Gender and age differences in the presentation of at-risk or probable Developmental Coordination Disorder in adults

Prevalence and associated factors of developmental coordination disorder in primary school children

Developmental coordination disorder (DCD) is one of the most frequently observed movement disorders in childhood, yet data on its prevalence are still unclear. This two-stage epidemiological study aims to determine the prevalence of DCD in children between 6 and 10 years of age according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). In the first stage, the Developmental Coordination Disorder Questionnaire (DCDQ'07) were given to primary school students. In the second stage, clinicians conducted psychiatric interviews with children who had an indication of DCD or were suspected of having DCD according to the DCDQ'07 and their parents. The interviews utilized the DSM-5 diagnostic criteria for DCD and applied the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Adaptation (K-SADS-PL) and Wechsler Intelligence Scale for Children (WISC-R) to identify co-occurring disorders. In the first stage, 2,306 children were evaluated, and 205 were invited for a clinical interview. Of the 198 children interviewed, 49 met the diagnostic criteria for DCD. The prevalence of DCD in Türkiye was found to be 2.1%. High parental education level, a previous psychiatric admission of the child, mother's postpartum depressive symptoms, co-occurring disorders, and co-occurring attention deficit hyperactivity disorder (ADHD) were significantly more common among children with DCD. Potentially associated factors were evaluated by logistic regression analysis. The mother's education level, the presence of postpartum depressive symptoms, and co-occurring disorders in the child were found to be associated factors.

Virtual reality-based interventions improve balance skills in children with developmental coordination disorder: systematic review and meta-analysis

PURPOSE

Virtual reality-based interventions (VRBI) are a gamified approach to therapy that can improve balance and motor skills in children diagnosed with Developmental Coordination Disorder (DCD). The aim was to investigate the effectiveness of VRBI in improving balance and motor skills in children with DCD.

METHODS

According to PRISMA guidelines, meta-analyses were conducted by searching randomized controlled trials (RCTs) that investigated the effect of VRBI on balance and motor skills in children with DCD. The global search was carried out in PubMed, SCOPUS, WOS, CINAHL and PEDro during the period from April 1st to 24th, 2024, without publication date restrictions. Standardized mean difference (SMD) and its 95% confidence interval (95%CI) was calculated as the pooled effect measure.

RESULTS

Nine RCTs, with a moderate mean methodological quality (5.11 points in PEDro) providing data from 266 participants, were included. All studies included used non-immersive virtual reality (NIVR) devices to carry out the VRBI. Meta-analyses revealed that NIVR was effective in increasing balance (SMD = 0.4; 95%CI 0.09-0.71), as well as running and agility skills (SMD = 0.45; 95%CI 0.03-0.87). However, no statistical differences were found in improving motor skills.

CONCLUSIONS

Findings reported in this meta-analysis support that VRBI that use NIVR devices can be effective in improving balance in children with DCD.

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

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

The evolution of symptoms of nervous system dysfunction in a First Nation community with a history of mercury exposure: a longitudinal study

BACKGROUND

Since the 1960's, mercury (Hg) contamination of the aquatic environment of Asubpeeschoseewagong Anishinabek (Grassy Narrows First Nation) territories has impacted the community members' traditions, culture, livelihood, diet and health. Despite decreasing Hg exposure over time, a recent study suggested that long-term exposure contributed to later-life symptom clusters of nervous system dysfunction. Here, the objective was to evaluate, 5 years later, the prevalence and progression of these symptoms and examine the contribution of long-term, past Hg exposure.

METHODS

The symptom questionnaire, applied in the 2016/17 Grassy Narrows Community Health Assessment (GN-CHA) (Time 1), was re-administered in the 2021/22 Niibin study (Time 2). A total of 85 adults (median age: 47y; range: 29-75y) responded at both times. Paired statistics were used to test the differences (Time 2 - Time 1) in self-reported symptom frequencies. The symptom clustering algorithm, derived from the entire study group of the GN-CHA (n = 391), which had yielded 6 clusters, was applied at Time 1 and 2. Equivalent hair Hg measurements (HHg) between 1970 and 1997 were used in Longitudinal Mixed Effects Models (LMEM), with a sub-group with ≥ 10 repeated HHg mesurements (age > 40y), to examine its associations with symptom cluster scores and their progression.

