Properties In Children Research Articles

Intersession Intra-Rater and Inter-Rater Reliability of Myotonometer for Upper and Lower Extremity Muscles in Children with Spinal Muscular Atrophy.

Background/Objectives: This study aimed to examine intra- and inter-rater reliability of a myotonometer (MyotonPRO) in measuring upper and lower extremity mechanical properties in children with spinal muscular atrophy types I and II. Methods: Biceps brachii, triceps brachii, rectus femoris, and gastrocnemius muscle tone and stiffness in children (n = 21) were measured using the MyotonPRO device. Examiner 1 performed two sets of measurements in 60 min to determine intra-rater reliability. Examiner 2 performed measurements between Examiner 1's sets. Intra-interclass correlation coefficient, minimal detectable change, and standard error of measurement values were calculated to assess intra- and inter-rater reliabilities in this cross-sectional study. Results: The results showed excellent intra- and inter-rater reliability analyses for frequency and stiffness values except for the stiffness value of the gastrocnemius muscle, which presented good reliability (ICC = 0.71). Minimal detectable change values ranged from 0.59 to 1.98 Hz for muscle tone and 16.08 to 124.74 N/m for stiffness (for both intra- and inter-rater reliabilities). Conclusions: Our findings indicate that MyotonPRO is a reliable tool for quantifying upper and lower extremity mechanical properties within one session in children with spinal muscular atrophy types I and II. Mechanical properties of the extremity muscle can be determined using this easily applied tool in future studies.

Ultrasound for assessing paediatric body composition and nutritional status: Scoping review and future directions.

This scoping review aims to assess the utility of ultrasound as a prospective tool in measuring body composition and nutritional status in the paediatric population. We provide a comprehensive summary of the existing literature, identify gaps, and propose future research directions. We conducted a systematic scoping review following the PRISMA Extension for Scoping Reviews guidelines. This involved screening titles and abstracts of relevant studies, followed by a detailed full-text review and extraction of pertinent data. We identified and synthesised 34 articles. The review revealed that while ultrasound has been used to assess body composition and bone properties in children, significant gaps remain in the literature. These include limited studies on ultrasound performance, insufficient attention to relevant sample characteristics, reliance on manual image measurements, and limited sample diversity. Point-of-care ultrasound shows significant promise for assessing paediatric body composition and nutritional status. To validate and enhance its effectiveness, further research is needed. Future studies should include larger and more diverse patient cohorts and conduct longitudinal investigations to evaluate nutritional interventions. Additionally, developing artificial intelligence (AI) for standardising and automating data interpretation will be crucial in improving the accuracy and efficiency of ultrasound assessments.

The Child Oral Health Impact Profile-Short Form 19 Cross-Cultural Adaptation and Validity for the Portuguese Pediatric Population.

Background/Objectives: To better understand the impact of different oral conditions on children, several instruments are available to measure oral health-related quality of life (OHRQoL). To adapt and validate cross-culturally the Child Oral Health Impact Profile-Short Form 19 (COHIP-SF19) questionnaire to the Portuguese language. Methods: The COHIP SF-19 was translated and back-translated, and tested for its reliability and for psychometric properties in children who were aged between 8 and 17 years old. The COHIP-19-PT was tested for its internal consistency, construct validity, content validity, and test-retest reliability. Results: The COHIP-19-PT revealed good internal consistency (Cronbach's alpha = 0.88) and test-retest reliability (interclass correlation = 0.78). The CFA analysis confirmed the structure of COHIP-19-PT. The first-order model showed an adequate fit: GFI = 0.878; CFI = 0.812; RMSEA = 0.083 (90% CI: 0.077-0.090). No invariance was found for the gender-based groups. The correlation between the sub-scales was also assessed, confirming significant correlations between all subdomains. Conclusions: The COHIP-19-PT is a valid and reliable scale for measuring children's oral health-related quality of life.

