Physical Literacy as A Framework of Assessment and Intervention for Children and Youth with Developmental Coordination Disorder: A Narrative Critical Review of Conventional Practice and Proposal for Future Directions

Effects of Holistically Conceptualised School-Based Interventions on Children's Physical Literacy, Physical Activity, and Other Outcomes: A Systematic Review

BACKGROUND

Schools are a key setting for promoting children's physical literacy development. This review aimed to identify school-based interventions that adopted a holistic conceptualisation of physical literacy and examine the effects on children's physical literacy and any other outcomes, including physical activity (PA).

METHODS

Searches were conducted in seven databases (APA PsycINFO, EMBASE, ERIC, CINAHL, Global Health, MEDLINE Complete, SPORTDiscus with Full Text), and Google and Google Scholar, to identify articles published since 1/1/2017. Studies were included if they (i) adopted a holistic conception of physical literacy as represented by the Australian Physical Literacy Framework (APLF), (ii) were grounded in movement, (iii) assessed three or more domains of learning (either quantitatively or qualitatively), and (iv) included children aged 5-14 years. Quantitative research designs needed to provide pre-and post-intervention measures, whereas qualitative designs (e.g. post-intervention interviews) did not. Study selection, data extraction and quality assessment were conducted independently by teams of two authors. For intervention effects, quantitative and qualitative data were synthesised separately. For quantitative data, level of evidence for intervention effects was assessed by physical literacy domain and/or elements/items by examining the proportion of tests with a significant change in the expected direction. Qualitative data were synthesised using the framework synthesis method and mapped to a framework that included APLF domains/elements, PA, and additional outcomes.

RESULTS

Twelve interventions with 1,427 participants from seven countries were identified: six physical education-based, three afterschool, one structured recess, and two multicomponent. All studies assessed the physical domain quantitatively, with strong positive evidence of intervention effects for the controlled designs (10 of 15 tests). For the affective and cognitive domains, evidence was mixed, and there was no evidence for interventions improving the social components of children's physical literacy (although this was understudied). Most studies assessed PA and one measured cognitive performance; however, there was no evidence for positive intervention effects (i.e. ≥35% of tests reporting an improvement) for either outcome. Five studies assessed intervention effects qualitatively, with positive results reported for all physical literacy domains, PA, and cognitive performance.

CONCLUSIONS

Holistic interventions in schools can improve the physical domain of children's physical literacy. For wider benefits, future interventions should aim to develop all facets of physical literacy, especially domains of learning less frequently targeted and examined.

TRIAL REGISTRATION

PROSPERO CRD42022351317.

Reliability of the Test of Gross Motor Development Third Edition Among Children with Developmental Coordination Disorder

AIM

The Test of Gross Motor Development Third Edition (TGMD-3) is used to assess the development of fundamental movement skills in children from 3 to 10 years old. This study aimed to evaluate the intra-rater, inter-rater, and test-retest reliability and to determine the minimal detectable change (MDC) value of the TGMD-3 in children with developmental coordination disorder (DCD).

METHODS

The TGMD-3 was administered to 20 children with DCD. The child's fundamental movement skills were recorded using a digital video camera. Reliability was assessed at two occasions by three raters using the generalizability theory.

RESULTS

The TGMD-3 demonstrates good inter-rater reliability for the locomotor skills subscale, the ball skills subscale, and the total score (φ = 0.77 - 0.91), while the intra-rater reliability was even higher (φ = 0.94 - 0.97). Test-retest reliability was also shown to be good (φ = 0.79-0.93). The MDC95 was determined to be 10 points.

CONCLUSION

This study provides evidence that the TGMD-3 is a reliable test when used to evaluate fundamental movement skills in children with DCD and suggests that an increase of 10 points represents a significant change in the motor function of a child with DCD.

Individuals experiencing disability and the ableist physical literacy narrative: critical considerations and recommendations for practice

Physical literacy (PL) has been readily accepted and integrated globally, including organizations affording services to individuals experiencing disability. Despite its uptake, recent research has illustrated that understandings of PL reflect the normative standards of those who do not experience disability, leading to practices that diminish the unique and embodied capability of others while simultaneously validating ableism. While a shift towards recognizing and valuing the heterogeneity associated with PL has recently occurred, the ableist narrative persists. As a result, the operationalization of PL directly contradicts its conceptualization, fostering a physical activity climate that continues to marginalize individuals experiencing disability. With this in mind, this paper critically unpacks PL, challenging the existing ableist narrative and offering suggestions to heighten the level of inclusivity that underscores PL. Pathways, where physical activity professionals contribute to reproducing ableism, will be discussed.

A Clinical Practice Guide to Enhance Physical Activity Participation for Children with Developmental Coordination Disorder in Canada

Purpose

This clinical practice guide (CPG) aims to provide evidence-based recommendations for promoting and enhancing the participation and integration of children with developmental coordination disorder (DCD) into physical activities that take place in the home, school, community, or rehabilitation clinic contexts.

Methods

A panel of key stakeholders relevant to these contexts (parents, instructors, rehabilitation professionals) developed evidence-based recommendations using a consensus methodology after reviewing results from a recent systematic review of relevant literature. The quality of the evidence on which the recommendations were based was evaluated (2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence scale) as was the strength of the final CPG recommendations (American Society of Plastic Surgeons Grade Recommendation Scale).