RESULTS

For most symptoms, paired analyses (Time 2 - Time 1) showed a significant increase in persons reporting " very often" or "all the time", and in the mean Likert scores for younger and older participants (< and ≥ 50y). The increase in cluster scores was not associated with age or sex, except for sensory impairment where a greater increase in symptom frequency was observed for younger persons. LMEM showed that, for the sub-group, long-term past Hg exposure was associated with most cluster scores at both times, and importantly, for all clusters, with their rate of increase over time (Time 2 - Time 1).

CONCLUSIONS

The persistence of reported symptoms and their increase in frequency over the short 5-year period underline the need for adequate health care services. Results of the sub-group of persons > 40y, whose HHg reflects exposure over the 28-year sampling period, suggest that there may be a progressive impact of Hg on nervous system dysfunction.

Visual and kinesthetic motor imagery in adults with different degrees of self-reported motor coordination difficulties

Developmental Coordination Disorder (DCD) involves difficulties in performing coordinated movements with fine and/or gross motor skills deficits. Several studies showed that DCD is characterized by motor imagery deficits as well. Here we investigated in neurotypical adults (N = 334) the relationships between the ease of imaging two main motor imagery components, that is the visual and the kinesthetic one, self-reported motor coordination difficulties and handwriting speed. Self-reported motor difficulties were measured by the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC) and scores were used to distinguish three groups: participants at risk of DCD (with both relevant childhood and current motor coordination difficulties); with motor coordination difficulties (relevant current but not childhood difficulties); without motor coordination difficulties (neither current nor childhood difficulties). The main results showed more kinesthetic and visual imagery difficulties in participants at risk of DCD than in those both with and without motor coordination difficulties. Interestingly, the relationships between the two imagery components and motor difficulties were different in the three groups, depending on: 1) the developmental phase (childhood or adulthood) to which motor coordination difficulties referred, and 2) the point of view (self or other), from which images were judged. Instead, no relationship was found between imagery abilities and handwriting speed. Thus, a nuanced pattern of the ease of imaging motor imagery emerged in adults with different degrees of self-reported motor coordination difficulties. These findings could be relevant for the assessment of people candidate to undergo a motor imagery training.

Impact of developmental coordination disorder in childhood on educational outcomes in adulthood among neonatal intensive care recipients: a register-based longitudinal cohort study

OBJECTIVES

Developmental coordination disorder (DCD) is related to poorer educational outcomes among children and adolescents. Evidence on this association into adulthood is lacking. Therefore, we aimed to investigate whether probable DCD (pDCD) in childhood affected educational outcomes among adults, and whether this was affected by sex or a co-occurring attention deficit in childhood.

DESIGN

Register-based longitudinal cohort study.

SETTING

Neonatal intensive care (NIC) recipients born at Uppsala University Children's Hospital, Uppsala, Sweden, from 1986 to 1989 until they reached the age of 28.

PARTICIPANTS

185 NIC recipients.

PRIMARY AND SECONDARY OUTCOME MEASURES

At the age of 6.5, 46 (24.6%) of the NIC recipients were diagnosed with pDCD. Using register-based longitudinal data, we compared participants with and without pDCD in terms of: (1) age at Upper Secondary School (USS) graduation, and (2) highest level of education achieved by age 28.

RESULTS

The median age at USS graduation was 19 years, with similar graduation ages and ranges between those with or without pDCD. However, a higher proportion of participants without pDCD had graduated from USS at ages 19 and 24. By age 29, most participants had completed USS. At age 28, 33% of participants had attained a bachelor's or master's degree. Although there was no significant difference between the groups, the proportion that had attained a degree was higher among those without pDCD and women without pDCD had achieved the highest level of education. Educational outcomes remained similar for those with pDCD, regardless of childhood attention deficit.

CONCLUSIONS

pDCD during childhood may have a lasting impact on educational outcomes, particularly among women. Raising awareness of DCD among parents, health and educational professionals is vital for early identification and the provision of appropriate support and interventions in schools, mitigating the potential negative consequences associated with DCD and promoting positive educational outcomes.

