electroencephalography (EEG) was used to measure mu rhythm (a proxy for MNS activation) in 8-12-year-old children either with (n = 20) or without (n = 19) a diagnosis of DCD. The mu rhythm was recorded at rest and during five experimental conditions: (1) observation of gross motor and (2) fine motor actions; (3) execution of gross motor and (4) fine motor actions; and (5) non-biological movement. To address whether potential co-occurring traits of other neurodevelopmental conditions were associated with differences in mu rhythm, parents reported their child's attention and social communication skills. Mixed and repeated measure ANOVAs were conducted to examine differences in mu desynchronization and mu power respectively.

RESULTS

The non-DCD group showed greater mu rhythm desynchronization than children with DCD (i.e., more MNS activity), with both groups demonstrating increasing desynchronization from observation of fine actions to execution of gross actions. However, we also found that the children with DCD had less mu power during the non-biological movement condition than the non-DCD children, although mu power did not differ between groups during the resting condition. Correlations between mu desynchronization and children's attention and motor skills showed that poorer attention and motor abilities were associated with reduced MNS activity.

CONCLUSION

Compared to children without DCD, the MNS in children with DCD did not distinguish between biological and non-biological movement. It is possible that the reduced specificity of the MNS in children with DCD is an underlying factor in the motor impairments observed in the disorder. The differential MNS activity could reflect broader atypical activity in perceptual networks that feed into the MNS in DCD.

Motor performance and attention outcomes in children born very preterm

AIM

To examine the relationship between motor performance and attention in children born very preterm and at term, and investigate the presence of individual profiles of motor and attention performance.

METHOD

Attention and motor performance at 7 and 13 years were assessed in 197 children born very preterm (52.5% male) and 69 children born at term (47.8% male) between 2001 and 2003. Linear regression models were fitted including an interaction term for birth group. Subgroups of children with similar attention and motor performance profiles were identified using latent profile analysis.

RESULTS

Balance was positively associated with all attention outcomes at both ages (p < 0.006). There were specific birth group interactions for aiming and catching and manual dexterity with attention at 13 years, with positive associations observed only for children born very preterm (p < 0.001). At 7 years, three profiles were observed: average attention and motor functioning; average motor functioning and low attention functioning; and low attention and motor functioning. At 13 years, two profiles of average attention and motor functioning emerged, as well as one profile of below-average attention and motor functioning. Children born very preterm were overrepresented in the lower functioning profiles (born very preterm 56%; born at term 29%).

INTERPRETATION

Motor functioning at age 7 years may be a useful marker of later attention skills, particularly for children born very preterm who are at greater risk of poorer long-term cognitive outcomes.

WHAT THIS PAPER ADDS

Balance was positively associated with attention in children born very preterm and at term. Relationships between motor performance and attention at age 13 years differed between children born very preterm and at term. Heterogeneous motor functioning and attention outcomes were noted for children born very preterm and at term. Children born very preterm were more likely to have lower attention and motor functioning profiles than children born at term. There was greater movement in motor functioning and attention profiles between the ages of 7 and 13 years in children born very preterm.

Physical activity, social-communicative skills and fitness for military service

INTRODUCTION

Research has suggested that increased difficulties in social-communicative skills are associated with release from military service. A few studies have focused on the association between physical activity and military fitness; however, studies of the association between social-communicative skills and physical activity remain scarce. The aim of this study was to investigate the association between the amount of leisure time physical activity and fitness for military service, as well as to investigate the association between social-communicative difficulties and physical activity.

METHODS

This is a population-based cross-sectional 'Young Men in the North Project', in which 2614 men (M age=18.1 years) participated in an obligatory military fitness call-up and filled out the study questionnaire.

RESULTS

The results showed that higher physical performance compared with peers and attaining the weekly amount of moderate-to-vigorous physical activity were associated with lower likelihood of being permanently or temporarily released from the service. In addition, difficulties in social-communicative skills were associated with lower physical performance and lower weekly amounts of moderate-to-vigorous physical activity. The results also showed that higher physical performance or attaining the recommended weekly amount of moderate-to-vigorous physical activity, together with higher social-communicative skills, lowered the likelihood of being permanently or temporarily released from the service.

CONCLUSIONS

These results suggest that better physical performance, or a higher level of physical activity, together with better social-communicative skills, lowers the likelihood of being permanently and temporarily released from the military service more than physical performance or physical activity alone.

Five-to-Fifteen-Parental Perception of Developmental Profile from Age 5 to 8 Years in Children Born Very Preterm

Children born very preterm have increased risk of developmental difficulties. We examined the parental perception of developmental profile of children born very preterm at 5 and 8 years by using the parental questionnaire Five-to-Fifteen (FTF) compared to full-term controls. We also studied the correlation between these age points. The study included 168 and 164 children born very preterm (gestational age < 32 weeks and/or birth weight ≤ 1500 g) and 151 and 131 full-term controls. The rate ratios (RR) were adjusted for sex and the father's educational level. At 5 and 8 years, children born very preterm were more likely to have higher scores (more difficulties) compared to controls in motor skills (RR = 2.3, CI 95% = 1.8-3.0 at 5 years and RR = 2.2, CI 95% = 1.7-2.9 at 8 years), executive function (1.7, 1.3-2.2 and 1.5, 1.2-2.0), perception (1.9, 1.4-2.5 and 1.9, 1.5-2.5), language (1.5, 1.1-1.9 and 2.2, 1.7-2.9), and social skills (1.4, 1.1-1.8 and 2.1, 1.6-2.7), and at 8 years in learning (1.9, 1.4-2.6) and memory (1.5, 1.2-2.0). There were moderate-to-strong correlations (r = 0.56-0.76, p < 0.001) in all domains between 5 and 8 years in children born very preterm. Our findings suggest that FTF might help to earlier identify children at the greatest risk of incurring developmental difficulties persisting to school-age.

