Criteria For Developmental Coordination Disorder Research Articles

Crossing the North Sea seems to make DCD disappear: Cross-validation of Movement Assessment Battery for Children-2 norms

The Movement Assessment Battery for Children has been revised as the Movement ABC-2 (Henderson, Sugden, & Barnett, 2007). In Europe, the 15th percentile score on this test is recommended for one of the DSM-IV diagnostic criteria for Developmental Coordination Disorder (DCD). A representative sample of Dutch and Flemish children was tested to cross-validate the UK standard scores, including the 15th percentile score. First, the mean, SD and percentile scores of Dutch children were compared to those of UK normative samples. Item standard scores of Dutch speaking children deviated from the UK reference values suggesting necessary adjustments. Except for very young children, the Dutch-speaking samples performed better. Second, based on the mean and SD and clinical relevant cut-off scores (5th and 15th percentile), norms were adjusted for the Dutch population. For diagnostic use, researchers and clinicians should use the reference norms that are valid for the group of children they are testing. The results indicate that there possibly is an effect of testing procedure in other countries that validated the UK norms and/or cultural influence on the age norms of the Movement ABC-2. It is suggested to formulate criterion-based norms for age groups in addition to statistical norms.

Coupling online control and inhibitory systems in children with Developmental Coordination Disorder: Goal-directed reaching.

For children with Developmental Coordination Disorder (DCD), the real-time coupling between frontal executive function and online motor control has not been explored despite reported deficits in each domain. The aim of the present study was to investigate how children with DCD enlist online control under task constraints that compel the need for inhibitory control. A total of 129 school children were sampled from mainstream primary schools. Forty-two children who met research criteria for DCD were compared with 87 typically developing controls on a modified double-jump reaching task. Children within each skill group were divided into three age bands: younger (6-7 years), mid-aged (8-9), and older (10-12). Online control was compared between groups as a function of trial type (non-jump, jump, anti-jump). Overall, results showed that while movement times were similar between skill groups under simple task constraints (non-jump), on perturbation (or jump) trials the DCD group were significantly slower than controls and corrected trajectories later. Critically, the DCD group was further disadvantaged by anti-jump trials where inhibitory control was required; however, this effect reduced with age. While coupling online control and executive systems is not well developed in younger and mid-aged children, there is evidence of age-appropriate coupling in older children. Longitudinal data are needed to clarify this intriguing finding. The theoretical and applied implications of these results are discussed.

Distinct patterns of cortical thinning in concurrent motor and attention disorders.

Many neurodevelopmental disorders co-occur yet are rarely studied in terms of brain development. Developmental coordination disorder (DCD) and attention-deficit-hyperactivity disorder (ADHD) co-occur at a high frequency and are associated with functional and structural brain alterations. The objective of this study was to examine whether the effects of comorbid motor and attention problems influence cortical thickness in children and whether the pattern of changes for concurrent disorders is distinct from the alterations seen in single disorders. A total of 34 children (19 males, 15 females, mean age 9y 9mo, range 8-17y) who met the criteria for DCD (n=14), ADHD (n=10), or DCD+ADHD (n=10) were recruited into the study. Fourteen participants with typical development (eight males, six females, mean age 11y 9mo, range 8-17y) were also recruited for comparison. Participants underwent neuropsychological assessment and magnetic resonance imaging. Cortical thickness analysis was performed to determine the patterns of cortical thinning in each disorder, which was then compared across groups. Children with comorbid DCD+ADHD demonstrated more widespread decreases in cortical thickness than participants with a diagnosis of DCD or ADHD alone. Cortical thinning was found to be concentrated in the frontal, parietal, and temporal lobes, and was correlated with measures of motor and attentional functioning. The co-occurrence of DCD+ADHD was associated with a distinct global pattern of regional cortical thickness decrease, highlighting the unique neurobiology of comorbid neurodevelopmental disorders. This novel feature of concurrent DCD and ADHD may help inform diagnostic definitions and provide clues to both the shared and the isolated genetic and environmental origins of motor and attention disorders.

