Clinical description of children with developmental coordination disorder

Evaluating handwriting in children with developmental coordination disorder (DCD): Temporal, spatial, pressure and grip-force measures

BACKGROUND

Writing involves complex sensorimotor and biomechanical processes that regulate pressure on the writing surface. Researchers analyze writing to understand kinetics and kinematics by evaluating temporal, spatial, and pressure aspects, yet discerning writing surface pressure and pen-grip force remains challenging.

AIMS

To compare handwriting kinetics (pen grip-force and surface pressure) and kinematics (temporal-spatial) of children with developmental coordination disorder (DCD) with those of typically developing (TD) children.

METHODS AND PROCEDURES

Twenty-seven children with DCD aged 7-12 years and 27 TD children matched by age and gender copied a 29-word passage onto a computerized tablet. Temporal, spatial and surface pressure as well as pen grip-force were measured with a tablet and a wearable device respectively.

OUTCOMES AND RESULTS

The DCD group displayed significantly longer total writing time, mean letter time, and greater letter height, width, variance, spacing, area, and erasures than the TD group. Although there were no significant between-group differences in the surface pressure or maintaining pressure, the DCD group displayed weaker grip-force, p = .01, with greater variance.

CONCLUSIONS AND IMPLICATIONS

The DCD group's weaker grip-force dynamics correlated with reduced legibility, form, and prolonged writing duration, revealing insights into handwriting mechanisms, particularly grip force, crucial for effective clinical interventions.

Dysgraphia Differs Between Children With Developmental Coordination Disorder and/or Reading Disorder

Handwriting deficits, or dysgraphia, are present in several neurodevelopmental disorders. To investigate whether dysgraphia differs according to the associated disorder, we performed a detailed analysis of handwriting in children with developmental coordination disorders (DCD), reading disorder (RD), or comorbid RD and DCD. Handwriting deficits were investigated at the product (quality of the trace) and the process (movement that generates the trace) levels. Nineteen children with singular RD (among which eight with dysgraphia), 13 children with singular DCD (among which seven with dysgraphia), 16 children with comorbid RD+DCD (among which 11 with dysgraphia), and 20 typically developing children, age 7 to 12, performed the BHK (Brave Handwriting Kinder) test, a standardized assessment of handwriting, on a graphic tablet. Developmental coordination disorders primarily affected handwriting quality, while RD affected slowness and, to a lesser extent, quality. Children with RD, solely or comorbid with DCD, wasted time by lifting and stopping the pen when writing. The comorbidity added to but did not worsen, handwriting difficulties. These results reflect distinct motor impairments and/or strategies in children with DCD or RD. We identified subtypes of dysgraphia and advocated for a fine-grained analysis of the writing process and the assessment of motor and reading skills when studying dysgraphia.

The Effect of a Short-Term Occupational Therapy Intervention on the Participation and Personal Factors of Preschoolers with Developmental Disabilities

BACKGROUND

Preschoolers with developmental disabilities are referred to occupational therapy due to their decreased participation in daily life occupations. The purpose of this study was to evaluate the improvement in preschoolers' participation and sensory-motor abilities following an occupational therapy intervention.

MATERIALS AND METHODS

A prospective cohort study of 38 preschoolers and their parents was conducted using an interrupted time-series design, including assessments at three time points: base line (upon referral to an occupational therapy assessment), pre-intervention, and post-intervention after 9-12 sessions of occupational therapy interventions. Children were evaluated with the Developmental Test of Visual-Motor Integration, as well as the balance and fine motor precision sub tests of the Bruininks-Oseretsky Test of Motor Proficiency. Parents completed the Children's Participation Questionnaire and the Child Performance Skills Questionnaire. Each intervention session was documented by the therapists using the Documentation of Occupational Therapy Session Intervention form.

RESULTS

Significant improvement in children's sensory-motor abilities were found in balance, visual integration, and fine motor precision post-intervention. There were also improvements in the measures of diversity, children's independence, and parental satisfaction.

CONCLUSIONS

A short-term occupational therapy intervention applied to preschoolers with developmental disabilities is effective in improving their sensory-motor abilities, as well as in promoting their participation in daily activities.

Developmental Coordination Disorder and Unhealthy Weight Status in Taiwanese Children: The Roles of Sex and Age

This study aimed to provide up-to-date information regarding the estimated prevalence of developmental coordination disorder (DCD) in Taiwanese children. Their unhealthy weight status was also examined, as well as the roles of sex and age. This cross-sectional study recruited 825 children aged between 4 and 12 years and categorized them into either typically developing children (TD, >16th percentile) or children at risk for DCD (rDCD, ≤16th percentile) based on the result of the Movement Assessment Battery for Children-2nd edition. Body mass index was calculated to determine weight status (i.e., normal weight, underweight, overweight, and obesity). The estimated prevalence of rDCD was 9.7%. There were significantly more boys in the rDCD groups (p < 0.001). Additionally, preschool children with rDCD were at greater risk for being underweight. However, there was no significant group difference which was found for overweight/obesity. A lower prevalence of rDCD was found in this study. Nevertheless, children with rDCD may be more likely to be underweight in early childhood. Early intervention should be provided to target this population.

Validation of the Concise Assessment Scale for Children's Handwriting (BHK) in an Italian Population

Handwriting difficulties represent a common complaint among children and may cause a significant delay in motor skills achievement. The Concise Assessment Scale for Children's Handwriting (BHK) assesses handwriting skill in clinical and experimental settings, providing a quick evaluation of handwriting quality and speed through a copying text. The aim of the present study was to validate the Italian adaptation of the BHK in a representative primary school population. Overall, 562 children aged 7-11 from 16 public primary schools of Rome were included and asked to copy a text in 5 min using cursive handwriting. Handwriting quality and copying speed were measured. The included population followed a normal distribution for the BHK quality scores. Sex influenced the total quality scores, whereas school level influenced the copying speed. The BHK quality score was higher in girls (p < 0.05) and resulted as a stable parameter along the school years, without significant variations with regard to the years spent in handwriting exercise (p = 0.76). The handwriting speed was influenced by school level, and significant differences were found for each of the grades from the second to the fifth (p < 0.05), but not for gender (p = 0.47). Both BHK measures represent a helpful tool for the characterization and assessment of children with handwriting difficulties. The present study confirms that sex influences total BHK quality score, while school level influences handwriting speed.

