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Kanevski M, Booth JN, Stewart TM, Rhodes SM. Cognitive heterogeneity in Attention Deficit Hyperactivity Disorder: Implications for maths. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2024; 42:596-621. [PMID: 39166844 DOI: 10.1111/bjdp.12517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 08/02/2024] [Indexed: 08/23/2024]
Abstract
This study investigated whether cognitive function better predicted maths test performance than a clinical diagnosis of attention deficit hyperactivity disorder (ADHD). Forty-four drug naïve children (Mage = 101.34 months, SD = 19.39; 30% girls) were recruited from clinical ADHD referral waiting lists. Children underwent assessment of Executive Functions (EF), lower-level cognitive processes, and maths performance. Children were grouped using a categorical approach comprising (1) children with a clinical ADHD diagnosis and (2) children without a diagnosis (i.e., subthreshold ADHD). Secondly, hierarchical cluster analysis generated subgroups of children using EF scores. Children were compared on cognition, maths, and parent-rated symptoms of ADHD and co-occurring difficulties. Children's diagnostic outcomes did not differentiate maths performance. By contrast, EF subgroups generated meaningful cognitive clusters which differentiated maths test scores. This suggests that cognitive patterns of performance, rather than children's diagnostic outcomes, are more informative for identifying meaningful groups with variable maths performance which has implications for remedial support.
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Affiliation(s)
- Margarita Kanevski
- Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Child Life and Health, University of Edinburgh, Edinburgh, UK
| | - Josie N Booth
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Tracy M Stewart
- Moray House School of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Sinead M Rhodes
- Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Child Life and Health, University of Edinburgh, Edinburgh, UK
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Park SH, Kim EY. Predictive validity of the Developmental Coordination Disorder Questionnaire as a screening tool to identify motor skill problems: A systematic review and meta-analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 150:104748. [PMID: 38744072 DOI: 10.1016/j.ridd.2024.104748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/02/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND The Developmental Coordination Disorder Questionnaire (DCDQ) has been used to screen children who probably have developmental coordination disorder (DCD). AIMS We systematically reviewed studies on the predictive validity of the DCDQ and performed a meta-analysis on its diagnostic accuracy. METHODS AND PROCEDURES Literature was searched through four electronic databases: MEDLINE, Embase, CINAHL, and PsycArticles. A total of 27 studies was selected based on the inclusion criteria. The sensitivity and specificity of the DCDQ were assessed using summary receiver operating characteristic (sROC) curves. Subgroup analyses were conducted according to the DCDQ type, reference standard, and participant type. OUTCOMES AND RESULTS Overall, the DCDQ has a sensitivity of 0.70 and a specificity of 0.77, showing moderate diagnostic accuracy (area under the curve, 0.80). Subgroup analysis showed that the revised version of the DCDQ had higher diagnostic accuracy than the original version. When the reference standard was the Diagnostic and Statistical Manual of Mental Disorders, the sensitivity and specificity of the DCDQ were 0.87 and 0.83, respectively. The diagnostic accuracy was higher in clinical samples compared to the general population. CONCLUSIONS AND IMPLICATIONS This study demonstrated that the DCDQ has adequate diagnostic accuracy, suggesting it can help screen children with motor skill deficits.
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Affiliation(s)
- Seong-Hi Park
- School of Nursing, Soonchunhyang University, 22 Soonchunhyang-ro, Asan-si 31538, South Korea
| | - Eun Young Kim
- Department of Occupational Therapy, Soonchunhyang University, 22 Soonchunhyang-ro, Asan-si 31538, South Korea.
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Busquets A, Ferrer-Uris B, Durduran T, Bešlija F, Añón-Hidalgo M, Angulo-Barroso R. Study protocol to examine the effects of acute exercise on motor learning and brain activity in children with developmental coordination disorder (ExLe-Brain-DCD). PLoS One 2024; 19:e0302242. [PMID: 38722962 PMCID: PMC11081356 DOI: 10.1371/journal.pone.0302242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/25/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Developmental coordination disorder (DCD) is one of the most prevalent pediatric chronic conditions. Without proper intervention, significant delays in motor skill performance and learning may persist until adulthood. Moderate-to-vigorous physical exercise has been proven to improve motor learning (adaptation and consolidation) in children with or without disorders. However, the effect of a short bout of physical exercise on motor adaptation and consolidation in children with DCD has not been examined. Furthermore, the role of perceptual-motor integration and attention as mediators of learning has not been examined via neuroimaging in this population. OBJECTIVES Therefore, the primary aims of this project will be to compare children with and without DCD to (a) examine the effect of acute exercise on motor learning (adaptation and consolidation) while performing a rotational visuo-motor adaptation task (rVMA), and (b) explore cortical activation in the dorsolateral- and ventrolateral-prefrontal cortex areas while learning the rVMA task under rest or post-exercise conditions. METHODS One hundred twenty children will be recruited (60 DCD, 60 controls) and within-cohort randomly assigned to either exercise (13-minute shuttle run task) or rest prior to performing the rVMA task. Adaptation and consolidation will be evaluated via two error variables and three retention tests (1h, 24h and 7 days post adaptation). Cortical activation will be registered via functional near-infrared spectroscopy (fNIRS) during the baseline, adaptation, and consolidation. DISCUSSION We expect to find exercise benefits on motor learning and attention so that children with DCD profiles will be closer to those of children with typical development. The results of this project will provide further evidence to: (a) better characterize children with DCD for the design of educational materials, and (b) establish acute exercise as a potential intervention to improve motor learning and attention.
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Affiliation(s)
- Albert Busquets
- Institut Nacional d’Educació Física de Catalunya, University of Barcelona, Barcelona, Spain
| | - Blai Ferrer-Uris
- Institut Nacional d’Educació Física de Catalunya, University of Barcelona, Barcelona, Spain
| | - Turgut Durduran
- Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Faruk Bešlija
- Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Spain
| | - Manuel Añón-Hidalgo
- Institut Nacional d’Educació Física de Catalunya, University of Barcelona, Barcelona, Spain
| | - Rosa Angulo-Barroso
- Institut Nacional d’Educació Física de Catalunya, University of Barcelona, Barcelona, Spain
- Kinesiology, California State University, Northridge, California, United States of America
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Maw KJ, Beattie G, Burns EJ. Cognitive strengths in neurodevelopmental disorders, conditions and differences: A critical review. Neuropsychologia 2024; 197:108850. [PMID: 38467371 DOI: 10.1016/j.neuropsychologia.2024.108850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/13/2024]
Abstract
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.
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Abrams G, Jayashankar A, Kilroy E, Butera C, Harrison L, Ring P, Houssain A, Nalbach A, Cermak SA, Aziz-Zadeh L. Differences in Praxis Errors in Autism Spectrum Disorder Compared to Developmental Coordination Disorder. J Autism Dev Disord 2024; 54:1113-1129. [PMID: 36515853 DOI: 10.1007/s10803-022-05858-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
Abstract
This study aimed to better understand how autism spectrum disorder (ASD) and developmental coordination disorder (DCD) differ in types of praxis errors made on the Florida Apraxia Battery Modified (FAB-M) and the potential relationships between praxis errors and social deficits in ASD. The ASD group made significantly more timing sequencing errors in imitation of meaningful gestures, as well as more body-part-for-tool errors during gesture-to-command compared to the other two groups. In the ASD group, increased temporal errors in meaningful imitation were significantly correlated with poorer affect recognition and less repetitive behaviors. Thus, in ASD, aspects of imitation ability are related to socioemotional skills and repetitive behaviors.
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Affiliation(s)
- Gabriel Abrams
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Aditya Jayashankar
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Emily Kilroy
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Christiana Butera
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Laura Harrison
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Priscilla Ring
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Anusha Houssain
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Alexis Nalbach
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Sharon A Cermak
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA
| | - Lisa Aziz-Zadeh
- Brain and Creativity Institute, University of Southern California, 3620A McClintock Avenue, Los Angeles, CA, 90089, USA.
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA, 90089, USA.
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Steenbergen B, Valtr L, Dunford C, Prunty M, Bekhuis H, Temlali TY, van Abswoude F, Lust JM, Warlop G, Augustijn M, Smits-Engelsman BCM, Wilson PH. Awareness about developmental coordination disorder. Front Public Health 2024; 12:1345257. [PMID: 38362216 PMCID: PMC10867205 DOI: 10.3389/fpubh.2024.1345257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/12/2024] [Indexed: 02/17/2024] Open
Abstract
The present paper is designed to promote awareness of DCD outside the academic world. With a prevalence of 5-6% it is one of the most common disorders of child development. It is therefore surprising that so little is known about it among professionals in child healthcare and education. Parents have expressed frustration about this lack of awareness, including the general public. The general aim of this paper was to describe those critical aspects of DCD that will promote awareness.
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Affiliation(s)
- Bert Steenbergen
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Ludvík Valtr
- Faculty of Physical Culture, Palacký University, Olomouc, Czechia
| | - Carolyn Dunford
- Department of Health Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Melissa Prunty
- Department of Health Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Hidde Bekhuis
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | | | - Femke van Abswoude
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Jessica M. Lust
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Griet Warlop
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Mireille Augustijn
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Bouwien C. M. Smits-Engelsman
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Department of Physical Activity, Sport and Recreation, Faculty Health Sciences, North-West University, Potchefstroom, South Africa
| | - Peter H. Wilson
- Faculty of Physical Culture, Palacký University, Olomouc, Czechia
- Healthy Brain and Mind Research Centre, Australian Catholic University, Melbourne, VIC, Australia
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Hua J, Rihtman T, Peng Y, Wang T, Su Y, Du W. Assessing the usefulness of the Little Developmental Coordination Disorder Questionnaire-Chinese in Chinese preschoolers: a sex-and age-specific analysis. Front Psychol 2024; 15:1321342. [PMID: 38352027 PMCID: PMC10861738 DOI: 10.3389/fpsyg.2024.1321342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Aim This study evaluated the sex-and age-specific usefulness of the Little Developmental Coordination Disorder Questionnaire-Chinese (LDCDQ-CH) in Chinese preschoolers. Method A population-based sample of 51,110 children aged 3-5 years was recruited. Internal reliability, construct validity, concurrent validity with the Ages and Stages Questionnaire-third edition (ASQ-3), and discriminant validity with the Movement Assessment Battery for Children-second edition (MABC-2) were assessed. Age and sex effects on LDCDQ-CH scores were analyzed using ANOVA and t-tests. Results The LDCDQ-CH exhibited excellent internal consistency and reliability across ages and genders. Confirmatory factor analysis supported the 15-item model's satisfactory fit. Positive and significant correlations were observed between LDCDQ-CH and ASQ-3 scores, indicating robust concurrent validity. Significant associations were found between LDCDQ-CH and MABC-2 scores. Higher scores were observed in older children and girls, indicating age- and sex-related differences in motor functional performance. Conclusion The LDCDQ-CH is a reliable and valid tool to support early identification of motor coordination difficulty in Chinese preschoolers, and guiding interventions. Findings support its use across ages and genders, highlighting its potential in the Chinese context. Age- and sex-specific norms are needed for enhanced clinical applicability.
