Developmental Coordination Disorder and Most Prevalent Comorbidities: A Narrative Review

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).

Developmental Coordination Disorder: Emotional and Cognitive Implications on Adults' Quality of Life

BACKGROUND

Developmental coordination disorder (DCD) may persist into adulthood, reduce function, participation, and quality of life (QOL). The negative impacts of DCD are mainly studied in children. Purpose. To explore the interrelations between factors affected by DCD in adults, with a focus on emotional/cognitive burdens, self-efficacy, and examine their direct/indirect effects on QOL. Methods. Based on Adult Developmental Co-ordination Checklist (ADC) cutoff scores, 240 adults were divided into three groups: (1) suspected DCD (s-DCD), (2) probable DCD (p-DCD), and (3) normal motor coordination. Participants completed the Depression, Anxiety and Stress Scale - 21, General Self-Efficacy scale, Daily Living Questionnaire (functional cognition), and The World Health Organization Quality of Life Questionnaire brief form. Structural equation modeling examined mediation effects. Findings. The p-DCD group had the lowest emotional status, functional cognition, self-efficacy, and QOL and significantly differed from the s-DCD group in functional cognition. Emotional distress and self-efficacy mediated between motor coordination and QOL. Conclusion. The emotional-cognitive burdens in adults with DCD are related to motor deficits severity, reduced self-efficacy, and lower QOL. DCD should be screened and treated in adults to reduce daily life restrictions and elevate QOL.

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.

Neurodevelopmental benefits of judo training in preschool children: a multinational, mixed methods follow-up study

Introduction

In our quasi-experimental study, we evaluated the neurodevelopmental impact of judo on young children (n = 182) aged 4-7 years, specifically focusing on primitive reflex integration. Participants were divided into judo and non-judo control groups, and assessments were conducted over 6 months across Hungary, Slovakia, and Austria.

Methods

Neurodevelopmental changes were measured using Institute for Neuro-Physiological Psychology (INPP) and Physical and Neurological Examination for Soft Signs (PANESS) for children, while parents completed the Performance Skills Questionnaire (PSQ).

Results

Analysis with Repeated Measures ANOVA (significance set at p < 0.05) revealed significant improvements in cognitive and motor performance in judo-practicing children compared to their non-judo counterparts. Furthermore, Spearman correlation analysis revealed that INPP and PANESS were effective in identifying neurodevelopmental changes, PSQ was not suitable as a simplified screening tool for parents, potentially due to its absence of items focused on primitive reflexes.

Conclusion

Despite the limitations of the study, our findings suggest that judo practice could foster central nervous system (CNS) maturation in young children, promoting the potential inclusion of judo in early childhood education programs.

Use of Virtual Reality in School-Aged Children with Developmental Coordination Disorder: A Novel Approach

Virtual reality (VR) applications in paediatric rehabilitation are recent but promising. This brief report describes a VR rehabilitation program for a small sample of children with Developmental Coordination Disorder (DCD). The program focused explicitly on executive functions, a key area of concern for this population. It was conducted over 11 weeks in the CARE Lab. This lab was designed with appropriate structural characteristics and sophisticated technology to provide a rehabilitative setting with recreational and semi-immersive features. Before and after the VR training, the children were evaluated in terms of visual attention, inhibition, planning abilities, and visual-motor coordination. The rehabilitation programs were customised according to the clinical needs and the functional profile of each patient, proposing different games with variable complexity levels. These preliminary results showed a global and clinically significant change in executive functions, especially visual attention and inhibition skills. These findings suggest interesting implications for clinical practice, providing new information for professionals regarding the application of VR in the field of paediatric rehabilitation.

A framework for remotely enabled co-design with young people: its development and application with neurodiverse children and their caregivers

Introduction

This paper describes an innovative Framework for Remotely Enabled Co-Design with Young people (FREDY), which details an adaptable four-stage process for generating design concepts with children and other key stakeholders in a naturalistic and inclusive way.

Methods

Recommendations from existing patient engagement and design methodologies were combined to provide research teams with procedures to capture and analyse end-user requirements rapidly. Resulting insights were applied through iterative design cycles to achieve accelerated and user-driven innovation.

Results

Applying this framework with neurodiverse children within the context of healthcare, shows how creative design methods can give rise to new opportunities for co-creating across diverse geographies, abilities, and backgrounds as well as strengthen co-designer approval of the co-design process and resulting product.