The Relationships between Self-Reported Motor Functioning and Autistic Traits: The Italian Version of the Adult Developmental Coordination Disorders/Dyspraxia Checklist (ADC)

BACKGROUND

We developed the Italian version of the adult developmental co-ordination disorders/dyspraxia checklist (ADC), providing reliability and concurrent validity data for the scale (Aim 1). In addition, we investigated the relationships between motor coordination difficulties and different autistic traits (Aim 2).

METHODS

498 participants (341 females; age range = 18-34) underwent the Italian version of the ADC, as well as a handwriting speed test, the autism spectrum quotient, the empathy quotient, and the systemizing quotient.

RESULTS

The distinction between three main factors (A, B, and C) identified in the original version of the ADC was confirmed here. Internal consistency of the ADC subscales was adequate, as well as the correlation with the handwriting speed test used to assess concurrent validity. No substantial sex differences on the ADC scores were found. Furthermore, data revealed that poor autistic-related communication skills and lower levels of systemizing tendencies were, among all the investigated autistic traits, those more strongly associated with higher motor coordination difficulties.

CONCLUSIONS

The Italian ADC seems a valuable tool for assessing motor coordination difficulties in adults and can reveal the nuanced impact exerted by different autistic traits on self-reported motor functioning.

Academic Challenges in Developmental Coordination Disorder: A Systematic Review and Meta-Analysis

AIMS

Developmental Coordination Disorder (DCD) is a chronic condition affecting motor coordination in daily activities. While motor difficulties are well documented in this population, it is unclear how frequent and to what extent academic activities are affected. This systematic review aims to comprehensively summarize the knowledge regarding the prevalence and extent of academic difficulties in reading, writing and mathematics in school-aged children with DCD.

METHODS

Two independent reviewers analyzed original studies on academic difficulties in school-aged children with DCD. A binary random-effects model was used to calculate the pooled prevalence by academic difficulty. A random-effects model using standardized mean differences (g statistic) was calculated to estimate the extent of the academic difficulties.

RESULTS

Twenty-four studies were included. A pooled prevalence of 84% of handwriting difficulties and 89.5% of mathematical difficulties was reported. No pooled prevalence of difficulties could be calculated for the other academic outcomes. Children with DCD present with poorer performance in handwriting legibility (g = -1.312) and speed (g = -0.931), writing (g = -0.859), mathematics (g = -1.199) and reading (g = -1.193).

CONCLUSIONS

This review highlights the high frequency and severity of academic difficulties in children with DCD, specifically in mathematics, which stresses the importance of evaluating academic performance to target interventions to support optimal functioning in daily life.

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

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

Cognitive, perceptual, and motor profiles of school-aged children with developmental coordination disorder

Developmental coordination disorder (DCD) is a heterogeneous condition. Besides motor impairments, children with DCD often exhibit poor visual perceptual skills and executive functions. This study aimed to characterize the motor, perceptual, and cognitive profiles of children with DCD at the group level and in terms of subtypes. A total of 50 children with DCD and 31 typically developing (TD) peers (7–11 years old) underwent a comprehensive neuropsychological (15 tests) and motor (three subscales of the Movement Assessment Battery for Children-2) assessment. The percentage of children with DCD showing impairments in each measurement was first described. Hierarchical agglomerative and K-means iterative partitioning clustering analyses were then performed to distinguish the subtypes present among the complete sample of children (DCD and TD) in a data-driven way. Moderate to large percentages of children with DCD showed impaired executive functions (92%) and praxis (meaningless gestures and postures, 68%), as well as attentional (52%), visual perceptual (46%), and visuomotor (36%) skills. Clustering analyses identified five subtypes, four of them mainly consisting of children with DCD and one of TD children. These subtypes were characterized by: (i) generalized impairments (8 children with DCD), (ii) impaired manual dexterity, poor balance (static/dynamic), planning, and alertness (15 DCD and 1 TD child), (iii) impaired manual dexterity, cognitive inhibition, and poor visual perception (11 children with DCD), (iv) impaired manual dexterity and cognitive inhibition (15 DCD and 5 TD children), and (v) no impairment (25 TD and 1 child with DCD). Besides subtle differences, the motor and praxis measures did not enable to discriminate between the four subtypes of children with DCD. The subtypes were, however, characterized by distinct perceptual or cognitive impairments. These results highlight the importance of assessing exhaustively the perceptual and cognitive skills of children with DCD.

Large-scale assessment of 7-11-year-olds' cognitive and sensorimotor function within the Born in Bradford longitudinal birth cohort study

Background: Cognitive ability and sensorimotor function are crucial aspects of children's development, and are associated with physical and mental health outcomes and educational attainment. This paper describes cross-sectional sensorimotor and cognitive function data collected on over 15,000 children aged 7-10 years, collected as part of the Born in Bradford (BiB) longitudinal birth-cohort study. Methodological details of the large-scale data collection process are described, along with initial analyses of the data involving the relationship between cognition/sensorimotor ability and age and task difficulty, and associations between tasks. Method: Data collection was completed in 86 schools between May 2016 and July 2019. Children were tested at school, individually, using a tablet computer with a digital stylus or finger touch for input. Assessments comprised a battery of three sensorimotor tasks (Tracking, Aiming, & Steering) and five cognitive tasks (three Working Memory tasks, Inhibition, and Processing Speed), which took approximately 40 minutes. Results: Performance improved with increasing age and decreasing task difficulty, for each task. Performance on all three sensorimotor tasks was correlated, as was performance on the three working memory tasks. In addition, performance on a composite working memory score correlated with performance on both inhibition and processing speed. Interestingly, within age-group variation was much larger than between age-group variation. Conclusions: The current project collected computerised measures of a range of cognitive and sensorimotor functions at 7-10 years of age in over 15,000 children. Performance varied as expected by age and task difficulty, and showed the predicted correlations between related tasks. Large within-age group variation highlights the need to consider the profile of individual children in studying cognitive and sensorimotor development. These data can be linked to the wider BiB dataset including measures of physical and mental health, biomarkers and genome-wide data, socio-demographic information, and routine data from local health and education services.