Mild impairments of motor imagery skills in children with DCD

It has been hypothesized that the underlying mechanism of clumsy motor behaviour in children with Developmental Coordination Disorder (DCD) is caused by a deficit in the internal modelling for motor control. An internal modelling deficit can be shown on a behavioural level by a task that requires motor imagery. Motor imagery skills are suggested to be related to anticipatory action planning, but motor imagery and action planning have not been tested within the same child. In the present study, action planning and motor imagery skills were assessed in 82 children between 7 and 12 years of age. Twenty-one of these children met the criteria for DCD, which was assessed by the McCarron Assessment of Neuromuscular Development and 56 of these children were used in the control group. Motor imagery was tested by a mental rotation task of hands that were shown from a back and palm point of view. The results show that motor imagery is affected in children with DCD but only in conditions with complex task constraints (i.e., rotation of hand stimuli presented in palm view). These results provide partial support for the internal modelling deficit hypothesis. We were not able to elicit motor planning deficits in this group, however, and argue that more complex planning tasks may be needed to identify such deficits.

The prenatal, perinatal and neonatal risk factors for children's developmental coordination disorder: A population study in mainland China

We initially conducted a population-based study on developmental coordination disorder (DCD) in mainland China to explore the prenatal, perinatal and neonatal risk factors on DCD. A total of 4001 children were selected from 160 classes in 15 public nursery schools. The Movement Assessment Battery for Children-Second Edition (MABC-2) was used to assess the children's motor function. Crude and adjusted odds ratios were estimated to determine the strength of association using a multilevel logistic regression model with a random intercept. Three hundred and thirty children out of 4001 subjects met the DSM-IV criteria for DCD, and 3671 children were non-DCD. Maternal age, threatened abortion, fetal distress during labor, preterm birth, chronic lung disease and newborn pathological jaundice were related with DCD (OR=1.72, 2.72, 9.14, 5.17, 1.43, and 2.54, respectively, each p<0.05). Considered collectively, these risk factors may provide clues to an etiology of DCD. Additionally, the practitioners of maternity and child health care should improve the assessment and monitoring of the prenatal, perinatal and neonatal risk factors for DCD.

Critical triangulation of a movement test, questionnaires, and observational assessment for children with DCD

Aims: Standardised assessment tools for developmental coordination disorder (DCD) do not always seem to agree with each other, which causes problems in making clinical and research decisions. This case study research aims to first determine whether or not three standardised assessment tools converge on diagnostic categories of DCD and, second, examine how useful observational assessment is to understanding the intervention process and the outcomes for selected children who exhibited discrepancies between the standard assessment tools. Methods: Based on the case formulation approach, a 7-week individual intervention program was developed for seven children who had delayed motor development and did not meet the DSM diagnostic exclusion criteria for DCD. The observational assessment of this 7-week, weekly intervention was documented, and a motor performance test and two questionnaires were administered before and after the intervention program. The authors examined the consistency and the discrepancies between the assessment tools regarding diagnostic status by employing methodological triangulation of the observational assessment, the movement test and the questionnaires. Results: The three standardised assessment tools agreed on the DCD categories of four out of the seven children both before and after the intervention. The standardised assessment tools produced discrepant results in the DCD categories of four children. Insights gained from the observational assessment could explain some of the reasons behind the discrepancies. Conclusions: Clinicians and researchers need to recognise discrepancies between different standardised assessment tools, not as errors, but as reflections of multiple aspects of motor development. Critical triangulation serves this purpose. Observational assessment can be useful to reconcile the discrepancy between standardised assessment tools and to make an ultimate clinical judgement for the diagnosis of DCD.

Assessments Used to Diagnose Developmental Coordination Disorder: Do Their Underlying Constructs Match the Diagnostic Criteria?

