Commentary on "Responsiveness of clinical and laboratory measures to intervention effects in children with developmental coordination disorder".

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“How could I apply this information?” The authors raise important questions in selecting appropriate outcome measures to detect change over time including the following: Are you assessing individual or population outcomes? Are you assessing change in participation and function or movement strategies? What are the parents' and children's goals and expectations? How clinically accessible and relevant is the selected measure? These authors reinforce the importance of using outcome measures to determine whether the selected intervention affects the overall goals of the child and family. The Movement Assessment Battery for Children, 2nd Edition (MABC-2), is an activity and participation outcome measure, whereas the Movement Analysis Laboratory (MAL) measures assess movement strategies or body structure and function as described by the International Classification of Functioning, Disability and Health model.1 The MABC-2 detected individual changes; however, although statistically significant changes were noted, neither measure was associated with meaningful change as reported by parents and children. This suggests the importance of understanding and addressing goals that are meaningful to the children and parents as well as the need to educate parents and children on the observed changes in body structure and function that result from chosen interventions and how these might affect the child's overall function. “What should I be mindful about when applying this information?” The movement patterns of children with developmental coordination disorder are heterogeneous, making reliable measures of movement strategies challenging. Furthermore, measuring change in movement strategies alone may not be sufficient or feasible in the clinic; an additional outcome measure would be needed to capture activity and participation level outcomes, which can add time and be challenging for the child, but may be more relevant. Assessing the efficacy of any intervention requires the selection of an appropriate tool that measures the desired outcomes and demonstrates both statistical and meaningful changes. Use of the MAL measures, not typically available in the clinical setting, along with the small sample size and limited age range limits generalizability and transferability of the results of this study to the clinic setting. Margaret M. Plack, PT, DPT, EdD The George Washington University Washington, DC Marisa Birkmeier, PT, DPT, PCS The George Washington University, Children's National Health System Washington, DC