Distinct structural brain network properties in children with familial versus non-familial attention-deficit/hyperactivity disorder (ADHD)

Attention-deficit/hyperactivity disorder (ADHD) is among the most prevalent, inheritable, and heterogeneous childhood-onset neurodevelopmental disorders. Children with a hereditary background of ADHD have heightened risk of having ADHD and persistent impairment symptoms into adulthood. These facts suggest distinct familial-specific neuropathological substrates in ADHD that may exist in anatomical components subserving attention and cognitive control processing pathways during development. The objective of this study is to investigate the topological properties of the gray matter (GM) structural brain networks in children with familial ADHD (ADHD-F), non-familial ADHD (ADHD-NF), as well as matched controls. A total of 452 participants were involved, including 132, 165 and 155 in groups of ADHD-F, ADHD-NF and typically developed children, respectively. The GM structural brain network was constructed for each group using graph theoretical techniques with cortical and subcortical structures as nodes and correlations between volume of each pair of the nodes within each group as edges, while controlled for confounding factors using regression analysis. Relative to controls, children in both ADHD-F and ADHD-NF groups showed significantly higher nodal global and nodal local efficiencies in the left caudal middle frontal gyrus. Compared to controls and ADHD-NF, children with ADHD-F showed distinct structural network topological patterns associated with right precuneus (significantly higher nodal global efficiency and significantly higher nodal strength), left paracentral gyrus (significantly higher nodal strength and trend toward significantly higher nodal local efficiency) and left putamen (significantly higher nodal global efficiency and trend toward significantly higher nodal local efficiency). Our results for the first time in the field provide evidence of familial-specific structural brain network alterations in ADHD, that may contribute to distinct clinical/behavioral symptomology and developmental trajectories in children with ADHD-F.

The Guarantee of Children's Right in Determinating Guardian ad Litem on Sale and Purchase of Inherited Property

On selling the property of minors, absolutely parents must pay attention to the main objective, namely the welfare of the child. Thus, it is not used for personal interests and overrides the interests of children because this is contrary to children's rights. This study examines protecting children's rights for Guardian ad Litem (GAL), which will trade their children's property. To study the rules governing how a guardian ad litem can handle inherited property for the benefit of minors because he is considered an heir to his parent's property if his parents die. This study uses an empirical juridical methodology from the legislative framework, cases, conceptual frameworks, and interviews. Then, the novelty contains the role of the government in regulating minors who legally sell their inherited property and consider related children's rights. The study shows that Badan Pertanahan Nasional (BPN) of Kota Surakarta has carried out its duties effectively, supported by the conditions set for parents who want to sell the property on behalf of their children. The results of this study are the steps taken by the government to ensure that parents do not abuse their power to steal children's property and further examine guardian ad litem ship according to Islamic law. The role of BPN of Kota Surakarta is also in collaboration with the Religious Court in charge of determining guardian ad litem of minors. It can be concluded that the reasons for parents who want to sell their children's inheritance are clear and not abused by parents who want to become guardian ad litem. It caused the role of guardian ad litem in Islam to include the maintenance of themselves and their property. So that all guardians ad litem maintain health, justice, honesty, and good behavior.

EPS10.03 Effects of elexacaftor/tezacaftor/ivacaftor on sputum viscoelastic properties in children with cystic fibrosis

EPS10.03 Effects of elexacaftor/tezacaftor/ivacaftor on sputum viscoelastic properties in children with cystic fibrosis

Risk of atrial fibrillation development in adolescent patients with inflammatory bowel disease.