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.

Large-scale assessment of 7-11-year-olds’ cognitive and sensorimotor function within the Born in Bradford longitudinal birth cohort study

Background: Cognitive ability and sensorimotor function are crucial aspects of children’s development, and are associated with physical and mental health outcomes and educational attainment. The current project forms part of the Born in Bradford (BiB) longitudinal birth-cohort study, and involved measuring sensorimotor and cognitive function in over 15,000 children aged 7-10 years. This paper describes the large-scale data collection process and presents initial analyses of the data, including the relationship between cognition/sensorimotor ability and age and task difficulty, and associations between tasks. Method: Data collection was completed in 86 schools between May 2016 and July 2019. Children were tested at school, individually, using a tablet computer with a digital stylus or finger touch for input. Assessments comprised a battery of three sensorimotor tasks (Tracking, Aiming, & Steering) and five cognitive tasks (three Working Memory tasks, Inhibition, and Processing Speed), which took approximately 40 minutes. Results: Performance improved with increasing age and decreasing task difficulty, for each task. Performance on all three sensorimotor tasks was correlated, as was performance on the three working memory tasks. In addition, performance on a composite working memory score correlated with performance on both inhibition and processing speed. Interestingly, within age-group variation was much larger than between age-group variation. Conclusions: The current project collected computerised measures of a range of cognitive and sensorimotor functions at 7-10 years of age in over 15,000 children. Performance varied as expected by age and task difficulty, and showed the predicted correlations between related tasks. Large within-age group variation highlights the need to consider the profile of individual children in studying cognitive and sensorimotor development. These data can be linked to the wider BiB dataset including measures of physical and mental health, biomarkers and genome-wide data, socio-demographic information, and routine data from local health and education services.

Efficacy of Sensory Interventions on School Participation of Children With Sensory Disorders: A Systematic Review

Research demonstrates lower school participation in children with sensory disorders. However, the scientific body of evidence supporting existing sensory intervention modalities is difficult to tackle. More specifically, the literature appears poorly organized, with a highly variable terminology, often with nonoverlapping definitions and lack of good keywords classification that would help organize the diversity of approaches. This systematic review organizes the body of evidence for 3 specific approaches (sensory based, sensorimotor, and sensory integration) and questions their efficacy in improving school participation for children with sensory disorders. Two methods were compared: first, a standard systematic review of the literature in 3 databases using appropriate keywords and descriptors, then an original method based on forward and backward citation connections. A total of 28 studies were retrieved, of which only 7 used the standard method for systematic reviews. For sensory-based approaches, the efficacy of weighted-vest varies according to different factors such as the protocol of use. For sensorimotor approaches, the efficacy of therapy balls, air cushions, platform swing, and physical exercise varies according to the child's sensory characteristics. The efficacy of the sensory integration approach remains mixed across studies.

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.

Handwriting Legibility and Its Relationship to Spelling Ability and Age: Evidence From Monolingual and Bilingual Children

Studies of the relationship between spelling and handwriting concur that spelling skills influence the dynamic processes of handwriting. However, it remains unclear whether variations in spelling ability are related to variations in the legibility of handwriting, how important spelling skills are relative to the amount of handwriting experience afforded by an individual's age and number of years of schooling, or to what extent this relationship may be task- and orthography-specific. We investigated these questions in a study comparing spelling and handwriting legibility in a group of N = 127 Welsh-English bilingual children matched in age and number of years of schooling to a group of N = 127 English-monolingual children, as well as to a group of N = 127 younger, English monolingual children matched to the bilingual group in spelling ability. All groups completed the Spelling and Handwriting Legibility Test (SaHLT) and a broader battery of literacy measures. The bilingual children were found to have poorer handwriting legibility than same age peers, and in some cases, than their younger, spelling-ability peers, suggesting that spelling ability, more so than amount of handwriting experience and years of schooling impacts handwriting legibility. This was corroborated in a series of multi-group path models, where all children's handwriting was predicted by spelling ability more strongly than by age, and, the effect of spelling generalized across two different spelling tasks in all groups. Finally, bilingual children seemed to draw on general (Welsh) as well as on orthography-specific (English) knowledge when handwriting in English.

Grip strength and pen pressure are not key contributors to handwriting difficulties in children with developmental coordination disorder

Introduction

Children with developmental coordination disorder have significant difficulties with handwriting. Factors such as hand grip strength and pen pressure are often assumed by clinicians to play a role, although empirical evidence is lacking. The aim of this study was to measure grip strength and pen pressure to examine their relationships with handwriting performance in children with developmental coordination disorder.

Method

Sixteen 8–14-year-old children with developmental coordination disorder were compared with 20 typically developing age- and gender-matched controls. Palmar, pinch and tripod grip strength were measured using hand dynamometers. The mean pressure exerted on a writing tablet by the pen was obtained during a handwriting task. Group comparisons were made and correlations conducted between grip strength and pen pressure and a range of handwriting product and process measures.

Results

There were no group differences on the three measures of grip strength. However, the developmental coordination disorder group exerted less pressure on the writing surface compared to typically developing peers. There were no significant correlations between grip strength or pen pressure and handwriting performance in children with developmental coordination disorder.

Conclusion

Clinicians should be cautious when using measures of grip strength or pen pressure to inform them about aspects of handwriting skill in children with developmental coordination disorder.

