Young Adults' Daily Participation Scale: A measure of objective and subjective participation

INTRODUCTION

Participation in occupations is considered essential for individuals' health and wellbeing. Participation is a multidimensional construct that encompasses objective and subjective dimensions that transform over the course of life. Nonetheless, there is a lack of comprehensive measures that examine young adults' participation in age-appropriate activities. Therefore, we developed the Young Adults' Daily Participation Scale (YADAPS) and aimed to explore its psychometric properties.

METHODS

In Study 1, the content validity of the YADAPS was established based on nine experts. Its internal consistency, criterion, convergent, and construct validity were explored among 115 typical young adults (21-35 years). Using a different sample, Study 2 examined YADAPS discriminant validity among 33 young adults with developmental coordination disorder (DCD) and 52 typical peers.

CONSUMER AND COMMUNITY INVOLVEMENT

No consumer and community involvement was included in these studies.

RESULTS

The relevance of YADAPS items was sufficient. Internal consistency was acceptable to excellent in most scales (.74 ≤ α ≤ .89). Criterion validity was supported by correlations between the subjective participation scales and a wellbeing measure. Convergent validity was found for all scales. No gender effect was observed (p ≥ .05). However, significant differences (p ≤ .05) were found between individuals with and without DCD.

CONCLUSIONS

The YADAPS appears to be a promising measure of objective and subjective dimensions of participation in young adults. The results support the importance of examining various participation dimensions, including occupational experience. Thus, it may be used for clinical purposes among young adults as well as for occupational science research, to broaden our understanding on the interplay between participation dimensions in various life situations in young adulthood. However, further research is needed on psychometric properties, the most suited scoring method, and to consolidate their robustness among diverse populations of young adults.

PLAIN LANGUAGE SUMMARY

Participation, or how one engages in daily life activities, greatly affects wellbeing. The activities in one's routine change over the lifespan, in accordance with one's developmental phase. Existing assessments of participation have limitations, like not considering young adults' concerns or only focussing on certain aspects of participation. By focussing on both the objective-observable and subjective-experiential aspects of participation, the Young Adults' Daily Participation Scale (YADAPS) strives to be a comprehensive assessment tool designed specifically for reflecting activities relevant in young adulthood. This manuscript provides preliminary validity and reliability for the YADAPS, a new questionnaire that assesses objective and subjective aspects of participation in activities relevant for individuals in young adulthood. Furthermore, the questionnaire is able to distinguish between young adults with and without participation difficulties; therefore, it is suitable for research and clinical use.

"It feels as though I need to exert more effort than others": the experience of daily participation of young adults with developmental coordination disorder (DCD) - a qualitative study

PURPOSE

Participation difficulties among adults with developmental coordination disorder (DCD) have been documented. However, little attention has been given to the subjective aspects of participation, also called occupational experience, including feeling during engagement in activities and their meaning. This study aimed to explore the occupational experience of young adults with DCD.

MATERIALS AND METHODS

Informed by the phenomenological approach, we conducted semi-structured interviews with 10 young adults with DCD.

FINDINGS

Three themes emerged: (1) Complexity of occupational experience; describes the motives for participation, with variations in experience across activities and individuals. Participants engage in activities that provide them with pleasure and fulfillment, while other activities require constant effort and cause stress and shame; (2) The role of internal factors; illustrates the influence of poor motor and organizational/planning skills, self-acceptance; and utilizing strategies on the participants' occupational experience; and (3) The role of the social environment; reveals the participants' dual perception of their environment - as a source of criticism as well as a source of support.

CONCLUSIONS

Individuals with DCD may benefit from intervention during young adulthood to enhance their well-being. The interventions should target their subjective occupational experiences in addition to their objective performance difficulties, by enhancing their psycho-social resources.

Maths performance of adults with and without developmental coordination disorder (DCD): The role of working memory and maths anxiety

Previous studies have shown that children with Developmental Coordination Disorder (DCD)/Dyspraxia have poorer maths performance compared to their neurotypical (NT) counterparts. However, no studies have explored the cognitive and emotional factors affecting the maths performance of adults with DCD. This study, therefore, investigated the role of working memory (WM), maths anxiety (MAS), and maths self-efficacy on the maths performance of adults with DCD. We found that adults with DCD had lower WM and maths performance and were more maths anxious than their NT peers. However, there were no significant differences in maths self-efficacy. When looking at the predictors of maths performance, we found a positive relationship between WM resources and the DCD maths performance, possibly indicating that they relied more on WM resources to perform simple mental arithmetic tasks than NTs. On the other hand, MAS had an inverse relationship with the NT maths performance but not with the DCD performance. The reasons and implications of these findings will be discussed.