ABSTRACTThis study examined the constructs underlying the Movement Assessment Battery for Children-2 (M-ABC-2), Bruninks-Oseretsky Test of Motor Proficiency (BOTMP) and Vineland Adaptive Behavior Scale-2 (VABS-2) using the framework of the International Classification of Functioning Disability and Health—Child Youth version (ICF-CY) and the diagnostic criteria of developmental coordination disorder (DCD). Two independent raters coded and matched items to ICF-CY codes as per the eight ICF linking rules developed by Cierza and colleagues. Content density and inter-rater reliability were also calculated. The majority of codes assigned to the M-ABC-2 and BOTMP related to body functions (54% and 64% respectively). For the VABS-2, 91% of codes pertained to activities and participation. The M-ABC-2, BOTMP, and the VABS-2 emphasize the ICF-CY constructs differently. The VABS-2 may be useful in the evaluation of performance of daily life activities and participation in children with DCD.

A case study to evaluate balance training with movement test items and through teaching observation: beyond specificity and transfer of learning

Background: Specificity and transfer of learning have been examined in experimental studies. However, their findings may not be relevant to practitioners because of the difference between the experiment conditions and teaching situations. This case study investigates the theoretical issue of specificity vs. transfer of learning by conducting balance training with real-life (functional) tasks and evaluating the teaching outcomes through teaching observation of functional task performance and on the performance of balance tests. Purpose: To describe how a case formulation approach to problem-driven intervention for common balance problems in children can be conducted on the bases of eclectic theories, and to explore the reasons why observed learning outcomes of balance training can be, or can not be reflected on the performance of balance test items. Participants and setting: Two children who met the diagnostic criteria of developmental coordination disorder participated in this study. They were individually taught by student teachers at a teaching and research laboratory for 17 weeks over a 28-week period. Research design: We used a mix-method multiple case study design with two cases to test the alternative hypotheses, specificity vs. transfer of learning by theoretical generalization, in which each case is tested against the hypotheses. Data collection: The effects of balance training were assessed with the Movement Assessment Battery for Children (MABC) and through teaching observation of functional task performance. Data analysis: The analytical method of pattern matching was used to examine the match between the improvement patterns shown by balance test tasks and real-life balance tasks. Findings: Training resulted in an improvement of the balance skills that corresponded with the sets of tasks and environments employed for the specific balance training in one case. In the other case improved performance occurred not only on the trained balance tasks, but also on the performance test balance tasks in the MABC. Conclusions: Transfer and specificity of learning can be explained by the similarities between teaching tasks and test items, the directions of transfers, and the possible contributions of non-balance factors.

Cross-sectional study of executive functioning in children with developmental coordination disorders.

BackgroundChildren with Developmental Coordination Disorder (DCD) have multiple impairments in movement, in learning, and in the activities of daily living. Studies from other countries have associated these impairments with cognitive function, particularly executive functioning, but these findings have not been confirmed in China.AimCompare the executive functioning of children with DCD with that of normal children.MethodsThe Wisconsin Card Sorting Test (WCST) was administered to 39 children who met DSM-IV criteria of DCD identified at the Seventh People's Hospital of Hangzhou from March 2008 through March 2010. The WCST was also administered to a control group of 39 randomly selected children from one elementary school in Hangzhou.ResultsThe total responses on the WCST and the number of non-perseverative errors for cases and controls were similar, but cases had significantly more errors, more perseverative responses and more perseverative errors; moreover, they completed fewer categories than controls and required more trials to complete the first category.ConclusionOur study confirms previous studies which show significantly impaired executive functioning in patients with DCD. Collectively, these studies suggest that the deficits in executive functioning of children with DCD significantly impair their intellectual and social development.

P-348 - Importance of multidimensional assessment to refine subtypes of developmental coordination disorder