Where Do Neurodevelopmental Disorders Go? Casting the Eye Away from Childhood towards Adulthood

Neurodevelopmental disorders (NDDs) encompass a group of complex conditions with onset during the early developmental period. Such disorders are frequently associated with a number of neuropsychiatric features, the most prevalent ones being autism spectrum disorder, attention-deficit/hyperactivity disorder, intellectual disability, communication and specific learning disorders, and motor disorders. These conditions are characterized by wide genetic and clinical variability, and although they were previously conceptualized as childhood-limited disorders, NDDs are progressively being recognized as persistent conditions with a potentially relevant impact on the quality of life and overall functioning during adult life. In addition, emerging evidence seems to point towards the hypothesis of a neurodevelopmental continuum, according to which NNDs could portray different time-dependent outcomes, depending on the severity of the altered brain development. Despite representing lifelong phenotypes, they are often not promptly identified and/or managed in adulthood. In this regard, specific guidelines on clinical and therapeutic approaches for these conditions have not yet been delineated. In this view, future research investigations should be encouraged to broaden available knowledge, characterize the clinical course of NDDs across an individual’s lifespan, and better understand the patterns of aging-related concerns in adults with an NDD diagnosis. Additionally, considering the difficulties many young adults encounter while transitioning from childhood to adult mental health services, new, specific programs should be developed and existing programs should be implemented to improve the transition process and for the management of NDDs in adulthood.

Functional connectivity based brain signatures of behavioral regulation in children with ADHD, DCD, and ADHD-DCD

Behavioral regulation problems have been associated with daily-life and mental health challenges in children with neurodevelopmental conditions such as attention-deficit/hyperactivity disorder (ADHD) and developmental coordination disorder (DCD). Here, we investigated transdiagnostic brain signatures associated with behavioral regulation. Resting-state fMRI data were collected from 115 children (31 typically developing (TD), 35 ADHD, 21 DCD, 28 ADHD-DCD) aged 7-17 years. Behavioral regulation was measured using the Behavior Rating Inventory of Executive Function and was found to differ between children with ADHD (i.e., children with ADHD and ADHD-DCD) and without ADHD (i.e., TD children and children with DCD). Functional connectivity (FC) maps were computed for 10 regions of interest and FC maps were tested for correlations with behavioral regulation scores. Across the entire sample, greater behavioral regulation problems were associated with stronger negative FC within prefrontal pathways and visual reward pathways, as well as with weaker positive FC in frontostriatal reward pathways. These findings significantly increase our knowledge on FC in children with and without ADHD and highlight the potential of FC as brain-based signatures of behavioral regulation across children with differing neurodevelopmental conditions.

[Formula: see text]Is active video gaming associated with improvements in social behaviors in children with neurodevelopmental disorders: a systematic review

Active video gaming (AVG) is a way that children with neurodevelopmental disorders can participate in social play and could be associated with improvements in social behaviors. However, limited research has investigated if AVG is associated with improvements in social behaviors in children and adolescents with neurodevelopmental disorders. A systematic literature search was conducted in Medline, Embase, Psycinfo, Cinahl, and Eric, Web of Science, and Scopus. Three main concepts were searched: exergaming, neurodevelopmental disorders, and social behaviors. Keywords and subject headings were used for each concept. 3080 articles were identified in the initial search in 2019; in January 2021, 167 additional articles were identified. Of these, 8 studies with 242 children with autism spectrum disorder, cerebral palsy, or developmental coordination disorder were included in this review. Six studies reported that participation in AVG was associated with improved social functioning, social interaction, emotional well-being, and social/emotional skills in children with ASD, CP, and DCD. In contrast, two studies that included children diagnosed with ASD did not find any association between AVG participation and social behaviors. The findings of this systematic review suggest that participation in an AVG intervention may be associated with improved social behaviors in children and adolescents with ASD, CP, and DCD. However, due to the limited number of studies included, this finding must be interpreted with caution. Future research is needed that examines the treatment fidelity of AVG in improving social behavior skills in children with neurodevelopmental disorders and the generalizability of these skills to real-life social situations.

Gross motor disorders in pediatric patients with acute lymphoblastic leukemia and survivors: A systematic review

Acute Lymphoblastic Leukemia (ALL) is the most common cancer in children and toxicities related to treatment are common. One of these adverse effects is related to the musculoskeletal system and especially to gross motor skills that allow body movements: walking, running, jumping, and balance. This systematic review aims to describe gross motor impairments in pediatric patients with ALL during and after chemotherapeutic treatment and to identify the most commonly used tools for their assessment. Multiple electronic databases were searched for observational studies describing gross motor skills in children with ALL and the assessment tool used. The STROBE checklist was used to assess the reporting quality of each study. Ten studies were included in this review with assessments of gross motor skills in children with ALL undergoing treatment and survivors. Evidence suggests impairments in the performance of daily life activities during intensification and maintenance and persists up to 5 to 6 years after treatment´s cessation. Balance problems are noted at the start of treatment when the cumulative dose of vincristine is low and, in the survivors, it was the most reported alteration. These skills are essential for an adequate performance of children in daily life activities, recreation and leisure. We emphasize the need to assess gross motor skills and implement interventions that include physiotherapy and occupational rehabilitation in children with ALL.

Differences between Healthy-Weight and Overweight Serbian Preschool Children in Motor and Cognitive Abilities

The aim of this study was to determine the differences between healthy-weight and overweight 5-6-year-old preschool children in fine and gross motor skills and cognitive abilities. There were 91 subjects, preschool children (41 boys and 50 girls), who participated in this cross-sectional study. The body mass index (BMI) was calculated based on measures of body height and body mass, and WHO cutoff points were used for the assessment of the children's nutrition status. Fine motor abilities were determined using two Bruininks-Oseretsky (BOT-2) subtests, and gross motor skills are determined by the Test of Gross Motor Development (TGMD-2), while cognitive abilities were tested by the School Maturity Test (TZŠ+). Based on an independent-samples t-test, a difference in two out of three variables of gross motor skills was determined: manipulative skills and total gross motor skills between healthy-weight and overweight children, while in fine motor abilities and cognitive abilities there was no difference between these two groups. Although significant differences were found only in gross motor skills between healthy and overweight preschool children but not in fine motor skills and cognitive abilities, further longitudinal studies are required to understand the mechanisms of this, including the possible role of psychological factors.