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Affiliation(s)
- Jing Hua
- The Women’s and Children’s Health Care Department of Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tanya Rihtman
- Department of Sport, Health Sciences and Social Work, Oxford Brookes University, Oxford, United Kingdom
| | - Yongmei Peng
- Shanghai Center for Women and Children’s Health, Shanghai, China
| | - Tianjing Wang
- School of Medicine, Tongji University, Shanghai, China
| | - Yuantao Su
- The Women’s and Children’s Health Care Department of Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wenchong Du
- NTU Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
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Elkins A, Petersen M, Nirjar U, Monticello N, Martel M. Evidence-Based Assessment of Developmental Disorders. Assessment 2024; 31:3-23. [PMID: 37303168 DOI: 10.1177/10731911231178290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Developmental disorders are diverse, common, and impairing; still, many clinicians lack comprehensive training in their assessment. This review presents thorough guidelines for the evaluation and diagnosis of common communication, sleeping, feeding, and elimination disorders that often onset in the early developmental period and that are commonly encountered in clinical practice. Thorough guidance on the evidence-based assessment of developmental disorders is critical, as they are prevalent, impairing, and commonly comorbid with other psychiatric disorders of childhood. This review is the first of its kind-providing critically needed, step-by-step guidance on the existing evidence-based methodologies and assessment tools available for diagnosis. This review also makes clear the dire need for further development and validation of relevant screening and diagnostic measure and calls for specific attention to the development of specific screening and diagnostic assessment measures for feeding disorders and elimination disorders in particular. Clinicians and researchers alike may find this article useful in guiding diagnostic, treatment, and research procedures.
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Klein ES, Licari M, Barbic S, Zwicker JG. Diagnostic services for developmental coordination disorder: Gaps and opportunities identified by parents. Child Care Health Dev 2024; 50:e13230. [PMID: 38265129 DOI: 10.1111/cch.13230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/19/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Affecting one in 20 children, Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder impacting a child's ability to learn motor skills. Despite its high prevalence, DCD is under-recognized and under-diagnosed, causing unnecessary frustration and stress for families who are seeking help for their child. This study aimed to understand how parents procure diagnostic services and their perspectives on needed supports and services to improve early identification and diagnosis of DCD. METHODS Using a multi-pronged recruitment strategy, we circulated the impACT for DCD online questionnaire to parents of children (<18 years) in British Columbia with suspected or diagnosed DCD. Data were analysed descriptively using medians/interquartile ranges for continuous data and frequencies/percentages for categorical data. Open-ended questions were analysed using exploratory content analysis. RESULTS A total of 237 respondent data were analysed. Parents identified poor awareness and understanding of health care professionals and educators regarding aetiology, symptomology, and impacts of DCD, affecting timely access to diagnostic services. Long waitlists were also a barrier that often led families with financial means to procure private diagnostic assessments. CONCLUSION A standard of care is needed for streamlined diagnostic services, enabling early identification and early intervention. A publicly funded, family-centred, collaborative care approach is critical to assess, diagnose, and treat children with this disorder and to mitigate the secondary physical and mental health consequences associated with DCD.
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Affiliation(s)
- Erin S Klein
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
- Brain, Behaviour, & Development Theme, BC Children's Hospital Research Institute, Vancouver, Canada
| | - Melissa Licari
- Telethon Kids Institute and University of Western Australia, Perth, Australia
| | - Skye Barbic
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Jill G Zwicker
- Brain, Behaviour, & Development Theme, BC Children's Hospital Research Institute, Vancouver, Canada
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada
- Department of Pediatrics (Division of Developmental Pediatrics), University of British Columbia, Vancouver, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, Canada
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Klein ES, Cheung C, Garces A, Barbic S, Zwicker JG. Caregiver burden and mental health: Parent perspectives when raising a child with developmental coordination disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 144:104656. [PMID: 38141380 DOI: 10.1016/j.ridd.2023.104656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 11/07/2023] [Accepted: 12/12/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Children with Developmental Coordination Disorder (DCD) are at high risk for mental health disorders, stemming from challenges participating in motor activities. Parents of children with DCD report increased caregiver burden exacerbated by insufficient support and services for their child. A paucity of literature exists on parent and child mental health associated with a DCD diagnosis. AIMS To explore parent perceptions of their child's mental health, and the impact of DCD on family and parental mental health. METHODS AND PROCEDURES Implementation of a secondary analysis using the impACT for DCD, a cross-sectional online survey of parents of children with self-reported suspected or confirmed diagnosis of DCD living in British Columbia, Canada. Data analysis included descriptive and inferential statistics and content analysis. OUTCOMES AND RESULTS Of the 237 participants, more than one third of parents (36%) rated their own mental health to be fair or poor, and the majority (90%) expressed concern for their child's mental health. Themes emerged on the impact of DCD on child, parent, and family, influenced by access to resources. CONCLUSIONS AND IMPLICATIONS Standard of care for DCD needs to include services and supports that address caregiver burden and mental health of children with DCD and their families. WHAT THIS PAPER ADDS This paper explores parent perceptions of their child(ren)'s and their own mental health when raising a child with DCD in British Columbia (BC). In BC, there is a lack of research on the mental health challenges families face when their child has a diagnosis of DCD. Amongst health care providers, there tends to be a focus on DCD as a motor disorder, with limited understanding and acknowledgement of the mental health component for children and their families. Thus, this study will inform health-care providers, parents, educators, and policy makers on parent-identified mental health needs and the essential services and supports. Unique to this study was the inclusion of a descriptive and exploratory content analysis, providing a holistic understanding of parents' perceptions regarding the impact of DCD on their children and themselves. Our results revealed that parents perceive significant inter-connected impacts of DCD on the child, parents, and family, leading to poor mental health for parents and their child(ren). Limited access to resources and supports results in a negative trajectory for family mental health and well-being. Study results indicate the critical importance of addressing mental health, in addition to motor challenges. Healthcare providers need to adopt a family-centred approach to address the physical and psychosocial impairments associated with DCD, ensuring positive outcomes for children and their families.
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Affiliation(s)
- Erin S Klein
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, T121 - 2211 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6B 2B5, Canada; Department of Occupational Science & Occupational Therapy, University of British Columbia, T325 - 2211 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2B5, Canada; BC Children's Hospital Research Institute, 4480 Oak Street, Musqueam, Squamish, & Tsleil-Waututh Territory, Vancouver, BC V6H 3V4, Canada; Department of Psychiatry, Detwiller Pavilion, University of British Columbia, 2255 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2A1, Canada
| | - Carrie Cheung
- Department of Occupational Science & Occupational Therapy, University of British Columbia, T325 - 2211 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2B5, Canada; Department of Psychiatry, Detwiller Pavilion, University of British Columbia, 2255 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2A1, Canada
| | - Angie Garces
- Department of Occupational Science & Occupational Therapy, University of British Columbia, T325 - 2211 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2B5, Canada; Department of Psychiatry, Detwiller Pavilion, University of British Columbia, 2255 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2A1, Canada
| | - Skye Barbic
- Department of Occupational Science & Occupational Therapy, University of British Columbia, T325 - 2211 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2B5, Canada; Centre for Health Evaluation Outcome Sciences, University of British Columbia, 570 - 1081 Burrard St, Musqueam, Squamish, & Tsleil-Waututh Territory, Vancouver, BC V6Z 1Y6, Canada; Department of Psychiatry, Detwiller Pavilion, University of British Columbia, 2255 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2A1, Canada; Foundry, 1260 Granville St, Musqueam, Squamish, & Tsleil-Waututh Territory, Vancouver, BC V6Z 1M4, Canada
| | - Jill G Zwicker
- Department of Occupational Science & Occupational Therapy, University of British Columbia, T325 - 2211 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2B5, Canada; BC Children's Hospital Research Institute, 4480 Oak Street, Musqueam, Squamish, & Tsleil-Waututh Territory, Vancouver, BC V6H 3V4, Canada; Department of Psychiatry, Detwiller Pavilion, University of British Columbia, 2255 Wesbrook Mall, Musqueam Territory, Vancouver, BC V6T 2A1, Canada; Department of Pediatrics, University of British Columbia, Rm 2D19 - 4480 Oak Street, Musqueam, Squamish, & Tsleil-Waututh Territory, Vancouver, BC V6H 3V4, Canada.
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Kim MJ, Nam SM, Kim B, Park I, Park J, Shim JK. Anthropometric, physical activity, and psychological characteristics of Korean adults with and without developmental coordination disorder (DCD). Front Hum Neurosci 2023; 17:1280356. [PMID: 38178993 PMCID: PMC10764483 DOI: 10.3389/fnhum.2023.1280356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024] Open
Abstract
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.
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Affiliation(s)
- Min Joo Kim
- Department of Mechanical Engineering, Kyung Hee University, Yongin-si, Republic of Korea
| | - Soo Mi Nam
- Division of Sports Science, Hanyang University, Ansan-si, Republic of Korea
| | - Byeol Kim
- Institute of Sport Science, Seoul National University, Seoul, Republic of Korea
| | - Ilhyeok Park
- Department of Physical Education, Seoul National University, Seoul, Republic of Korea
| | - Jaebum Park
- Department of Physical Education, and Advanced Institute of Convergence Science, Institute of Sport Science, Seoul National University, Seoul, Republic of Korea
| | - Jae Kun Shim
- Department of Mechanical Engineering, Kyung Hee University, Yongin-si, Republic of Korea
- Department of Kinesiology, and Neuroscience and Cognitive Science Program, The University of Maryland, College Park, MD, United States
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12
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Dominguez-Vega ZT, de Quiros MB, Elting JWJ, Sival DA, Maurits NM. Instrumented Gait Classification Using Meaningful Features in Patients with Impaired Coordination. SENSORS (BASEL, SWITZERLAND) 2023; 23:8410. [PMID: 37896504 PMCID: PMC10611111 DOI: 10.3390/s23208410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023]
Abstract
Early onset ataxia (EOA) and developmental coordination disorder (DCD) both affect cerebellar functioning in children, making the clinical distinction challenging. We here aim to derive meaningful features from quantitative SARA-gait data (i.e., the gait test of the scale for the assessment and rating of ataxia (SARA)) to classify EOA and DCD patients and typically developing (CTRL) children with better explainability than previous classification approaches. We collected data from 18 EOA, 14 DCD and 29 CTRL children, while executing both SARA gait tests. Inertial measurement units were used to acquire movement data, and a gait model was employed to derive meaningful features. We used a random forest classifier on 36 extracted features, leave-one-out-cross-validation and a synthetic oversampling technique to distinguish between the three groups. Classification accuracy, probabilities of classification and feature relevance were obtained. The mean classification accuracy was 62.9% for EOA, 85.5% for DCD and 94.5% for CTRL participants. Overall, the random forest algorithm correctly classified 82.0% of the participants, which was slightly better than clinical assessment (73.0%). The classification resulted in a mean precision of 0.78, mean recall of 0.70 and mean F1 score of 0.74. The most relevant features were related to the range of the hip flexion-extension angle for gait, and to movement variability for tandem gait. Our results suggest that classification, employing features representing different aspects of movement during gait and tandem gait, may provide an insightful tool for the differential diagnoses of EOA, DCD and typically developing children.