The DSM-IV-TR criteria for Developmental Coordination Disorder (DCD) involve a marked impairment in the development of motor coordination although visuo-spatial, digital and visuo-motor perception, neuromuscular tone, qualitative and quantitative measures of gross and fine motor coordination related impairments might be used to isolate three main subtypes of DCD/dyspraxia: ideo-motor, visuo-spatial and constructional, and a mix group sharing common impairments with additional comorbidities. This study focus on isolating specific markers of coordination disorder and their interactions in mix vs. pure form of dyspraxia. Tree-based bagged classifiers were used to highlight relevant markers among 49 pass/fail tests that best discriminate two clinical subgroups based on a sample (N = 63) of 5–15 years old children having IQ in the expected range (40% mix dyspraxia). Model calibration was done on a training sample through nested repeated 5-fold cross-validation while predictive performance were assessed on a held-out validation sample, using a split ratio of 0.7/0.3. We found that digital praxia, imitation of gestures, manual dexterity, digital perception, lego blocks, and visual motor integration were among the top most important impairments when predicting subtypes. Specific interactions among those predictors and other impairments (motor pathway, visual evoked potential, language) were shown to provide additional insights into DCD subtyping. Taylored follow-up of patients presenting with DCD should consider the specificity of visuo-spatial, neuromotor and neuropsychological impairments whose co-occurrence allow to define different subtypes of DCD.

Participation patterns of school-aged children with and without DCD

Participation is recognized as a key to one's health and well-being and is considered to be a vital part of the development of children and youth. The purpose of this study was to examine the participation patterns of children with and without Developmental Coordination Disorder (DCD) in their out-of-school-time (OST) activities, and to see whether there is a relationship between the children's motor abilities and their choices and participation. Methods: 50 children (5–7 years old), 25 who met diagnostic criteria of DCD and 25 without DCD, completed the Children Assessment of Participation and Enjoyment (CAPE) and were administered the Motor Assessment Battery for Children (MABC) and the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI). Results: A relationship was found between participation patterns and motor ability. Children with DCD had limited participation diversity in which they participated less frequently, and chose activities that were quieter and more socially isolated compared to children without DCD; there were no differences in their levels of enjoyment. Conclusions: The present study emphasizes the importance of looking at the children's participation from a broad perspective, and the many difficulties children with DCD experience in OST participation. Future studies might consider other factors (e.g., environment) while examining participation among children with DCD.

Services for children with developmental co‐ordination disorder: the experiences of parents

Parents provide valuable information on their experiences of engaging with therapy services for their children, which can inform the future development of these services. The aim of this study was to explore the views and experiences of parents who had accessed therapy services for their child with developmental co-ordination disorder (DCD). Seven focus groups were conducted incorporating 52 parents who had a child diagnosed with, or fitting the diagnostic criteria for DCD. Focus groups were audiotaped, transcribed and analysed thematically. Parents reported struggling to gain access to therapy services. When they gained access, they found the services beneficial for their child but continued to experience difficulties regarding the quality of service delivery. The study suggests that parents thought some health-care professionals lacked knowledge and understanding of DCD, which they believed impacted upon early recognition and access to services. They perceived that therapy at an early age was vital for children's development, and indicated that a clearer path for accessing these services was necessary in addition to improved service quality. They called for an increase in awareness of DCD by all therapy service professionals to aid early recognition and improved treatment.

A staged approach for identifying children with developmental coordination disorder from the population

The purpose of this study was to describe the motor, attention and intellectual characteristics of a population-based sample of children first screened for motor impairment and to discuss the recruitment and identification methods employed. A two stage cross-sectional, school-based survey was conducted to screen for children with motor coordination difficulties and to identify children with an existing diagnosis of attention deficit hyperactivity disorder/attention deficit disorder (ADHD/ADD). The identified children, and a random sample of typically developing children, were assessed to confirm or rule out the presence of developmental coordination disorder (DCD).Six thousand four hundred and seventy five children were invited to participate; 2943 children, with parental consent, completed the initial screening process. Two hundred eighty four children with possible motor impairment were identified. The parents of 113 children consented to a full assessment. Sixty eight children of the 113 children met diagnostic criteria for DCD, and 26 also had ADHD. Twenty eight of the 55 children who screened in with a diagnosis of ADHD were subsequently found to have DCD. The total number of children with confirmed characteristics of DCD was reduced after application of DCD diagnostic criteria. This study differs from others with regard to the additional screening for children with ADHD/ADD. The second stage assessment notably increased the number of children identified with both ADHD and DCD.

Developmental Coordination Disorder and cerebral palsy: Categories or a continuum?