Cerebellar and brainstem differences in children with developmental coordination disorder: A voxel-based morphometry study

Developmental coordination disorder (DCD) is a neurodevelopmental disorder that significantly impairs a child’s ability to learn motor skills and to perform everyday activities. The cause of DCD is unknown; however, evidence suggests that children with DCD have altered brain structure and function. While the cerebellum has been hypothesised to be involved in developmental coordination disorder, no studies have specifically examined cerebellar structure in this population. The purpose of our study was to examine cerebellar differences in children with DCD compared to typically-developing children. Using voxel-based morphometry, we assessed cerebellar morphology in children 8–12 years of age. Forty-six children (12 typically-developing and 34 with DCD) were investigated using high resolution T1-weighted images, which were then processed using the spatially unbiased atlas template of the cerebellum and brainstem (SUIT) toolbox for a region of interest-based examination of the cerebellum. Results revealed that children with DCD had reduced grey matter volume in several regions, namely: the brainstem, right/left crus I, right crus II, left VI, right VIIb, and right VIIIa lobules. Further, Pearson correlations revealed significant positive associations between the total motor percentile score on the Movement Assessment Battery for Children-2 and regions that had reduced grey matter volume in our cohort (brainstem, left crus I, right VIIb, and right VIIIa). These findings indicate that reductions in cerebellar grey matter volume are associated with poorer motor skills. Given the cerebellum’s involvement in internal models of movement, results of this study may help to explain why children with DCD struggle to learn motor skills.

Developmental Coordination Disorder and Most Prevalent Comorbidities: A Narrative Review

This narrative review describes, in detail, the relationships between Developmental Coordination Disorder (DCD) and most prevalent associated comorbidities in their complexity, heterogeneity and multifactoriality. The research has been conducted on the main scientific databases, excluding single case papers. Blurred borders between the different nosographic entities have been described and advances in this field have been highlighted. In this multifaceted framework a specific profiling for co-occurring DCD, ADHD and ASD signs and symptoms is proposed, confirming the need for a multidisciplinary approach to define new diagnostic paradigms in early childhood.

Motor impairments in early onset schizophrenia

AIM

Motor impairments are frequent both at and before diagnosis. In childhood, impairments in general fine and gross motor function are among others identified using test batteries, and while elements of coordination are assessed in onset schizophrenia, the assessment of general motor functions is absent. Thus, we aimed to assess general motor function including childhood motor function in adolescents with schizophrenia in comparison with healthy controls and examine clinical correlates to general motor function.

METHOD

General fine and gross motor function was assessed using two standardized age-normed test batteries and a questionnaire in 25 adolescents with schizophrenia compared with age and gender-matched controls using t-test and χ² -test. Stepwise linear regression assessed potential developmental predictors on motor function including complications during childbirth, reported childhood motor function, executive function including false discovery rate q-values. Associations with schizophrenia symptom severity, executive function, cognitive function were assessed using Pearson's correlation and the impact of antipsychotic medication using t-test.

RESULT

All measures of motor function but one significantly differentiated adolescents with schizophrenia from healthy controls. The presence of schizophrenia (β =4.41, β = 10.96), explained the main part of the variance however, childhood motor function (β = .08) also added significantly to motor function. Executive function (β = -.45) was important for childhood motor function. Severity of schizophrenia was associated with strength (p < .0011) and manual coordination (p = .0295), and receiving antipsychotics affected manual dexterity (p = .0378).

CONCLUSION

The documentation of significant differences in general motor function in early onset schizophrenia compared with healthy controls highlights the need for general motor assessments and potential interventions.

Atypical resting-state functional brain connectivity in children with developmental coordination disorder

•

Atypical connectivity in children with developmental coordination disorder.

•

Stronger connectivity mainly found within the dorsal extrastriate network.

•

May reflect a brain trait of children with developmental coordination disorder.

•

This atypical connectivity is not associated with motor/visual perceptual abilities.

•

Lower visuomotor performance associated with stronger sensorimotor connectivity.

Children with developmental coordination disorder (DCD) present lower abilities to acquire and execute coordinated motor skills. DCD is frequently associated with visual perceptual (with or without motor component) impairments. This magnetoencephalography (MEG) study compares the brain resting-state functional connectivity (rsFC) and spectral power of children with and without DCD.

29 children with DCD and 28 typically developing (TD) peers underwent 2 × 5 min of resting-state MEG. Band-limited power envelope correlation and spectral power were compared between groups using a functional connectome of 59 nodes from eight resting-state networks. Correlation coefficients were calculated between fine and gross motor activity, visual perceptual and visuomotor abilities measures on the one hand, and brain rsFC and spectral power on the other hand. Nonparametric statistics were used.

Significantly higher rsFC between nodes of the visual, attentional, frontoparietal, default-mode and cerebellar networks was observed in the alpha (maximum statistics, p = .0012) and the low beta (p = .0002) bands in children with DCD compared to TD peers. Lower visuomotor performance (copying figures) was associated with stronger interhemispheric rsFC within sensorimotor areas and power in the cerebellum (right lobule VIII).

Children with DCD showed increased rsFC mainly in the dorsal extrastriate visual brain system and the cerebellum. However, this increase was not associated with their coordinated motor/visual perceptual abilities. This enhanced functional brain connectivity could thus reflect a characteristic brain trait of children with DCD compared to their TD peers. Moreover, an interhemispheric compensatory process might be at play to perform visuomotor task within the normative range.