Discussion

We summarise key learnings and principles for fostering trust and sustaining participation with remote activities, and facilitating stakeholder design input through continuous collaboration, as well as highlight the potential benefits and challenges of utilising FREDY with neurotypical populations.

Evaluating the Efficacy of Gross-Motor-Based Interventions for Children with Developmental Coordination Disorder: A Systematic Review

Objectives: This review quantitatively evaluates the effectiveness of gross-motor-based interventions in children with developmental coordination disorder (DCD), examining treatment aspects such as group interventions, therapy duration, and frequency. Methods: A systematic literature review, spanning January 2010 to December 2022, identified 11 relevant articles involving 492 children. Results: Positive outcomes were observed, with a moderate to large overall effect size (Cohen's d) indicating significant improvements in motor function through strategies emphasizing activity, bodily function, games, and small group events. Notably, interventions targeting complex motor skills were crucial for enhancing preparedness and activity engagement, improving fitness, and preventing obesity in children with DCD. Conclusions: The review underscores the effectiveness of activity-oriented and body-function-focused therapies in enhancing motor skills and functioning, emphasizing the need for interventions aligned with real-world activities. Future research should explore the long-term effects and retention of motor improvements, offering valuable insights for designing targeted interventions to promote overall well-being in children with DCD.

Object Exploration and Manipulation in Infants at Typical vs. Elevated Likelihood for ASD: A Review

The present review considers the growing body of literature on fine motor skills in infants at elevated genetic likelihood (EL) for autism spectrum disorder (ASD). This area of study aims to identify crucial motor markers associated with the disorder, facilitating earlier and more accurate identification of ASD, using various experimental methodologies, including standardized assessments, observational measures, and technological tools. The reviewed evidence revealed distinct developmental trajectories in EL infants, marked by differences in fine motor skills and exploratory behaviors compared to typically developing infants. We discuss the developmental trajectory of fine motor skills in infants and their predictive value for later ASD diagnosis, highlighting the significance of fine motor skills as early indicators of ASD risk in infants and emphasizing the need for further research to elucidate their predictive value and underlying mechanisms.

Finger counting to relieve working memory in children with developmental coordination disorder: Insights from behavioral and three-dimensional motion analyses

A limited number of studies have attempted to understand how motor deficits affect numerical abilities in children with developmental coordination disorder (DCD). The purpose of this study was to explore the functionality of finger-counting (FC) in children with DCD. The participants, 15 children with DCD and 15 typically developing (TD) children matched on school level and fluid reasoning abilities, were asked to use FC to solve an ordinal task with high working memory (WM) load. Behavioral measures supplemented with biomechanical measures, from three-dimensional motion analysis synchronized to a voice recording were used to assess children's performance and FC functionality (total duration, inter-finger [IF] transition, IF variance, finger/voice synchronization, and automatization of FC movements). Children with DCD were less accurate than TD children in using FC to solve ordinal problems with high WM load. This group difference could not be accounted for by poor FC skills given that FC movement turned out to be as functional in children with DCD as in their TD peers. When added to the model as a covariate, WM captured a greater proportion of intergroup variability than manual dexterity, further suggesting that their difficulties would be better accounted for by limited WM resources than by fine motor skills.

Auditory rhythm facilitates perception and action in children at risk for developmental coordination disorder

Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder featuring deficits in motor coordination and motor timing among children. Deficits in rhythmic tracking, including perceptually tracking and synchronizing action with auditory rhythms, have been studied in a wide range of motor disorders, providing a foundation for developing rehabilitation programs incorporating auditory rhythms. We tested whether DCD also features these auditory-motor deficits among 7-10 year-old children. In a speech recognition task with no overt motor component, modulating the speech rhythm interfered more with the performance of children at risk for DCD than typically developing (TD) children. A set of auditory-motor tapping tasks further showed that, although children at risk for DCD performed worse than TD children in general, the presence of an auditory rhythmic cue (isochronous metronome or music) facilitated the temporal consistency of tapping. Finally, accuracy in the recognition of rhythmically modulated speech and tapping consistency correlated with performance on the standardized motor assessment. Together, the results show auditory rhythmic regularity benefits auditory perception and auditory-motor coordination in children at risk for DCD. This provides a foundation for future clinical studies to develop evidence-based interventions involving auditory-motor rhythmic coordination for children with DCD.