Motor Performance in Children With Childhood Apraxia of Speech and Speech Sound Disorders

Purpose This study sought to determine if (a) children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development (TD) would perform differently on a standardized motor assessment and (b) whether comorbid language impairment would impact group differences. Method Speech, language, and motor abilities were assessed in children with CAS (n = 10), SSD (n = 16), and TD (n = 14) between the ages of 43 and 105 months. Motor skills were evaluated using the Movement Assessment Battery for Children-Second Edition (Henderson, Sugden, & Barnett, 2007), a behavioral assessment that is sensitive in identifying fine/gross motor impairments in children with a range of motor and learning abilities. Data were reanalyzed after reclassifying children by language ability. Results The CAS group performed below the normal limit on all components of the motor assessment and more poorly than the TD and SSD groups on Aiming and Catching and Balance. When children were reclassified by language ability, the comorbid CAS + language impairment group performed worse than the SSD-only and TD groups on Manual Dexterity and Balance and worse than the TD group on Aiming and Catching; all 7 children with CAS + language impairment evidenced performance in the disordered range compared to 1 of 3 children in the CAS-only group and 2 of 6 children in the SSD + language impairment group. Conclusions Children with CAS + language impairment appear to be at an increased risk for motor impairments, which may negatively impact social, academic, and vocational outcomes; referrals for motor screenings/assessments should be considered. Findings may suggest a higher order deficit that mediates cognitive-linguistic and motor impairments in this population.

Determining the clinical knowledge and practice of Australian podiatrists on children with developmental coordination disorder: a cross-sectional survey

Background

Developmental coordination disorder (DCD) is a common condition in children affecting motor coordination. This impacts on academic performance, and activities of daily living. Literature surrounding interventions for DCD has focused mostly on physical and occupational therapies. However, it is known that children with DCD present to podiatrists as these children often also have abnormalities in lower limb functioning associated with the condition. This study aimed to determine current knowledge of Australian podiatrists regarding presentation, assessment, and management of children with developmental coordination disorder.

Methods

A single-round survey, developed using SurveyMonkey®, was completed by a sample of Australian podiatrists. Data were collected through either online or paper means. Participants were asked about their familiarity with DCD and depending on their response, were directed via skip logic to questions on presentation, assessment and management strategies of DCD in children. Participants were also asked about their willingness and preferences for further education on DCD. Descriptive statistics were used to describe the data.

Results

There were 365 Australian podiatrists who completed the survey. There were 30% (n = 109) who reported being familiar with DCD as a diagnosis, while a further 37% (n = 134) reported familiarity with alternate or outdated terminology associated with the DCD diagnosis. Participants who were familiar with DCD or terminology relating to DCD, showed good knowledge of signs and symptoms associated with DCD. Both familiar and unfamiliar participants favoured referral to other health professionals over completing assessments. Common podiatric management strategies such as footwear advice, orthoses, and strength training were the most frequently chosen by both groups, despite current evidence only supporting strength training as an intervention. Participants were willing to receive education on DCD through a range of both online and in-person mediums.

Conclusion

The majority of Australian podiatrists were unfamiliar with DCD, despite its prevalence and symptomology falling within the podiatric scope. However, participants did overwhelmingly show willingness to receive further education on DCD. Further research should consider understanding the role of podiatrists in the assessment and management of children with DCD and the impact of the type of treatment strategies that may be provided.

Electronic supplementary material

The online version of this article (10.1186/s13047-019-0353-y) contains supplementary material, which is available to authorized users.

Patient-Centered Goal Setting in Developmental Therapy: Discordance between Documented Goals and Caregiver-Perceived Goals

INTRODUCTION

Productive interactions between engaged patients and clinical teams are key to effective clinical practice. Accordingly, the identification of needs and priorities through the process of collaborative goal setting is fundamental to patient-centered care. Executing a goal-setting process that is truly collaborative is challenging; many caregivers do not feel that they are adequately involved in the goal-setting process. This study presents the results of an initiative intended to understand goal concordance between therapists and caregivers.

METHODS

We conducted an observational, cross-sectional design study. Twenty-nine pediatric physical and occupational therapists developed and documented collaborative goals for their patients. Over 6 months, 120 randomly selected caregivers from a weekly list of patients scheduled for a follow-up physical or occupational therapy visit participated. Caregivers completed structured interviews related to their children's therapy goals. We calculated agreement coefficients between caregiver-perceived goals and therapist-documented goals.

RESULTS

Overall strength of agreement was poor (M = -0.03, SD = 0.71). There were no significant differences within variables of a goal setter, goal importance, or goal utility. Median agreement coefficients were greatest for goals perceived to be identified solely by the caregiver, perceived as important, and perceived as functionally useful.

CONCLUSIONS

The results of this study underscore the state of discordance in the collaborative goal-setting process in pediatric physical and occupational therapy. Healthcare encounters continue to be framed by provider perspectives and priorities. Developing therapy goals that enhance family involvement, relate to function, and are important to the healthcare consumer may improve the agreement.

Understanding handwriting difficulties: A comparison of children with and without motor impairment

The nature of handwriting difficulties have been explored in children with specific developmental disorders. The aim of this study was to investigate the nature of handwriting difficulties in children with dysgraphia, a less studied group who have significant handwriting difficulties in the absence of motor control or cognitive difficulties. The performance of a dysgraphia group aged 8-14 years was compared to a group with Developmental Coordination Disorder and to typically developing (TD) controls. Participants completed two handwriting tasks on a digitizing writing tablet. The amount and accuracy of the handwriting product was measured, plus various temporal and spatial features of the writing process. There were no significant differences in performance between the two groups with handwriting difficulties but both performed more poorly than the TD group. Individual differences in the type and severity of handwriting impairments suggest the need for a range of classroom assessments to tailor intervention appropriately.

Evaluation and Classification of Types of Chinese Handwriting Deficits in Elementary Schoolchildren

The handwriting problems of elementary schoolchildren were investigated in this study. A questionnaire for evaluation of Chinese handwriting was developed and then administered to 165 children with handwriting deficits. Factor analysis indicated that the questionnaire has six major dimensions, including construction of characters, accuracy, developmental delay, pencil grip, gross movement, and emotional reaction. These six dimensions were utilized to search for subtypes of handwriting deficits. By further sampling, another 209 children were administered the handwriting evaluation questionnaire to classify their handwriting deficits. According to the severity of deficits on different dimensions of the questionnaire, K-means clustering was utilized to classify the children into four subtypes of mild, severe, motor-originated, and academic learning dysfunction subtypes. The classification by subtype might be helpful in planning interventions for children with handwriting deficits.

