Academic Challenges in Developmental Coordination Disorder: A Systematic Review and Meta-Analysis

Artificial intelligence-supported occupational therapy program on handwriting skills in children at risk for developmental coordination disorder: Randomized controlled trial

AIM

This study investigates the impact of an AI-supported occupational therapy program, developed using the Model of Human Occupation (MOHO), on handwriting skills in children at risk for Developmental Coordination Disorder (DCD).

METHOD

A randomized controlled trial was conducted with 42 children aged 8-12 years, identified as being at risk for DCD using the Developmental Coordination Disorder Questionnaire (DCDQ). Participants were randomized into an intervention group (n = 21) and a control group (n = 21). The intervention group received an AI-supported occupational therapy program twice weekly for 8 weeks. Handwriting performance was assessed pre- and post-intervention using the Minnesota Handwriting Assessment (MHA).

RESULTS

Significant improvements were observed in the intervention group across all MHA subdomains, including writing speed, alignment, size, spacing, shape, and legibility (p < 0.001). The most pronounced improvements were in shape (d=2.279), alignment (d=1.893), and the total score (d=2.291). In contrast, the control group showed minimal changes, with significant improvement observed only in alignment (p = 0.006; d=0.311). Between-group comparisons demonstrated superior performance in the intervention group across all subdomains (p < 0.05).

CONCLUSION

This study highlights the transformative potential of AI-supported occupational therapy programs in addressing the multifaceted challenges of handwriting rehabilitation in children at risk for DCD.

Atypical implicit procedural learning of adults with developmental coordination disorder: Evidence involving the modulation of cortical power

This study aimed to explore the implicit procedural learning and associated neural oscillatory activities in adults with Developmental Coordination Disorder (DCD) using electroencephalography (EEG). The sample consisted of 22 adults with DCD (14 females) and 22 age-matched controls (11 females), aged 18-21 years. Participants engaged in a modified Serial Reaction Time Task (SRTT) designed to assess implicit sequence learning. Behavioral results did not show significant differences in reaction times or speed-accuracy trade-off indices between the DCD and control groups, suggesting that implicit sequence learning might not be impaired in adults with DCD. However, EEG analysis revealed marked differences in theta oscillation energies; notably, the DCD group displayed higher theta amplitudes in the frontal region and delayed peaks in frontal-region theta bands compared to controls. These findings suggest that while behavioral performance might appear typical, the underlying neural processes in the DCD group are significantly different and underscore procedural learning deficits in adults with DCD. The results enrich our understanding of the neural underpinnings of DCD and offer insights for devising targeted interventions to improve procedural learning abilities in affected individuals.

Quality of life in children with developmental coordination disorder (DCD): A systematic review and meta-analysis

BACKGROUND

Children with developmental coordination disorder (DCD) often report reduced quality of life (QoL). However, substantial variability in findings across studies hinders insight into the profile of QoL in DCD. To address this, we investigated QoL in children with DCD using a meta-analytic approach, examining overall QoL, and QoL across its separate domains - physical, emotional, social, and school.

METHODS

Participants included 831 children with DCD (Mage = 10.10 years) and 10,283 neurotypical children (Mage = 10.04 years), i.e., controls. Separate meta-analyses were conducted for parent (N = 8) and child (N = 7) report data to compare overall QoL between those with and without DCD. Subgroup analyses compared QoL between groups across QoL domains. Concordance between parent and child-report was explored.

RESULTS

Children with DCD reported significantly lower overall QoL relative to controls (SMDchild = -0.38, pchild <.001). This effect was consistent across domains, regardless of report-type. Parents reported significantly worse overall QoL for children with DCD than children themselves (95 % CIparent [-1.59, -0.95], 95 % CIchild [-0.52, -0.24]) driven by the social (95 % CIparent [-1.89, -0.52], 95 % CIchild [-0.36, -0.03]) and school domains (95 % CIparent [-2.52, -0.65], 95 % CIchild [-0.53, -0.15]).

CONCLUSIONS

Our results demonstrate the widespread impact of DCD on well-being, supporting recent arguments that DCD is more than just a disorder of movement. Discordance between parent and child perceptions highlight the importance of using both report-types when examining QoL in DCD. Our work highlights the need for more research directly comparing the profile of QoL observed in those with DCD to those with neurodevelopmental conditions (either in isolation of, or co-occurrence with, DCD).

Systematic Review to Inform the Developmental Coordination Disorder Clinical Practice Guideline Update: Physical Therapy Examination/Evaluation

PURPOSE/HYPOTHESIS

Systematically review current evidence on the content of physical therapy (PT) examination and evaluation to inform the update to the 2020 Developmental Coordination Disorder (DCD) Clinical Practice Guideline (CPG).

METHODS

Eight databases were searched for studies that informed the content of PT examination and evaluation, including psychometric properties of tests and measures used in the PT management of DCD. Methodological quality and certainty of evidence were assessed.

RESULTS

Three systematic reviews and 30 cohort studies were included. Two findings impacting the 2020 DCD CPG are: (1) very low- to high-quality evidence supports cultural adaptations and cutoff scores for DCD-specific questionnaires, and (2) very low-quality evidence supports 4 outcome measures that are responsive to change with intervention.

CONCLUSION

Newer evidence reaffirms 4 of 5 recommendations on examination of the 2020 DCD CPG and adds evidence that could increase the recommendation strength of 2 action statements from best practice to moderate.

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.