Towards system redesign: An exploratory analysis of neurodivergent traits in a childhood population referred for autism assessment

BACKGROUND

Children's health services in many countries are moving from single condition diagnostic silo assessments to considering neurodevelopment in a more holistic sense. There has been increasing recognition of the importance of clinical overlap and co-occurrence of different neurotypes when assessing neurodivergent children. Using a cross-sectional service evaluation design, we investigated the overlap of neurodivergences in a cohort of children referred for autism assessment, focusing on motor, learning, and attention/activity level domains. We aimed to determine what proportion of children in a cohort referred for an autism assessment showed traits of additional neurodivergences, and what proportion were further investigated.

METHODS

We evaluated anonymised medical records of children aged between two and 17 years referred for autism assessment. We used validated questionnaires to assess for neurodivergent traits. A weighted scoring system was developed to determine traits in each neurodevelopmental domain and a score above the median was considered to indicate a neurodivergent trait. Evidence of further investigations were recorded. We then examined the relationships between autism traits and traits of additional neurodivergence.

RESULTS

114 participants were included for evaluation. 62.3% (n = 71) had completed questionnaires for analysis. Of these, 71.8% (n = 51) scored greater than the median for at least one additional neurotype, indicating the presence of other neurodivergent traits, and 88.7% (n = 64) attracted a diagnosis of autism. Only 26.3% of children with evidence of additional neurotypes were further investigated beyond their autism assessment.

CONCLUSIONS

Our results demonstrate the extensive overlap between additional neurodivergent traits in a population of children referred with suspected autism and show that only a small proportion were further investigated. The use of standardised questionnaires to uncover additional neurodivergences may have utility in improving the holistic nature of neurodevelopmental assessments.

Associations of ADHD-Risk and Motor Competence With School Functioning

OBJECTIVES

This study investigated the unique associations of motor competence and ADHD risk status on school functioning. Additionally, this study examined the factor structure of the Bruininks-Oseretsky Test of Motor Proficiency, Short Form (BOT2-SF).

METHODS

Participants included early elementary school children (N = 202, Mage = 6.83, SD = 0.96, Male = 53.5%, ADHD-risk = 46.5%). Child assessments of motor competence and teacher and parent reports of school functioning were used.

RESULTS

A two-factor model of the BOT2-SF with correlated fine and gross motor factors and correlated residuals best fit the data. Fine and gross motor competence were unique positive predictors of academic performance, after accounting for the effects of ADHD-risk on academic performance. ADHD-risk was the only unique predictor of adaptive school behavior.

CONCLUSION

Findings suggest that assessing for ADHD and motor competence in children demonstrating school functioning problems may better allow for targeted intervention in school.

[Recent research on the long-term neurodevelopmental outcomes of very preterm infants]

With the increase in the survival rate of very preterm infants, the long-term neurodevelopmental outcomes of such infants have attracted more and more attention. Very preterm infants tend to develop movement disorders and psychological and behavioral problems, including cerebral palsy, developmental coordination disorders, autism spectrum disorders, attention deficit hyperactivity disorders, specific learning disorders, and intellectual developmental disorders. It is of vital importance to improve the long-term prognosis of very preterm infants, and early comprehensive intervention measures can minimize disability and achieve optimal parenting outcomes. This article provides a review of the research progress on the long-term neurodevelopmental outcomes in extremely preterm infants.

Bringing therapy home: Exploring parents' experiences of telehealth for children with developmental coordination disorder

Introduction

Developmental coordination disorder (DCD) significantly impacts a child's motor skills and ability to learn and perform self-care and academic tasks. Telehealth is a rapidly emerging service delivery model, ensuring expanded access to services and continuity of care. Many benefits to the use of telehealth have been identified; yet, there is a dearth of published evidence available on the experiences of parents of children with DCD.

Aim

The aim of this study was to explore parents' experiences of implementing a telehealth motor skills programme for their child with DCD.

Method

This study utilised a qualitative descriptive approach to best capture parents' experiences of a telehealth programme. Data were collected through in-depth, semi-structured interviews with eight participants and analysed using thematic analysis. Measures to ensure the trustworthiness of the study were observed within the naturalistic paradigm comprising criteria of credibility, transferability, dependability and confirmability.