Developmental Coordination Disorder and Self-Esteem: Do Occupational Therapy Groups Have a Positive Effect?

Children with developmental coordination disorder (DCD) have motor difficulties that impede the acquisition of both functional and academic skills and evidence suggests that these children may also have reduced self-esteem. One approach to treatment often adopted by occupational therapists is in the form of group therapy. Anecdotal evidence indicates that although these groups may produce little improvement in motor skills, there may be an associated increase in the children's self-confidence and self-esteem. This pilot study aimed to evaluate whether this was the case.

A mixed methodology was used to evaluate the self-esteem of 12 children with DCD and to obtain the views of their parents/carers. A repeated measure design was used to assess the children using a validated measure of self-esteem, the Culture-Free Self-Esteem Inventories (CFSEI-2, Battle 1992), at initial assessment and pre and post therapy group. The parents/carers of the children were asked to complete a questionnaire during the last therapy group session and this formed the basis of a post-group interview.

The results indicated that for this group of children the therapy groups did have a positive effect on their self-esteem in the majority of cases. Although it is unreasonable to draw definite conclusions from this pilot study because of the small sample size, possible implications for policy and practice are discussed and suggestions for further research are given.

Motor-Free Visual Perception Test — Revised: An Overview and Critique

Paediatric occupational therapists often assess and treat school-age children and youth presenting with visual perceptual dysfunction. It is, therefore, important that occupational therapists use visual perceptual instruments that possess sound measurement properties (such as validity, reliability, responsiveness and clinical utility). The Motor-Free Visual Perception Test – Revised (MVPT-R) is an instrument frequently used by paediatric occupational therapists. Clinicians need to be cognisant of the measurement properties of the assessments they use in order to provide the best level of care for the paediatric clients they serve. Therefore, a review and critique of the MVPT-R is presented.

Even though the MVPT-R has been revised recently, little has been done to address issues related to its reliability and validity. Evidence of criterion-related validity and construct validity, in particular, is still lacking. The rationale for measuring motor-free visual perception is also not well developed and needs to be expanded in the MVPT-R manual. In addition, the issue of summing the scores from the five MVPT-R subscales is questionable. What the final MVPT-R summed score really measures in terms of a screening evaluation or diagnosis is also lacking. At this stage, this instrument should be used and interpreted by occupational therapists with caution.

Paediatric Occupational Therapy University Programme Curricula in the United Kingdom

The paediatric curriculum component of entry-level occupational therapy education programmes in the United Kingdom was examined and comparisons were made with the practice literature to determine if students were being taught current best practices.

Questionnaires were mailed electronically to the identified paediatric faculty members of the 27 universities with an entry-level occupational therapy education programme in the United Kingdom. Ten completed questionnaires were returned, giving a response rate of 37%.

The survey results indicated that paediatrics constituted less than 5% of the total curriculum content of the respondent university programmes. The theory, assessments and treatment approaches taught in the education programmes were similar to those used in clinical practice with children. Some gaps in what was taught to students were apparent, notably in the key paediatric area of visual perceptual dysfunction. The theory, assessments and intervention methods were not always taught as a cohesive stand-alone unit, so gaps occurred in the education programmes. This could lead to graduates using an eclectic approach or using personal conceptual frameworks based on postgraduate learning and work experience.

The Application of Cognitive Orientation to Daily Occupational Performance (CO-OP) with Children 5–7 Years with Developmental Coordination Disorder

There has been an increase in the use of cognitive frameworks in occupational therapy with children with developmental coordination disorder (DCD). Investigations into the utility of one such cognitive approach, namely Cognitive Orientation to (daily) Occupational Performance (CO-OP), with children with DCD have shown the intervention to be effective with children over 7 years. However, there has been limited research into its utility with younger children.

This paper presents two case studies to demonstrate the use of CO-OP with children aged 5–7 years. Two boys with DCD engaged in 10 sessions of CO-OP. These younger children were found to be able to use the global framework (Goal, Plan, Do, Check) to improve their task performance, to develop plans using domain-specific strategies and to engage in checking strategies. Issues relating to attention, motivation and goal setting are discussed in the context of the two case studies.

Does a physiotherapy programme of gross motor training influence motor function and activities of daily living in children presenting with developmental coordination disorder?

BACKGROUND

Children with developmental coordination disorder (DCD) lack motor coordination and have difficulty performing motor skills and activities of daily living. Research shows these children do not outgrow their motor difficulties and without intervention do not improve. Physiotherapy is relevant for these children, but due to limited clinical protocols for DCD the aim of this study was to determine the effect of a gross motor training programme for 6-12-year-old children with DCD.

METHODS

This randomised pre-test, post-test study recruited 64 children with scores of 15th percentile or below using the Movement Assessment Battery for Children (M-ABC). The children were divided equally into an intervention group receiving 8 weeks of gross motor training for core stability, strengthening exercises, balance and coordination with task-specific activities for 30 min per week, while the control group continued with general therapy and activities of daily living. The M-ABC and Developmental Coordination Disorder Questionnaire (DCDQ) were used to assess each child before and after 8 weeks.

RESULTS

Sixty children completed the study, with 43 males and 17 females (mean age 10.02 years, SD = 2.10). There were no adverse reactions to the programme and M-ABC scores for the intervention programme improved by 6.46%, ball skills (3.54%) and balance (4.80%) compared with the control (0.17%) and (0.15%), respectively. There were significant (p < 0.05) improvements in DCDQ scores, but teachers allocated lower scores than parents.

CONCLUSION

This study supports 8 weeks of gross motor training which can be a beneficial intervention for physiotherapists to improve gross motor function for DCD.

CO-OP Intervention for Young Children with Developmental Coordination Disorder

Children with developmental coordination disorder experience difficulties with fine and gross motor tasks that affect their occupational performance. Research has found the Cognitive Orientation to daily Occupational Performance (CO-OP) measure to be an effective approach for improving skills in daily occupations with children between 7 and 12 years old who have developmental coordination disorder. The purpose of this single-case design study was to determine the effectiveness of using the CO-OP approach with children ages 5 to 7 years. Four children chose three different goals to work on during therapy. Child and parent Canadian Occupational Performance Measure ratings and performance observation ratings at follow-up demonstrated the effectiveness of the CO-OP approach, supporting the use of the CO-OP with younger children and suggesting further research on the CO-OP with younger children is warranted.

