Early intervention for children with/at risk of developmental coordination disorder: a scoping review.

Os movimentos das crianças, inicialmente, são caracterizados por ações inconsistentes e imprecisas, mas com a prática e a experiência, os padrões motores tornam-se mais refinados e apresentam melhor coordenação e controle. No entanto, não é raro observar crianças que manifestam certas dificuldades de movimento, podendo interferir nas relações sociais, emocionais, afetivas e escolares das crianças. O estudo investigou a prevalência de Desordem Coordenativa Desenvolvimental (DCD) em escolares com idade entre 7 e 10 anos e, em que tarefas motoras as crianças com provável DCD e risco de DCD apresentam maior dificuldade motora. Foram avaliadas 581 crianças, matriculadas regularmente do 2º ao 5º ano do ensino fundamental de escolas públicas de Maringá-Pr, por meio da bateria II e III do teste Movement Assessment Battery for Children (MABC). Os resultados indicaram que 78,1% das crianças apresentam Desenvolvimento Típico (DT), 10,5% de crianças com risco de Desordem Coordenativa Desenvolvimental (Risco de DCD) e 11,4% de crianças diagnosticadas com potencial Desordem Coordenativa Desenvolvimental (Potencial DCD). Portanto, os resultados demonstraram alta prevalência da população para Risco de DCD e potencial DCD, o que prediz níveis desfavoráveis na aquisição e aperfeiçoamento das habilidades fundamentais, podendo, assim, prejudicar a continuidade do processo de desenvolvimento motor das crianças. A maior dificuldade motora encontrada pelas crianças que apresentaram DT foi nas habilidades manuais, enquanto que para as crianças identificadas com provável DCD e risco de DCD foi nas habilidades com bola.

Motor impairments are pervasive in Autism Spectrum Disorder (ASD); however, children with ASD rarely receive a dual diagnosis of Developmental Coordination Disorder (DCD). The Simons Foundation SPARK study engaged families affected by ASD through an online study. The DCD parent questionnaire (DCDQ) was used to assess the prevalence of a risk for motor impairment or DCD in children with ASD between 5 and 15years of age. This study utilizes parent reports from a large database of children with ASD. A total of 16,705 parents of children with ASD completed the DCDQ. We obtained our final SPARK dataset (n=11,814) after filtering out invalid data, using stronger cut-offs to confirm ASD traits, and excluding children with general neuromotor impairments/intellectual delays. We compared DCDQ total and subscale scores from the SPARK dataset with published norms for each age between 5 and 15years. The proportion of children with ASD at risk for a motor impairment was very high at 86.9%. Children with ASD did not outgrow their motor impairments and continued to present with a risk for DCD even into adolescence. Yet, only 31.6% of children were receiving physical therapy services. Our analysis of a large database of parent-reported outcomes using the DCDQ did not involve follow-up clinical assessments. Using a large sample of children with ASD, this study shows that a risk for motor impairment or DCD was present in most children with ASD and persists into adolescence; however, only a small proportion of children with ASD were receiving physical therapist interventions. A diagnosis of ASD must trigger motor screening, evaluations, and appropriate interventions by physical and occupational therapists to address the functional impairments of children with ASD while also positively impacting their social communication, cognition, and behavior. Using valid motor measures, future research must determine if motor impairment is a fundamental feature of ASD.