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Affiliation(s)
- Zeus T. Dominguez-Vega
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Z.T.D.-V.); (M.B.d.Q.); (J.W.J.E.)
| | - Mariano Bernaldo de Quiros
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Z.T.D.-V.); (M.B.d.Q.); (J.W.J.E.)
| | - Jan Willem J. Elting
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Z.T.D.-V.); (M.B.d.Q.); (J.W.J.E.)
| | - Deborah A. Sival
- Department of Paediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| | - Natasha M. Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Z.T.D.-V.); (M.B.d.Q.); (J.W.J.E.)
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13
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Dostie R, Gaboury I, Trottier N, Hurtubise K, Camden C. Acceptability of a Multimodal Telerehabilitation Intervention for Children Ages 3-8 Years with Motor Difficulties: Results of a Qualitative Study. Dev Neurorehabil 2023; 26:287-301. [PMID: 37403439 DOI: 10.1080/17518423.2023.2233020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE The purpose of this study is to explore the acceptability of a telerehabilitation intervention provided to parents of children with motor difficulties. MATERIAL AND METHODS Sixteen parents of children were purposefully recruited to participate in semi-structured interviews aimed at assessing the acceptability of the telerehabilitation intervention. Interviews were analyzed thematically. RESULTS All participants described evolving acceptability associated with their interactions with the web platform. The opportunities generated, suitability in relation to families' values and perceived effects positively impacted acceptability. The understanding and consistency of intervention delivery, the child's level of involvement, the associated parental burden of the intervention and the therapeutic alliances created also affected acceptability. CONCLUSION Our study findings support the acceptability of a telerehabilitation intervention for families of children with motor difficulties. Telerehabilitation seems to be more acceptable to families with children without suspected or confirmed diagnoses.
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14
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Kanevski M, Booth JN, Stewart TM, Rhodes SM. Cognition and maths in children with Attention-Deficit/Hyperactivity disorder with and without co-occurring movement difficulties. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 136:104471. [PMID: 36924616 DOI: 10.1016/j.ridd.2023.104471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/26/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Movement difficulties are common in ADHD, however, the implications of their co-occurrences on cognitive and maths performance is unknown. AIMS This study set out to examine whether cognitive and maths performance of children with high ADHD symptoms differs depending on the co-occurrence of movement difficulties given evidence that weaker visuospatial processing, known to be important for maths performance, differentiates ADHD and DCD. We also aimed to examine whether relationships between cognition and maths in ADHD differs depending on co-occurring movement difficulties. METHODS Participants were 43 drug naïve children between 6 and 12 years old (M = 101.53 months SD = 19.58). The ADHD-only group (n = 18) included children with high ADHD scores, and those in the ADHD+DCD group (n = 25) concurrently had high movement difficulty scores. All completed executive function and memory, including 2 visuo-spatial memory tasks from the CANTAB battery and Mathematics Problem Solving, Numeracy, and Maths Fluency tasks from the WIAT-III and specific factual, conceptual, and procedural maths component tasks. RESULTS Children in the ADHD+DCD group scored significantly lower on visuospatial working memory (WM) capacity, than those in the ADHD-only group. Both groups were comparable on all other cognitive assessments of executive functions, memory, and processing speed. The groups did not differ in their maths attainment scores, nor on more specific maths skills. Comparison of the correlations between cognitive processes and maths revealed that the association between visuospatial WM updating and procedural skill efficiency was stronger for the ADHD-only group. Moreover, associations between visuospatial WM and maths problem solving attainment were stronger in the ADHD+DCD group. CONCLUSIONS Despite similarities in maths performance, children with ADHD+DCD could be distinguished by lower visuospatial WM. Differential associations with some of the maths domain implicate recruitment of different cognitive processes for some aspects of maths. This distinction can be particularly useful for conceptualising cognitive characteristics of different clinical groups and understanding cognitive pathways of maths difficulties. Implications for interventions are discussed.
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Affiliation(s)
| | - Josephine N Booth
- University of Edinburgh, Moray House School of Education and Sport, Edinburgh, UK
| | - Tracy M Stewart
- University of Edinburgh, Moray House School of Education and Sport, Edinburgh, UK
| | - Sinead M Rhodes
- University of Edinburgh, Clinical Brain Sciences, Edinburgh, UK.
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15
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Koul P, Qureshi MI, Kovela RK. Handwriting Evaluation in School-Aged Children With Developmental Coordination Disorder: A Literature Review. Cureus 2023; 15:e35817. [PMID: 37033536 PMCID: PMC10075016 DOI: 10.7759/cureus.35817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/05/2023] [Indexed: 03/08/2023] Open
Abstract
Despite widespread computer use, legible handwriting remains an important common life skill that requires more attention from schools and health professionals. Importantly, instructors and parents typically attribute the difficulties to laziness or a lack of effort, causing the youngster anger and disappointment. Handwriting issues are a public health concern in terms of both prevalence and consequences. Writing is a tough and diverse activity that requires cognitive, perceptual-motor, mental, and emotional talents. It is largely a motor process involving an effective level of motor organization that results in exact movement synchronization. Handwriting problems have been connected to developmental disorders such as developmental coordination disorder. For the affected youngsters, forming letters takes more work, and the kid may forget what he or she planned to write. School children's primary handwriting issues include illegible writing, slow handwriting, and strained writing. Handwriting problems may lead to scholastic underachievement and low self-esteem. Because of this complication, some school-aged children develop handwriting difficulties, which cause psychological distress and learning impairments. In the treatment of children with bad handwriting, the therapeutic intervention has been demonstrated to be successful. We aimed to determine how efficient tools and scales are which assess handwriting in school-aged children having developmental coordination disorder. Keyword searches were conducted on Google Scholar and PubMed, yielding 45 results, eight of which met the inclusion requirements. We concluded that there are a lot of scales and tools to date but no scale focuses on the temporal and spatial parameters for handwriting evaluation.
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Affiliation(s)
- Prishita Koul
- Department of Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND
| | - Moh'd Irshad Qureshi
- Department of Neurophysiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, IND
| | - Rakesh K Kovela
- Department of Physiotherapy, Nitte Institute of Physiotherapy, Nitte (Deemed to be University), Mangalore, IND
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16
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Hunt J, Zwicker J, Godecke E, Raynor A. Assessing children to identify developmental coordination disorder: A survey of occupational therapists in Australia. Aust Occup Ther J 2023. [PMID: 36823758 DOI: 10.1111/1440-1630.12864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Developmental coordination disorder (DCD), a prevalent neurodevelopmental disorder with motor and psychosocial consequences, can significantly impact children's quality of life. In Australia, most children with diagnosed/suspected DCD have received occupational therapy services, more so than any other health service. As such, occupational therapists are key in identification and treatment and require a sound knowledge of diagnostic criteria and the best evidence for practice. This study explored current occupational therapy services for children with DCD. Areas for development are identified to improve the identification of, and subsequent intervention for, children with DCD. METHODS In this cross-sectional study, an online survey was completed in September and October 2020 by 175 occupational therapists working in Australia. RESULTS Although all therapists worked with children who met the criteria for DCD diagnosis, 70% worked with children with no specific diagnosis and 50% worked with children with outdated diagnostic labels. Australian occupational therapists used similar models/frameworks (commonly a multisensory/sensory processing approach) to guide practice with children with DCD, regardless of therapist characteristics, practice setting (clinic/community, rural/urban), how therapy is funded, or the state where the therapists completed their training/currently practiced. Although assessment practices did not differ significantly, therapists with greater years of paediatric practice and those who studied and/or practiced in Western Australia were more likely to assess to identify DCD. Half of the therapists did not assess to identify DCD; however, 60% of assessing therapists reported best practice methods in assessment for DCD, indicating emerging best practices in the Australian context. CONCLUSION The findings from this study suggest that small adaptations to current occupational therapy practice may enhance the early identification of children with DCD in Australia. The existing gaps in evidence to practice must be addressed to improve current Australian practice and increase access to appropriate services and ultimately improve the quality of life for children with DCD.
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Affiliation(s)
- Jacqui Hunt
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Jill Zwicker
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, Canada.,BC Children's Hospital Research Institute, Vancouver, Canada
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,Sir Charles Gairdner Osborne Park Health Care Group, North Metropolitan Health Service, Perth, Australia
| | - Annette Raynor
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,School of Medical and Health Sciences, Centre for Human Performance, Edith Cowan University, Edith Cowan University, Joondalup, Western Australia, Australia
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17
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Risk factors for cerebral palsy and movement difficulties in 5-year-old children born extremely preterm. Pediatr Res 2023:10.1038/s41390-022-02437-6. [PMID: 36694025 DOI: 10.1038/s41390-022-02437-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Motor impairment is common after extremely preterm (EPT, <28 weeks' gestational age (GA)) birth, with cerebral palsy (CP) affecting about 10% of children and non-CP movement difficulties (MD) up to 50%. This study investigated the sociodemographic, perinatal and neonatal risk factors for CP and non-CP MD. METHODS Data come from a European population-based cohort of children born EPT in 2011-2012 in 11 countries. We used multinomial logistic regression to assess risk factors for CP and non-CP MD (Movement Assessment Battery for Children - 2nd edition ≤5th percentile) compared to no MD (>15th percentile) among 5-year-old children. RESULTS Compared to children without MD (n = 366), young maternal age, male sex and bronchopulmonary dysplasia were similarly associated with CP (n = 100) and non-CP MD (n = 224) with relative risk ratios (RRR) ranging from 2.3 to 3.6. CP was strongly related to severe brain lesions (RRR >10), other neonatal morbidities, congenital anomalies and low Apgar score (RRR: 2.4-3.3), while non-CP MD was associated with primiparity, maternal education, small for GA (RRR: 1.6-2.6) and severe brain lesions, but at a much lower order of magnitude. CONCLUSION CP and non-CP MD have different risk factor profiles, with fewer clinical but more sociodemographic risk factors for non-CP MD. IMPACT Young maternal age, male sex and bronchopulmonary dysplasia similarly increased risks of both cerebral palsy and non-cerebral palsy movement difficulties. Cerebral palsy was strongly related to clinical risk factors including severe brain lesions and other neonatal morbidities, while non-cerebral palsy movement difficulties were more associated with sociodemographic risk factors. These results on the similarities and differences in risk profiles of children with cerebral palsy and non-cerebral palsy movement difficulties raise questions for etiological research and provide a basis for improving the identification of children who may benefit from follow-up and early intervention.
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18
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Ke L, Su X, Yang S, Du Z, Huang S, Wang Y. New trends in developmental coordination disorder: Multivariate, multidimensional and multimodal. Front Psychiatry 2023; 14:1116369. [PMID: 36778631 PMCID: PMC9911460 DOI: 10.3389/fpsyt.2023.1116369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
Developmental coordination disorder (DCD) is a motor development disorder that affects an individual's growth and development, and may persist throughout life. It is not caused by intellectual or physical disability. Studies have suggested DCD often occurs in childhood, resulting in a series of abnormal manifestations that hinder children's normal development; cohort studies suggest a higher incidence in boys than in girls. Early diagnosis and appropriate interventions can help relieve symptoms. Unfortunately, the relevant research still needs to be further developed. In this paper, we first start from the definition of DCD, systematically investigate the relevant research papers in the past decades and summarize the current research hotspots and research trends in this field. After summarizing, it is found that this research field has attracted more researchers to join, the number of papers published has increased year by year and has become a hot spot in multidisciplinary research, such as education, psychology, sports rehabilitation, neurobiology, and neuroimaging. The continuous development of the correlation between perinatal factors and DCD, various omics studies, and neuroimaging methods also brings new perspectives and working targets to DCD research. DCD-related research will continue to deepen along the research direction of multivariate, multidimensional, and multimodal.