There is increasing evidence linking chronic inflammation to the initiation and continuation of atrial fibrillation (AF). Inflammatory bowel diseases (IBD), namely (Crohn's disease (CD) and ulcerative colitis (UC), are chronic systemic inflammatory disorders with both intestinal and extra-intestinal manifestations. Atrial electromechanical delay (EMD) has been known as an early marker of AF. The objective of this study was to evaluate the atrial electromechanical properties in children and adolescents with IBD during remission. One hundred IBD patients aged 12-17 years (50 with CD and 50 with UC) in remission state and 100 healthy controls were recruited for the study. Atrial electromechanical properties were measured using transthoracic echocardiography, tissue Doppler imaging, and simultaneous surface ECG recording. Interatrial EMD, left intra-atrial, and right intra-atrial EMD were calculated. IBD patients in remission state have significantly prolonged left and right intra-atrial EMD and interatrial EMD compared to healthy controls (P = 0.03, P = 0.02, and P = 0.01 respectively). No statistical difference was observed between CD and UC in terms of inter- and intra-atrial EMDs. Conclusion:Atrial EMD is increased in pediatric patients with IBD indicating the increased risk of AF development. Measurement of atrial EMD parameters might be used to predict the risk of the development of AF in pediatric patients with IBD. What is Known: • There is increasing evidence linking chronic inflammation to the initiation and continuation of atrial fibrillation (AF). • Inflammatory bowel diseases are chronic systemic inflammatory disorders with both intestinal and extra-intestinal manifestations. • Atrial electromechanical delay (EMD) has been reported as an early marker of AF. What is New: • Atrial EMD is increased in pediatric patients with IBD indicating the increased risk of AF development. • Measurement of atrial EMD parameters might be used to predict the risk of the development of AF in pediatric patients with IBD.

Biofabrication of silver nanoparticles with Feijoa sellowiana tailored by box-behnken design: An eco-friendly approach to enhance antifungal properties in Children's toothpaste

Oral candidiasis and its association with dental caries necessitate the development of toothpaste with enhanced antifungal properties, particularly for children at high risk of infection. This study aims to investigate the antifungal efficacy of children's toothpaste incorporating biosynthesized silver nanoparticles (AgNPs) using Feijoa sellowiana. Silver fluoride and Feijoa leaf extract were used for the synthesis of AgNPs. The independent variables were the concentration of AgF, pH of the extract, and temperature. The optimized formula was obtained using Design Expert software and Box-Benken design. The physicochemical properties of AgNPs were evaluated by UV-absorption wavelength measurements, SEM, and TEM analyses. Finally, the powder of optimized AgNPs was added to Colgate Kids Toothpaste® and its antifungal effect was evaluated using the standard agar well diffusion method. The optimization process identified an AgF concentration of 8 mM, a pH value of 9.56, and a temperature of 58 °C as influential factors for the formulation. The optimized AgNPs exhibited a size of 42.75 nm, and SEM and TEM analyses confirmed their spherical shape. Both toothpaste formulations, with and without AgNPs, demonstrated antifungal activity. Although the antifungal effect of both toothpaste types against Candida glabrata did not show a significant difference (p > 0.088), the toothpaste containing AgNPs exhibited significantly higher antifungal efficacy against Candida albicans (p < 0.014). In conclusion, the biosynthesis of silver nanoparticles using silver fluoride and Feijoa leaf extract as an eco-friendly approach can effectively enhance the antifungal potency of toothpaste against C. albicans.

Differential Effects of Disruptive Mood Dysregulation Disorder Comorbidity in Attention Deficit Hyperactivity Disorder on Social Cognition and Empathy

Objective: This study aimed to investigate social cognition and empathy properties in children among Disruptive Mood Dysregulation Disorder (DMDD) + Attention and Hyperactivity Disorder(ADHD); ADHD and healthy controls from Türkiye. Methods: Twenty-two children with DMDD were compared to matched 30 children with ADHD and 60 healthy controls. We administered Affective Reactivity Index (ARI), KaSi Empathy Scale, Kiddie-SADS, and Reading Mind in the Eyes Test (RMET) to evaluate Theory of Mind skills to all study participants. Results: DMDD + ADHD group had lower performance in ToM skills and empathy than in two groups. The ARI scores were found to be statistically significantly higher in the DMDD group than in two groups. It was also found that ARI, empathy, and ToM scores were significantly related in children with DMDD + ADHD. Conclusion: These results might be important to understand the difficulties in social functioning and interpersonal relationship in children with DMDD and ADHD. Children with DMDD may attend specific therapeutic programs which include specific techniques in social cognition, emotion regulation, and irritability.