To examine cross-sectional differences in patterns of daily physical activity accumulation between preschool children at risk for developmental coordination disorder (DCD) compared to typically developing children. In total, 514 children (292 males, 222 females; 4-5y) were recruited as part of the Coordination and Activity Tracking in CHildren (CATCH) study. Motor competence was assessed using the Movement Assessment Battery for Children, Second Edition; children scoring ≤5th centile comprised the probable DCD group (pDCD, n=87), between the 6th and 16th centile were considered to be at risk for DCD (rDCD, n=149), and >16th centile were considered typically developing (n=278). Seven-day physical activity was measured using hip-worn accelerometers. Average daily intensity of activity, frequency, and duration of moderate-to-vigorous physical activity (MVPA) bouts, and triaxial activity counts per minute were determined. No differences in daily activity in any intensity or axis of movement were found among the three groups. However, young children with pDCD accumulated their MVPA in slightly shorter bouts compared to typically developing children. Young children at risk for DCD are not yet in an activity deficit. This may be because of the low motor skill demands of play in this age group. Early motor interventions may be able to promote continued physical activity participation in children with DCD. Preschool children at risk for developmental coordination disorder (DCD) are not less active than their peers. Overall intensity and frequency of daily activity bouts are similar among motor groups. Children with probable DCD accumulate their activity in shorter bouts.

Role of Intervention Strategies for At-risk Preterm Infants

Early identification of young children at risk of developmental coordination disorder (DCD) can support early intervention and prevent secondary sequelae. To examine the psychometric properties of a translated and cross-culturally adapted version of the Little Developmental Coordination Disorder Questionnaire-Taiwan (LDCDQ-TW). Prospective study. Kindergartens and preschools in north, central, and south Taiwan. In Phase 1 the participants were 1,124 parents of typically developing children ages 36-71 mo. Children with confirmed developmental diagnoses were excluded. Participants in Phase 3 were 162 children who had been recruited in Phase 2. Outcomes and Measures: The LDCDQ-TW, a 15-item parent questionnaire for identifying children at risk for DCD, and the Movement Assessment Battery for Children (2nd ed.; MABC-2), were administered. The findings revealed excellent test-retest reliability (intraclass correlation coefficient [ICC] = .97) and poor interrater reliability (ICC = .47). On the basis of MABC-2 scores, the non-DCD group (≥15th percentile) scored significantly higher than the DCD and suspect-DCD groups on the LDCDQ-TW, but the latter two groups did not differ from one another. Using the 15th percentile as a cutoff for both the MABC-2 and the LDCDQ-TW, sensitivity was .96 and specificity was .68. Although standardized performance-based assessments are required to confirm a diagnosis of DCD (typically after age 5 yr), the LDCDQ-TW demonstrated sound reliability and validity and can support the early identification of young children at risk of DCD in Taiwan. What This Article Adds: The LDCDQ-TW can facilitate early intervention for DCD and prevent secondary sequelae, improving outcomes for children with DCD.

The consequences of developmental co-ordination disorder (DCD) indicate a need for identification in order to provide adequate intervention. The goals of the study were to investigate DCD prevalence across age bands, gender, race and school performance; the motor difficulties of children with DCD, at-risk and typically developing children in the Movement Assessment Battery for Children (MABC) sub-tests across age bands and gender; and the relationship between motor outcomes, age, gender and socio-economic status (SES) in socially disadvantaged Brazilian children. The MABC was administered to 1056 Brazilian children from 4 to 10 years old. Eighteen per cent of the children were screened as probable DCD (≤5th percentile) and a further 15% as at risk for DCD (>5th and ≤15th percentile). Significantly more children were screened with probable DCD at age 9-10 years (AB3: P = 0.00), whereas at risk classification was equally distributed across age bands (P = 0.12). Boys showed lower prevalence than girls of probable DCD and at risk for DCD (P = 0.04). Children (9-10 years) showed higher motor impairment in the manual dexterity test results. Children with probable DCD and at risk of DCD showed, in general, poor performance in balance and manual dexterity tasks. SES was the strongest predictor of motor outcomes, accounting for 21% of the variance in the MABC percentile scores. The prevalence of probable and at-risk DCD cases as well as the percentage of female were higher than those found in the previous studies, and low SES enhances the risk of poor motor development.