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Affiliation(s)
- Li Ke
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Xueting Su
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Sijia Yang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Zhihao Du
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Shunsen Huang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yun Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
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Zoia S, Biancotto M, Caravale B, Valletti A, Montelisciani L, Croci I, Voller F, Rusconi F, Carrozzi M, Chiandotto V, Di Lallo D, Vicari S, Cuttini M. Early factors associated with risk of developmental coordination disorder in very preterm children: A prospective area-based cohort study in Italy. Paediatr Perinat Epidemiol 2022; 36:683-695. [PMID: 35437802 PMCID: PMC9546412 DOI: 10.1111/ppe.12878] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Developmental coordination disorder (DCD) is a motor disorder of unknown aetiology that may have long-term consequences on daily activities, and psychological and physical health. Studies investigating risk factors for DCD have so far provided inconsistent results. OBJECTIVES To assess, using a parent-report screening tool, risk of DCD in school-age very preterm children born in Italy, and investigate the associated early biomedical and sociodemographic factors. METHODS A prospective area-based cohort (804 children, response rate 73.4%) was assessed at 8-11 years of age in three Italian regions. Perinatal data were abstracted from medical records. DCD risk was measured using the Italian-validated version of the Developmental Coordination Disorder Questionnaire (DCDQ-IT). For this study, children with cognitive deficit (i.e. intelligence quotient <70), cerebral palsy, severe vision and hearing disabilities, and other impairments affecting movement were excluded. A total of 629 children were analysed. We used inverse probability weighting to account for loss to follow-up, and multilevel, multivariable modified Poisson models to obtain adjusted risk ratio (aRR) and 95% confidence interval (CI). Missing values in the covariates were imputed. RESULTS 195 children (weighted proportion 31.8%, 95% CI 28.2, 35.6) scored positive on the DCDQ-IT, corresponding to the 15th centile of the reference Movement-ABC test. Factors associated with overall DCD risk were male sex (aRR 1.35, 95% CI 1.05, 1.73), intrauterine growth restriction (aRR 1.45, 95% CI 1.14, 1.85), retinopathy of prematurity (aRR 1.62, 95% CI 1.07, 2.45), and older maternal age at delivery (aRR 1.39, 95% CI 1.09, 1.77). Complete maternal milk feeding at discharge from the neonatal unit and higher parental socio-economic status were associated with decreased risk. CONCLUSIONS Both biomedical and sociodemographic factors increase DCD risk. These findings can contribute to elucidating the origins of this disorder, and assist in the identification of children at risk for early referral and intervention.
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Affiliation(s)
- Stefania Zoia
- Struttura Complessa Tutela Salute Bambini Adolescenti Donne FamigliaAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | - Marina Biancotto
- Struttura Complessa Tutela Salute Bambini Adolescenti Donne FamigliaAzienda Sanitaria Universitaria Giuliano IsontinaTriesteItaly
| | - Barbara Caravale
- Department of Developmental and Social PsychologyLa Sapienza UniversityRomeItaly
| | - Alessandra Valletti
- Clinical Care and Management Innovation Research AreaBambino Gesù Children’s HospitalIRCCSRomeItaly
| | - Laura Montelisciani
- Clinical Care and Management Innovation Research AreaBambino Gesù Children’s HospitalIRCCSRomeItaly
| | - Ileana Croci
- Clinical Care and Management Innovation Research AreaBambino Gesù Children’s HospitalIRCCSRomeItaly
| | - Fabio Voller
- Unit of EpidemiologyRegional Health Agency of TuscanyFlorenceItaly
| | - Franca Rusconi
- Unit of EpidemiologyMeyer Children's University HospitalFlorenceItaly,Present address:
Department of Mother and Child HealthAzienda USL Toscana Nord OvestPisaItaly
| | - Marco Carrozzi
- Department of NeuroscienceBurlo Garofolo Maternal and Child Health HospitalIRCCSTriesteItaly
| | - Valeria Chiandotto
- Neonatal Intensive Care Unit, S. Maria della Misericordia University HospitalUdineItaly
| | - Domenico Di Lallo
- Hospital Network Planning and Research AreaLazio Regional Health AuthorityRomeItaly
| | - Stefano Vicari
- Department of Life Sciences and Public HealthCatholic University, and Department of NeuroscienceChild & Adolescent Psychiatry UnitBambino Gesù Children’s HospitalIRCCSRomeItaly
| | - Marina Cuttini
- Clinical Care and Management Innovation Research AreaBambino Gesù Children’s HospitalIRCCSRomeItaly
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20
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Costa R, Aubert AM, Seppänen AV, Ådén U, Sarrechia L, Zemlin M, Cuttini M, Männamaa M, Pierrat V, van Heijst A, Barros H, Johnson S, Zeitlin J. Motor-related health care for 5-year-old children born extremely preterm with movement impairments. Dev Med Child Neurol 2022; 64:1131-1144. [PMID: 35298035 DOI: 10.1111/dmcn.15202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 01/24/2023]
Abstract
AIM To (1) determine the proportion of 5-year-old children born extremely preterm (EPT) with movement difficulties including cerebral palsy (CP) and the proportion of these children receiving motor-related health care (MRHC), and (2) describe factors associated with receiving MRHC. METHOD Children born before 28 weeks' gestation in 2011 to 2012 in 11 European countries were assessed with the Movement Assessment Battery for Children, Second Edition (MABC-2) at 5 years of age. Information on family characteristics, child health including CP diagnosis, and health care use were collected using parent-report questionnaires. MRHC was defined as visits in the previous year with health care providers (physical and occupational therapists) specialized in assessing/treating motor problems. We analysed receipt of MRHC and associated factors among children at risk of movement difficulties (MABC-2 score 6th-15th centiles), with significant movement difficulties (SMD; ≤5th centile) or with CP. RESULTS Of 807 children assessed at 5 years 7 months (SD 4 months; 4 years 7 months-7 years 1 month), 412 were males (51.1%), 170 (21.1%) were at risk of movement difficulties, 201 (24.9%) had SMD, and 92 (11.4%) had CP. Those who received MRHC comprised 89.1% of children with CP, 42.8% with SMD, and 25.9% at risk of movement difficulties. MRHC for children with SMD varied from 23.3% to 66.7% between countries. Children were more likely to receive MRHC if they had other developmental problems or socioemotional, conduct, or attention difficulties. INTERPRETATION Efforts are needed to increase MRHC for 5-year-old children born EPT with movement difficulties. WHAT THIS PAPER ADDS Children born extremely preterm without cerebral palsy frequently experienced motor difficulties. Most of these children were not receiving motor-related health care (MRHC). Large geographical differences throughout Europe were observed in receipt of MRHC. Socioemotional problems were related to MRHC use.
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Affiliation(s)
- Raquel Costa
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Adrien M Aubert
- Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRAE, Université de Paris Cité, Paris, France
| | - Anna-Veera Seppänen
- Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRAE, Université de Paris Cité, Paris, France
| | - Ulrika Ådén
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Lemke Sarrechia
- Department of Medicine & Population Health, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Michael Zemlin
- Department of Medicine, University of Saarland, Saarland, Germany
| | - Marina Cuttini
- Clinical Care and Management Innovation Research Area, Bambino Gesù Children's Hospital, Rome, Italy
| | - Mairi Männamaa
- Department of Paediatrics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Véronique Pierrat
- Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRAE, Université de Paris Cité, Paris, France.,Department of Neonatal Medicine, CHU Lille, Jeanne de Flandre Hospital, Lille, France
| | - Arno van Heijst
- Department of Neonatology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Henrique Barros
- EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Jennifer Zeitlin
- Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Inserm, INRAE, Université de Paris Cité, Paris, France
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Sack L, Dollaghan C, Goffman L. Contributions of early motor deficits in predicting language outcomes among preschoolers with developmental language disorder. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 24:362-374. [PMID: 34793281 PMCID: PMC9881565 DOI: 10.1080/17549507.2021.1998629] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Purpose: We assessed the extent to which language, speech, and fine/gross motor skills in preschoolers with developmental language disorder (DLD; also referred to as specific language impairment) predicted language outcome two years later.Method: Participants with DLD (n = 15) and typical development (TD; n = 14) completed language, speech, and fine/gross motor assessments annually, beginning as 4- to 5-year-olds (Year 1 timepoint) and continuing through 6 to 7 years of age (Year 3 timepoint). We performed Pearson correlation and hierarchical regression analyses to examine the relative contributions of Year 1 language, speech, and motor skills to Year 3 language outcome in each group.Result: Among children with DLD, Year 1 fine/gross motor scores positively correlated with Year 3 language scores, uniquely explaining 40% of the variance in language outcomes. Neither Year 1 language, speech-sound, nor speech-motor scores predicted language outcome in this group. Among children with TD, only Year 1 language predicted language outcome.Conclusion: This small longitudinal study reveals that, among preschoolers with DLD, certain early fine/gross motor deficits predict persistent language impairment. Future research that includes larger sample sizes and motor tasks that incorporate complex sequencing will enhance the understanding of the relationship between language, speech, and motor skills; specifically, whether certain motor deficits simply co-occur with language deficits or whether they are tied to DLD through shared impairments in sequential learning mechanisms.
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Affiliation(s)
- Leah Sack
- Callier Center for Communication Disorders, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Christine Dollaghan
- Callier Center for Communication Disorders, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Lisa Goffman
- Callier Center for Communication Disorders, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
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22
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Saletta Fitzgibbons M. The Interface Between Reading and Handwriting. Front Psychol 2022; 13:892913. [PMID: 35874341 PMCID: PMC9298537 DOI: 10.3389/fpsyg.2022.892913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/16/2022] [Indexed: 11/13/2022] Open
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23
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Developmental Coordination Disorder and Joint Hypermobility in Childhood: A Narrative Review. CHILDREN 2022; 9:children9071011. [PMID: 35883995 PMCID: PMC9317025 DOI: 10.3390/children9071011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/05/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
Children with developmental coordination disorder (DCD) and joint hypermobility could present an overlap of symptoms and motor functional difficulties. The link between these two clinical conditions has not yet been clarified. Recent studies reported a high incidence (30–50%) of motor delay in children who are referred to hypermobility and of enhanced joint hypermobility in children with DCD. The aim of this study was to provide a critical review of the literature outlining the association between DCD or limited motor performance and joint hypermobility. Studies were eligible for inclusion if they were written in English and human-based. All the studies were first selected, looking for the presence of a clinical association between developmental coordination disorder or motor performance and hyperlaxity and reporting details of outcome. After a review of the full texts, 16 articles for a total of 1898 children met the inclusion criteria. In general, there was evidence of a higher incidence of motor delay or DCD in children who are referred to hypermobility and of enhanced joint hypermobility in children with DCD with similar range of functional difficulties. These results could influence the way to support children with rehabilitation and the type of intervention according to the prevalence of one of the two conditions.
