Effect of verbal cues on the coupling and stability of anti-phase bimanual coordination pattern in children with probable developmental coordination disorder

The study of the emergence and stability of bimanual and interlimb coordination patterns in children with Developmental Coordination Disorder (DCD) has shown that they encounter greater difficulties in coupling their limbs compared to typically developing (TD) children. Verbal cues have been identified as strategies to direct children's attention to more relevant task information, thus potentially improving motor performance. Consequently, this study investigated the effect of providing verbal cues on the execution of bimanual tasks in children with and without probable DCD. Twenty-eight children aged 9-10, matched by age and gender, were divided into two groups: pDCD [n = 14] and TD. The children performed bilateral trajectory movements with both hands (horizontal back-and-forth), holding a pen on a tablet, in anti-phase (180°) coordination pattern, in two conditions: No cues and Verbal cues. In the last condition, children received verbal cues to maintain the anti-phase pattern even with an increase in hand oscillation frequency. Relative phase and variability of relative phase between the hands were calculated for analysis of pattern coupling and stability. Hand cycles, movement amplitude, and tablet pressure force were calculated to analyze pattern control parameters. All these variables were compared between groups and conditions. The results indicated that despite the pDCD group showing greater variability in the anti-phase coordination pattern compared to the TD group, both groups performed better in the Verbal cues than the No cues condition. Furthermore, the pDCD group exhibited more hand movement cycles and applied greater pressure force compared to the TD group, suggesting different motor control strategies during the bimanual task. It is suggested that the use of verbal cues during bimanual task execution improves children's performance, potentially by promoting interaction between attention, as a cognitive function, and intrinsic coordination dynamics, thereby reducing variability in the perceptual-motor system.

Faktorielle Struktur motorischer Kompetenzen bei Grundschulkindern der ersten Klasse

Zusammenfassung. Theoretischer Hintergrund: Das Wissen über die faktorielle Struktur motorischer Kompetenzen ist unter anderem für die Interventionsplanung relevant; bei distinkten Faktoren sind domänspezifische Ansätze sinnvoll. Die zugrundeliegende Struktur ist ferner für die Interpretation von Gesamt- und Subskalenwerten bedeutsam. Fragestellung: Untersucht wird, ob den Leistungen von Grundschulkindern in der motorischen Testbatterie Movement ABC-2 ( Petermann, 2015 ) die drei distinkten, interkorrelierten Faktoren Handgeschicklichkeit, Balance und Ballfertigkeiten zugrunde liegen. Methode: Die Daten von n = 123 7- bis 8-jährigen Erstklässlern wurden mittels konfirmatorischer Faktorenanalyse ausgewertet. Ergebnisse: Das Originalmodell mit elf Indikatoren stellte sich für die betrachtete Stichprobe als nicht adäquat heraus. Nach Ausschluss des Indikators Mattenhüpfen 2 – besseres Bein konnte eine gute globale Passung des getrimmten dreifaktoriellen Modells mit korrelierten Faktoren nachgewiesen werden. Diskussion und Schlussfolgerung: Eine Revision einzelner Items für diese Altersgruppe scheint sinnvoll. Die Schwierigkeit des Items Mattenhüpfen 2 könnte erhöht werden, und das Item Zweihändiges Fangen könnte leicht abgeändert werden, um präzises Fangen isoliert zu erfassen. Diese Maßnahmen könnten auch dazu beitragen, das gesamte Leistungsspektrum in dieser Altersgruppe besser zu erfassen.

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.