The impact of handwriting difficulties on compositional quality in children with developmental coordination disorder

Introduction

There is substantial evidence to support the relationship between transcription skills (handwriting and spelling) and compositional quality. For children with developmental coordination disorder, handwriting can be particularly challenging. While recent research has aimed to investigate their handwriting difficulties in more detail, the impact of transcription on their compositional quality has not previously been examined. The aim of this exploratory study was to examine compositional quality in children with developmental coordination disorder and to ascertain whether their transcription skills influence writing quality.

Method

Twenty-eight children with developmental coordination disorder participated in the study, with 28 typically developing age and gender matched controls. The children completed the ‘free-writing’ task from the detailed assessment of speed of handwriting tool, which was evaluated for compositional quality using the Wechsler objective language dimensions.

Results

The children with developmental coordination disorder performed significantly below their typically developing peers on five of the six Wechsler objective language dimensions items. They also had a higher percentage of misspelled words. Regression analyses indicated that the number of words produced per minute and the percentage of misspelled words explained 55% of the variance for compositional quality.

Conclusion

The handwriting difficulties so commonly reported in children with developmental coordination disorder have wider repercussions for the quality of written composition.

Prevalence of developmental coordination disorder among mainstream school children in India

OBJECTIVE

To estimate the prevalence of DCD in children between ages of 6-15 years attending mainstream schools in a school district in southern India using criteria of Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5).

METHODS

A total of 2282 children, were screened with Kannada version of DCDQ'07. All the children who were identified as probable. DCD cases were defined by using inclusion (Criteria A, B and C) and exclusion criteria (D) of DSM-5 which are ascertained by specific tests.

RESULTS

Nineteen (0.8%) children were identified as DCD with girls (1.1%) affected more than boys (0.5%) at confidence interval of 95%.

CONCLUSION

The prevalence of DCD using DSM-5 criteria is found to be 0.8% in Southern India. Girls were twice affected than boys.

Impact of tactile function on upper limb motor function in children with Developmental Coordination Disorder

This study investigated the presence of, and relationship between tactile dysfunction and upper limb motor function in children with Developmental Coordination Disorder (DCD) compared to typical developing (TD) children. Participants were 36 children aged 6-12 years. Presence of DCD (n=20) or TD (n=16) was confirmed using the Movement Assessment Battery for Children, second edition. All children participated in a comprehensive assessment of tactile registration (Semmes Weinstein Monofilaments); tactile spatial perception (Single Point Localisation (SPL) and two-point discrimination (2PD)); haptic perception (Stereognosis); speed of simple everyday manual tasks (Jebsen-Taylor Test of Hand Function (JTTHF)); and handwriting speed and accuracy (Evaluation Tool of Children's Handwriting (ETCH)). Compared to TD children, children with DCD demonstrated poorer localisation of touch in the non-dominant hand (p=0.04), slower speed of alphabet writing (p<0.05) and less legible handwriting (p<0.01), but no difference in speed of simple everyday manual tasks (JTTHF: p>0.05). Regression analysis showed that spatial tactile perception (SPL) predicted handwriting legibility (ETCH: r=0.11) and speed of functional tasks (JTTHF: r=0.33). These results suggest that tactile function, specifically single point localisation, should be a primary tactile assessment employed to determine reasons for upper limb motor difficulties experienced by children with DCD.

Reduced motor imagery efficiency is associated with online control difficulties in children with probable developmental coordination disorder

Recent evidence indicates that the ability to correct reaching movements in response to unexpected target changes (i.e., online control) is reduced in children with developmental coordination disorder (DCD). Recent computational modeling of human reaching suggests that these inefficiencies may result from difficulties generating and/or monitoring internal representations of movement. This study was the first to test this putative relationship empirically. We did so by investigating the degree to which the capacity to correct reaching mid-flight could be predicted by motor imagery (MI) proficiency in a sample of children with probable DCD (pDCD). Thirty-four children aged 8 to 12 years (17 children with pDCD and 17 age-matched controls) completed the hand rotation task, a well-validated measure of MI, and a double-step reaching task (DSRT), a protocol commonly adopted to infer one's capacity for correcting reaching online. As per previous research, children with pDCD demonstrated inefficiencies in their ability to generate internal action representations and correct their reaching online, demonstrated by inefficient hand rotation performance and slower correction to the reach trajectory following unexpected target perturbation during the DSRT compared to age-matched controls. Critically, hierarchical moderating regression demonstrated that even after general reaching ability was controlled for, MI efficiency was a significant predictor of reaching correction efficiency, a relationship that was constant across groups. Ours is the first study to provide direct pilot evidence in support of the view that a decreased capacity for online control of reaching typical of DCD may be associated with inefficiencies generating and/or using internal representations of action.

Young adults with developmental coordination disorder: a longitudinal study

We conducted a longitudinal study to assess the continuing influence of developmental coordination disorder (DCD) on quality of life and participation. Ninety-six participants (25 in the DCD group, 30 in the borderline group, and 41 in the control group) ages 22-29 yr who had been screened for DCD 3-4 yr previously completed the Participation in Every Day Activities of Life, the Life-Satisfaction Questionnaire, and the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Multivariate analysis of variance revealed a significant between-groups difference, F(7, 95) = 2.89, p = .001, η = 0.173, and post hoc analyses revealed that participants in the DCD and borderline groups scored lower overall on participation, quality of life, and life satisfaction. Linear regression found the Psychological Health domain of the WHOQOL-BREF to be a significant predictor of life satisfaction (B = 0.533; p = .001).