Oral fluid properties in children with head and neck malignant tumors

The aim of the present study was to estimate the relationship between TNF-α level and degree of microcrystallization (DMC) of oral fluid (OF) in children with malignant tumors in the head and neck region (HNR). In the case-control study, 72 children aged between 1 and 18 were included, divided into 2 identical groups according to structure. The research group (L1) consisted of 36 children with malignant tumors in the HNR. 36 conventionally healthy children were included in the control group (L0). We studied the combined biomarkers in OF samplesmorphological biomarkers (DMC of OF) and TNF-α cytokine level in OF in children with malignant tumors in HNR and conventionally healthy subjects. TNF-α in OF was evaluated by the immunoenzymatic analysis method. The analysis of the results of the study elucidated the increased level of TNF-α, in the OF of children with malignant tumors, compared to healthy subjects. Correlational analysis detected the significant inverse relationship (r=-0.83, р&lt;0.01) between TNF-α level and DMC of OF in children with malignant tumors in RCG in I and II stages. At the same time, in conventionally healthy children, but also in children with malignant tumors in III and IV stages, the interdependence between the level of TNF-α in OF and DMC of OF was not observed.Conclusions. The assessment of combined biomarkers in OF samples (TNF-α level and morphological particularities) represents an innovative non-invasive analysis for the early detection of tumors and the assessment of the risk of oral malignancy. For the clinical use of OF biomarkers, it is necessaryto develop standardized protocols and to perform extensive studies in which the influence of various confounding variables is excluded.

Alterations in Antioxidant Status and Erythrocyte Properties in Children with Autism Spectrum Disorder.

Erythrocytes are responsible for the transport of oxygen within the organism, which is particularly important for nerve tissues. Erythrocyte quality has been shown to be deteriorated in oxidative stress conditions. In this study, we measured the same series of oxidative stress markers in plasma and erythrocytes to compare the differences between neurotypical children (controls) and children with autism spectrum disorder (ASD). We also focused on erythrocyte properties including their deformability, osmotic resistance, Na,K-ATPase activity, nitric oxide levels and free radical levels in children with ASD and controls. Greater oxidative damage to proteins and lipids was observed in the erythrocytes than in the plasma of ASD subjects. Additionally, antioxidant enzymes were more active in plasma samples from ASD children than in their erythrocytes. Significantly higher nitric oxide level and Na,K-ATPase enzyme activity were detected in erythrocytes of ASD individuals in comparison with the controls. Changes in oxidative status could at least partially contribute to the deterioration of erythrocyte morphology, as more frequent echinocyte formation was detected in ASD individuals. These alterations are most probably responsible for worsening the erythrocyte deformability observed in children with ASD. We can conclude that abnormalities in antioxidant status and erythrocyte properties could be involved in the pathomechanisms of ASD and eventually contribute to its clinical manifestations.

Guardianship Supervisory in Indonesia: A Comparative Analyzes of Baitul Mal Aceh and the Heirloom Board

Guardianship supervisory has been a dilemma in the Indonesian legal system. The article assesses the practice of guardianship supervisory in Indonesia by comparing two prominent institutions, Baitul Mal Aceh (BMA) and the Heirloom Board (Balai Harta Peninggalan or BHP). The article focuses on understanding these organizations’ roles and responsibilities in preserving and managing guardianship supervisory. The article uses normative juridicial method to examine how Baitul Mal Aceh and BHP become guardian supervisors and their differences and similarities by reading norms, laws, journals, and the like. The article found that Baitul Mal Aceh has been unable to carry out its duties because of a lack of operational regulation (i.e., Governor’s Regulation) of Qanun Baitul Mal, while BHP only focuses on non-Muslim related issues. These two institutions work independently and cannot support each other. Dualism and lack of implementing regulations in guardianship institutions in Indonesia have posed a dilemma for ensuring proper guardianship over the personal and property of children who are not yet mature or not married under court decisions. The article sheds light on the limitations and complexity of guardianship and its surrounding issues in both institutions.

Psychometric Evaluation of the PedsQL GCS and CHU9D in Australian Children and Adolescents with Common Chronic Health Conditions.