Relationship between the Developmental Coordination Disorder Questionnaire 2007 and the Bruininks-Oseretsky Test of Motor Proficiency Second Edition in Korean Children

This study investigated the relationship between the Developmental Coordination Disorder Questionnaire 2007 (DCDQ’07) and the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2) in Korea. This study also adjusted the cutoff score of the DCDQ’07 based on the BOT-2 for Korean children. A total of 256 children were recruited from communities in Korea. They were divided into two age groups: 8 to 9 years old and 10 to 12 years old. Children performed the BOT-2, and their parents completed the DCDQ’07. The correlation between the DCDQ’07 and the BOT-2 was analyzed. The adjusted DCDQ’07 cutoff score for Korean children was calculated using the BOT-2 as the criterion through a receiver operating characteristic curve. A significant correlation between the DCDQ’07 and the BOT-2 was found, indicating that Korean parents’ perception of children’s motor skills was related to their children’s actual motor proficiency. The adjusted cutoff score of the DCDQ’07 had a sensitivity of 72.7–85.7% and a specificity of 62.5–64.0%. This study demonstrated that children’s motor skills reported by Korean parents on the DCDQ’07 were valid based on a community sample. The adjusted cutoff score of the DCDQ’07 could be used to identify children suspected of having a developmental coordination disorder.

Retrospective Case-Control Study of Communication and Motor Abilities in 143 Children With Suspected Childhood Apraxia of Speech: Effect of Concomitant Diagnosis

Purpose

This study sought to determine if children with childhood apraxia of speech (CAS) plus another major diagnosis (CAS+) are equivalent in communication and motor profiles to those with a primary diagnosis of CAS and no indication or report of any other diagnosis (CAS-Primary).

Method

This retrospective case-control study included a chart review of 143 children who were suspected of having CAS at Children's Hospital-Wisconsin between 1998 and 2004. Participants were between 30 and 127 months old and included 107 males. Participants were assigned to the suspected CAS-Primary group (n = 114) if they had characteristics of CAS but no other major diagnosis (e.g., galactosemia) and to the CAS+ group (n = 29) if a comorbid diagnosis was present. Groups were compared across demographic, communication, and motor characteristics.

Results

Children with CAS+ evidenced more severe motor profiles than those with CAS-Primary, χ² = (1, n = 122) = 4.952, p = .026, and a small-to-medium effect size (Φ = .201). On average, communication profiles also tended to be more severe among those with CAS+ wherein receptive language was poorer and phonemic inventories were smaller than those with CAS-Primary.

Conclusions

These retrospective data suggest that comorbid diagnosis may play an important role in communication and motor development in children with suspected CAS. These exploratory findings should motivate future prospective studies that consider the role of concomitant diagnoses in symptom profile and response to treatment in children with CAS.

The Organization of Diagnosis, Care and Funding for Specific Learning and Developmental Disorders (SLDD): A French Regional Experimental Protocol

Introduction: Access in France to early diagnosis and care for the most severe, but infrequent, Neurodevelopmental Disorders (NDD), autism spectrum disorder and global developmental delay, in children aged 0-7 was improved through measures implemented in 2019. However, there are no such measures for specific learning disorders (SLD), attention, motricity and language disorders (SLDD), despite their annual incidence of between 5 and 8%. Method: We describe the design of a new type of organization and financing of care for SLDD including evaluation procedure, as well as other factors, mainly at the prevention level that will contribute to local and national policy for this frequent health problem. This in response to a national call for projects, commonly called Article 51, targeted innovation in healthcare delivery and funding in the context of medium-term national reform. This provides project stakeholders with the opportunity to set up and implement "bottom-up" projects, mainly using local professionals. A joint initiative by the regional Health Authorities of the Occitanie region, the French Social Security system and a non-profit Association (Occitadys) proposed an experimental new structure of NDD care and funding. Discussion: We here discuss the design of this experiment that aims, over two to three years, to alleviate families' financial burden of care and establish a regional three-tier care system with respect to evaluation, re-education and rehabilitation care. Our approach may benefit SLDD health-care planning, and addresses the questions of prevention, early detection and care-design for families, taking local and socioeconomic disparities into account.

Motor Functional Characteristics in Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorders: A Systematic Review

BACKGROUND

The development of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs) has various influences on physical abilities. Identification of specific physical abilities of people with ADHD/ASDs as biomarkers for diagnosing these conditions is necessary. Therefore, in the present review, we aimed firstly to extract the difference in physical abilities of people with ADHD or ASDs compared to those of normal individuals. Secondly, we aimed to extract the specific physical ability characteristics for identifying potential diagnostic biomarkers in people with ADHD/ASDs.

METHODS

A systematic literature review was performed. The databases were searched for relevant articles on motor function deficits and characteristics of ADHD or ASD.

RESULTS

Forty-one cross-sectional studies and three randomized controlled trials were identified, comprising 33 studies of ADHD, 10 studies of ASDs, and 1 study of both ADHD and ASDs. The quality of studies varied. Three types of physical activities/exercises were identified, including coordinated movement, resistance-type sports, and aerobic-type sports. People with ADHD/ASDs generally exhibited poorer physical abilities for all types of activities, possibly because of low levels of physical activity. Specifically, we found temporal discoordination of movement in ADHD and integration or synchronization of separate movements in ASDs.

CONCLUSION

Specific deficits in physical ability may be attributed to ADHD/ASDs. However, there is not enough research on the physical abilities of people with ADHD and ASDs to clarify the specific deficits. Investigation of specific motor functions that characterize ADHD/ASDs should be facilitated.

Externalizing problems mediate the relationship between motor proficiency and internalizing problems in children: An extension of the Environmental Stress Hypothesis

The Environmental Stress Hypothesis (ESH) is a causal theoretical framework that provides a flexible context for understanding factors that mediate the relationship between low motor proficiency and internalizing problems in children. The purpose of the present study was to use the ESH framework to determine whether body mass index (BMI), physical activity levels, psychosocial health and physical health, self-efficacy, perceived social status, prosocial behavior and externalizing problems were potential mediators between motor proficiency and internalizing factors in a population of Brazilian children. 431 children aged 7- to 10 years (240 females, 191 males) participated in the study. The variables were measured with the Movement Assessment Battery for Children, 2^nd ed. (MABC-2), the Pediatric Quality of Life Inventory (PedsQL), the Strengths and Difficulties Questionnaire (SDQ), the MacArthur Subjective Social Status Scale (MacArthur SSS), the Self-efficacy Sense Assessment Roadmap (RASAE), and the Physical Activity Questionnaire (PAQ). The results indicated a direct relationship between motor proficiency and internalizing problems in a population of Brazilian children, with externalizing problems being the only variable mediating that relationship. To the best of our knowledge, this is the first time that externalizing problems were tested in the context of the ESH. Understanding and evaluating potential mediators in the relationship between motor proficiency and internalizing problems using the ESH framework is essential to promote prevention policies and interventions for school-age children.