An examination of writing pauses in the handwriting of children with developmental coordination disorder

Difficulties with handwriting are reported as one of the main reasons for the referral of children with Developmental Coordination Disorder (DCD) to healthcare professionals. In a recent study we found that children with DCD produced less text than their typically developing (TD) peers and paused for 60% of a free-writing task. However, little is known about the nature of the pausing; whether they are long pauses possibly due to higher level processes of text generation or fatigue, or shorter pauses related to the movements between letters. This gap in the knowledge-base creates barriers to understanding the handwriting difficulties in children with DCD. The aim of this study was to characterise the pauses observed in the handwriting of English children with and without DCD. Twenty-eight 8-14 year-old children with a diagnosis of DCD participated in the study, with 28 TD age and gender matched controls. Participants completed the 10 min free-writing task from the Detailed Assessment of Speed of Handwriting (DASH) on a digitising writing tablet. The total overall percentage of pausing during the task was categorised into four pause time-frames, each derived from the literature on writing (250 ms to 2 s; 2-4 s; 4-10 s and >10 s). In addition, the location of the pauses was coded (within word/between word) to examine where the breakdown in the writing process occurred. The results indicated that the main group difference was driven by more pauses above 10 s in the DCD group. In addition, the DCD group paused more within words compared to TD peers, indicating a lack of automaticity in their handwriting. These findings may support the provision of additional time for children with DCD in written examinations. More importantly, they emphasise the need for intervention in children with DCD to promote the acquisition of efficient handwriting skill.

Convergent validity of two motor skill tests used to assess school-age children

BACKGROUND

Motor skills allow children to interact with their surrounding environment, making the progression of competent motor skills crucial to development. The most common form of motor skill assessment is through the use of performance-based tests. Performance measures need to be both reliable and valid to ensure they are of high quality. Two examples of performance-based motor skill tests often used to assess children are the Bruininks-Oseretsky Test of Motor Proficiency--2nd edition (BOT-2) and the Movement Assessment Battery for Children--2nd edition (MABC-2).

AIM

This study investigated the convergent validity between the BOT-2 and MABC-2 when completed by typically developing school-aged children aged 7-16 years.

METHOD

A convenience sample of 50 children aged 7-16 years with no history of motor or intellectual impairments was recruited. Scores from the BOT-2 and MABC-2 were analysed using Spearman's rho correlation.

RESULTS

The study found that the MABC-2 11- to 16-year-old group (age band 3) was significantly associated with the BOT-2; however, there were no significant relationships between the MABC-2 7- to 10-year-old group (age band 2) and the BOT-2.

CONCLUSION

The MABC-2 and BOT-2 appear to assess associated motor skill abilities in children aged 11-16 years but not in children aged 7-10. This study adds to the body of convergent validity evidence regarding the MABC-2 and BOT-2.

Developmental coordination disorder and overweight and obesity in children: a systematic review

Children with developmental coordination disorder (DCD) find themselves less competent than typically developing children with regard to their physical abilities and often experience failure. They are therefore likely to avoid physical activity. Physical inactivity is considered an important risk factor for developing overweight and obesity. The aim of this study is to assess the association between DCD and overweight and obesity in children and whether this association is influenced by age and/or gender. Six electronic databases were systematically searched. Titles and abstracts were screened for relevance. Remaining studies were subjected to full paper review. The quality of the included articles was assessed and relevant data were extracted for comparison. The search yielded 273 results. Twenty-one studies, based on 10 cohorts, were included. Participants' ages ranged from 4 to 14 years. In all cohorts, children with DCD had higher body mass index scores, larger waist circumference and greater percentage body fat compared with controls. Seven studies assessed the effect of gender and four studies provided information on the effect of age. Children with DCD seem to be at greater risk for overweight and obesity. This risk may be higher for boys and seems to increase with age and with the severity of motor impairment.

Manual control age and sex differences in 4 to 11 year old children

To what degree does being male or female influence the development of manual skills in pre-pubescent children? This question is important because of the emphasis placed on developing important new manual skills during this period of a child's education (e.g. writing, drawing, using computers). We investigated age and sex-differences in the ability of 422 children to control a handheld stylus. A task battery deployed using tablet PC technology presented interactive visual targets on a computer screen whilst simultaneously recording participant's objective kinematic responses, via their interactions with the on-screen stimuli using the handheld stylus. The battery required children use the stylus to: (i) make a series of aiming movements, (ii) trace a series of abstract shapes and (iii) track a moving object. The tasks were not familiar to the children, allowing measurement of a general ability that might be meaningfully labelled ‘manual control’, whilst minimising culturally determined differences in experience (as much as possible). A reliable interaction between sex and age was found on the aiming task, with girls' movement times being faster than boys in younger age groups (e.g. 4–5 years) but with this pattern reversing in older children (10–11 years). The improved performance in older boys on the aiming task is consistent with prior evidence of a male advantage for gross-motor aiming tasks, which begins to emerge during adolescence. A small but reliable sex difference was found in tracing skill, with girls showing a slightly higher level of performance than boys irrespective of age. There were no reliable sex differences between boys and girls on the tracking task. Overall, the findings suggest that prepubescent girls are more likely to have superior manual control abilities for performing novel tasks. However, these small population differences do not suggest that the sexes require different educational support whilst developing their manual skills.

Visual-perceptual-kinesthetic inputs on influencing writing performances in children with handwriting difficulties

This study investigated the role of visual-perceptual input in writing Chinese characters among senior school-aged children who had handwriting difficulties (CHD). The participants were 27 CHD (9-11 years old) and 61 normally developed control. There were three writing conditions: copying, and dictations with or without visual feedback. The motor-free subtests of the Developmental Test of Visual Perception (DTVP-2) were conducted. The CHD group showed significantly slower mean speeds of character production and less legibility of produced characters than the control group in all writing conditions (ps<0.001). There were significant deteriorations in legibility from copying to dictation without visual feedback. Nevertheless, the Group by Condition interaction effect was not statistically significant. Only position in space of DTVP-2 was significantly correlated with the legibility among CHD (r=-0.62, p=0.001). Poor legibility seems to be related to the less-intact spatial representation of the characters in working memory, which can be rectified by viewing the characters during writing. Visual feedback regarding one's own actions in writing can also improve legibility of characters among these children.