The Effect of a Structured Intervention to Improve Motor Skills in Preschool Children: Results of a Randomized Controlled Trial Nested in a Cohort Study of Danish Preschool Children, the MiPS Study

The preschool age seems to be decisive for the development of motor skills and probably the most promising time-window in relation to improvement of motor skills. This trial investigates the effect of an intensive structured intervention to improve motor skills in 3-6-year-old preschool children. A total of 471 Danish preschool children participated in a cluster randomized controlled trial. The intervention was to enhance motor skills, including predefined minimum criteria. Motor skills were measured using the Motor Assessment Battery for Children-2 (MABC-2) (total and three domains) at baseline and 6-, 18-, and 30-months post-intervention. The effect was estimated by multilevel linear regression with preschool and child included as random effects and adjusted for baseline values. Effect estimates were mainly positive at 6 months, but negative at 30 months with very few statistically significant estimates. In preschools with baseline motor skills scores below average, there was a tendency towards a larger improvement in the intervention group. Future interventions and research should focus on clusters with poor motor skills, as there is larger room for improvement. It remains to be seen whether the intervention can influence general well-being, physical activity, and self-perceived competence, both short- and long-term.

Autonomous nervous system modulation in supine and standing postures in children with probable developmental coordination disorder

Background

Children with Developmental Coordination Disorder (DCD) are known to have poor physical fitness and psychosocial problems. The autonomous nervous system (ANS) plays an essential role in the regulation of human neurophysiological processes. Inadequate ANS modulation has been associated with harmful health conditions such as poor aerobic power, high body mass index, and symptoms of stress and anxiety. Modulation of ANS in children with DCD needs to be further investigated taking into consideration variables that may influence its function. For instance, would the level of physical fitness or the symptoms of stress and anxiety affect the ANS modulation of children with DCD?

Aims

To examine the ANS modulation during supine and standing postures, and stress/anxiety with questionnaire data from children with probable-DCD (p-DCD).

Methods

and procedures: Thirty children, 8–12 years old, composed two groups paired by age, gender, peak volume of oxygen uptake (aerobic power), and body mass index (BMI): p-DCD (9 boys, mean age 10.8 y) and typically developing (TD). Both groups were compared for stress/anxiety assessment by questionnaire and spectral, symbolic, and complexity heart rate variability (HRV) analyses during posture changes.

Outcomes and results

p-DCD group showed higher stress symptoms than TD group for stress/anxiety assessment in the questionnaire's data, but HRV analyses showed no differences between the two groups. Both groups showed parasympathetic prevalence during supine posture and sympathetic prevalence during standing posture.

Conclusions and implications

Children with p-DCD had similar autonomic control function as TD children during posture change (supine to standing). Symptoms of stress and anxiety demonstrated by p-DCD did not impact their ANS modulation. These results indicate that aerobic power and BMI are probable protective factors of ANS modulation for these children.

Validity and reliability evidence for motor competence assessments in children and adolescents: A systematic review

Valid and reliable tests of motor competence are necessary to allow researchers and practitioners to quantify levels of motor competence, identify skill deficiencies, and determine the effectiveness of motor skill interventions. The primary study aim was to systematically review the validity and reliability of scores derived from gross motor competence tests for typically developing child and adolescent populations. The secondary aim of this review was to identify the most prevalent motor skills assessed across all instruments. A search of seven electronic databases identified 57 different skill assessment tools from 107 studies. Construct validity was the most common measurement property examined (60 studies; 56%). Content validity (21 studies; 20%) was the least commonly explored measurement property. Scores derived from the Test of Gross Motor Development - second and third edition had the most support for validity and reliability. The most common skills included in these skill batteries were the overhand throw (n = 33), catch (n = 32), jump (n = 31) and hop (n = 26). Research efforts should focus on: (1) further investigation of measurement properties of existing tools rather than developing new assessments and (2) further investigation of existing tools and their measurement properties in adolescent populations.