Effects of Baduanjin on motor function in children with developmental coordination disorders: study protocol for a randomised controlled trial

INTRODUCTION

Children diagnosed with developmental coordination disorder (DCD) exhibit a range of challenges in both gross and fine motor skills, characterised by sluggish and awkward movements. Additionally, they experience deficits in balance and coordination. Without appropriate intervention, these difficulties may endure into adolescence and adulthood, impacting various facets of their daily lives, including learning, social interactions and recreational activities.

METHODS AND ANALYSIS

Employing a randomised controlled trial design, 60 children diagnosed with DCD will be randomly assigned to two groups. The experimental group will receive Baduanjin training in addition to health education, while the control group will undergo health education alone. Following an 8-week intervention period, assessments using motor assessment battery for children-second edition, ProKin 254 Balance Test System will be conducted to evaluate the impact of Baduanjin on the motor coordination and balance in children with DCD. Furthermore, functional near-infrared spectroscopy will be employed to capture haemodynamic data from the children's brain movement-related cortex during functional activities. These data will be analysed to assess the level of cortical activation, strength of functional connectivity and their correlation with changes in motor function, with the goal of investigating the cerebral blood oxygenation mechanisms underlying the effectiveness of the Baduanjin intervention.

ETHICS AND DISSEMINATION

This study has been submitted for approval and has received ethical clearance from the Medical Ethics Committee of Shanghai Fourth People's Hospital (2023080-001). The results of the study will be published in a peer-reviewed scientific journal.

TRIAL REGISTRATION NUMBER

ChiCTR2300078980.

Which outcomes are key to the pre-intervention assessment profile of a child with developmental coordination disorder? A systematic review and meta-analysis

BACKGROUND

Purpose of this study was to determine what key aspects of function should be incorporated to make up a pre-intervention assessment profile of a child with Developmental Coordination Disorder (DCD); more specifically, what aspects of functioning are implicated in DCD and what is their relative impact?

METHODS

A systematic review and meta-analysis were conducted, for which Pubmed, Web of Science, Scopus and Proquest were searched (last update: April 2023, PROSPERO: CRD42023461619). Case-control studies were included to determine point estimates for performances on field-based tests in different domains of functioning. The risk of bias was assessed, and the level of evidence was estimated. Random-effect meta-analyses were performed to calculate the pooled standardized mean differences for domains of functioning and subgrouping was done for clinically relevant subdomains. Heterogeneity was determined with I2.

RESULTS

121 papers were included for analyses. Data of 5923 children with DCD were included (59.8% boys) and 23 619 Typically Developing (TD) children (45.8% boys). The mean (SD) age of the DCD group was 10.3y (1.2) and 9.3y (1.3) for the TD children. Moderate evidence was found for motor performance, executive functions, sensory processing and perceptions, cognitive functions and sports and leisure activities to be affected in children with DCD.

CONCLUSION

Differences between the two groups varied per domain of functioning. This emphasizes the diversity present within children with DCD and provides a rationale for explaining the heterogeneity in this patient group. Yet, results highlight the potential involvement of all these domains and call for clinicians to be alert not only to examine motor skill difficulties but also other aspects of function. Results indicate the need to develop an individualized pre-intervention multi-dimensional assessment profile for each child with DCD. It also supports the important role that clinicians play in an interdisciplinary team to tackle the difficulties encountered by children with DCD.

Motor Adaptation Deficits in Children with Developmental Coordination Disorder and/or Reading Disorder

Procedural learning has been mainly tested through motor sequence learning tasks in children with neurodevelopmental disorders, especially with isolated Developmental Coordination Disorder (DCD) and Reading Disorder (RD). Studies on motor adaptation are scarcer and more controversial. This study aimed to compare the performance of children with isolated and associated DCD and RD in a graphomotor adaptation task. In total, 23 children with RD, 16 children with DCD, 19 children with DCD-RD, and 21 typically developing (TD) children wrote trigrams both in the conventional (from left to right) and opposite (from right to left) writing directions. The results show that movement speed and accuracy were more impacted by the adaptation condition (opposite writing direction) in children with neurodevelopmental disorders than TD children. Our results also reveal that children with RD have less difficulty adapting their movement than children with DCD. Children with DCD-RD had the most difficulty, and analysis of their performance suggests a cumulative effect of the two neurodevelopmental disorders in motor adaptation.

The impact for DCD - USA study: The current state of Developmental Coordination Disorder (DCD) in the United States of America

BACKGROUND

Developmental Coordination Disorder (DCD) is among the most under-recognized and under-supported disorders worldwide.

AIMS

To present a preliminary national study that evaluated the unmet needs of children with DCD in the USA using the Impact for DCD survey.

METHODS AND PROCEDURES

232 parents of individuals aged 5-18 years provided responses from 36 items in five domains (diagnosis, activity/participation, education, therapy, and social/emotional health).

OUTCOMES AND RESULTS

Most children (81.9%) had a formal diagnosis for movement difficulties, and 91.6% of parents reported that receiving a diagnosis was helpful, but most had not heard of the diagnosis before. The most common co-occurring diagnoses were childhood apraxia of speech and other speech-language disorders (24.6%), ADHD (23.1%), and anxiety (18.8%). Most parents reported that their children withdrew from or avoided movement-related activities (53%), and nearly all (94.8%) were concerned about the impact of motor difficulties on their children's social and emotional health. Only 37% of parents reported feeling that their child received sufficient therapy.

CONCLUSIONS AND IMPLICATIONS

Generally, parents reported feeling frustrated with others' understanding and awareness of the condition and with therapy services. The results shown here provide timely data that can support efforts for increased awareness, improved diagnosis, and increased availability of services for DCD in the USA.