Body schema plasticity is altered in Developmental Coordination Disorder

Developmental Coordination Disorder (DCD) is a pathological condition characterized by impaired motor skills. Current theories advance that a deficit of the internal models is mainly responsible for DCD children's altered behavior. Yet, accurate movement execution requires not only correct movement planning, but also integration of sensory feedback into body representation for action (Body Schema) to update the state of the body. Here we advance and test the hypothesis that the plasticity of this body representation is altered in DCD. To probe Body Schema (BS) plasticity, we submitted a well-established tool-use paradigm to seventeen DCD children, required to reach for an object with their hand before and after tool use, and compared their movement kinematics to that of a control group of Typically Developing (TD) peers. We also asked both groups to provide explicit estimates of their arm length to probe plasticity of their Body Image (BI). Results revealed that DCD children explicitly judged their arm shorter after tool use, showing changes in their BI comparable to their TD peers. Unlike them, though, DCD did not update their implicit BS estimate: kinematics showed that tool use affected their peak amplitudes, but not their latencies. Remarkably, the kinematics of tool use showed that the motor control of the tool was comparable between groups, both improving with practice, confirming that motor learning abilities are preserved in DCD. This study thus brings evidence in favor of an alternative theoretical account of the DCD etiology. Our findings point to a deficit in the plasticity of the body representation used to plan and execute movements. Though not mutually exclusive, this widens the theoretical perspective under which DCD should be considered: DCD may not be limited to a problem affecting the internal models and their motor functions, but may concern the state of the effector they have to use.

What Do We Know About Motor Development of Preterm Children Without Major Neurological Damage and Disorder? A Narrative Review

This review addresses the question of a possible specificity of motor development of preterm children with no diagnosis of neurological impairment or major cerebral lesion. With that goal, we proceed with a narrative review on the basis of nine studies. All the studies used standardized assessments of motor abilities with a comparison methodology of preterm and full-term groups aged between 3 and 8 years. The review stresses three major findings in the preterm groups as compared with the full-term groups: (a) inferior fine motor abilities; (b) heterogeneity in motor skills; and (c) differences in efficiency of cognitive, perceptual, and mobilization of perceptual motor processes, which do not necessarily result in lower scores in global performances. These findings suggest the need of long-term medical follow-up for all preterm children whether or not they are at risk for neurodevelopmental disorder. Focusing attention on the use of sensory information for motor control in preterm children could also lead to more precise evaluations of motor abilities, which will then provide more detailed parameters for improved learning and rehabilitation programs.

Effects of Quiet Eye Training on Performance of Bimanual Coordination in Children with DCD

Objectives

Children with developmental coordination disorder (DCD) are physically characterized by poor motor coordination and are at particular risk of losing their motor control. Quiet eye training (QET), with the latest techniques as an uncomplicated approach recently entered the field of rehabilitation research, has drawn the researchers’ attention. Therefore, the objective of this study was to examine the effects of QET on the performance of bimanual coordination in children with DCD.

Materials & Methods

Children with DCD (n=20; aged 8-9 years) were randomly divided into two groups, including QET and traditional training (TT). The participants performed bimanual in-phase and anti-phase movements with their wrists at three speed levels ranging from slow to fast. Bimanual coordination accuracy was assessed at the baseline, after 4 weeks at study completion, and at the retention test.

Results

Bimanual coordination improved over time from the baseline to study completion. The results showed that there was a significant difference between the pretest and posttest in the QET group (P=0.001), and bimanual coordination accuracy in the posttest significantly increased, compared to that reported for the pretest. Moreover, there was a significant difference between the pretest and posttest in bimanual coordination accuracy in the TT group (P=0.01), and the posttest accuracy significantly increased (F=2.32); however, the increase was less than that of the QET group.

Conclusion

The obtained results indicated that the performance of the in-phase and anti-phase coordination modes was strongly influenced by QET. Furthermore, it was concluded that a successful performance of a bimanual linear task mainly depends on the availability of visual feedback.

Apnoea of Prematurity and Neurodevelopmental Outcomes: Current Understanding and Future Prospects for Research

Infants who are born prematurely are at significant risk of apnoea. In addition to the short-term consequences such as hypoxia, apnoea of prematurity has been associated with long-term morbidity, including poor neurodevelopmental outcomes. Clinical trials have illustrated the importance of methylxanthine drugs, in particular caffeine, in reducing the risk of long term adverse neurodevelopmental outcomes. However, the extent to which apnoea is causative of this secondary neurodevelopmental delay or is just associated in a background of other sequelae of prematurity remains unclear. In this review, we first discuss the pathophysiology of apnoea of prematurity, previous studies investigating the relationship between apnoea and neurodevelopmental delay, and treatment of apnoea with caffeine therapy. We propose a need for better methods of measuring apnoea, along with improved understanding of the neonatal brain's response to consequent hypoxia. Only then can we start to disentangle the effects of apnoea on neurodevelopment in preterm infants. Moreover, by better identifying those infants who are at risk of apnoea, and neurodevelopmental delay, we can work toward a risk stratification system for these infants that is clinically actionable, for example, with doses of caffeine tailored to the individual. Optimising treatment of apnoea for individual infants will improve neonatal care and long-term outcomes for this population.

