Assessment of Developmental Coordination Disorder in Children Born With Extremely Low Birth Weights

Abstract

There is no tool that is considered the “gold” standard for identifying children with developmental coordination disorder (DCD) and various techniques have been reported in the research literature. The aim of this study was to examine the prevalence of DCD in a cohort of extremely low birth weight (ELBW; birth weight ≤ 1,000g) children at age 5 years using various methods including standardized motor assessment measures, an established clinic protocol, and a parent report. We also examined the association between selected neonatal risk factors and severity of the motor impairment. Four methods were used to assess motor functioning: (1) the Movement Assessment Battery for Children (Movement ABC); (2) a motor assessment battery, which included the Movement ABC, the Beery-Buktenica Developmental Test of Visual Motor Integration, and the Developmental Test of Visual Perception–2; (3) a Perinatal Follow-up Clinic protocol, which included the Geometric Design and the Mazes subtests of the Wechsler Preschool and Primary Scale of Intelligence–Revised, the Fine and Gross Motor subscales of the Child Development Inventory, and a pediatric neuromotor exam; and (4) a parent completed questionnaire (i.e., Developmental Coordination Disorder Questionnaire (DCDQ)). The prevalence of motor impairment in ELBW children was 64% on the Movement ABC, 67% on the motor assessment battery, 66% on the Perinatal Follow-up Clinic protocol, and 26% on the DCDQ. Sensitivity ranged from 36% to 100% and specificity from 65% to 92% using the Movement ABC as the reference standard. Neonatal risk factors associated with increased severity of motor impairment were bronchopulmonary dysplasia, postnatal steroids, and increasing gestational age. Children with birth weights ≤1,000 g are at considerable risk for motor impairment; therefore, developmental evaluations should include an assessment of motor functions. A standardized motor assessment test such as the Movement ABC appears to be the most effective and efficient means of identifying motor impairment in this high-risk population.