School-age children with developmental coordination disorder (DCD) have poor health-related fitness (HRF), but little is known about when these deficits emerge. The purpose of this study was to determine if 4- and 5-yr-old children who meet the criteria for DCD exhibit poorer HRF compared with typically developing (TD) children, and if this relationship is mediated by vigorous physical activity (VPA) engagement. Five hundred and ninety-two children participated (age, 5.0 ± 0.6 yr) from the Coordination and Activity Tracking in CHildren study. Motor skills were assessed using the Movement Assessment Battery for Children-2, with groups defined as having DCD (≤5th percentile), at risk for DCD (6th-16th percentile), and TD (>16th percentile). Measures of body composition included body mass index, waist circumference, and body fat percentage. Musculoskeletal fitness assessments included standing long jump distance, as well as peak and mean power assessed using a 30-s Wingate protocol on a pediatric cycle ergometer. Time to exhaustion on a progressive, treadmill test was used to determine aerobic fitness. Flexibility and VPA were assessed using a sit-and-reach test and 7-d accelerometry, respectively. Children in the DCD group had the poorest musculoskeletal and aerobic fitness, whereas TD children had the highest. No differences in body composition among groups were found. Daily VPA was similar among groups and did not explain HRF differences. Preschool children with DCD have decreased anaerobic and aerobic fitness compared with TD children; however, VPA and body composition seem to be less affected by DCD in the early years. Early motor interventions may be able to improve fitness and reduce the risk of hypoactivity and obesity as children with DCD get older.

Children with Developmental Coordination Disorder (DCD) have poorer fitness and greater internalizing/externalizing problems compared with typically developing (TD) children. The purpose of this study was to examine the potential mediating role of internalizing/externalizing problems on the relationship between children at risk for DCD (DCDr) and physical fitness. Participants (N = 589) included 288 children with DCDr (Mage = 4.9, 67% male) and 301 TD children (Mage = 5.0, 48% male). Motor skills were assessed using the Movement Assessment Battery for Children-2nd edition (DCDr: at or below the 16th percentile, TD: >16th percentile). Parent-reported internalizing/externalizing problems were measured using the Child Behaviour Checklist. Physical fitness was measured using the Bruce protocol maximal treadmill test and a 30-second Wingate test. Tests for indirect (mediation) effects were assessed using the PROCESS v3.5 software macro. Children with DCDr had higher internalizing and externalizing problems (p < 0.001, d = 0.35-0.46) and poorer fitness levels (p < 0.001, ηp2 = 0.05-0.09). Internalizing problems mediated fitness performance on both the treadmill and Wingate test; however, externalizing problems showed no mediating effects. Thus, interventions targeting internalizing problems may contribute to improving performance on fitness-based tasks among children with DCDr. Novelty: Children at risk for DCD have poorer fitness when compared with TD children. Children at risk for DCD experience greater internalizing/externalizing problems. Internalizing problems were found to mediate the DCD-physical fitness relationship.

Limited information on early risk factors of Developmental Coordination Disorder (DCD) exists, especially in term-born children. We examined possible causal effects of early risk factors on DCD in predominantly term-born children. An add-on study to the Dutch Lifelines Cohort was performed in 2017. All 5-to-12-year-olds and their parents were included (n = 5479). Children were identified as at risk for DCD when the Developmental Coordination Disorder Questionnaire 2007 indicated suspicion of DCD, and as having probable DCD when another questionnaire, the DCD Daily Questionnaire, also suggested DCD. Causal graphs and multiple logistic regression models were used, including covariates sex, preterm birth (birth < 37 weeks), maternal education, parental subfertility, maternal smoking, and neonatal admission to the paediatric ward. 5479 children were identified; the response rate was 34% (n = 1856). 1722 children (50% male, 50% female sex; mean age 8.6 years) remained after exclusion for missing data. The prevalence of at risk for DCD and probable DCD was 13.0% (n = 223) and 5.9% (n = 100), respectively. Only male sex and neonatal admission to the paediatric ward had a direct causal effect on at risk for DCD and probable DCD. In the large Lifelines population, only male sex and neonatal admission were risk factors for DCD.