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24
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Kilroy E, Ring P, Hossain A, Nalbach A, Butera C, Harrison L, Jayashankar A, Vigen C, Aziz-Zadeh L, Cermak SA. Motor performance, praxis, and social skills in autism spectrum disorder and developmental coordination disorder. Autism Res 2022; 15:1649-1664. [PMID: 35785418 PMCID: PMC9543450 DOI: 10.1002/aur.2774] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/24/2022] [Indexed: 12/20/2022]
Abstract
Previous research has shown that individuals with autism spectrum disorder (ASD) and developmental coordination disorder (DCD) may have overlapping social and motor skill impairments. This study compares ASD, DCD, and typically developing (TD) youth on a range of social, praxis and motor skills, and investigates the relationship between these skills in each group. Data were collected on participants aged 8–17 (n = 33 ASD, n = 28 DCD, n = 35 TD). Overall, the clinical groups showed some similar patterns of social and motor impairments but diverged in praxis impairments, cognitive empathy, and Theory of Mind ability. When controlling for both social and motor performance impairments, the ASD group showed significantly lower accuracy on imitation of meaningful gestures and gesture to command, indicating a prominent deficit in these praxis skills in ASD.
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Affiliation(s)
- Emily Kilroy
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA.,Dornsife College of Letters, Arts and Sciences, University of Southern California, Brain and Creativity Institute, Los Angeles, California, USA
| | - Priscilla Ring
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Anusha Hossain
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Alexis Nalbach
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Christiana Butera
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA.,Dornsife College of Letters, Arts and Sciences, University of Southern California, Brain and Creativity Institute, Los Angeles, California, USA
| | - Laura Harrison
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA.,Dornsife College of Letters, Arts and Sciences, University of Southern California, Brain and Creativity Institute, Los Angeles, California, USA
| | - Aditya Jayashankar
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA.,Dornsife College of Letters, Arts and Sciences, University of Southern California, Brain and Creativity Institute, Los Angeles, California, USA
| | - Cheryl Vigen
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Lisa Aziz-Zadeh
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA.,Dornsife College of Letters, Arts and Sciences, University of Southern California, Brain and Creativity Institute, Los Angeles, California, USA
| | - Sharon A Cermak
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
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25
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Diminished coordination skills may predispose injury to lesser toe fractures—a pilot study. Neurol Sci 2022; 43:4531-4536. [DOI: 10.1007/s10072-022-05989-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/25/2022] [Indexed: 11/25/2022]
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26
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Smits-Engelsman B, Verbecque E, Denysschen M, Coetzee D. Exploring Cultural Bias in Two Different Motor Competence Test Batteries When Used in African Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116788. [PMID: 35682371 PMCID: PMC9180268 DOI: 10.3390/ijerph19116788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 05/29/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022]
Abstract
Both the Movement Assessment Battery for Children second edition (M-ABC-2) and Bruininks-Oseretsky Test of Motor Proficiency second edition short form (BOT-2-SF) are frequently used in research and in the clinical practice to evaluate motor competence in children. Despite its widespread use in research, no studies have reported the results of case identification in African children. Comparing these two motor assessment tools for a different target group is important in order to select the most appropriate clinical and research tool. Methods. A total of 444 children performed MABC-2, 165 children also performed the BOT-2-SF and subsamples were tested on specific subtests of the BOT-2 (Running and Agility, Balance, and Strength). Tests were administered to randomly selected children between 6 and 10 years of age. Results: 36% for the children scored at or below the 16th percentile of the MABC-2, while this was 43%, 27%, and 23% for the component score in Manual Dexterity, Aiming and Catching, and Balance, respectively. Of the children 16% scored at or below the 17th percentile of the BOT-2-SF total score, while this was 3%, 9% and 22% for the subtest scores Running and agility, Balance, and Strength, respectively. A moderate correlation (r = 0.44) was found between total scores of the two tests. No significant correlations were found between the dynamic MABC-2 item (Jumping/Hopping) standard scores and any of the 9 balance items of the BOT-2. Conclusion: Far more children scored in the clinical “at risk” range (<16th percentile) when tested with the MABC-2 than with the BOT-2-SF. Overall, these children seemed not to be limited in motor performance measured by the BOT-2-SF, Running and Agility, and Balance. South African children did show lower levels of strength and explosive power. Children from different cultures will need tests for the specific motor skills that are representative for optimal functioning in their own setting. Thus, adapting reference norms and cut-off values may not be the optimal solution.
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Affiliation(s)
- Bouwien Smits-Engelsman
- Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, The University of Cape Town, Cape Town 7925, South Africa
- Physical Activity, Sport and Recreation, Faculty Health Sciences, North-West University, Potchefstroom 2520, South Africa; (M.D.); (D.C.)
- Correspondence:
| | - Evi Verbecque
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and Physiotherapy, Hasselt University, Agoralaan Building A, 3590 Diepenbeek, Belgium;
| | - Marisja Denysschen
- Physical Activity, Sport and Recreation, Faculty Health Sciences, North-West University, Potchefstroom 2520, South Africa; (M.D.); (D.C.)
| | - Dané Coetzee
- Physical Activity, Sport and Recreation, Faculty Health Sciences, North-West University, Potchefstroom 2520, South Africa; (M.D.); (D.C.)
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27
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Potard C, Auger AC, Lenoir-Perrotel S, Jarry C. Examining frustration intolerance beliefs among adults with dyslexia or developmental coordination disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 123:104184. [PMID: 35121415 DOI: 10.1016/j.ridd.2022.104184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 12/14/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Research suggests that adults diagnosed with specific learning disorders, such as dyslexia or developmental coordination disorder (DCD), are at greater risk of emotional problems related to frustration and anger. AIMS The purpose of this study was to investigate patterns of frustration intolerance beliefs among two groups of adults with a specific learning disorder (dyslexia or DCD), compared with typical adults. METHODS AND PROCEDURES Participants were 235 French adults (students or in employment) with dyslexia (Mage = 35.8 years, SD = 13.3; females = 63 %), DCD (Mage = 32.9 years, SD = 11.8; females = 58 %) or typical development (Mage = 33.2 years, SD = 12.7; females = 65 %), who completed an online self-report questionnaire. OUTCOMES AND RESULTS Analysis of variance revealed a significant between-groups difference, as both learning disorder groups had higher frustration intolerance beliefs than the typical adults. Post hoc analysis showed that participants with DCD scored higher than those with dyslexia on each type of frustration intolerance belief, while participants with dyslexia scored higher than typical adults on achievement frustration and discomfort intolerance. CONCLUSIONS AND IMPLICATIONS These results underline the usefulness of distinguishing between frustration intolerance dimensions, and of using rational emotive behavior therapy to reduce the irrational beliefs of people with DCD or dyslexia.
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28
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Yun JH, Shin SM, Son SM. Clinical Utility of Repeated Urimal Test of Articulation and Phonation for Patients with Childhood Apraxia of Speech. CHILDREN 2021; 8:children8121106. [PMID: 34943301 PMCID: PMC8700655 DOI: 10.3390/children8121106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/20/2021] [Accepted: 11/25/2021] [Indexed: 11/21/2022]
Abstract
Childhood apraxia of speech (CAS) causes inconstant oromotor production. We investigated the clinical efficacy of repeated urimal test of articulation and phonation (U-TAP) in CAS patients. Twenty-eight children were recruited: 19 with CAS and 9 with functional articulation disorder (FAD). Four age-matched typically developing children were also recruited. U-TAP was performed twice repeatedly, and the error rate of consonant accuracy (CA) was measured. Preschool Receptive-Expressive Language Scale (PRES) was also performed. The mean U-TAP CA showed a significant difference between the three groups, with 42.04% for CAS, 77.92% for FAD, and 99.68% for the normal group (p < 0.05). The mean difference between the two U-TAP CAs was 10.01% for CAS, 0.82% for FAD, and no difference for the normal group, revealing a significant intergroup difference between CAS and FAD (p < 0.05). For the expressive and receptive PRES scores, CAS group showed significantly decreased results compared to FAD and normal group. Only in the CAS group, expressive PRES showed significant decrease rather than receptive PRES score. The CAS group showed a significant difference in the two U-TAP CA compared to the FAD and normal groups. This result implies that repeated U-TAP can be useful for supportive diagnostic tool for CAS by detecting poor reliability of phonation.
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29
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Morris B, Ogden J, Gentle J. Experiences of adult siblings of those with developmental coordination disorder (DCD): a qualitative study. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02550-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractThis qualitative study explored the childhood experiences of growing up with a sibling with Developmental Coordination Disorder (DCD) to offer an ‘outsider’s’ view of this condition. Ten individuals who had grown up with a sibling with DCD were interviewed about their experiences. Data were analysed using Thematic Analysis. Analysis described three main themes: i)‘witnessing the challenges for their sibling with DCD’ ii) ‘experiencing the impact on the family’; iii) ‘a vacuum of knowledge’. Not all experiences were negative and transcending these themes was the notion ‘resolution and finding benefit’ highlighting access to support, being more empathic and resilient, becoming a role model for others and finding success. Participants play witness to their sibling’s experiences which can often be negative sometimes impacted by a vacuum of knowledge but they also describe how a diagnosis of DCD comes with some benefits which are discussed in the context of ‘posttraumatic growth’.
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30
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Lense MD, Ladányi E, Rabinowitch TC, Trainor L, Gordon R. Rhythm and timing as vulnerabilities in neurodevelopmental disorders. Philos Trans R Soc Lond B Biol Sci 2021; 376:20200327. [PMID: 34420385 PMCID: PMC8380970 DOI: 10.1098/rstb.2020.0327] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 12/22/2022] Open
Abstract
Millions of children are impacted by neurodevelopmental disorders (NDDs), which unfold early in life, have varying genetic etiologies and can involve a variety of specific or generalized impairments in social, cognitive and motor functioning requiring potentially lifelong specialized supports. While specific disorders vary in their domain of primary deficit (e.g. autism spectrum disorder (social), attention-deficit/hyperactivity disorder (attention), developmental coordination disorder (motor) and developmental language disorder (language)), comorbidities between NDDs are common. Intriguingly, many NDDs are associated with difficulties in skills related to rhythm, timing and synchrony though specific profiles of rhythm/timing impairments vary across disorders. Impairments in rhythm/timing may instantiate vulnerabilities for a variety of NDDs and may contribute to both the primary symptoms of each disorder as well as the high levels of comorbidities across disorders. Drawing upon genetic, neural, behavioural and interpersonal constructs across disorders, we consider how disrupted rhythm and timing skills early in life may contribute to atypical developmental cascades that involve overlapping symptoms within the context of a disorder's primary deficits. Consideration of the developmental context, as well as common and unique aspects of the phenotypes of different NDDs, will inform experimental designs to test this hypothesis including via potential mechanistic intervention approaches. This article is part of the theme issue 'Synchrony and rhythm interaction: from the brain to behavioural ecology'.