Developmental Coordination Disorder (DCD) is a movement disorder affecting between 1.7% and 6% of children aged 5–11 years. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision codes DCD as an Axis I Clinical Disorder. If there is neurological involvement, as is the case for cerebral palsy, the movement disorder would be coded as an Axis III General Medical Condition. What little is known of the aetiology of DCD implicates neurological involvement. In a previous co-twin control study of monozygotic twins concordant and discordant for DCD, seven of the nine twins who met criteria for DCD on the McCarron Assessment of Neuromuscular Development experienced perinatal oxygen perfusion problems, while another experienced prenatal complications. This supported findings in an earlier study of a relationship between environmental factors and DCD, and strengthened the hypothesis that DCD and cerebral palsy have similar causal pathways and may fall on a continuum of movement disorder rather than being discrete categories. In the present paper, this hypothesis is tested by application of the nine principles identified by Sir Austin Bradford Hill as important when considering observed associations between two variables. Implications for prevention, clinical intervention, policy, and classification systems are discussed.

Developmental coordination disorder in children.

Objective In this article, a motor skill disorder called developmental coordination disorder (DCD), that is usually first diagnosed during childhood, is explained and discussed. In the year 1987, DCD was formally recognized as a distinct disorder in children by the American Psychiatric Association (APA). DCD is a generalized term for the children who have some degrees of impairment in the development of motor coordination and therefore have difficulties with physical skills which significantly interfere with their academic achievements and /or performing everyday activities. As they develop, other age-related tasks are also below average. Because these impairment & conditions are often associated with emotional distress, they can seriously interfere with the person's everyday life and social relationships. Reviews indicate that most of the training rocedures have only a limited effect on the development of general coordination, and that they have no effect at all on academic progress. This includes approaches based on assumed underlying deficiencies such as sensory integration deficits and kinesthetic functioning deficits, as well as the more traditional perceptual - motor training. One new approach is Cognitive Orientation to daily Occupational Performance (CO-OP), based on problem - solving strategies and guided discovery of the child and task specific strategies. The aim of this article was to inform, promote and disseminate more information about some difficulties in applying the diagnostic criteria for DCD. Also, a brief review of the researches on the intervention methods is presented.

Developmental coordination disorder and other motor control problems in girls with autism spectrum disorder and/or attention-deficit/hyperactivity disorder

Examine the rate, predictors, and effect on daily life skills of developmental coordination disorder (DCD) and other motor control difficulties in school age girls with autism spectrum disorder (ASD) and/or attention-deficit/hyperactivity disorder (ADHD), in preschool age girls with ASD referred to a neuropsychiatric clinic, and in a community sample of school age girls. The girls (131 in total) were examined with standardised test of motor function and parent interviews and questionnaires. The school girls were compared with 57 age-and IQ-matched girls from the community. DCD was diagnosed in 25% of clinic school girls with ASD, in 32% of those with ADHD, and in 80% of the clinic preschool girls with ASD. Parents reported more motor problems in the school age clinic group. Agreement between a brief motor screening test and a full comprehensive motor examination was moderate to good in the clinic group. Young age, autistic symptomatology, and low performance IQ predicted more motor coordination problems. Motor coordination problems were related to lower ability in daily life skills even when the effect of PIQ was controlled for. A large minority of school girls with ASD and/or ADHD, and a majority of preschool girls with ASD meet full diagnostic criteria for DCD. Their motor problems contribute to reduced activity in daily life even when the effects of IQ have been partialled out.

An Investigation Into Etiological Pathways of DCD and ADHD Using a Monozygotic Twin Design