Little research has been produced about literacy readiness in Kindergarten children at risk for Developmental Coordination Disorder (DCD), despite this age being one of the most important epoch of motor and cognitive development. In this study we compared pre-literacy skills in Kindergarten children at risk for Developmental Coordination Disorder (DCD) with Typically Developing (TD) children. Participants were 26 Italian children, who had a mean age of 5.1 years, 13 at risk for DCD and 13 TD attending kindergarten schools. Pre-literacy abilities were measured trough tasks derived by the Italian PRCR-2 battery: Semi-circles (A and B), Letter identification and Object Naming Time. Significant differences were found between children at risk for DCD and TD children on tasks of visual memory of printed signs, visual analysis ability, visual discrimination and attention and sequentiality of eye movements. Findings suggest the need to implement pre-school cognitively challenging motor activities programs to enhance manual dexterity, aiming and catching skills as well as static and dynamic balance at early age Little research has been produced about literacy readiness in Kindergarten children at risk for Developmental Coordination Disorder (DCD), despite this age being one of the most important epoch of motor and cognitive development. In this study we compared pre-literacy skills in Kindergarten children at risk for Developmental Coordination Disorder (DCD) with Typically Developing (TD) children. Participants were 26 Italian children, who had a mean age of 5.1 years, 13 at risk for DCD and 13 TD attending kindergarten schools. Pre-literacy abilities were measured trough tasks derived by the Italian PRCR-2 battery: Semi-circles (A and B), Letter identification and Object Naming Time. Significant differences were found between children at risk for DCD and TD children on tasks of visual memory of printed signs, visual analysis ability, visual discrimination and attention and sequentiality of eye movements. Findings suggest the need to implement pre-school cognitively challenging motor activities programs to enhance manual dexterity, aiming and catching skills as well as static and dynamic balance at early age

The aims of the study were to compare the performance of children with probable developmental coordination disorder (DCD) and motor typically developing peers on items from the Assessment of Motor Coordination and Dexterity (AMCD), to determine whether age, gender and type of school had significant impact on the scores of the AMCD items, to estimate the frequency of DCD among Brazilian children ages 7 and 8 years and to investigate whether children with DCD exhibit more symptoms of attention deficit and hyperactivity disorder than children with motor typical development. A total of 793 children were screened by the Developmental Coordination Disorder Questionnaire - Brazilian version (DCDQ-Brazil); 90 were identified as at risk for DCD; 91 matched controls were selected from the remaining participants. Children in both groups were evaluated with the AMCD, the Movement Assessment Battery for Children (MABC-II) and Raven's coloured progressive matrices. Thirty-four children were classified as probable DCD, as defined by a combination of the DCDQ-Brazil and MABC-II scores (fifth percentile). The final frequency of DCD among children ages 7 and 8 years was 4.3%. There were significant differences between children with and without DCD on the majority of AMCD items, indicating its potential for identifying DCD in Brazilian children. The use of a motor test (MABC-II) that is not validated for the Brazilian children is a limitation of the present study. Further studies should investigate whether the AMCD is useful for identifying DCD in other age groups and in children from different regions of Brazil. The application of the AMCD may potentially contribute in improving occupational therapy practice in Brazil and in identifying children that could benefit from occupational therapy services.