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Affiliation(s)
- Miriam D. Lense
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eniko Ladányi
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Laurel Trainor
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Reyna Gordon
- Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
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31
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Ip A, Mickelson ECR, Zwicker JG. Assessment, diagnosis, and management of developmental coordination disorder. Paediatr Child Health 2021; 26:375-378. [PMID: 34552678 DOI: 10.1093/pch/pxab047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/14/2021] [Indexed: 11/14/2022] Open
Abstract
Developmental coordination disorder (DCD) is a neurodevelopmental condition that affects 5% to 6% of school-aged children. DCD can significantly impact early development and life-long functioning. Evidence supports promising interventions for DCD, but the disorder continues to be under-recognized and under-diagnosed. Paediatricians play an important role in the identification and management of DCD. This practice point, with accompanying tables, assists and supports paediatricians in diagnosing and managing uncomplicated cases of DCD.
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Affiliation(s)
- Angie Ip
- Canadian Paediatric Society, Developmental Paediatrics Section, Ottawa, Ontario, Canada
| | | | - Jill G Zwicker
- Canadian Paediatric Society, Developmental Paediatrics Section, Ottawa, Ontario, Canada
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32
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Ip A, Mickelson ECR, Zwicker JG. L'évaluation, le diagnostic et la prise en charge du trouble développemental de la coordination. Paediatr Child Health 2021; 26:379-383. [PMID: 34552679 DOI: 10.1093/pch/pxab049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/14/2021] [Indexed: 11/12/2022] Open
Abstract
Le trouble développemental de la coordination est une affection neurodéveloppementale qui touche de 5 % à 6 % des enfants d'âge scolaire. Il peut avoir des effets considérables sur le début du développement et le fonctionnement tout au long de la vie. Les données probantes appuient des interventions prometteuses, mais ce trouble continue d'être sous-estimé et sous-diagnostiqué. Les pédiatres jouent un rôle important dans son diagnostic et sa prise en charge. Le présent point de pratique et les tableaux qui l'accompagnent visent à aider les pédiatres à diagnostiquer et prendre en charge les cas de trouble développemental de la coordination non compliqué.
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Affiliation(s)
- Angie Ip
- Société canadienne de pédiatrie, section de la pédiatrie du développement, Ottawa (Ontario)Canada
| | - Elizabeth C R Mickelson
- Société canadienne de pédiatrie, section de la pédiatrie du développement, Ottawa (Ontario)Canada
| | - Jill G Zwicker
- Société canadienne de pédiatrie, section de la pédiatrie du développement, Ottawa (Ontario)Canada
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33
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Walker E, Shaw SCK, Reed M, Anderson JL. The experiences of foundation doctors with dyspraxia: a phenomenological study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:959-974. [PMID: 33559779 PMCID: PMC8338860 DOI: 10.1007/s10459-021-10029-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 01/13/2021] [Indexed: 05/23/2023]
Abstract
Dyspraxia, otherwise known as Developmental Coordination Disorder (DCD), is a specific learning difficulty (SpLD). Its main difficulties manifest as problems with motor coordination, organisation, academic and social difficulties. There are now more students arriving at university with SpLDs, and, therefore, a similar rise may be expected within medical education. There has been no previous research focusing on dyspraxia in doctors. An interpretive phenomenological approach was used. Six UK foundation schools disseminated the announcements. Three participants took part in loosely structured telephone interviews regarding their experiences of undertaking medical school and foundation school with dyspraxia. These were transcribed verbatim and then thematically analysed. The themes could be split into two main categories: "Weakness and Coping Strategies" and "Perspectives of Dyspraxia". "Weakness" included: clumsiness, organisation and needing extra time. The participants focused on their "Coping Strategies" that included: Ensuring safety, adapted learning preferences and external support. "Perspectives of Dyspraxia" included: diagnosis, career choice, stigma, "normalisation" and the "difference view" or "medical deficit" view of dyspraxia. Doctors with dyspraxia often mask their difficulties through sophisticated coping strategies. These were determined and hardworking individuals who believe that their dyspraxia was a positive aspect of their identity, adopting a "difference view". They felt further education is needed about dyspraxia to change the perceived stigma. There is now a need for further research in this area.
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Affiliation(s)
| | - Sebastian C. K. Shaw
- Department of Medical Education, Brighton and Sussex Medical School, University of Brighton, Falmer, Brighton, BN1 9PH UK
| | - Malcolm Reed
- Department of Medical Education, Brighton and Sussex Medical School, University of Brighton, Falmer, Brighton, BN1 9PH UK
| | - John L. Anderson
- Department of Medical Education, Brighton and Sussex Medical School, University of Brighton, Falmer, Brighton, BN1 9PH UK
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34
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Lee EJ, Zwicker JG. Early identification of children with/at risk of developmental coordination disorder: a scoping review. Dev Med Child Neurol 2021; 63:649-658. [PMID: 33469912 DOI: 10.1111/dmcn.14803] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 12/12/2022]
Abstract
AIM To summarize current evidence for early identification and motor-based intervention for children aged 5 years and younger with/at risk of developmental coordination disorder (DCD). METHOD Using scoping review methodology and after duplicates were removed, 11 115 peer-reviewed articles and grey literature were independently screened by two authors. Data from 103 included records were extracted and synthesized by both assessors. One author entered the relevant data into tables, while the other author double-checked the entries. RESULTS Records included peer-reviewed studies, guidelines, conference presentations, and theses/dissertations. Most literature pertained to early identification (n=78), with fewer studies targeting intervention (n=22) or covering both topics (n=3). Literature was summarized in two main categories: (1) assessments for diagnostic criteria A and B; and (2) motor-based interventions for young children with/at risk of DCD. This article highlights the findings related to assessments, while a companion article summarizes the intervention literature. INTERPRETATION Emerging evidence shows that children, especially those at greatest risk of DCD, may be identified before formal school entry. Earlier identification will allow for earlier intervention, which may help to improve the developmental trajectories of children with/at risk of DCD and prevent secondary consequences of the disorder. It is recommended that health care providers explicitly use the term 'at risk of DCD'.
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Affiliation(s)
- Emily J Lee
- Rehabilitation Science Online Programs, University of British Columbia, Vancouver, British Columbia, Canada.,Nurture Society for Learning and Development, Vancouver, British Columbia, Canada
| | - Jill G Zwicker
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pediatrics, Division of Developmental Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Brain, Behaviour, and Development, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Sunny Hill Health Centre at BC Children's Hospital, Vancouver, British Columbia, Canada.,CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada
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35
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Son SM, Lee JW, Chang MC. Successful Application of an Insole with a Metatarsal Inhibition Bar and Deep Heel Cup for Improving Gait Dysfunction in a Patient with Poor Coordination with Disrupted Corticoreticular Tracts: A Case Report. CHILDREN-BASEL 2021; 8:children8050320. [PMID: 33921951 PMCID: PMC8143587 DOI: 10.3390/children8050320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 11/17/2022]
Abstract
We report the successful management of gait dysfunction in a patient with coordination problems using an insole with a metatarsal inhibition bar (MIB) and a deep heel cup. Furthermore, we investigated the state of the neural tracts via diffusion tensor tractography (DTT). A 23-month-old boy with gait dysfunction presented with toe walking with a wide base and decreased hip flexion. Motor weakness or spasticity was not observed. Conventional brain magnetic resonance imaging did not reveal any abnormal findings, but DTT revealed disrupted bilateral corticoreticulospinal tracts (CRTs). No abnormalities were observed in the corticospinal tract or the medial lemniscus. We applied a custom-made insole with an MIB and a deep heel cup. Immediately after application, the patient’s gait pattern stabilized significantly and was nearly normalized. Our therapeutic experience indicates that the application of an insole with an MIB and deep heel cups could be beneficial for patients with coordination problems and gait dysfunction. Our DTT results showed that CRTs could be the causative brain pathology for gait dysfunction in patients with coordination problems.
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36
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Harrison LA, Kats A, Kilroy E, Butera C, Jayashankar A, Keles U, Aziz-Zadeh L. Motor and sensory features successfully decode autism spectrum disorder and combine with the original RDoC framework to boost diagnostic classification. Sci Rep 2021; 11:7839. [PMID: 33837251 PMCID: PMC8035204 DOI: 10.1038/s41598-021-87455-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/25/2021] [Indexed: 12/28/2022] Open
Abstract
Sensory processing and motor coordination atypicalities are not commonly identified as primary characteristics of autism spectrum disorder (ASD), nor are they well captured in the NIMH's original Research Domain Criteria (RDoC) framework. Here, motor and sensory features performed similarly to RDoC features in support vector classification of 30 ASD youth against 33 typically developing controls. Combining sensory with RDoC features boosted classification performance, achieving a Matthews Correlation Coefficient (MCC) of 0.949 and balanced accuracy (BAcc) of 0.971 (p = 0.00020, calculated against a permuted null distribution). Sensory features alone successfully classified ASD (MCC = 0.565, BAcc = 0.773, p = 0.0222) against a clinically relevant control group of 26 youth with Developmental Coordination Disorder (DCD) and were in fact required to decode against DCD above chance. These findings highlight the importance of sensory and motor features to the ASD phenotype and their relevance to the RDoC framework.
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Affiliation(s)
- Laura A Harrison
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA.
| | - Anastasiya Kats
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA
| | - Emily Kilroy
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA
| | - Christiana Butera
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA
| | - Aditya Jayashankar
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA
| | - Umit Keles
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Lisa Aziz-Zadeh
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- Brain and Creativity Institute, University of Southern California, Los Angeles, CA, USA
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37
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Camden C, Zwicker JG, Morin M, Schuster T, Couture M, Poder TG, Maltais DB, Battista MC, Baillargeon JP, Goyette M, Pratte G, Hurtubise K, Phoenix M, Nguyen T, Berbari J, Tousignant M. Web-based early intervention for children with motor difficulties aged 3–8 years old using multimodal rehabilitation (WECARE): protocol of a patient-centred pragmatic randomised trial of paediatric telerehabilitation to support families. BMJ Open 2021. [PMCID: PMC8039274 DOI: 10.1136/bmjopen-2020-046561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Mild motor difficulties in children are underdiagnosed despite being highly prevalent, leaving such children often underserved and at higher risk for secondary consequences such as cardiovascular disease and anxiety. Evidence suggests that early patient-oriented interventions, coaching parents and providing children with early stimulation should be provided, even in the absence of a diagnosis. Such interventions may be effectively delivered via telerehabilitation. Methods and analysis A family-centred, pragmatic randomised controlled trial will be carried out to evaluate the real-world effectiveness of a Web-based Early intervention for Children using multimodAl REhabilitation (WECARE). Families of children with motor difficulties, 3–8 years of age, living in Quebec, Canada, and receiving no public rehabilitation services (n=118) will be asked to determine up to 12 performance goals, evaluated using the Canadian Occupational Performance Measure (COPM, the primary outcome). Families will be randomised to receive either usual care or the WECARE intervention. The WECARE intervention will be delivered for 1 year via a web-based platform. Families will have access to videoconferences with an assigned rehabilitation therapist using a collaborative coaching approach, a private chat function, a forum open to all intervention arm participants and online resources pertaining to child development. Participants will be asked to re-evaluate the child’s COPM performance goals every 3 months up to 1 year post allocation. The COPM results will be analysed using a mixed Poisson regression model. Secondary outcomes include measures of the child’s functional ability, parental knowledge and skills and health-related quality of life, as well as qualitative outcomes pertaining to parental satisfaction and service delivery trajectories. Investigators and quantitative data analysts will be blinded to group allocation. Ethics and dissemination The CIUSSS de l’Estrie—CHUS ethics committee approved this trial (2020-3429). Study results will be communicated via peer-reviewed journal publications, conference presentations and stakeholder-specific knowledge transfer activities. Trial registration number NCT04254302.
