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

Actual and perceived motor competence in children with motor coordination difficulties: Effect of a movement-based intervention

BACKGROUND

The present study analyses the effect of a Movement-Based Intervention to improve Actual and Perceived Motor Competence in children with probable Developmental Coordination Disorder aged four and six years.

METHODS AND PROCEDURES

A longitudinal pre-experimental study was designed with measurements conducted at pre-test, post-test and follow-up (after 5 months without intervention). The group, composed of children with probable Developmental Coordination Disorder or low motor competence, consisted of 57 participants, and the duration of a Movement-Based Intervention was 27 sessions allocated in nine weeks.

OUTCOMES AND RESULTS

Actual Motor Competence was evaluated with the Movement Assessment Battery for School children and Perceived Motor Competence with Pictorial Scale of Perceived Motor Skill Competence for Children. The results showed significant improvements in both study variables (Actual Motor Competence and Perceived Motor Competence), both at post-test and follow-up, five months after the end of the intervention. In conclusion, a Movement-based Intervention is effective in improving Actual and Perceived Motor Competence in the participants of this research, children with low motor competence or probable Developmental Coordination Disorder.

WHAT THIS PAPER ADDS

Considering the improvements observed after the program in Spanish sample, it seems that the usual practice in Early Childhood Education in our context may not be sufficient, i.e., it may not provide children with the necessary support (number of lesson and time) and appropriate learning contexts to promote the development of their motor skills. Considering the results, this study suggests that using an Movement-Based Intervention with an appropriate pedagogical approach, and offering different learning opportunities to children according to their needs, could positively influence their Actual and Perceived Motor Competence, and could motivate them towards future practice.

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

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

Cognitive strengths in neurodevelopmental disorders, conditions and differences: A critical review

Neurodevelopmental disorders are traditionally characterised by a range of associated cognitive impairments in, for example, sensory processing, facial recognition, visual imagery, attention, and coordination. In this critical review, we propose a major reframing, highlighting the variety of unique cognitive strengths that people with neurodevelopmental differences can exhibit. These include enhanced visual perception, strong spatial, auditory, and semantic memory, superior empathy and theory of mind, along with higher levels of divergent thinking. Whilst we acknowledge the heterogeneity of cognitive profiles in neurodevelopmental conditions, we present a more encouraging and affirmative perspective of these groups, contrasting with the predominant, deficit-based position prevalent throughout both cognitive and neuropsychological research. In addition, we provide a theoretical basis and rationale for these cognitive strengths, arguing for the critical role of hereditability, behavioural adaptation, neuronal-recycling, and we draw on psychopharmacological and social explanations. We present a table of potential strengths across conditions and invite researchers to systematically investigate these in their future work. This should help reduce the stigma around neurodiversity, instead promoting greater social inclusion and significant societal benefits.

Motor Impairments in Children with Autism Spectrum Disorder: A Systematic Review and Meta-analysis

This article comprehensively reviews motor impairments in children with autism spectrum disorder (ASD) to: (1) determine the prevalence of motor problems in children with ASD; (2) understand the nature of motor difficulties in ASD and whether they are consistent with developmental coordination disorder (DCD); and (3) determine if the term DCD was used as a co-occurring diagnosis in children with ASD after publication of the DSM-5 in 2013. The following databases were systematically searched: MEDLINE, EMBASE, CINAHL, and PsycINFO from 2010 to December 2021. Articles were included if they: (1) were peer-reviewed and published in a scientific journal; (2) included children with ASD who were between 5 and 12 years; (3) used motor or function measures to assess motor abilities in children with ASD. Studies that included children with intellectual disabilities were excluded. Two independent reviewers reviewed titles, abstracts, and full-text articles for inclusion. Twenty-seven studies met the inclusion criteria and were assessed for quality by two independent reviewers using the Appraisal tool for Cross-Sectional Studies. The majority of articles (92.5%) indicated that 50-88% of children with ASD had significant motor impairments on standardized motor assessments and/or functional questionnaires. The nature of motor and function problems in ASD were consistent with DCD; however, only three out of 20 papers (15%) that were published from 2014 described the motor problems as DCD. One study reported that 15.1% of children with ASD with motor impairments had a co-occurring diagnosis of DCD, suggesting that DCD is under-recognized in this clinical population.

Early signs of functioning and contextual factors in children 0 to 6 years of age at high risk of or with developmental coordination disorder: A scoping review

BACKGROUND

Developmental coordination disorder (DCD) can significantly impact body structures and functions, activities, participation and contextual factors. Using a scoping review methodology, we aimed to identify the characteristics or signs that can have an early impact on the development and functioning of children with DCD between 0 and 6 years.

METHODS

We searched the Medline, Cochrane and PEDro databases. The screening of the 1580 articles obtained was conducted independently and in duplicate. From the included articles, among others, we extracted results that reported the early developmental characteristics of children at high risk or diagnosed with DCD, the components of the International Classification of Functioning (ICF) and the F-Words studied in the results or the agents involved in the evaluation.

RESULTS

Seventeen articles were included in the review. From them, a set of early signs of DCD-general and specific-were collected that reflected the existence of restrictions in daily life activities from an early age and in certain routines, such as eating, dressing, grooming or playing. The most studied components of the ICF were activities and participation, with functioning being the most studied F-word.

CONCLUSIONS

Detection of activity limitations and restrictions in participation between 0 and 6 years in children with DCD is possible. Recognition of parental concerns and early assessment could facilitate the follow-up of children at high risk for DCD and their inclusion in screening programs that include standardized tools for their diagnosis.

