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

Quality of instruments measuring activity and participation in children with developmental coordination disorder: A systematic review

OBJECTIVES

To identify instruments assessing the activity and participation of children with developmental coordination disorder (DCD) and analyze the quality and current level of evidence regarding their measurement properties.

METHODS

A comprehensive search was conducted in January 2023 on PubMed/MEDLINE, Scopus, Web of Science, Embase, Chinese Biomedical Databases, Wanfang and China National Knowledge Infrastructure to identify psychometric studies of instruments used to assess activity and participation in children with DCD. The selection process involved 2 independent reviewers who assessed the quality and level of evidence for each instrument using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist.

RESULTS

The search yielded 4221 references, of which 96 studies with 28 standardized clinical tests or questionnaires were included. According to the COSMIN criteria, most instruments had sufficient (68 %) or indeterminate (20 %) ratings in terms of their measurement properties. The quality of evidence was mainly high (59 %) or moderate (12 %), as per the Grading of Recommendations Assessment, Development, and Evaluation. The Movement Assessment Battery-second Edition was recommended for assessing motor activities (criterion A) based on moderate- to high-quality evidence showing satisfactory ratings for most measurement properties. The Developmental Coordination Disorder Questionnaire-Revised and its Little extension were recommended to provide information on daily activity limitations (criterion B) supported by sufficient measurement properties with moderate- to high-quality evidence. The standardized clinical tests DCDDaily, Körperkoordinationstest für Kinder, Performance Fitness Battery, and the DCDDaily-Questionnaire and Motor Observation Questionnaire for Teachers received acceptable ratings and evidence but had limitations requiring further investigation. More evidence was required for the remaining standardized tests and questionnaires.

CONCLUSION

Various assessment scales have been identified and a clinical decision map has been developed based on their measurement properties and quality of evidence. The clinical decision map provides easily understandable information that helps in selecting evidence-based instruments for research and clinical practice in children with DCD.

REGISTRATION

The protocol of this review was registered on PROSPERO (CRD42022327251).

Predictive validity of the Developmental Coordination Disorder Questionnaire as a screening tool to identify motor skill problems: A systematic review and meta-analysis

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.

Cross-cultural validation of the Arabic version of the Developmental Coordination Disorder Questionnaire DCDQ'07, in a Lebanese sample of children

BACKGROUND

The revised version of the Developmental Coordination Disorder Questionnaire (DCDQ'07) is a parent questionnaire designed to identify Developmental Coordination Disorder in 5-15-year-old children.

AIM

The aim of this study was to carry out the translation and cross-cultural adaptation of the DCDQ'07, to examine psychometric properties, and to define the cut-off scores of the Arabic-Lebanese version of the questionnaire (DCDQ-AL).

METHOD

38 parents of children with and without motor difficulties participated in the translation and cross-cultural phase. As for the validation phase and the study of the psychometric properties, a total of one hundred and twenty-four typically developing children (N=124) aged between 5 and 15 years were recruited through schools in different districts across Lebanon, whereas the clinical sample (N = 56) of children with motor difficulties was recruited via psychomotor rehabilitation centers in Beirut and psychomotor therapists working in private clinics across the country. This study used the Movement Assessment Battery for Children - second edition (MABC-2) motor test developed to classify children according to their degree of motor impairment.

RESULTS

For test-retest reliability and inter-rater reliability, excellent Intraclass Correlation Coefficients (ICC) were shown with values of 0.94 and 0.9, respectively. The internal consistency value for the DCDQ-AL was high (Cronbach's alpha = 0.947). Correlations between the DCDQ-AL scores and Movement Assessment Battery for Children (MABC-2) show adequate convergent validity (ρ = 0.65, p < .001). Differences in DCDQ-AL scores between children with and without motor difficulties (p < .001) provide clear evidence of discriminative validity. The Lebanese cut-offs are very similar to the Canadian version, except for the 5-7 age band. The DCDQ-AL shows a sensitivity of 0.91 and specificity of 0.77. The adapted questionnaire showed solid psychometric properties, allowing us to conclude that the DCDQ-AL can be used to support a diagnosis of DCD.

CONCLUSION

The results provide evidence that the DCDQ-AL is a valid clinical screening tool for DCD that can assist Arabic speaking professionals in screening children aged 5-15 years old who are at risk of having DCD.