Findings

This study uncovered three major themes: (1) Parents in the dark, (2) telehealth in the family and (3) telehealth: what success looks like. Ten further subthemes highlighted the factors for success and parents' considerations for future service delivery.

Conclusion

Challenges for parents in accessing traditional occupational therapy services present an opportunity to explore alternative means of delivery such as telehealth. Parents, however, are clear in their preference for a blended approach for future services.

Handwriting processes when spelling morphologically complex words in children with and without Developmental Language Disorder

Introduction

Representations activated during handwriting production code information on morphological structure and reflect decomposition of the root and suffix. Children with Developmental Language Disorder (DLD) have significant difficulties in spelling morphologically complex words, but previous research has not sought evidence for a morphological decomposition effect via an examination of handwriting processes in this population.

Method

Thirty-three children aged 9-10 years with DLD, 33 children matched for chronological age (CA), and 33 younger children aged 7-8 years matched for oral language ability (LA) completed a dictated spelling task (21 words; 12 with inflectional suffixes, nine with derivational suffixes). The task was completed on paper with an inking pen linked to a graphics tablet running the handwriting software Eye and Pen. Pause analyses and letter duration analyses were conducted.

Results

The three groups showed similar handwriting processes, evidencing a morphological decomposition effect in a natural writing task. Pause durations observed at the root/suffix boundary were significantly longer than those occurring in the root. Letter durations were also significantly longer for the letter immediately prior to the boundary compared to the letter after it. Nevertheless, despite being commensurate to their LA matches for mean pause durations and letter durations, children with DLD were significantly poorer at spelling derivational morphemes. Handwriting processes did significantly predict spelling accuracy but to a much lesser extent compared to reading ability.

Discussion

It is suggested that derivational spelling difficulties in DLD may derive more from problems with underspecified orthographic representations as opposed to handwriting processing differences.

Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study

Background: Task-oriented approaches are recommended for children with developmental coordination disorder (DCD) to address deficits in motor performance and reduce activity limitations. Although this approach is used in several settings, the efficacy of these approaches in children with in dual-diagnosis of specific learning disabilities (SLD) and DCD is less widely known. This study aims to determine the effect of a group-based intervention based on neuromotor task training (NTT) principles on the motor performance of children aged 6–10 years with SLD/DCD. Methods: A pre-post-test controlled study design was conducted in children with a primary diagnosis of specific learning disabilities (SLD). DCD status was confirmed based on clinical assessment. Children scoring ≤16th percentile on the Motor Assessment Battery for Children 2nd Edition (MABC-2), who also presented with a functional motor problem, according to the MABC checklist were considered as having DCD. Children were allocated to the NTT intervention group based on teachers’ perceived notion of need and received two 45–60 min training sessions per week for nine weeks. Children allocated to the usual care (UC) group, received their planned occupational therapy and physical education. The MABC-2 was used to assess changes in motor performance. Outcome and Results: Our numbers confirm that it is crucial to identify the presence of motor coordination difficulties in children who have been diagnosed with SLD. A task-oriented training program based on NTT principles, presented in small groups, has a positive effect on the motor performance in learners with neurodevelopmental disorders and this effect was larger than in the usual care group. Conclusion and Implications: Although using a small group format in children with multiple neurodevelopmental disorders may be challenging for the therapists, it may be a way of delivering services to children in schools for special education. What this paper adds: Children with DCD plus LSD show improvement in their motor skills by performing group-based NTT in the school environment. Group-based NTT shows a significant improvement in the TSS score of the MABC-2 compared to usual care. Children with DCD plus SLD show equal effect sizes after NTT intervention as DCD without SLD.

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.

Motor Skills and Visual Deficits in Developmental Coordination Disorder: A Narrative Review

Developmental coordination disorder (DCD) is a developmental disorder in which numerous comorbidities seem to coexist, such as motor and visual impairment and some executive functions; Methods: A narrative review on motor and visual deficits in children with DCD was carried out; Results and Discussion: Fine and gross motor skills are affected in children with DCD. In addition, they seem to be related to visual deficits, such as difficulty in visual perception, sensory processing and visual memory. Limitations have also been found in accommodation. Interventions in children with DCD should be aimed at improving both aspects, since vision affects motor skills and vice versa; Conclusions: In children with DCD, who present a marked deficit in global shape processing, it causes an association between deficiencies in visual perception and motor skills.