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Affiliation(s)
- Chantal Camden
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Jill G Zwicker
- Occupational Science & Occupational Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Melanie Morin
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montreal, Québec, Canada
| | - Melanie Couture
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Thomas G Poder
- School of Public Health, Université de Montréal, Montreal, Québec, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Montreal, Québec, Canada
| | - Desiree B Maltais
- Département de réadaptation, Universite Laval, Québec City, Québec, Canada
| | - Marie-Claude Battista
- Department of Medicine, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada
| | - Jean-Patrice Baillargeon
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
- Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Quebec, Canada
| | - Mathieu Goyette
- Département de sexologie, Université du Québec à Montréal, Montreal, Québec, Canada
| | - Gabrielle Pratte
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
| | - Karen Hurtubise
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Tram Nguyen
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Jade Berbari
- Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie—CHUS, Sherbrooke, Québec, Canada
| | - Michel Tousignant
- École de réadaptation, Universite de Sherbrooke Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada
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Hunt J, Zwicker JG, Godecke E, Raynor A. Awareness and knowledge of developmental coordination disorder: A survey of caregivers, teachers, allied health professionals and medical professionals in Australia. Child Care Health Dev 2021; 47:174-183. [PMID: 33140459 PMCID: PMC7894302 DOI: 10.1111/cch.12824] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND To allow for accurate and timely diagnosis of developmental coordination disorder (DCD) key stakeholders must be familiar with and be able to identify features of this disorder. No studies to date have investigated the awareness of DCD among key stakeholders in Australia. METHODS An online survey was complete by 494 Australian participants: primary caregivers (n = 153), teachers (n = 149), allied health professionals (n = 165) and medical professionals (n = 27). RESULTS DCD and related terms were among the least known childhood disorders. Approximately half of the sample were familiar with the term DCD but every stakeholder group were more familiar with the term dyspraxia. Allied health professionals demonstrated greater knowledge of the features of DCD, particularly motor features. Every stakeholder group showed poor recognition of the social and psychological effects of DCD. A relatively low percentage of allied health (53%) and medical (33%) professionals reported they had identified or diagnosed DCD and less than 20% of these felt that the DSM-5 contained adequate information to make a DCD diagnosis. Most teachers (82%) believed they should play a role in identifying early warning signs of this disorder, and 80% believed there are children in the school system who were labelled as lazy or defiant when they have motor skills impairments. Primary caregivers were supportive of a diagnosis of DCD being provided; however, only 16% were confident that a physician would provide an accurate and timely diagnosis. CONCLUSION Key stakeholders play a unique and important role in the identification of children with DCD. Though most participants acknowledge the role that they play, all stakeholder groups demonstrated poor familiarity with the term DCD and low levels of knowledge about the features of this disorder. Improved familiarity and knowledge of the disorder is needed for access to appropriate services and improved long-term outcomes for this condition.
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Affiliation(s)
- Jacqui Hunt
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Jill G Zwicker
- Department of Occupational Science & Occupational TherapyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Department of PediatricsUniversity of British ColumbiaVancouverBritish ColumbiaCanada
- Brain, Behaviour, & DevelopmentBC Children's Hospital Research InstituteVancouverBritish ColumbiaCanada
- Neuromotor ProgramSunny Hill Health Centre at BC Children's HospitalVancouverBritish ColumbiaCanada
| | - Erin Godecke
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Annette Raynor
- School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
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Shared Features or Co-occurrence? Evaluating Symptoms of Developmental Coordination Disorder in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:3443-3455. [PMID: 33387238 PMCID: PMC10177628 DOI: 10.1007/s10803-020-04766-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 12/20/2022]
Abstract
Motor differences are common in Autism Spectrum Disorder (ASD), but rarely evaluated against diagnostic criteria for Developmental Coordination Disorder (DCD). We aimed to determine whether motor problems in ASD represent the possible co-occurrence of DCD. We retrospectively reviewed standardized assessments and parent-reports to evaluate motor ability in 43 individuals with ASD against diagnostic criteria for DCD, and compared to 18 individuals with DCD. Over 97% of cases in the ASD group scored below the 16th percentile in motor ability, with most below the 5th percentile. Over 90% of cases in the ASD group met criteria for co-occurring DCD. Motor challenges are a clinically-significant problem in ASD; systematically assessing the prevalence of co-occurring ASD + DCD is necessary to optimize assessment and intervention.
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Dragoumanaki G, Patelarou A, Vorgia P, Sifaki-Pistolla D, Patelarou E. Validation and Translation of the Greek Version of the “DCDDaily-Q-GR” Questionnaire. Health (London) 2021. [DOI: 10.4236/health.2021.1311090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Smith M, Ward E, Williams CM, Banwell HA. Differences in walking and running gait in children with and without developmental coordination disorder: A systematic review and meta-analysis. Gait Posture 2021; 83:177-184. [PMID: 33160227 DOI: 10.1016/j.gaitpost.2020.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 10/02/2020] [Accepted: 10/11/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Developmental coordination disorder (DCD) is a common motor skills disorder in children. Although gait changes are often reported clinically, affecting children's participation in play and sport, there has been no synthesis of research evidence comparing gait of children with and without DCD. Thus, the aim of this research was to determine differences in gait between children with and without DCD METHODS: A search of electronic databases (AMED, CINAHL, Cochrane Library, Embase, Medline, SPORTDiscus, & Web of Science) was conducted from inception to August 2019 for studies comparing walking and/or running gait of children with and without DCD. The McMaster Critical Appraisal Form for Quantitative Studies was used to assess risk of bias amongst included studies. Meta-analysis was completed on measures with four or more homogenous outcomes. RESULTS 20 studies fulfilled the inclusion criteria and were eligible for review - three of which were pre-post designs, and 17 were cross-sectional designs. Data was extracted in five domains: kinetics, kinematics, physical function, electromyography, and temporospatial parameters. Meta-analysis was performed on one outcome measure - the 6 min Walk Test (6MWT), finding that children with DCD walked significantly shorter distances, indicating reduced endurance in walking gait. Other statistically significant results all favoured typically developing children, however there is little consistency between studies. CONCLUSION Although a clear gait pattern for children with DCD is not evident, functional deficits appear to be present in endurance and cardiorespiratory fitness. The current evidence base for gait changes in DCD is currently low-level, and further high quality research is warranted. PROSPERO REGISTRATION NUMBER CRD42018106791.
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Affiliation(s)
- Mitchell Smith
- School of Health Sciences, University of South Australia, Adelaide, South Australia, 5001, Australia; International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, 5001, Australia.
| | - Emily Ward
- School of Health Sciences, University of South Australia, Adelaide, South Australia, 5001, Australia.
| | - Cylie M Williams
- School of Health Sciences, University of South Australia, Adelaide, South Australia, 5001, Australia; Allied Health, Peninsula Health, Frankston, Victoria, 3199, Australia; School of Primary and Allied Health, Monash University, Frankston, Victoria, 3199, Australia.
| | - Helen A Banwell
- School of Health Sciences, University of South Australia, Adelaide, South Australia, 5001, Australia; International Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, 5001, Australia.
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Derikx DFAA, Schoemaker MM. The nature of coordination and control problems in children with developmental coordination disorder during ball catching: A systematic review. Hum Mov Sci 2020; 74:102688. [PMID: 33049460 DOI: 10.1016/j.humov.2020.102688] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 11/26/2022]
Abstract
The aim of this review was to examine what is presently known about the nature of motor coordination and control problems in children with developmental coordination disorder (DCD) during ball catching and to provide directions for future research. A systematic literature search was conducted using four electronic databases (PubMed, Embase, PsycINFO and Web of Science), which identified 15 eligible studies. The results of the included studies were discussed, structured around the target population characteristics, the task used to measure motor coordination and control aspects, and the type of outcome. Children with DCD experience difficulties with both motor coordination and control during ball catching. They have been suggested to apply four compensation strategies to overcome these difficulties: a later initiation of the reaching phase, an earlier initiation of the grasping phase, a higher degree of coupling of the joints both intra- and inter-limb, and fixating the joints. However, despite these compensation strategies, children with DCD still caught fewer balls than typically developing children in all studies. This was especially due to a higher amount of grasping errors, which indicates a problem with the timing of the grasping phase. Directions for future research and practical implications were discussed.
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Affiliation(s)
- Dagmar F A A Derikx
- Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, the Netherlands.
| | - Marina M Schoemaker
- Centre for Human Movement Sciences, University of Groningen, University Medical Centre Groningen, PO Box 196, 9700 AD Groningen, the Netherlands
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Physical Therapy Management of Children With Developmental Coordination Disorder: An Evidence-Based Clinical Practice Guideline From the Academy of Pediatric Physical Therapy of the American Physical Therapy Association. Pediatr Phys Ther 2020; 32:278-313. [PMID: 32991554 DOI: 10.1097/pep.0000000000000753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Developmental coordination disorder (DCD), classified as a neurodevelopmental disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), affects approximately 5% to 6% of school-aged children. Characteristics of DCD include poor motor coordination and delayed development of motor skills, not explained by other conditions. Motor deficits negatively affect school productivity, performance in activities of daily living, and recreation participation. Children with coordination problems, at risk for or diagnosed with DCD, should be evaluated by a team of professionals, including a physical therapist (PT). PURPOSE This clinical practice guideline (CPG) provides management strategies for PTs and informs clinicians and families about DCD. It links 13 action statements with specific levels of evidence through critical appraisal of the literature and provides recommendations for implementation. RESULTS/CONCLUSIONS The DCD CPG addresses examination, referral, first choice and supplemental interventions, discharge, compliance audits, implementation, and research recommendations. Supplemental tools are provided to support PT management.
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Jijon AM, Leonard HC. Parenting stress in parents of children with developmental coordination disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 104:103695. [PMID: 32474232 DOI: 10.1016/j.ridd.2020.103695] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 04/14/2020] [Accepted: 05/10/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder which affects around 5% of children but is often not detected by clinicians. AIMS The aim of the current study was to investigate whether parents of children with DCD report clinically-significant levels of parenting stress, and to assess a number of factors contributing to this stress, based on evidence from research into other neurodevelopmental disorders. METHODS AND PROCEDURES A survey was completed by 174 parents of children aged 5-12 years with DCD (parents age M = 42;3, SD = 4;11), comprising measures of the child's motor difficulties and behavioural problems, the parent's perceived competence in the parenting role and perceived levels of social support, and parenting stress. OUTCOMES AND RESULTS Two thirds of parents reported clinically-significant levels of stress. Multiple regression analyses revealed that all variables except for level of motor difficulties were unique predictors of parenting stress. CONCLUSIONS AND IMPLICATIONS The study highlights the need for greater awareness of DCD by bringing attention to the impact it can have on the whole family. Providing targeted interventions, particularly addressing parents' perceived competence in managing their child, could reduce parenting stress and improve parents' wellbeing. This in turn could influence their parenting and, therefore, child outcomes.