Psychometric Validation and Reference Norms for the European Spanish Developmental Coordination Disorder Questionnaire: DCDQ-ES

The Developmental Coordination Disorder Questionnaire (DCDQ) is a widely used and well-validated tool that contributes to the diagnosis of Developmental Coordination Disorder (DCD). The aim of this study was to further analyze the psychometric properties of the European Spanish cross-culturally adapted version of the Developmental Coordination Disorder Questionnaire (DCDQ-ES) in a sample of Spanish children aged 6-11 years and to establish reference norms with respect to age groups. Parents of 540 typically developing children completed the DCDQ-ES. A second sample of 30 children with probable DCD (pDCD) was used to test its discriminant validity. Confirmatory factor analysis supported the original three-factor structure and the internal consistency was excellent (Cronbach's α = 0.907). Significant differences between age groups were found. The pDCD group scored significantly lower than the reference sample in the three subscales and DCDQ-ES total score (p < 0.001; AUC = 0.872). The DCDQ-ES is a reliable and valid tool for screening motor coordination difficulties in Spanish children and for identifying children with probable DCD. The findings of this research suggest that context-specific cut-off scores should be systematically utilized when using cross-cultural adaptations of the DCDQ. Age-specific cut-off scores for Spanish children are provided.

Interrelation of Individual, Country and Activity Constraints in Motor Activities of Daily Living among Typically Developing Children: A Cross-sectional Comparison of Spanish and Dutch Populations

Motor performance is influenced by individual, environmental, and task constraints. Children perform differently according to individual (i.e., sex), environmental (i.e., country), and task (i.e., type of activity) factors. However, little is known about the effect of the interaction between sex and country factors across different activities of daily living (ADL) learning, participation, and performance. The main aim of this study was to examine the relationship between sex, country, and type of activity in motor-based ADL learning, participation, and performance in five-to-eight-year-old, typically developing children. Additionally, we aimed to compare the prevalence of probable Developmental Coordination Disorder (DCD) across sex and country. The DCDDaily-Q was used to assess ADL learning, participation, and performance in 300 age and sex-matched children from Spain and The Netherlands. The prevalence of probable DCD was determined based on the total ADL performance score. Results showed that differences in ADL learning, participation and performance differed across sex and country (p < 0.05). Prevalence of probable DCD was statistically similar in both countries. These findings show that daily participation and performance in typically developing children may be influenced by individual, country, and task constraints, and that country and sex may have different influences on particular tasks.

Identifying Children with Developmental Coordination Disorder via Parental Questionnaires. Spanish Reference Norms for the DCDDaily-Q-ES and Correlation with the DCDQ-ES

Developmental Coordination Disorder (DCD) is one of the most prevalent neurodevelopmental disorders in school-aged children, with major consequences in psychosocial and physical health. Adequate identification of this disorder is necessary to prompt effective interventions. The aims of this study were to develop the Spanish adjusted reference norms for the DCDDaily-Q and to test the correlation and agreement between the Spanish versions of the DCDDaily-Q (DCDDaily-Q-ES) and the Developmental Coordination Disorder Questionnaire (DCDQ-ES), two reliable instruments to assess motor performance and DCD. Clinically relevant percentiles were calculated for the DCDDaily-Q-ES using a representative sample of Spanish children aged 5 to 10 years (n = 356; M = 7.3 years, SD = 1.8; boys = 50%). Pearson's correlation coefficient and intraclass correlation coefficient (ICC) were used to determine correlation and agreement between questionnaires, respectively. A moderate and significant correlation and agreement between DCDDaily-Q-ES and DCDQ-ES was found (r = 0.406; ICC = 0.381; p < 0.001). Differences in daily participation and performance were found between age groups, but not between boys and girls. Spanish age-adjusted percentiles and cutoff scores for DCDDaily-Q-ES are provided. This study offers further validation and relevant information regarding assessment of DCD and has practical implications for clinical practice and research.