Translation and Adaptation of the Adult Developmental Coordination Disorder/Dyspraxia Checklist (ADC) into Asian Uzbekistan

Developmental Coordination Disorder (DCD) is a neurodevelopmental condition that emerges in childhood and its symptoms continue through adulthood. The Adult Developmental Coordination Disorders/Dyspraxia Checklist was the first instrument used to screen adults with possible DCD. The psychometric characteristics of the Uzbek version of the scale were explored. An independent translation of the questionnaire from the original version into the Uzbek language was made. The sample comprised 301 Uzbekistan adults, aged between 17 and 42 years old (M = 20.66; SD = 2.26). Analyses were performed using R software (4.1.0). Descriptive analysis, exploratory factor analysis, and evidence of reliability in terms of internal consistency were assessed using the psych package (2.1.6), intraclass correlation coefficients were assessed using the irr package (0.84.1), and weighted Kappa were assessed using vcd package (1.4-10). To analyse the factor structure of the ADC scale, when applied to an Uzbekistan sample, exploratory factor analysis (EFA) was performed. In the Uzbek version, a one-factor structure was identified, and moderated psychometric properties were found, which makes it a possible alternative to the original scale when applied to adults. This Uzbek version reduces respondents' fatigue since it is smaller than the original one. More studies are needed to confirm the cut-off scores of this new version.

Self-esteem, self-efficacy, and social support mediate the relationship between motor proficiency and internalizing problems in adults: Exploring the environmental stress hypothesis in adulthood

The Environmental Stress Hypothesis (ESH) is a theoretical model used to understand the factors mediating the relationship between motor proficiency and internalizing problems. The aim of this study is to explore a potential extension of the ESH by examining whether BMI, physical activity levels, self-esteem, self-efficacy and social support are potential mediators between motor proficiency and internalizing problems in young adults. 290 adults aged between 18 and 30 years old (150 women, 140 men) were evaluated with the following instruments: Adult Developmental Coordination Disorders Checklist (ADC), Depression, Anxiety and Stress Scale (DASS 21), Social Support Satisfaction Scale (SSSS), Perceived General Self-Efficacy Scale (GSE), Rosenberg Self-Esteem Scale (RSES), International Physical Activity Questionnaire (IPAQ), and self-reported body mass index (BMI). The results indicated that self-esteem, self-efficacy, and social support mediate the relationship between motor proficiency and internalizing problems in this sample. Thus, the findings reinforce the notion that early intervention and preventive psychological care can serve as protective aspects of mental health in adults at risk for low motor proficiency.

Sex and gender in neurodevelopmental conditions

Health-related conditions often differ qualitatively or quantitatively between individuals of different birth-assigned sexes and gender identities, and/or with different gendered experiences, requiring tailored care. Studying the moderating and mediating effects of sex-related and gender-related factors on impairment, disability, wellbeing and health is of paramount importance especially for neurodivergent individuals, who are diagnosed with neurodevelopmental conditions with uneven sex/gender distributions. Researchers have become aware of the myriad influences that sex-related and gender-related variables have on the manifestations of neurodevelopmental conditions, and contemporary work has begun to investigate the mechanisms through which these effects are mediated. Here we describe topical concepts of sex and gender science, summarize current knowledge, and discuss research and clinical challenges related to autism, attention-deficit/hyperactivity disorder and other neurodevelopmental conditions. We consider sex and gender in the context of epidemiology, behavioural phenotypes, neurobiology, genetics, endocrinology and neighbouring disciplines. The available evidence supports the view that sex and gender are important contributors to the biological and behavioural variability in neurodevelopmental conditions. Methodological caveats such as frequent conflation of sex and gender constructs, inappropriate measurement of these constructs and under-representation of specific demographic groups (for example, female and gender minority individuals and people with intellectual disabilities) limit the translational potential of research so far. Future research and clinical implementation should integrate sex and gender into next-generation diagnostics, mechanistic investigations and support practices.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Moderation of parental socioeconomic status on the relationship between birth health and developmental coordination disorder at early years

Objective

This study investigated whether parental SES moderates the effect of birth health on Developmental Coordination Disorder (DCD) in preschool children.

Methods

One hundred and twenty-two children aged 4 to 6 years were enrolled in the study. The Movement Assessment Battery for Children --2nd Edition (MABC-2) test was used to assess the motor coordination of children. They were preliminarily categorized into either the DCD (<=16th percentile, n = 23) or typically developing (TD) group (>16th percentile, n = 99) based on the testing results. All children in the DCD group were further confirmed to meet other diagnostic criteria of the DSM-V using the intellectual test and parental questionnaires. Moderation analysis was conducted using the PROCESS macro for SPSS, and 95% confidence intervals with a bootstrap procedure were calculated to identify the significant moderating effect.

Results

Maternal education (unstandardized coefficient = 0.6805, SE = 0.3371, p < 0.05) and maternal employment status (unstandardized coefficient = 0.6100, SE = 0.3059, p < 0.05) were found to moderate the relationship between birth length and the probability of having DCD. Moreover, the relationship between birth weight and the probability of having DCD was moderated by the annual household income (unstandardized coefficient = -0.0043, SE = 0.0022, p < 0.05).