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Affiliation(s)
- Ana M Jijon
- School of Psychology, University of Surrey, Guildford, Surrey, UK
| | - Hayley C Leonard
- School of Psychology, University of Surrey, Guildford, Surrey, UK.
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The Physiotherapy in Preschools Program: Describing a Student-Led Assessment Service for Children With Possible Motor Skill Difficulties. Adapt Phys Activ Q 2020; 37:324-337. [PMID: 32559737 DOI: 10.1123/apaq.2019-0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 01/13/2020] [Accepted: 02/24/2020] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to describe and undertake an initial evaluation of a student-led assessment service for children with possible motor-skill difficulties. A secondary analysis of cross-sectional descriptive clinical data collected from 2015 to 2016 was undertaken. Children (N = 102) were assessed in preschools by physiotherapy students (supervised by qualified physiotherapists). Key outcomes included the following: Children's Activities Scale, Movement Assessment Battery for Children-2, and demographic/service-usage/onward referral statistics. The results highlighted that for every five children referred/assessed, two were at risk of motor-skill difficulties (∼43%). About 66% of children were subsequently referred on or monitored (40% requiring multidisciplinary follow-up). Conversely 34% of children did not require further services. In conclusion, a student-led assessment service may be a sustainable and feasible option to assist children at risk of motor-skill difficulties, enabling onward referral. Additional evaluation is required to garner stakeholder feedback.
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Rinat S, Izadi-Najafabadi S, Zwicker JG. Children with developmental coordination disorder show altered functional connectivity compared to peers. Neuroimage Clin 2020; 27:102309. [PMID: 32590334 PMCID: PMC7320316 DOI: 10.1016/j.nicl.2020.102309] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 02/06/2023]
Abstract
Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder that affects a child's ability to learn motor skills and participate in self-care, educational, and leisure activities. The cause of DCD is unknown, but evidence suggests that children with DCD have atypical brain structure and function. Resting-state MRI assesses functional connectivity by identifying brain regions that have parallel activation during rest. As only a few studies have examined functional connectivity in this population, our objective was to compare whole-brain resting-state functional connectivity of children with DCD and typically-developing children. Using Independent Component Analysis (ICA), we compared functional connectivity of 8-12 year old children with DCD (N = 35) and typically-developing children (N = 23) across 19 networks, controlling for age and sex. Children with DCD demonstrate altered functional connectivity between the sensorimotor network and the posterior cingulate cortex (PCC), precuneus, and the posterior middle temporal gyrus (pMTG) (p < 0.0001). Previous evidence suggests the PCC acts as a link between functionally distinct networks. Our results indicate that ineffective communication between the sensorimotor network and the PCC might play a role in inefficient motor learning seen in DCD. The pMTG acts as hub for action-related information and processing, and its involvement could explain some of the functional difficulties seen in DCD. This study increases our understanding of the neurological differences that characterize this common motor disorder.
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Affiliation(s)
- Shie Rinat
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada
| | - Sara Izadi-Najafabadi
- Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada
| | - Jill G Zwicker
- BC Children's Hospital Research Institute, Vancouver, Canada; Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada; Department of Pediatrics, University of British Columbia, Vancouver, Canada; Sunny Hill Health Centre for Children, Vancouver, Canada; CanChild Centre for Childhood Disability Research, Hamilton, Canada.
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Bhat AN. Is Motor Impairment in Autism Spectrum Disorder Distinct From Developmental Coordination Disorder? A Report From the SPARK Study. Phys Ther 2020; 100:633-644. [PMID: 32154876 PMCID: PMC7297441 DOI: 10.1093/ptj/pzz190] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 04/23/2019] [Accepted: 10/09/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Motor impairments are pervasive in Autism Spectrum Disorder (ASD); however, children with ASD rarely receive a dual diagnosis of Developmental Coordination Disorder (DCD). The Simons Foundation SPARK study engaged families affected by ASD through an online study. OBJECTIVES The DCD parent questionnaire (DCDQ) was used to assess the prevalence of a risk for motor impairment or DCD in children with ASD between 5 and 15 years of age. DESIGN This study utilizes parent reports from a large database of children with ASD. METHODS A total of 16,705 parents of children with ASD completed the DCDQ. We obtained our final SPARK dataset (n = 11,814) after filtering out invalid data, using stronger cut-offs to confirm ASD traits, and excluding children with general neuromotor impairments/intellectual delays. We compared DCDQ total and subscale scores from the SPARK dataset with published norms for each age between 5 and 15 years. RESULTS The proportion of children with ASD at risk for a motor impairment was very high at 86.9%. Children with ASD did not outgrow their motor impairments and continued to present with a risk for DCD even into adolescence. Yet, only 31.6% of children were receiving physical therapy services. LIMITATIONS Our analysis of a large database of parent-reported outcomes using the DCDQ did not involve follow-up clinical assessments. CONCLUSIONS Using a large sample of children with ASD, this study shows that a risk for motor impairment or DCD was present in most children with ASD and persists into adolescence; however, only a small proportion of children with ASD were receiving physical therapist interventions. A diagnosis of ASD must trigger motor screening, evaluations, and appropriate interventions by physical and occupational therapists to address the functional impairments of children with ASD while also positively impacting their social communication, cognition, and behavior. Using valid motor measures, future research must determine if motor impairment is a fundamental feature of ASD.
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Affiliation(s)
- Anjana Narayan Bhat
- A.N. Bhat, PT, PhD, Department of Physical Therapy, University of Delaware, 540 South College Avenue, Newark, DE 19713 (USA); and Biomechanics & Movement Science Program, University of Delaware; and Department of Psychological & Brain Sciences, University of Delaware,Address all correspondence to Dr Bhat at:
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Identifying Developmental Motor Difficulties: A Review of Tests to Assess Motor Coordination in Children. J Funct Morphol Kinesiol 2020; 5:jfmk5010016. [PMID: 33467232 PMCID: PMC7739297 DOI: 10.3390/jfmk5010016] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 11/17/2022] Open
Abstract
The latest guidelines recommend early identification of children with motor impairments using a standardized norm-referenced test. Motor coordination difficulties in developmental age have been studied extensively over recent years, with experimental literature on developmental coordination disorder (DCD) suggesting that motor proficiency assessments depend on the nature of the task at hand. In this article we reviewed 14 assessment tools to measure movement performance in childhood and adolescence, which are often referred to in an international context. This updated review aims to compare motor tests depending on a) the nature of the tasks included in the battery (i.e., questionnaire and clinical examination), b) psychometric properties, and c) cultural adaptation to relevant developmental norms. Finally, implications for diagnosis and clinical practice are discussed. Considering there are several tests used for DCD, it is important to better define their reliability and validity in different cultures in order to better compare the validation studies and select the most appropriate test to use in the assessment procedure.
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Ferreira L, Gabbard C, Vieira JL, Tamplain P. Associations Between the Developmental Coordination Disorder Questionnaire - Brazilian Version (DCDQ-BR) and Motor Competence in School-Age Children. Phys Occup Ther Pediatr 2020; 40:121-133. [PMID: 31544582 DOI: 10.1080/01942638.2019.1665154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aim: Parental screening of children's motor skills can be helpful for early identification of Developmental Coordination Disorder (DCD). The present study examined the associations between the Developmental Coordination Disorder Questionnaire - Brazilian version (DCDQ-BR) and motor competence in school-age children.Methods: 707 children (332 boys, 375 girls) aged between 6- to 10-years and one of their parents participated in the study. Parents completed the DCDQ-BR and children's motor competence was determined using the Bruininks-Oseretsky Test of Motor Proficiency - 2nd edition (BOT-2).Results: The agreement between the BOT-2 and DCDQ-BR results was comparable across age, ranging from 74-84 percent. In general, there were low- to moderate correlations between all aspects of the parent report and children's motor competence. Sensitivity and specificity of the DCDQ-BR were 70% and 81%, respectively. Overall, boys had higher motor competence than girls, but parent reports were similar for gender.Conclusions: Parental assessment of their child's motor ability is moderately associated with motor competence, and this association is similar for boys and girls, even though boys scored higher in motor competence. Our findings suggest that it may be possible to reduce the length of clinical assessment by only testing children that flag as suspect for DCD in the DCDQ-BR.
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Affiliation(s)
- Luciana Ferreira
- Department of Physical Education, State University of Maringa, Maringa, Pr, Brazil.,Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA
| | - Carl Gabbard
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA
| | - José Luiz Vieira
- Department of Physical Education, State University of Maringa, Maringa, Pr, Brazil.,Department of Physical Activity Sciences, Catholic University of Maule, Talca, Chile
| | - Priscila Tamplain
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA
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Lawerman TF, Brandsma R, Maurits NM, Martinez‐Manzanera O, Verschuuren‐Bemelmans CC, Lunsing RJ, Brouwer OF, Kremer HPH, Sival DA. Paediatric motor phenotypes in early-onset ataxia, developmental coordination disorder, and central hypotonia. Dev Med Child Neurol 2020; 62:75-82. [PMID: 31529709 PMCID: PMC6916203 DOI: 10.1111/dmcn.14355] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2019] [Indexed: 01/28/2023]
Abstract
AIMS To investigate the accuracy of phenotypic early-onset ataxia (EOA) recognition among developmental conditions, including developmental coordination disorder (DCD) and hypotonia of central nervous system origin, and the effect of scientifically validated EOA features on changing phenotypic consensus. METHOD We included 32 children (4-17y) diagnosed with EOA (n=11), DCD (n=10), and central hypotonia (n=11). Three paediatric neurologists independently assessed videotaped motor behaviour phenotypically and quantitatively (using the Scale for Assessment and Rating of Ataxia [SARA]). We determined: (1) phenotypic interobserver agreement and phenotypic homogeneity (percentage of phenotypes with full consensus by all three observers according to the underlying diagnosis); (2) SARA (sub)score profiles; and (3) the effect of three scientifically validated EOA features on phenotypic consensus. RESULTS Phenotypic homogeneity occurred in 8 out of 11, 2 out of 10, and 1 out of 11 patients with EOA, DCD, and central hypotonia respectively. Homogeneous phenotypic discrimination of EOA from DCD and central hypotonia occurred in 16 out of 21 and 22 out of 22 patients respectively. Inhomogeneously discriminated EOA and DCD phenotypes (5 out of 21) revealed overlapping SARA scores with different SARA subscore profiles. After phenotypic reassessment with scientifically validated EOA features, phenotypic homogeneity changed from 16 to 18 patients. INTERPRETATION In contrast to complete distinction between EOA and central hypotonia, the paediatric motor phenotype did not reliably distinguish between EOA and DCD. Reassessment with scientifically validated EOA features could contribute to a higher phenotypic consensus. Early-onset ataxia (EOA) and central hypotonia motor phenotypes were reliably distinguished. EOA and developmental coordination disorder (DCD) motor phenotypes were not reliably distinguished. The EOA and DCD phenotypes have different profiles of the Scale for Assessment and Rating of Ataxia.
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Affiliation(s)
- Tjitske F Lawerman
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - Rick Brandsma
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - Natalia M Maurits
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - Octavio Martinez‐Manzanera
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | | | - Roelineke J Lunsing
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - Oebo F Brouwer
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - Hubertus PH Kremer
- Department of NeurologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - Deborah A Sival
- Department of PediatricsUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
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