Results

Recommendations (n = 50; 36% supported by robust, empirically derived evidence) for the different stakeholder groups fell into three categories: 1) Choose an appropriate activity for your child, 2) Harmonize the activity with the child's interests and abilities, and 3) Help the child learn new movements prior to the activity.

Conclusions

This comprehensive CPG provides concrete recommendations, based on the currently available evidence, that can be used by stakeholders to address the physical activity participation and integration needs of children with DCD in a variety of contexts.

The Effects of Physical Activity in Children and Adolescents with Developmental Coordination Disorder

The purpose of this literature review was to detect and study the effectiveness of therapeutic intervention programs, such as physical activities and sports, on children and adolescents with Developmental Motor Coordination Disorder (DCD) to improve their motor skills. The sample for this study consisted of 48 (100%) papers, specifically, 40 (83.5%) articles, 3 (6.2%) doctoral theses, 2 (4.1%) master's theses and 3 (6.2%) papers from conference proceedings from the year 2014 to 2022. To search the sample, the following terms were used: DCD or dyspraxia, physical activity programs, intervention, physical intervention, physical education, etc. The results for the existence of statistically significant results and internal validity of intervention programs using physical activities and sports in children and adolescents with DCD showed that a large number of intervention programs improved the children's motor skills as well as their daily functionality. In contrast, other interventions failed to improve dynamic and static balance. The negative result could be due either to the short duration of the interventions or to the improper suboptimal design-organization of the methodology of these programs-such as the heterogeneous intervention samples and the use of inappropriate and reliable assessment tools.

Development, explanation, and presentation of the Physical Literacy Interventions Reporting Template (PLIRT)

BACKGROUND

The physical literacy (PL) concept integrates different personal (e.g., physical, cognitive, psychological/affective, social) determinants of physical activity and has received growing attention recently. Although practical efforts increasingly adopt PL as a guiding concept, latest evidence has shown that PL interventions often lack specification of important theoretical foundations and basic delivery information. Therefore, the goal of the present study was to develop an expert-based template that supports researchers and practitioners in planning and reporting PL interventions.

METHODS

The development process was informed by Moher et al.'s guidance for the development of research reporting guidelines. We composed a group of ten distinguished experts on PL. In two face-to-face meetings, the group first discussed a literature-driven draft of reporting items. In the second stage, the experts anonymously voted and commented on the items in two rounds (each leading to revisions) until consensus was reached.

RESULTS

The panel recommended that stakeholders of PL initiatives should tightly interlock interventional aspects with PL theory while ensuring consistency throughout all stages of intervention development. The Physical Literacy Interventions Reporting Template (PLIRT) encompasses a total of 14 items (two additional items for mixed-methods studies) in six different sections: title (one item), background and definition (three items), assessment (one item each for quantitative and qualitative studies), design and content (five items), evaluation (one item plus one item each for quantitative and qualitative studies), discussion and conclusion (two items).

CONCLUSION

The PLIRT was designed to facilitate improved transparency and interpretability in reports on PL interventions. The template has the potential to close gaps between theory and practice, thereby contributing to more holistic interventions for the fields of physical education, sport, and health.

The Effectiveness of Physical Literacy Interventions: A Systematic Review with Meta-Analysis

BACKGROUND

The holistic concept of physical literacy assumes that individuals require adequate cognitive (knowledge and understanding), affective (motivation and confidence), and physical (physical competence) qualities to engage in lifelong physical activity behavior. In recent years, the research field has undergone rapid development and has also yielded an increasing number of interventions that aim to translate the theoretical-philosophical ideas into practical endeavors.

OBJECTIVE

The goal of the present pre-registered systematic review was to (a) provide a general overview of evaluation studies on physical literacy interventions and (b) to quantitatively examine the effectiveness of physical literacy interventions.

METHODS

Drawing on the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched a total of 18 databases for physical literacy interventions. Inclusion criteria were English language, publication by November 2021, and interventions using physical literacy as a theoretical underpinning or evaluation outcome. Articles that met these criteria were analyzed with respect to their basic delivery characteristics, study quality, evaluation approach, and main findings. We additionally ran meta-analyses with all non-randomized and randomized controlled trials to examine and compare the effect of these interventions on five outcome categories: (i) physical competence, (ii) motivation and confidence, (iii) knowledge and understanding, (iv) physical activity behavior, and (v) total physical literacy. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated to assess the effects on the different categories.

RESULTS

The screening process with two independent raters yielded 48 eligible interventions reported in 51 eligible articles. Quantitative evaluations most frequently addressed physical competence (72.2%), followed by motivation and confidence (47.2%), physical activity behavior (41.7%), and knowledge and understanding (33.3%). The controlled intervention studies (n = 24) exerted significant effects on all five physical literacy categories. Despite meaningful heterogeneity across the subgroups, the strongest effects were found for physical competence (SMD 0.90; 95% CI 0.55-1.25), followed by physical literacy aggregate scores (SMD 0.61; 95% CI 0.20-1.01), knowledge and understanding (SMD 0.54; 95% CI 0.30-0.79), physical activity behavior (SMD 0.39; 95% CI 0.23-0.55), and motivation and confidence (SMD 0.30; 95% CI 0.17-0.44).

CONCLUSIONS

The present study empirically demonstrated the effectiveness of physical literacy interventions on several outcomes relevant for promoting physical activity and health. To better inform current practices, future studies are advised to identify those program characteristics that significantly influence the effectiveness of physical literacy interventions.

CLINICAL TRIAL REGISTRATION

PROSPERO CRD42020188926.