Effect of dual tasking on a dynamic balance task in children with and without DCD

The purpose of this study was to compare performance of children with Developmental Coordination Disorder (DCD) and typically developing (TD) children in a dual task paradigm with a dynamic balance task on the Wii Fit as primary task and a concurrent cognitive (counting) or a concurrent bimanual fine motor task as secondary tasks. Using a cross-sectional design, 25 children with DCD and 38 TD children were assessed with the Movement Assessment Battery for Children, 2nd edition (MABC-2) and Divided Attention (DA) task of the KiTAP. Next, the single- and dual-tasks were performed and the level of interference or facilitation of the dual tasks was calculated. Regression analysis determined the predictive value of the DA and MABC-2 component balance outcomes on the dual task performance. On the motor and attentional tasks, the group of children with DCD scored significantly below the level of the TD children. The dual task effect showed similar interference and facilitation of tasks in the different dual-task conditions in both groups. In the dual task-cognitive condition, the divided attention abilities and the MABC-2 balance score predicted 25% of the Wii Fit dynamic balance task performance, whereas in the dual task-motor condition this was higher (31.6%). In both conditions, DA was a stronger predictor than MABC balance score and appears to be an important factor to consider when developing motor task training for children with DCD.

Gender and age differences in the presentation of at-risk or probable Developmental Coordination Disorder in adults

BACKGROUND

Developmental Coordination Disorder (DCD), also called Dyspraxia, is a common Neurodevelopmental Disorder (NDD) that affects motor coordination with a marked impact on both academic and day-to-day living activities. It is increasingly clear that NDDs such as Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder may present differently in males and females, resulting in underdiagnoses of women and girls.

AIMS

To consider age and gender differences in the presentation of at-risk and probable DCD.

METHODS AND PROCEDURES

A sample of 1,476 adults aged 16-60 years were surveyed online using the Adult DCD Checklist.

OUTCOMES AND RESULTS

Women with at-risk (n = 1 8 6, 1 6. 6 %) or probable DCD (n = 6 4 3, 5 6. 6 %) reported significantly greater gross motor and non-motor difficulties and significantly greater impact on activities and participation, whereas men with at-risk (n = 58,16.3 %) or probable (n = 177,49.9 %), DCD reported significantly greater fine motor difficulties. Emerging adults (aged 16-25 years) with at-risk (n = 65,14.3 %) or probable (293,64.3 %) DCD reported significantly greater non-motor difficulty than adults (aged 26-60+ years) with at-risk (n = 179,17.5 %) or probable (n = 518, 50.8 %) DCD.

CONCLUSIONS AND IMPLICATIONS

Both age and gender differences were found in the presentation of at-risk and probable DCD in adults. This may have implications for the development of future DCD assessment tools and for the training of front-line staff who may encounter individuals with DCD throughout their lives, including teachers, doctors and employers' Human Resources and Occupational Health staff.

Attentional and executive functions in children and adolescents with developmental coordination disorder and the influence of comorbid disorders: A systematic review of the literature

Developmental coordination disorder (DCD) is a neurodevelopmental disorder affecting primarily motor skills, but attentional and executive impairments are common in affected individuals. Moreover, the presence of neurodevelopmental comorbidities is frequent in this population, which certainly influences the cognitive profile of the children concerned. Previous studies have reported deficits in visuospatial/nonverbal and planning tasks. This systematic review of the literature aims to determine if impairments can be found in other attentional and executive functions as well. The type of cognitive tasks, the tasks’ modality (verbal/nonverbal), and the influence of comorbid disorders on attentional and executive profiles are systematically considered. Forty-one studies were identified through the PubMed/Medline and PsycINFO databases according to pre-established eligibility criteria. The results reveal weaknesses in inhibitory control, working memory, planning, nonverbal fluency, and general executive functioning in children with DCD. The presence of comorbid disorders seemingly contributes to the verbal working memory difficulties findings. This review contributes to a better understanding of the cognitive impairments in DCD and of the needs of children with this disorder, allowing to optimize practitioners’ therapeutic interventions.

White Matter Changes With Rehabilitation in Children With Developmental Coordination Disorder: A Randomized Controlled Trial

Background and Objectives: Children with developmental coordination disorder (DCD) have difficulty learning motor skills, which can affect their participation in activities of daily living and psychosocial well-being. Over 50% of children with DCD also have attention deficit hyperactivity disorder (ADHD), which further exacerbates their motor problems and impact on quality of life. A rehabilitation approach known as Cognitive Orientation to Occupational Performance uses problem-solving strategies to help children learn motor skills they wish to achieve. While this cognitive approach has been effective for children with DCD, few studies have examined the effectiveness of this approach for children with co-occurring ADHD. Further, the underlying mechanism and neural basis of this intervention are largely unknown.

Methods: In this randomized waitlist-controlled trial, we used MRI to examine white matter microstructure after intervention in 8–12-year-old children with DCD (n = 28) and with DCD and co-occurring ADHD (n = 25). Children in both groups were randomized to either a treatment group or waitlist group at their first MRI. The treatment group began the intervention after their MRI scan and returned for a post-treatment scan at 3 months, and follow-up scan at 6 months; the waitlist group waited 3 months before their second MRI, received the intervention, and then had a post-treatment scan. Each child received intervention once weekly for 10 weeks. Diffusion tensor imaging was used to acquire white matter diffusion parameters and was analyzed using tract-based spatial statistics (TBSS).

Results and Conclusion: Children with DCD showed significant improvement in white matter microstructure in the bilateral anterior thalamic radiation, bilateral sensorimotor tract, bilateral cingulum, fornix, splenium and body of corpus callosum, right inferior fronto-occipital fasciculus, and white matter pathways to bilateral inferior gyri, right middle frontal gyrus, frontal medial cortex, and left cuneus. We suggest that these rehabilitation-induced neural changes in children with DCD occurred in regions associated with attention, self-regulation, motor planning, and inter-hemispheric communication, which positively affected brain connectivity and motor function. In contrast, children with DCD and co-occurring ADHD did not show any brain changes following the intervention. Modifications to the treatment protocol might help address the attentional and self-regulatory needs of children with a dual diagnosis.

Clinical Trial Registration: ClinicalTrials.gov ID: NCT02597751.

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.