Children with Developmental Coordination Disorder (DCD) and children at risk for DCD (r-DCD) present motor impairments interfering in their school, leisure and daily activities. In addition, these children may have abnormalities in their cardiac autonomic control, which together with their motor impairments, restrict their health and functionality. Therefore, this study aimed to assess the cardiac autonomic control, by linear and nonlinear analysis, at supine and during an orthostatic stimulus in DCD, r-DCD and typically developed children. Thirteen DCD children (11 boys and 2 girls, aged 8.08 ± 0.79 years), 19 children at risk for DCD (13 boys and 6 girls, aged 8.10 ± 0.96 years) and 18 typically developed children, who constituted the control group (CG) (10 boys and 8 girls, aged 8.50 ± 0.96 years) underwent a heart rate variability (HRV) examination. R-R intervals were recorded in order to assess the cardiac autonomic control using a validated HR monitor. HRV was analyzed by linear and nonlinear methods and compared between r-DCD, DCD, and CG. The DCD group presented blunted cardiac autonomic adjustment to the orthostatic stimulus, which was not observed in r-DCD and CG. Regarding nonlinear analysis of HRV, the DCD group presented lower parasympathetic modulation in the supine position compared to the r-DCD and CG groups. In the within group analysis, only the DCD group did not increase HR from supine to standing posture. Symbolic analysis revealed a significant decrease in 2LV (p < 0.0001) and 2UV (p < 0.0001) indices from supine to orthostatic posture only in the CG. In conclusion, r-DCD and DCD children present cardiac autonomic dysfunction characterized by higher sympathetic, lower parasympathetic and lower complexity of cardiac autonomic control in the supine position, as well as a blunted autonomic adjustment to the orthostatic stimulus. Therefore, cardiovascular health improvement should be part of DCD children's management, even in cases of less severe motor impairment.

To determine the validity of standing long jump (SLJ) for predicting muscle power in children with and without developmental coordination disorder (DCD). A total of 589 children were recruited as part of the Coordination and Activity Tracking in CHildren study (251 girls and 338 boys; mean age 59.2 mo). Children were classified as typically developing (>16th percentile), at risk for DCD (sixth to 16th percentile), or probable DCD (<sixth percentile) based on Movement Assessment Battery for Children-Second Edition scores. SLJ was measured from the back of the heel. Peak power and mean power over 10 seconds and 30 seconds were measured using the Wingate test. SLJ was moderately correlated with peak and mean powers in all groups (R = .51-.55). Regression analysis showed that when combined with weight and age, SLJ performance could predict peak power and mean power over 10 seconds and 30 seconds in typically developing children (adjusted R2 = .68, .61, and .58, P < .001, respectively) and in children with risk for DCD (adjusted R2 = .74, .65, and .60, respectively) and probable DCD (adjusted R2 = .68, .61, and .59, respectively). SLJ, in combination with weight and age, may be used to measure muscle power in typically developing children, and in children with risk for DCD and probable DCD. This measure can be used as an inexpensive estimate of musculoskeletal fitness in children regardless of motor abilities.

The objective of this study was to determine whether school readiness differs between children born <30 weeks' gestation who are classified as at risk for developmental coordination disorder (DCD) and those who are not. This study was a prospective cohort study of children born <30 weeks' gestation. Children were classified as at risk for DCD at a corrected age of 4 to 5 years if they scored <16th centile on the Movement Assessment Battery for Children-Second Edition (MABC-2), had a full scale IQ score of ≥80 on the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV), and had no cerebral palsy. Children were assessed on 4 school readiness domains: (1) health/physical development [Physical Health domain of Pediatric Quality of Life Inventory (PedsQL), Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and Little Developmental Coordination Disorder Questionnaire], (2) social-emotional development (Strengths and Difficulties Questionnaire and PedsQL psychosocial domains), (3) cognitive skills/general knowledge (WPPSI-IV), and (4) language skills (WPPSI-IV). Of 123 children assessed, 16 were ineligible (IQ < 80 or cerebral palsy: n = 15; incomplete MABC-2: n = 1); 28 of 107 (26%) eligible children were at risk for DCD. Children at risk for DCD had poorer performance on all school readiness domains, with group differences of more than 0.4 SD in health/physical development, social-emotional development, and language skills and up to 0.8 SD for cognitive skills/general knowledge compared with those not at risk of DCD. Being at risk for DCD in children born <30 weeks' gestation is associated with challenges in multiple school readiness domains, not only the health/physical domain.

Can children at risk for developmental coordination disorder step-clap to the beat? Evidence from an online motion tracking study.