Cross-Cultural Adaptation and Preliminary Reliability of the Adolescents and Adults Coordination Questionnaire into European Spanish

Developmental Coordination Disorder (DCD) is a developmental disorder affecting motor coordination skills, that frequently persists into adolescence and adulthood. Despite this, very few instruments exist to identify DCD in this population, and none of them are available for Spanish young adults. The purpose of this study was to cross-culturally adapt and preliminarily validate the Adolescents and Adults Coordination Questionnaire (AAC-Q) into European Spanish. The AAC-Q was translated and adapted following international recommendations, including: (a) two independent forward translations; (b) synthesis and reconciliation; (c) expert committee review; and (d) a comprehensibility test. In addition, the internal consistency and homogeneity were examined using a sample of 100 Spanish higher education students. Cultural equivalence and idiomatic differences were addressed to produce the AAC-Q-ES. Findings show that the AAC-Q-ES is a cross-culturally adapted instrument with good preliminary reliability indicators in Spanish young adults (Cronbach’s α = 0.74; corrected item-total correlations = 0.217–0.504).

Developmental Coordination Disorder, Motor Performance, and Daily Participation in Children with Attention Deficit and Hyperactivity Disorder

Children with Attention Deficit and Hyperactivity Disorder (ADHD) often present with Developmental Coordination Disorder (DCD) or motor coordination problems that further impact their daily functioning. However, little is known about the prevalence of co-occurring DCD and ADHD in the Spanish context, and research about the impact of ADHD on performance and participation in motor-based activities of daily living (ADL) is scarce. The aims of this study were to explore the prevalence of co-occurring DCD in children with ADHD, and to examine differences in performance and participation in motor-based ADL between children with ADHD and typically developing children. We conducted a case-control study including 20 children with ADHD and 40 typically developing controls randomly matched for exact age and sex (males = 80%; mean age = 8, 9 (2, 3) years). Presence of probable DCD (p-DCD) was confirmed with the Developmental Coordination Disorder Questionnaire (DCDQ). The DCDDaily-Q was administered to assess performance and participation in ADL. A 75% prevalence of p-DCD was found in the ADHD group (OR = 27; p < 0.001). Children with ADHD showed poorer motor performance and less participation in ADL (p < 0.01; d = 0.9-1.4). These findings contribute to understand the functional consequences of ADHD in motor-based ADL and its relationship with DCD.

Participation in Everyday Activities of Children with and without Neurodevelopmental Disorders: A Cross-Sectional Study in Spain

Children with neurodevelopmental disorders (NDDs) often report significant difficulties performing activities of daily living (ADLs), which may restrict their daily participation. The aim of this study was to investigate the differences in ADLs participation between children with NDDs and typically developing (TD) children, and to explore the associations between different daily participation contexts. A cross-sectional study was conducted that included twenty children with a medical diagnosis of an NDD and 26 sex- and age-matched TD controls. The daily participation across home, community, school, and instrumental living activities was measured using the Child and Adolescent Scale of Participation (CASP). The results show that children with NDDs engaged in lower participation in all CASP contexts (Δ = 1.7-5.5, p < 0.001) and had a significantly higher prevalence of moderate or severe restricted participation than their TD peers (OR = 23.4, 95% CI = 3.6-154.2, p < 0.001). Additionally, a strong association was found between the different contexts of participation (r = 0.642-0.856). Overall, the children with NDDs experienced significant participation restrictions on their daily activities. This study adds to the growing evidence showing that intervention strategies in this population should adopt a participation-oriented approach.

Assessment of Motor Activities of Daily Living: Spanish Cross-Cultural Adaptation, Reliability and Construct Validity of the DCDDaily-Q

The DCDDaily-Q is an instrument that aims to comprehensively assess motor performance in a broad range of activities of daily living (ADL) and to identify risk of Developmental Coordination Disorder (DCD) in children. The aim of this study was to cross-culturally adapt the DCDDaily-Q into European Spanish (DCDDaily-Q-ES) and to test its psychometric properties in Spanish 5 to 10 year old children. The DCDDaily-Q was translated and cross-culturally adapted into Spanish following international guidelines. Two-hundred and seventy-six parents of typically developing Spanish children completed the final version of the DCDDaily-Q-ES (M = 7.5 years, SD = 1.7; girls = 50%). Confirmatory Factor Analysis (CFA), internal consistency, and corrected item-total correlations were conducted to test construct validity, internal consistency, and homogeneity of the DCDDaily-Q-ES. The DCDDaily-Q-ES achieved good semantic, conceptual, and cultural equivalence. CFA supported construct validity of the DCDDaily-Q-ES. Reliability values were also good (Cronbach's alpha = 0.703-0.843; corrected item-total correlations = 0.262-0.567). This is the first study to cross-culturally adapt and examine the DCDDaily-Q outside the Netherlands. The findings suggest that the DCDDaily-Q-ES is a reliable and valid measure to assess learning, participation, and performance in a broad range of ADL.