Reliance on visual feedback from ocular accommodation on motor skills in children with developmental coordination disorder and typically developing controls

Children with developmental coordination disorder (DCD) present with marked impairments in motor skills, including visual-motor integration. Oculomotor anomalies are more prevalent in children with DCD than typically developing children. Children with DCD further demonstrate altered use of visual feedback compared to typically developing controls. We investigated whether the accommodation system, a key component of the oculomotor system, contributes to visual feedback during fine and gross motor skills performance; and whether children with DCD demonstrate differences in reliance on visual feedback from accommodation. Minus dioptre lenses were used to maximally induce accommodation and impede accommodation dynamics. Children with DCD and typically developing controls performed motor skills tests assessing balance, upper limb coordination, visual-motor performance, gross and fine dexterity. Motor skills performance in controls was significantly affected by impeded accommodation in all tasks. Children with DCD demonstrated reliance on accommodation feedback in upper limb and visual-motor tasks only. Children with DCD may be less reliant on visual feedback obtained from accommodation due to adaptive mechanisms to overcome faulty information in the presence of oculomotor anomalies. These results strengthen our previous findings that accommodation anomalies contribute to motor skills impairment, and suggest that performance on these motor tasks is heavily reliant on visual feedback from accommodation.

Effect of comorbid developmental dyslexia on oculomotor behavior in children with developmental coordination disorder: A study with the Developmental Eye Movement test

Studies have suggested a dysfunction in oculomotor skills in children with developmental coordination disorder (DCD). It has been proposed that the Developmental Eye Movement (DEM) test is useful in testing the dyslexics' (DD) oculomotor behavior during reading, in a simple and indirect manner. The present study aimed at exploring the oculomotor behavior in children with DCD as assessed with the DEM test. We thus compared children with DCD to children with DD and to children with both DCD and DD in order to investigate the specificity of the oculomotor difficulties, as measured by the DEM test. Results showed that 1) children with DCD presented mild atypical performance at the DEM test (error z-score only), 2) children with DD presented particularly poor performance at the DEM test, and 3) the co-morbid condition (DCD + DD) did not add to the severity of atypical performance at the DEM test. In sum, children with DCD were the less affected according to the DEM test, and children with DD (isolated or comorbid) presented the most atypical performance. Results at the DEM test did not allow to highlight clear oculomotor atypicalities in DCD. We thus concluded that more research using eye-tracking techniques is needed to explore the nature of oculomotor atypicalities in DCD children, to distinguish DD and DCD oculomotor behavior, and to understand the profile of children with dual diagnosis.

Profile of language abilities in a sample of adults with developmental disorders

This study investigated the profile of language abilities in a sample of high-achieving English speaking adults with developmental disorders. Ninety-seven adult participants were recruited: 49 with a dyslexia diagnosis (dyslexic group), 16 with a diagnosis of a different developmental disorder including dyspraxia, autism and SpLD (non-dyslexic developmental disorder group) and 32 with no diagnosis (non-disordered group). Dyslexic and non-dyslexic developmental disorder groups demonstrated similar impairments across measures of word reading, working memory, processing speed and oral language. Dyslexic participants showed the usual pattern of impaired phonological skills but spared non-verbal intelligence and vocabulary. There were also some suggestions of impaired structural oral language skills in this group. A data-driven clustering analysis found that diagnosis was not a reliable predictor of similarity between cases, with diagnostic categories split between data-driven clusters. Overall, the findings indicate that high-achieving adults with developmental disorders do demonstrate impairments that are likely to affect success in higher education, but that support needs should be assessed on a case-by-case basis, rather than according to diagnostic label.

Effects of Transcranial Direct Current Stimulation on Motor Function in Children 8-12 Years With Developmental Coordination Disorder: A Randomized Controlled Trial

Background and objectives: Developmental coordination disorder (DCD) is a neurodevelopmental motor disorder occurring in 5-6% of school-aged children. It is suggested that children with DCD show deficits in motor learning. Transcranial direct current stimulation (tDCS) enhances motor learning in adults and children but is unstudied in DCD. We aimed to investigate if tDCS, paired with motor skill training, facilitates motor learning in a pediatric sample with DCD.

Methods: Twenty-eight children with diagnosed DCD (22 males, mean age: 10.62 ± 1.44 years) were randomized and placed into a treatment or sham group. Anodal tDCS was applied (1 mA, 20 min) in conjunction with fine manual training over 5 consecutive days. Children's motor functioning was assessed with the Purdue Pegboard Test and Jebsen-Taylor Hand Function Test at baseline, post-intervention and 6 weeks following intervention. Group differences in rates of motor learning and skill transfer/retention were examined using linear mixed modeling and repeated measures ANOVAs, respectively.

Results: There were no serious adverse events or drop-outs and procedures were well-tolerated. Independent of group, all participants demonstrated improved motor scores over the 5 training days [F_(69.280), p < 0.001, 95% CI (0.152, 0.376)], with no skill decay observed at retention. There was no interaction between intervention group and day [F_(2.998), p = 0.086, 95% CI (−0.020, 0.297)].

Conclusion: Children with DCD demonstrate motor learning with long-term retention of acquired skill. Motor cortex tDCS did not enhance motor learning as seen in other populations. Before conclusions of tDCS efficacy can be drawn, additional carefully designed trials with reproducible results are required.

Clinical Trial Registration:ClinicalTrials.gov: NCT03453983

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.

Correlation between Motor Coordination Skills and Emotional and Behavioral Difficulties in Children with and without Developmental Coordination Disorder

The purpose of this study was to compare whole factors of emotional and behavioral problems between children with and without developmental coordination disorder (DCD) and investigate the interrelationship between motor coordination skills and emotional and behavioral problems among the children. As a result of screening participants (288 children) based on DSM-5 standard, participants were classified as DCD and typically developing (TD) groups. A total of 60 children (mean age: 8.8 years ± 3.5 months; DCD group n = 30, TD group n = 30) were assessed using the Korean Behavior Assessment System for Children, Second Edition for emotional and behavioral problems. Children with DCD showed significantly poor scores in internalizing problems (p = 0.009), inattention/hyperactivity (p = 0.004), and emotional symptoms index (p = 0.001) among the criteria of emotional problems and in personal adjustment (p = 0.000) among the criteria of behavioral problems. The MABC-2 composite percentile score of participants showed a significant correlation with internalizing problem behavior (r = −0.382, p = 0.003), inattention / hyperactivity disorder (r = −0.409, p = 0.001), emotional symptoms index (r = −0.483, p = 0.000), and personal adjustment (r = 0.474, p < 0.01). Our results validated that children with DCD have more emotional and behavioral difficulties than TD children. Our results revealed that the motor coordination skills have correlated with emotional and behavioral difficulties among children.