Conclusion

The lower maternal education level and maternal unemployment strengthened the negative relationship between birth length and the probability of having DCD. Additionally, the negative relationship between birth weight and the probability of having DCD was statistically significant in high annual household salaries.

Relationship Between Childhood Sensory Processing Differences and Quality of Life as Adults

Research suggests a relationship between sensory processing, motor skills and quality of life (QOL) in a variety of clinical populations of adults and children. There have been no studies which investigated the relationship of childhood sensory processing and integration and related motor performance (sensori-motor) patterns identified using an Ayres Sensory Integration® (ASI) frame of reference and later QOL of those children as adults. This longitudinal follow-up study examined this relationship. Adult QOL was also examined in relation to current adult sensori-motor patterns. Fifty-three adults who received occupational therapy services as children, were identified as having sensori-motor difficulties at that time and completed a sensory history and a quality-of-life measure as adults participated. Measures included the OTA the Koomar Center Sensory History (SXHX), Adult/Adolescent Sensory History (ASH), and the World Health Organization Quality of Life-Brief (WHOQOL-BREF). MANCOVA found that Total childhood sensori-motor scores had a small relationship to Physical Health QOL as adults that approached significance. Pearson Correlations found that adults with childhood sensori-motor challenges who report sensori-motor challenges as adults had a moderate significant relationship among overall sensori-motor functioning and Physical Health (r = −0.56, p = 0.018). Visual (r = −0.76, p = 0.001), movement (vestibular; r = −0.48, p = 0.042) and tactile processing (r = −0.63, p = 0.008) had moderate to large significant relationships with Physical Health. Visual processing (r = −0.54, p = 0.024) was also significantly related to Psychological Health. Motor Coordination trended to significance for Physical Health (r = −0.42) and Psychological Health (r = −0.41). Conversely, adults who reported typical sensori-motor scores as adults, despite childhood sensori-motor challenges, had a good QOL. Furthermore, similar to previous research, there was a relationship between current visual, movement (vestibular) and tactile (touch) sensory processing and adult Physical and Psychological Health. A multivariate linear regression found Sensory Discrimination and Modulation accounted for one-quarter of the variance in QOL in adults with only Discrimination being statistically significant. Therefore, it is important to consider childhood sensori-motor function as well as adult functioning when examining QOL. Further, heretofore unexamined Sensory Discrimination was found to play a role in adult QOL.

The Role of Motor Coordination, ADHD-Related Characteristics and Temperament among Mothers and Infants in Exclusive Breastfeeding: A Cohort Prospective Study

Although exclusive breastfeeding is recommended for the first 6 months of life, breastfeeding rates are low. Motor skills and ADHD-related characteristics have not yet been examined as breastfeeding barriers. The aim of this study was to explore whether mothers' and infants' motor skills, mothers' ADHD-related characteristics and infants' temperament are associated with exclusive breastfeeding at 6 months after birth. Participants were 164 mothers and their infants recruited 2 days after birth. Mothers completed a demographic and delivery information questionnaire, the Infant Feeding Intentions Scale and the Iowa Infant Feeding Attitude Scale. At 6 months, mothers completed the Adult DCD (developmental coordination disorder)/Dyspraxia Checklist, the Adult ADHD (attention deficit hyperactivity disorder) Self-Report Scale Symptom Checklist-v1.1, and the Infant Characteristics Questionnaire, and provided information about their breastfeeding status. They were then divided into two groups accordingly: EBF (exclusive breastfeeding) and NEBF (non-exclusive breastfeeding). Infants were observed using the Test of Sensory Functions in Infants and the Alberta Infant Motor Scale. At 6 months, NEBF mothers reported higher prevalence of DCD (10.2% vs. 1.9%, χ2 = 5.561, p = 0.018) and ADHD (20.3% vs. 8.6%, χ2 = 4.680, p = 0.030) compared to EBF mothers. EBF infants demonstrated better motor coordination (t = 2.47, p = 0.016, d = 0.511), but no temperament differences compared to NEBF infants. Maternal DCD, ADHD and poor infant motor coordination are associated with non-exclusive breastfeeding and may become exclusive breastfeeding barriers. These findings may assist in identifying women at risk of not exclusively breastfeeding and encourage tailoring interventions for achieving higher exclusive breastfeeding rates.