Generic instruments such as the Pediatric Quality of Life Inventory™ v4.0 Generic Core Scales (PedsQL GCS) and Child Health Utility 9D (CHU9D) are widely used to assess health-related quality of life (HRQOL) of the general childhood population, but there is a paucity of information about their psychometric properties in children with specific health conditions. This study assessed psychometric properties, including acceptability, reliability, validity, and responsiveness, of the PedsQL GCS and the CHU9D in children and adolescents with a range of common chronic health problems. We used data from the Longitudinal Study of Australian Children (LSAC), for children aged 10-17 years with at least one of the following six parent-reported health conditions: asthma, anxiety/depression, attention deficit hyperactivity disorder (ADHD), autism/Asperger's, epilepsy, and type 1 diabetes mellitus. The LSAC used parent proxy-reported PedsQL GCS and child self-reported CHU9D assessments. The performance of each instrument (PedsQL GCS and CHU9D) for each psychometric property (acceptability, reliability, validity, and responsiveness) was assessed against established criteria. The study sample included 7201 children and adolescents (mean age = 14 years; range 10.1-17.9 years; 49% female) with 15,568 longitudinal observations available for analyses. Across the six health conditions, acceptability of the PedsQL GCS was high, while acceptability for the CHU9D was mixed. Both the PedsQL GCS and CHU9D showed strong internal consistency (Cronbach's alpha range: PedsQL GCS = 0.70-0.95, CHU9D = 0.76-0.84; item-total correlations range: PedsQL GCS = 0.35-0.84, CHU9D = 0.32-0.70). However, convergent validity for both the PedsQL GCS and CHU9D was generally weak (Spearman's correlations ≤ 0.3). Known group validity was strong for the PedsQL GCS (HRQOL differences were detected for children with and without asthma, anxiety/depression, ADHD, autism/Asperger's, and epilepsy). CHU9D was only able to discriminate between children with and without anxiety/depression, ADHD, and autism/Asperger's. The responsiveness of both the PedsQL GCS and CHU9D was variable across the six conditions, and most of the estimated effect sizes were relatively small (<0.5). This study expands the evidence base of psychometric performance of the PedsQL GCS and CHU9D and can aid in appropriate HRQOL instrument selection for the required context by researchers and clinicians.

Skull bone acoustics properties in children with specific language disorders

The acoustic properties of the skull OF children with specific language disorders and how they might affect hearing were investigated. Broadband noise was isolated throw 2 procedures first by all tests in the audiology room and second by a tailored isolated helmet with six bone mics attached to skull gaps and spectrally analyzed using a Fast Fourier Transform and in 1/3-octave bands. Energetic peaks were found centered near 63 and 125 Hz, and all on the left side of the skull (e.g., range greater than 10 dB around 900 Hz). Acoustic patterns from each skull were subsequently compared with air and bone conduction sensory thresholds. Individual skull patterns reliably correlated with bone conduction thresholds, but not air conduction thresholds, indicating a possible mediating role of the skull to hearing.

Effects of childhood obesity on myocardial performance, autonomic and conduction properties of the heart.

Childhood obesity tends to persist into adulthood and associated with increase in developing ischemic and non-ischemic cardiovascular diseases. We aimed to evaluate the effect of obesity on cardiac functions, atrial electromechanical coupling, and heart rate response, which are considered to be predictors of atrial fibrillation and sudden cardiac arrest. Study population included 52 obese children and 52 healthy controls. We performed 12-lead electrocardiography, echocardiographic examination, and treadmill exercise testing. Mitral, septal, and tricuspid segments were analysed by tissue Doppler imaging. Myocardial performance index (p = 0.011, p < 0.001, and p = 0.001, respectively) was higher and E'/A' ratio (p = 0.011, p < 0.001, and p < 0.001, respectively) was lower in obese group than controls. Atrial electromechanical coupling was longer in the obese group at all three segments (p < 0.001, p = 0.009, and p = 0.04, respectively). They had significantly longer interatrial (p < 0.001) and intra-atrial (p = 0.003) electromechanical conduction delay. While chronotropic index was similar between two groups, heart rate reserve was lower in obese children than controls (p = 0.043). The 1st- and 2nd-minute heart rate recovery indices of the obese group were lower compared to controls (p < 0.001 and p = 0.03, respectively). Body mass index was positively correlated with intra- and inter-atrial conduction times, whereas it was negatively correlated with heart rate recovery indices. We showed a deterioration in the diastolic function, atrial conduction, and heart rate response properties in children with obesity. Given the prognostic importance of these parameters, obese patients are might be at risk for atrial fibrillation and severe dysrhythmias from a young age.