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.

Interorganisational collaboration to improve accessibility of diagnostic evaluations for children with a developmental disability

Introduction

A timely integrated diagnostic and care trajectory for children with a developmental disability may prevent severe problems in later life. In Flanders, Belgium, different types of governmental regulated and subsidised settings offer diagnostic evaluations, as (part of) their mission. However, they operate in a non-coordinated way inducing severe accessibility problems for the public. This article studies the factors impacting on interorganisational collaboration and proposes an interorganisational conceptual model improving accessibility.

Methods

Focus groups were performed per type of organisation. Qualitative data were categorised thematically in an iterative process of data- and researcher triangulation. A member check validation was organised.

Results

Fifty-nine individuals participated in 6 focus groups. Structural and agency-related barriers for interorganisational collaboration were identified at micro, meso and macro level. Participants provided suggestions for better interorganisational collaboration.

Discussion

To improve accessibility adapted to patients' needs, a patient-centred, integrated and interorganisational network model grounded in a stepped care logic is proposed to adapt the current organisation-centred model.

Conclusion

A timely, integrated, diagnostic and care trajectory for children with a developmental disability preventing severe problems in later life requires an integration of services during the overall care trajectory of children by means of interorganisational collaboration.

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.

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

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

Exploring Executive Functioning of Adults With Probable Developmental Coordination Disorder Using the Jansari Assessment of Executive Functions

Many individuals with Developmental Coordination Disorder (DCD) demonstrate executive functioning difficulties on standardized assessments, yet these difficulties have not been investigated using ecologically-valid measures. 26 adults with probable DCD (pDCD), and 26 typically developing (TD) adults completed selected background measures and the Jansari assessment of Executive Functions (JEF©). JEF© is an ecologically-valid measure that provides measures of Planning, Prioritization, Selective-Thinking, Creative-Thinking, Adaptive-Thinking, and Action-, Event- and Time-Based Prospective Memory. pDCD participants were impaired relative to TD participants, with difficulties in Planning, Action-, and Event-Based Prospective Memory. These findings are consistent with self-reported difficulty and provide avenues for research investigating intervention.

Perspective: Acknowledging complexity to advance the understanding of developmental coordination disorder

Developmental Coordination Disorder (DCD) is a heterogeneous neurodevelopmental disorder known for primary symptoms of motor learning and execution difficulties. Recent research has consistently suggested DCD symptoms span broadly beyond motor difficulties, yet a majority of research and practice approaches the investigation, diagnosis, and treatment of DCD with a reductionist framework. Therefore, this paper suggests the paradigm of complexity theory as a means for better conceptualization, assessment, and treatment of DCD. First, the perspective of complexity theory and its relevance to DCD is described. Then, examples from recent research which attempt to acknowledge and capture the complex nature of DCD are highlighted. Finally, suggestions for considering and measuring complexity of DCD in future research and practice are provided. Overall, the perspective of complexity can propel the research forward and improve the understanding of DCD relevant to assessment and treatment. The complexity paradigm is highly relevant to describing the evolving and multidimensional picture of DCD, understanding heterogeneous symptom profiles, making connections to interconnected secondary symptoms, and beyond.

The adult developmental coordination disorders/dyspraxia checklist - German: adapted factor structure for the differentiation of DCD and ADHD

BACKGROUND

The Adult Dyspraxia/DCD Checklist (ADC) is the only existing self-report questionnaire to screen adults for potential Developmental Coordination Disorder (DCD). It was developed in English and Hebrew, however, its factor structure has not yet been assessed.

AIMS

The goals of the current study were to (1) develop and refine a German translation, (2) explore the emerging factors in a new and restructured ADC in German and apply this structure to an English ADC, and (3) explore its potential for distinguishing DCD versus ADHD.

METHOD

In a series of three studies, we assessed comprehensibility of the translation and revisions to the questionnaire. We further examined subscale structure in a sample of N = 148 individuals with DCD or ADHD and retested it in an English-speaking sample (N = 134).

RESULTS

Overall, we found decent reliability and construct validity for the German ADC. Three components emerged with themes of fine motor coordination, gross motor coordination, and executive functions which had strong psychometric properties in German and English.