RECONSIDERING THE USE OF CUT-OFF SCORES: DCDQ - BRAZIL

ABSTRACT Introduction: The DCDQ is a parental report designed to assess daily living activities of children, and serves as a useful questionnaire to aid in the diagnostic criteria of Developmental Coordination Disorder (DCD). It is divided into three components: control during movement, fine motor/handwriting, and general coordination. The results categorize children in two groups: “Indication of DCD/suspect DCD”, and “probably not DCD”. Objective: The objective of this study was to determine appropriate cut-off scores for the Developmental Coordination Disorder Questionnaire - Brazil (DCDQ-BR) for use with Brazilian children employing a large sample. Methods: Seven hundred and seven children ages 6-10 were assessed with the DCDQ-BR and the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). Descriptive statistics was used to characterize the sample, and concurrent validity was assessed using Pearson's Correlation Coefficient. Predictive validity was determined through values of sensitivity (S) and specificity (E), while ROC curves were used to determine the optimal cut-off score for the DCDQ-BR. Results: Pearson's correlation coefficient analysis revealed a significant correlation between total scores of the DCDQ-BR and BOT-2 (r= 0.55 (p=0.00). Cut-off scores for the DCDQ-BR based on the BOT-2 17th percentile (relating to below average descriptive category) were established as ≤40, ≤46 and ≤51 for ages 6-7 years and 11 months; 8-9 years and 11 months; and 10-10 years and 11 months, respectively. Conclusion: Based on the results of this study and previous literature suggesting the need for a reevaluation of cut-off scores for the Brazilian population with a larger sample, we recommend that the cut-off scores of the DCDQ-BR are adjusted to the values found with our sample. Level of evidence II; Diagnostic studies – Investigating a diagnostic test.

Motor tests for primary school aged children: A systematic review

Motor testing in education has gained in relevance in light of recent developments in educational systems (Köller & Baumert, 2012). The purpose of this systematic review was to identify studies using motor tests in primary school children aged 4 to 12 years and to synthetize information about the quality and application of the test instruments used. A systematic review of 910 records identified by a search of nine databases yielded 144 papers reporting motor testing in primary school age children, including 25 articles reporting on the quality of 20 test instruments. In the selected articles, tests grounded on the constructs of "motor abilities" and/or "motor skills" are the most frequent and are mostly used for monitoring purposes or for impact research. Tests based on the construct "motor competencies" have become popular only recently, being relevant for educational motor testing due to their curricular validity. The test instruments have been investigated towards their validity and reliability to different extents. However, for several test instruments factorial validity has not been established and more validation studies are needed to improve their psychometric quality especially if used in educational contexts.

Linear and Nonlinear Analyses of the Cardiac Autonomic Control in Children With Developmental Coordination Disorder: A Case-Control Study

Children with Developmental Coordination Disorder (DCD) and children at risk for DCD (r-DCD) present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children. Thirteen DCD children (11 boys and 2 girls, aged 8.08 ± 0.79 years), 19 children at risk for DCD (13 boys and 6 girls, aged 8.10 ± 0.96 years) and 18 typically developed children, who constituted the control group (CG) (10 boys and 8 girls, aged 8.50 ± 0.96 years) underwent a heart rate variability (HRV) examination. R-R intervals were recorded in order to assess the cardiac autonomic control using a validated HR monitor. HRV was analyzed by linear and nonlinear methods and compared between r-DCD, DCD, and CG. The DCD group presented blunted cardiac autonomic adjustment to the orthostatic stimulus, which was not observed in r-DCD and CG. Regarding nonlinear analysis of HRV, the DCD group presented lower parasympathetic modulation in the supine position compared to the r-DCD and CG groups. In the within group analysis, only the DCD group did not increase HR from supine to standing posture. Symbolic analysis revealed a significant decrease in 2LV (p < 0.0001) and 2UV (p < 0.0001) indices from supine to orthostatic posture only in the CG. In conclusion, r-DCD and DCD children present cardiac autonomic dysfunction characterized by higher sympathetic, lower parasympathetic and lower complexity of cardiac autonomic control in the supine position, as well as a blunted autonomic adjustment to the orthostatic stimulus. Therefore, cardiovascular health improvement should be part of DCD children's management, even in cases of less severe motor impairment.