We previously described a co-twin control design using questionnaire data on monozygotic twins discordant and concordant for developmental coordination disorder (DCD) and attention deficit hyperactivity disorder (ADHD). Our results suggested that DCD and developmental ADHD had different causal pathways, and that second-born twins were at higher risk for oxygen perfusion problems than first-born twins. In the current study we further explored our findings using DNA confirmed zygosity and assessments of 4 female and 10 male sets of monozygotic twins, aged 8 to 17 years, from the first study. Using the McCarron Assessment of Neuromuscular Development (MAND), twice as many second- as first-born twins met criteria for DCD. Second-born twins attained significantly lower scores on 1-minute Apgar, MAND Gross Motor, Bimanual Dexterity and Neuromuscular Development Index. Seven of the nine twins who met criteria for DCD experienced perinatal oxygen perfusion problems. This supported findings in the first study of an association between perinatal oxygen perfusion problems and DCD, and our hypothesis that DCD and cerebral palsy have similar causal pathways. We found similar numbers of males and females discordant for DCD. On telephone interview using the Diagnostic Interview Schedule for Children Parent Interview, the only first-, and all five second-born twins who met criteria for ADHD had an inattentive component - three Inattentive; three Combined. All twins positive for ADHD were male. This adds support to our hypothesis that ADHD symptoms found in some participants may reflect secondary ADHD associated with environmental factors, rather than developmental ADHD.

Prevalence of Developmental Coordination Disorder Using the DSM-IV at 7 Years of Age: A UK Population–Based Study

To calculate the prevalence of developmental coordination disorder at 7 years of age by using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria in a large UK birth cohort. Cases of developmental coordination disorder were defined by using data from the Avon Longitudinal Study of Parents and Children, a UK birth cohort. The motor coordination of >7000 children was assessed by using tests that measured manual dexterity, ball skills, and balance. The 5th percentile of the derived Avon Longitudinal Study of Parents and Children coordination impairment score was used to define severe motor coordination difficulties. Data from national handwriting tests and an activities-of-daily-living scale quantified the impact of poor coordination on daily life. Children with known neurologic conditions or an IQ of <70 were excluded. Complete data were available from 6990 children aged 7 to 8 years who attended the coordination session and completed the writing test or activities-of-daily-living scale. One hundred nineteen children met criteria for developmental coordination disorder, resulting in a prevalence of 17 of 1000 children at a mean age of 7.5 years (SD: 2.9 months). An additional 222 children were considered as having "probable developmental coordination disorder" by using broader cut-offs for coordination testing and activities of daily living. There was an increased risk of developmental coordination disorder in families from lower socioeconomic backgrounds, in children with a birth weight of <2500 g, and those born before 37 weeks' gestation. This is the first study to use strict criteria to define the prevalence of developmental coordination disorder in a representative cohort of UK children. A prevalence of 1.7% is lower than studies that have not taken into account the impact of poor motor coordination on daily living but indicates that poor coordination is an important, and often hidden, cause of disability in childhood.

The qualitative motor observations in Movement ABC: Aspects of reliability and validity

The aim of the present project was to study aspects of reliability and validity of the qualitative motor observations in the Swedish version of the Movement Assessment Battery for Children (Movement ABC). In total 12 children, divided into three groups, were assessed by 18 experienced physical and occupational therapists. Four of the children were typically developed, four fulfilled the criteria for Developmental Coordination Disorder and four were diagnosed with mild cerebral palsy. A video recording with the 12 children performing two of the eight items of the normative part of Movement ABC were sent to the 18 therapists. The therapists scored the performance of the children according to the guidelines given for the qualitative motor observations. They were informed of the age of the children but blinded to the result of the normative part of the Movement ABC and the children's diagnoses. The inter-rater reliability was moderate to high (ICC=0.75) for the two items together. The total number of observed...

Clinical expression of developmental coordination disorder in a large Canadian family

Previous studies of the phenotype of developmental coordination disorder (DCD) have largely concentrated on population-based samples. The present study reports on an in-depth examination of a large Canadian family with eight children, after three children who were suspected to have DCD were referred for evaluation. Subsequently, five of the six children whose motor impairments could be measured, and the mother, met the diagnostic criteria for DCD as per the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders - fourth edition. The family members diagnosed with DCD showed remarkably similar profiles of motor difficulties. Additionally, the five children diagnosed with DCD had current speech articulation difficulties, with four of them having visited speech/language pathologists; the mother had a lateral lisp. More in-depth testing for three children revealed intact intellectual, academic and language comprehension skills. Three of the children diagnosed with DCD were obese. The present report highlights familial clustering of DCD and the presence of comorbid conditions in the affected children.