Developmental coordination disorder, psychopathology and IQ in 22q11.2 deletion syndrome.

Adam C Cunningham,Sue Delport,David E J Linden,Monica Busse,Jeremy Hall,Marianne B M Van Den Bree,Wendy Cumines,Michael J Owen

doi:10.1192/bjp.2017.6

Abstract

22q11.2 deletion syndrome (22q11.2DS) is associated with high rates of neurodevelopmental disorder, however, the links between developmental coordination disorder (DCD), intellectual function and psychiatric disorder remain unexplored. Aims To establish the prevalence of indicative DCD in children with 22q11.2DS and examine associations with IQ, neurocognition and psychopathology. Neurocognitive assessments and psychiatric interviews of 70 children with 22q11.2DS (mean age 11.2, s.d. = 2.2) and 32 control siblings (mean age 11.5, s.d. = 2.1) were carried out in their homes. Nine children with 22q11.2DS and indicative DCD were subsequently assessed in an occupational therapy clinic. Indicative DCD was found in 57 (81.4%) children with 22q11.2DS compared with 2 (6.3%) control siblings (odds ratio (OR) = 36.7, P < 0.001). Eight of nine (89%) children with indicative DCD met DSM-5 criteria for DCD. Poorer coordination was associated with increased numbers of anxiety, (P < 0.001), attention-deficit hyperactivity disorder (ADHD) (P < 0.001) and autism-spectrum disorder (ASD) symptoms (P < 0.001) in children with 22q11.2DS. Furthermore, 100% of children with 22q11.2DS and ADHD had indicative DCD (20 of 20), as did 90% of children with anxiety disorder (17 of 19) and 96% of children who screened positive for ASD (22 of 23). The Developmental Coordination Disorder Questionnaire score was related to sustained attention (P = 0.006), even after history of epileptic fits (P = 0.006) and heart problems (P = 0.009) was taken into account. Clinicians should be aware of the high risk of coordination difficulties in children with 22q11.2DS and its association with risk of mental disorder and specific neurocognitive deficits. Declaration of interest None.

Highlights

This was achieved by conducting the gold-standard Movement Assessment Battery for Children-2 (MABC-2)[22] in an occupational therapy clinic in a subset of nine of the children with indicative developmental coordination disorder (DCD), to ensure that the Developmental Coordination Disorder Questionnaire (DCDQ) is accurately reflecting coordination difficulties in this population
We aimed to explore the relationship between indicative DCD and IQ and specific neurocognitive functions in this population
In children with 22q11.2DS, DCDQ score was not related to set shifting ability, or total errors on the Wisconsin Card Sorting Test 32 (WCST), nor the processing speed, spatial planning, and spatial working memory (SWM) tasks of the Cambridge Neuropsychological Test Automated Battery (CANTAB)

Summary

Background

22q11.2 deletion syndrome (22q11.2DS) is associated with high rates of neurodevelopmental disorder, the links between developmental coordination disorder (DCD), intellectual function and psychiatric disorder remain unexplored. Aims To establish the prevalence of indicative DCD in children with 22q11.2DS and examine associations with IQ, neurocognition and psychopathology. Method Neurocognitive assessments and psychiatric interviews of 70 children with 22q11.2DS Nine children with 22q11.2DS and indicative DCD were subsequently assessed in an occupational therapy clinic. Hyperactivity disorder (ADHD) (P < 0.001) and autism-spectrum disorder (ASD) symptoms (P < 0.001) in children with 22q11.2DS. 100% of children with 22q11.2DS and ADHD had indicative DCD (20 of 20), as did 90% of children with anxiety disorder (17 of 19) and 96% of children who screened positive for ASD (22 of 23).

Results

Participants

Discussion

Findings

Strengths and limitations