Developmental Screening Tools Used with First Nations Populations: A Systematic Review

Developmental surveillance and screening is recommended for all children under five years of age, especially for those from at-risk populations such as First Nations children. No review to date has, however, evaluated the use of developmental screening tools with First Nations children. This review aimed to examine and synthesise the literature on developmental screening tools developed for, or used with, First Nations populations children aged five years or younger. A PRISMA-compliant systematic review was performed in the PsychInfo, PubMed, and Embase databases. Additional searches were also undertaken. In total 444 articles were identified and 13 were included in the final review. Findings indicated that several developmental screening tools have been administered with First Nations children. Most tools, however, have only been evaluated in one study. Results also found that no studies evaluated actions taken following positive screening results. More research evaluating the accuracy, acceptability, and feasibility of using developmental screeners with First Nations children is required before widespread implementation of developmental screening in clinical settings with First Nations children is recommended.

A Bibliometric and Visualization Analysis of Motor Learning in Preschoolers and Children over the Last 15 Years

Motor learning enables preschoolers and children to acquire fundamental skills that are critical to their development. The current study sought to conduct a bibliometric and visualization analysis to provide a comprehensive overview of motor-learning progress in preschoolers and children over the previous 15 years. The number of studies is constantly growing, with the United States and Australia, as well as other productive institutions and authors, at the leading edge. The dominant disciplines were Neurosciences and Neurology, Psychology, Rehabilitation, and Sport Sciences. The journals Developmental Medicine & Child Neurology, Human Movement Science, Physical Therapy, Neuropsychology, Journal of Motor Behavior, and Journal of Experimental Child Psychology have been the most productive and influential in this regard. The most common co-citations for clinical symptoms were for cerebral palsy, developmental coordination disorder, and autism. Research has focused on language impairment (speech disorders, explicit learning, and instructor-control feedback), as well as effective intervention strategies. Advances in brain mechanisms and diagnostic indicators, as well as new intervention and rehabilitation technologies (virtual reality, transcranial magnetic stimulation, and transcranial direct current stimulation), have shifted research frontiers and progress. The cognitive process is critical in intervention, rehabilitation, and new technology implementation and should not be overlooked. Overall, our broad overview identifies three major areas: brain mechanism research, clinical practice (intervention and rehabilitation), and new technology application.

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.

Behavioral and Neuroimaging Research on Developmental Coordination Disorder (DCD): A Combined Systematic Review and Meta-Analysis of Recent Findings

AIM

The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD.

METHODS

The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis.

RESULTS

The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions.

INTERPRETATION

Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO, identifier: CRD42020185444.

Early Motor Milestones in Infancy and Later Motor Impairments: A Population-Based Data Linkage Study

BACKGROUND

Developmental Coordination Disorder (DCD) is a neurodevelopmental condition with high prevalence. Early motor milestones are important markers to identify DCD. The current study aims to evaluate the association between the onset of crawling and independent walking and their transition pattern during infancy and later motor impairments.

METHODS

A total of 8,395 children aged 3-6 years old in China were included in the final analysis. A parent questionnaire was used to collect early milestone onset data. Children's motor performance was measured using the Movement Assessment Battery for Children-2nd edition (MABC-2). The association between motor milestones and motor impairment was analyzed using a multilevel regression model.

RESULTS

The result showed that a 1-month delay in crawling onset increased the risk of significant overall motor impairment by 5.3, and 14.0% when adjusting for child and family characteristics. A 1-month delay in walking onset increased the risk of significant overall motor, fine, gross, and balance impairment by 21.7, 8.3, 13.3, and 17.8%. A 1 month increase in the transition time from crawling to independent walking increased the risk of significant overall motor and gross motor impairment by 7.7 and 6.6%. These results were inconsistent across different age bands (each p < 0.05).

CONCLUSIONS

Our study indicates that even a mild delay in crawling and walking onsets in infancy increase the risk for subsequent motor impairments in childhood, and children with motor impairments revealed a different transition pattern from crawling to walking. The motor abilities of children with motor impairments can be observed to diverge from typically developing children as early as 6-8 months old. The findings can facilitate the early identification of motor impairments in children, and provide early signs to initiate intervention.

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

IMPORTANCE

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

OBJECTIVE

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

DESIGN, SETTING, AND PARTICIPANTS

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

MAIN OUTCOMES AND MEASURES

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

RESULTS

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

CONCLUSIONS AND RELEVANCE

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

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

AIM

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

METHOD

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

RESULTS

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

INTERPRETATION

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

Studies on Children With Developmental Coordination Disorder in the Past 20 Years: A Bibliometric Analysis via CiteSpace

Children with developmental coordination disorder (DCD) have been commonly observed and drawn an increasing amount of attention over the past decades. The aim of the present study is to evaluate the origin, current hotspots, and research trends on children with DCD using a bibliometric tool. After searching with "children" and "developmental coordination disorder" as the "topic" and "title" words, respectively, 635 original articles with 12,559 references were obtained from the electronic databases, Web of Science Core Collection (WoSCC). CiteSpace V.5.7.R2 was used to perform the analysis. The number of publications in this field was increasing over the past two decades. John Cairney from the Department of Family Medicine, McMaster University, Canada, was found to be the most productive researcher. Meanwhile, McMaster University and Canada were the most productive research institution and country, respectively. Reference and journal co-citation analyses revealed the top landmark articles and clusters in this field. Clumsiness was the most strength burst keyword. Moreover, task, meta-analysis, difficulty, adult, and impact will be the active research hotspots in future. These findings provide the trends and frontiers in the field of children with DCD, and valuable information for clinicians and scientists to identify new perspectives with potential collaborators and cooperative countries.