CONCLUSIONS

The studies collectively highlight the German translation is effective and has strong potential to differentiate DCD and ADHD. Most notably, there are unique symptom profiles in motor and executive functioning difficulties in adults with DCD or ADHD. WHAT THIS PAPER ADDS?: The translation and preliminary validation of the German ADC in this study has the potential to screen for probable DCD in German-speaking adults for the first time. In addition, the new subscale structure can be generalized to the English version as well and allows for the potential assessment of several key symptomatic patterns in the realms of gross motor, fine motor, and executive functioning skills that differ between adults with DCD and ADHD. These differences were fairly consistent between English- and German-speaking samples, indicating potential for more widespread assessment and differentiation of DCD and ADHD.

Developmental Coordination Disorder (DCD): Relevance for clinical psychologists in Europe

Background

Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder primarily characterized by fine and gross motor coordination difficulties. Yet, many aspects remain unclear regarding the clinical presentation of secondary symptoms and their implications for Clinical Psychology. Therefore, the purpose of this review is to provide an update about the current understanding of DCD for clinical psychologists and psychotherapists across Europe, particularly based on new insights stemming from the last decade of research.

Method

We provide a narrative review of articles published in the last decade on the topic of DCD, and relevant aspects to clinical psychologist, including lesser known aspects of DCD (e.g., executive functions, psychological consequences, and adult DCD).

Results

DCD is a highly prevalent, disruptive, and complex disorder, which should be investigated further in many areas (e.g., co-occurrence to ADHD). Existing evidence points toward a key role of executive functioning difficulties at all ages. Most patients report secondary psychological problems, but little headway has been made in examining the effectiveness of psychotherapy for DCD.

Conclusions

Insights and remaining research gaps are discussed. It is critical for psychologists and clinical researchers to raise awareness for DCD, take note of the growing literature, and foster continued interdisciplinary approaches to research and treatment of DCD.

Awareness about Developmental Coordination Disorder (DCD) is low among some European Psychologists.

Growing knowledge about DCD should be disseminated among psychotherapists.

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.

Anxiety, confidence and self-concept in adults with and without developmental coordination disorder

BACKGROUND

Previous research suggests that adults with Developmental Coordination Disorder (DCD) report lower general wellbeing and higher general anxiety levels than typically developing (TD) adults.

AIMS

To examine and explore relationships between anxiety and confidence (self-efficacy and resilience) generally and in a movement-specific context, along with self-concept among adults with DCD and TD adults.

METHODS

74 adults with diagnosed DCD, 26 adults with suspected DCD and 79 TD adults (18-60 years) completed an online questionnaire composed of a mixture of existent psychometric measures and novel scales.

RESULTS

General and movement-specific anxiety, self-efficacy and general resilience were all poorer in adults with diagnosed and suspected DCD compared to TD adults. Higher resilience was related to higher self-efficacy and lower anxiety in adults with DCD. Individuals with suspected DCD for whom motor skills difficulties were an important aspect of their self-concept had lower movement-specific self-efficacy.

CONCLUSIONS

Interventions to improve the psychosocial wellbeing of adults with DCD should include a focus on lowering anxiety and building self-efficacy and resilience, with particular attention to movement-related domains.

IMPLICATIONS

This would facilitate the effective development of strategies to manage motor skills difficulties and their impact on everyday life for adults with DCD.

Driving Skills of Individuals With and Without Developmental Coordination Disorder (DCD/Dyspraxia)

Learning to drive is a significant event for the transition to adulthood and delay or avoidance may have social, practical, and psychological implications. For those with Developmental Coordination Disorder (DCD/Dyspraxia), driving presents a considerable challenge, and the literature shows that there are differences in driving ability between individuals with and without DCD. The aim of the current research is to further our understanding of the mechanisms underlying the driving experiences of individuals with DCD. Nineteen participants with DCD (10 drivers and 9 non-drivers) and 36 controls (17 drivers and 19 non-drivers) aged 18-57 years took part in this study. Participants completed standardized tests, questionnaires and a driving simulation task designed to measure speed, road positioning, and rate of change of steering in three conditions with increasing perceptual complexity. Results indicate that behaviors for all participants changed as the perceptual demands of the task increased. However, drivers with DCD were more affected than all other groups, driving more slowly, and driving further to the right. These findings illustrate how the impact of both internal and external constraints negatively affect the success of the driving task for individuals with DCD compared to their TD peers.