Analysis of cursive letters, syllables, and words handwriting in a French second-grade child with Developmental Coordination Disorder and comparison with typically developing children

Poor handwriting is a core deficit in Developmental Coordination Disorder (DCD). In a previous study, we compared the evolution of cursive letters handwriting in a girl with DCD throughout her second-grade year with that of typically developing (TD) children. We found that her handwriting evolved much less than that of TD children and remained similar to that of pre-schoolers at all stages, suggesting that her handwriting skills have reached a steady state level. We present here a continuation of this work, in which we focused on the velocity aspects of handwriting in another French child with DCD. Indeed, different velocity patterns have been observed in Chinese and English children with DCD. In the French cursive style of writing, consecutive letters are joined, a major difference with the English script style of writing. We thus analyzed the handwriting of a second-grade French girl with DCD, not only for isolated letters but also for syllables and words, in comparison to that of TD first-graders (6-7 years old; N = 85) and second-graders (7-8 years old; N = 88). Each written track was digitized, and nine kinematic parameters were measured to evaluate writing fluency. Results showed that the productions of the child with DCD were more similar to those of first-graders than to those of second-graders. In line with our previous study, the most discriminative parameters between the child with DCD and TD children were size and mean speed. Moreover, her handwriting was less fluent than that of TD children. In contrast to previous observations, we observed a higher writing velocity of the child with DCD when compared to TD children, whatever the complexity of the item, and no significant difference with TD children in the pausing time during writing. These differences may reflect linguistic specificities. For syllables and words, each letter was treated separately as a single unit, thus reflecting a problem in anticipation and automation.

Motor Abilities and Coping in Children with and without Developmental Coordination Disorder

Introduction:

This study was conducted in order to identify differences in motor abilities and coping in children with and without developmental coordination disorder. The study also discusses the relationship between coping and motor abilities.

Method:

A cross-sectional design with two independent groups was chosen to identify the differences. The Movement Assessment Battery for Children — second edition (Henderson et al 2007) was used to assess motor skills. Coping was evaluated with the Coping Inventory observation form (Adaptive Behaviour Index) (Zeitlin 1985).

Results:

Univariate analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA) showed significant differences between the motor abilities and coping efforts of children with and without developmental coordination disorder. Calculations using Pearson's correlation coefficient showed a significant correlation between coping and motor competences. In the overall model, boys and children with lower coping efforts were found more likely to be participants in the group with development coordination disorder.

Conclusion:

Children with coordination problems differ from typically developing children in their motor and coping abilities when rated by their parents. This highlights the importance of paying attention to the coping strategies and resources of children with developmental coordination disorder during therapy.

Handwriting speed in children with Developmental Coordination Disorder: are they really slower?

Handwriting difficulties are often included in descriptions of Developmental Coordination Disorder (DCD). They are cited as the most common reason for referral to health professionals following parent and teacher concerns about slow and untidy writing. The aim of this study was to compare handwriting performance in English children with and without DCD across a range of writing tasks, to gain a better understanding of the nature of 'slowness' so commonly reported. Twenty-eight 8-14 year-old children with a diagnosis of DCD participated in the study, with 28 typically developing age and gender matched controls. Participants completed the four handwriting tasks from the Detailed Assessment of Speed of Handwriting (DASH) and wrote their own name; all on a digitising writing tablet. The number of words written, speed of pen movements and the time spent pausing during the tasks were calculated. The findings confirmed what many professionals report, that children with DCD produce less text than their peers. However, this was not due to slow movement execution, but rather a higher percentage of time spent pausing. Discussion centres on the understanding of the pausing phenomenon in children with DCD and areas for further research.

A profile of canadian pediatric occupational therapy practice

PURPOSE

This study established a current profile of Canadian pediatric occupational therapy practice in terms of theories/practice models, assessments, and interventions.

METHOD

Respondents were 272 members of the Canadian Association of Occupational Therapists who indicated that pediatrics was their primary area of clinical practice. A purpose-designed survey was mailed to participants.

RESULTS

The response rate was adequate at 27.2% (n = 272/1,000). The primary client groups seen by pediatric therapists were developmental delay, learning disability, neurology, and those requiring rehabilitation. Sensory Integration and Client-Centred Practice were the most frequently utilized theories/practice models. The most commonly used assessments were the Developmental Test of Visual Motor Integration, Peabody Developmental Motor Scales, Bruininks-Oseretsky Test of Motor Proficiency, and the Sensory Profile. The most frequently used intervention techniques with pediatric clients were the instruction of parents/caregivers and children; assistive devices, adaptive equipment, and technology; activities of daily living/self-care skills; and environmental modification/access/structuring/adaptation.

CONCLUSIONS

Pediatric occupational therapists mainly used theories/ practice models that focused on three areas: Client-Centred practice, practice-oriented theories, and several theories/practice models based on occupation. Interventions focused on teaching, activities unique to occupational therapy, and on the functional needs of the client.

The profile of performance skills and emotional factors in the context of participation among young children with Developmental Coordination Disorder

Participation is a person's involvement in daily activities in a variety of environments, roles and life situations. Children with Developmental Coordination Disorder (DCD) experience difficulties in gaining academic achievements or in their engagement in activity of daily living. Motor difficulties have a negative effect on the ability to participate, as well as on various affective components. Senses of coherence, effort and hope have not yet been assessed, within the context of participation, in children with DCD. The purpose of the present study is to look into the relations between participation and senses of coherence, effort and hope among children with DCD, in comparison to typically developed children. Fifty subjects aged 5-6 years participated in the study, 25 of whom are children diagnosed with DCD, the other 25 being typical children. The DCD diagnosis was established according to the DSM-IV criteria and the M-ABC test. All children completed the coherence questionnaire for children as well as the children's questionnaire on effort and hope. Parents completed the Children Participation Questionnaire (CPQ), and the Performance Skills Questionnaire (PSQ). Children with DCD had lower performance skills, lower sense of coherence, hope, and effort than their peers. They less enjoy their participation and their parents are less satisfied in comparison to control group. Significant correlations were found between sense of coherence and hope to participation. Process skills were found to be the main predictor for explaining child's participation. While treating children with DCD we have to consider also socio-psychological aspects that may be weakened.