CO-OP for Children with DCD: Goals Addressed and Strategies Used

INTRODUCTION.

Developmental coordination disorder (DCD) is a neurodevelopmental disorder that impacts motor coordination and interferes with participation in everyday activities. Cognitive Orientation to Occupational Performance (CO-OP) is a client-centered treatment approach that focuses on skill acquisition through cognitive strategy use.

OBJECTIVES.

To determine which types of goals a sample of children with DCD choose most frequently and which domain-specific strategies were most commonly used to address these goals.

METHODS.

Retrospective chart review of 50 children (8-12 years) with DCD who completed CO-OP intervention was conducted to identify goal types and strategy use.

RESULTS.

Leisure was the most common goal type. Supplementing task knowledge, body position, and task modification were the most frequently used strategies.

CONCLUSIONS.

Results confirm the types of goals that are commonly selected by children with DCD and highlight commonly used strategies used to meet these goals. Findings will help guide occupational therapists in selecting appropriate strategies to meet children's goals.

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.

Physical Fitness and Dynamic Balance in Medication Naïve Turkish Children with ADHD

This study investigated physical fitness levels and dynamic balance in medication-naïve children with Attention-Deficit/Hyperactivity Disorder (ADHD). Participants were 24 medication-naïve Turkish children with ADHD (4 girls, 20 boys) and 19 typically developing (TD) Turkish children (4 girls, 15 boys). We measured physical fitness levels with the Eurofit Test Battery, body composition with the Inbody 720 Body Composition Analyzer, cognitive attention with the Stroop Test, and dynamic balance with the Y-Balance Test. We found significantly poorer dynamic balance and both upper extremity and running fitness problems among the medication-naïve Turkish children with ADHD compared to the TD group (p = 0.002; p = 0.032; p = 0.002). It may be important to adress dynamic balance and physical fitness when treating children with ADHD.

Adaptive Behavior Moderates Health-Related Pathways in Children with Autism Spectrum Disorder

The purpose of this study was to examine the moderating role of adaptive behavior on the pathways connecting motor competence, physical activity, and health-related fitness in 7-12 year old children with ASD (N = 27). Results demonstrate that motor competence and health-related fitness were positively related (r = .42, p < .05), and this relationship was moderated by adaptive behavior. Specifically, we found that motor competence and health-related fitness were significantly related for those participants scoring approximately one or more standard deviations below the mean on adaptive behavior. No other significant pathways were present. Implications of these associations and directions for future research are discussed.

Differences in White Matter Microstructure Among Children With Developmental Coordination Disorder

IMPORTANCE

Developmental coordination disorder (DCD) is a motor impairment that significantly interferes with activities of daily living. Little is known about the cause of DCD and how it develops, making it difficult to understand why children with DCD struggle in learning motor skills and to determine the best intervention to optimize function.

OBJECTIVE

To characterize white matter differences using diffusion tensor imaging in children with and without DCD.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study collected diffusion tensor imaging data at BC Children's Hospital Research Institute in Vancouver, British Columbia, Canada, from September 2014 to January 2017. Using a sample of convenience, children with DCD and children without DCD aged 8 to 12 years underwent magnetic resonance imaging. Data analysis was conducted from January 2017 to January 2020.

MAIN OUTCOMES AND MEASURES

The main outcome measures were diffusion parameters, including fractional anisotropy and mean, axial, and radial diffusivity, which are thought to provide an indirect measure of white matter microstructure. Tract-based spatial statistics, a voxelwise statistical analysis of diffusion parameters, were conducted using a 2-group comparison design matrix with age and attention as covariates.

RESULTS

Thirty children without DCD (mean [SD] age, 9.9 [1.4] years; 21 [70%] boys) and 31 children with DCD (mean [SD] age, 10.1 [1.2] years; 26 [84%] boys) were included in the study. Compared with children without DCD, children with DCD were characterized by significantly lower fractional anisotropy and axial diffusivity in regions of white matter pathways associated with motor and sensorimotor processing, including the corticospinal tract (fractional anisotropy: mean [SD], 0.54 [0.03] vs 0.51 [0.03]; P < .001; axial diffusivity: mean [SD], 0.13 [0.98] vs 0.12 [0.46]; P = .01), posterior thalamic radiation at the retrolenticular part of the internal capsule (axial diffusivity: mean [SD], 0.14 [0.57] vs 0.14 [0.44]; P = .01), and cerebellar pathways (eg, superior cerebellar peduncle, fractional anisotropy: mean [SD], 0.49 [0.05] vs 0.46 [0.03]; P = .03; axial diffusivity: mean [SD], 0.14 [0.66] vs 0.14 [0.63]; P = .009). There were no significant differences in mean diffusivity and radial diffusivity between children with and without DCD.

CONCLUSIONS AND RELEVANCE

These findings suggest that children with DCD show significant brain differences in motor and sensorimotor white matter pathways compared with children without DCD. The pattern of diffusion parameters in children with DCD suggests that axonal development may be disrupted in this neurodevelopmental disorder.

Multidimensional impairments

Children and adolescents with neurodevelopmental disorders often show complex developmental disorders, including multiple areas of dysfunction such as emotional regulation and behavior, school integration, and learning difficulties. These multidimensionally impaired children share some common features with children with autism spectrum disorders (ASDs). However, paradoxically, they could qualify as diagnostically homeless. Several proposals have been formulated to categorize subgroups of these children, whose diversity and overlap in clinical expression emphasize the importance of using a multidimensional assessment inscribed in a developmental perspective. Here, we review these different classification proposals and describe a multidimensional approach that, in addition to a categorical approach, could constitute a complementary point of view. We believe that this multidimensional perspective allows one to address the child holistically, taking into account his or her interactive experience with the environment, and achieve a functional diagnosis enabling the elaboration of a tailored therapeutic plan and better school inclusion.