Examining academic confidence and study support needs for university students with dyslexia and/or developmental coordination disorder

Higher education providers are seeing a shift from externally funded support for students with specific learning difficulties (SpLD), to a need to develop more inclusive practices generally. However, the precise needs of students with different SpLD diagnoses is unknown. A total of 367 students in England and Wales (163 students with dyslexia, 50 students with developmental coordination disorder [DCD/"dyspraxia"], 62 students with dyslexia and DCD, and 92 non-SpLD students) completed an online questionnaire to determine: (a) how confident they are with their study-related capabilities, (b) the types of support they access, and (c) their views on current inclusive practices. Students with dyslexia and students with dyslexia/DCD reported lower confidence in their grades and studying than non-SpLD students, and accessed more technology-related support than students with DCD only. Examination accommodations supporting writing were common for all SpLD students. Inclusive practices were perceived positively, although different priorities were seen across groups. The findings demonstrate the complexities inherent in providing effective support for all students at university, with the varied profiles across and within SpLD groups suggesting that an individualized approach is necessary. Practical implications are discussed.

Developmental coordination disorder

Developmental coordination disorder (DCD) is a neurodevelopmental disorder that affects children's ability to execute coordinated motor actions, resulting in slow, clumsy, or inaccurate motor performances and learning difficulties (of new motor tasks or to adapt previously learned gestures to a modified or additional constraint). In the course of development, children with DCD exhibit a diversity of motor signs, including fine and gross motor problems with impaired postural control and balance, and sensorimotor coordination or motor learning difficulties. The prevalence ranges between 1.8% and 8%, depending on the diagnostic criteria used, based on the cutoff of motor scores from standardized scales. Four main hypotheses have been postulated to explain DCD in terms of deficits in visuospatial functions, procedural learning, internal modeling, or executive functions. Neuroimaging studies are scarce but have highlighted several brain regions, including the parietal, frontal, and cerebellar cortices. Meta-analyses have supported task-oriented approaches as effective therapies to improve motor performance in children with DCD.

Developmental Coordination Disorder: The Importance of Grounded Assessments and Interventions

This focused review is based on earlier studies which have shown that both children and adults diagnosed as having developmental coordination disorder (DCD), benefited from sensorimotor therapy according to the method Retraining for Balance (RB). Different approaches and assessments for children and adults in regard to DCD are scrutinized and discussed in comparison to RB which mainly includes (a) vestibular assessment and stimulation (b) assessment and integration of aberrant primary reflexes and (c) assessment and stimulation of auditory and visual perception. Earlier results indicate that the process of Sensorimotor therapy using RB techniques could be described according to a conceptual Kinesthetic-Vestibular Developmental Model (KVDM) whereby the training elicited temporary physical and psychological regressions followed by transformations i.e., positive physical and psychological development. We have also seen that this recurring pattern is similar for children and adults. In our conceptual model vestibular stimulation (perceptual priming) stimulates the nervous system, which might enhance object-related priming. This perceptual priming will also assist the suppression of persistent aberrant primary reflexes. In order to develop effective methods for assessment and intervention of DCD over the life span the importance of primary reflex inhibition and vestibular stimulation as well as a combination of bottom-up and top-down approaches have to be considered.

Interhemispheric Cortical Inhibition Is Reduced in Young Adults With Developmental Coordination Disorder

Introduction

While the etiology of developmental coordination disorder (DCD) is yet to be established, brain-behavior modeling provides a cogent argument that neuropathology may subserve the motor difficulties typical of DCD. We argue that a number of the core behavioral features of the DCD profile (such as poor surround inhibition, compromised motor inhibition, and the presence of mirror movements) are consistent with difficulties regulating inhibition within the primary motor cortex (M1). This study aimed to be the first account of the integrity of cortical inhibition in motor cortices in DCD.

Method

The sample consisted of eight adults with DCD aged (18–30 years) and 10 aged matched neurotypical controls. Participants received a common battery of single and paired-pulse transcranial magnetic stimulation from which a series of neurophysiological measures classically used to measure intra- [e.g., short-interval cortical inhibition (SICI), long-interval cortical inhibition (LICI), and cortical silent period] and inter hemispheric [e.g., ipsilateral silent period (ISP)] cortical inhibition of the M1 at rest were recorded.

Results

While no group differences were observed for any measure of intrahemispheric cortical inhibition, individuals with DCD demonstrated significantly reduced interhemispheric cortical inhibition relative to controls, shown by consistently lower ISP_ratios.

Conclusion

Our findings are consistent with the view that regulation of cortical inhibition of M1 activity may be atypical in individuals with DCD, indicating differential GABAergic operation. This effect, however, appears to be select to cortical inhibition. Importantly, our data support the notion that reduced interhemispheric M1 cortical inhibition may at least partly explain commonly reported difficulties with bimanual motor control in DCD. The neurochemical implications and limitations of this evidence will be discussed.