Management of Property of Minors Under Guardianship

Management of guardianship of minors is the provision of services in the case of minors under the power of guardians which includes supervision of the performance of guardian duties over minors who are not under the control of parents and management of the child's property or property as regulated by law. A person can also be determined to be the guardian of a child through the determination/decision of the District Court or Religious Court. Generally, child guardianship applications for Islamic religion are submitted to the Religious Court, and for non-Muslim religions guardianship applications are submitted to the District Court. In practice, however, applications for guardianship of children to be Muslim can be filed with the District Court. Provisions regarding the appointment of a child's guardian through the court can be seen in Articles 359 to Article 364 of the Civil Code. In addition, Article 107 paragraph (3) also stipulates "if the guardian is unable to do or neglects to carry out his guardianship duties, the religious court may appoint one of the relatives to act as guardian at the request of the relative".

Impact of perinatal factors on biomarkers of cardiovascular disease risk in preadolescent children.

This review aims to summarize associations of the perinatal environment with arterial biophysical properties in childhood, to elucidate possible perinatal origins of adult cardiovascular disease (CVD). A systematic search of PubMed database was performed (December 2020). Studies exploring associations of perinatal factors with arterial biophysical properties in children 12 years old or less were included. Properties studied included: pulse wave velocity; arterial stiffness or distensibility; augmentation index; intima-media thickness of aorta (aIMT) or carotids; endothelial function (laser flow Doppler, flow-mediated dilatation). Two reviewers independently performed study selection and data extraction. Fifty-two of 1084 identified records were included. Eleven studies explored associations with prematurity, 14 explored maternal factors during pregnancy, and 27 explored effects of low birth weight, small-for-gestational age and foetal growth restriction (LBW/SGA/FGR). aIMT was consistently higher in offspring affected by LBW/SGA/FGR in all six studies examining this variable. The cause of inconclusive or conflicting associations found with other arterial biophysical properties and perinatal factors may be multifactorial: in particular, measurements and analyses of related properties differed in technique, equipment, anatomical location, and covariates used. aIMT was consistently higher in LBW/SGA/FGR offspring, which may relate to increased long-term CVD risk. Larger and longer term cohort studies may help to elucidate clinical significance, particularly in relation to established CVD risk factors. Experimental studies may help to understand whether lifestyle or medical interventions can reverse perinatal changes aIMT. The field could be advanced by validation and standardization of techniques assessing arterial structure and function in children.

Competition Between Object Topology and Surface Features in Children's Extension of Novel Nouns.

Objects' topological properties play a central role in object perception, superseding objects' surface features in object representation and tracking from early in development. We asked about the role of objects' topological properties in children's generalization of novel labels to objects. We adapted the classic name generalization task of Landau et al. (1988, 1992). In three experiments, we showed children (n = 151; 3-8-year-olds) a novel object (the standard) and gave the object a novel label. We then showed children three potential target objects and asked children which of the objects shared the same label as the standard. In Experiment 1, the standard object either did or did not contain a hole, and we asked whether children would extend the standard's label to a target object that shared either metric shape or topology with the standard. Experiment 2 served as a control condition for Experiment 1. In Experiment 3, we pitted topology against another surface feature, color. We found that objects' topology competed with objects' surface features (both shape and color) in children's extension of labels to novel objects. We discuss possible implications for our understanding of the inductive potential of objects' topologies for making inferences about objects' categories across early development.

Preparing “the Activities of Daily Living Inventory for Children with Disabilities” (ADLIC-D) and Investigating Its Psychometric Properties in Children with Autism Spectrum Disorder, Intellectual Disability and Cerebral Palsy

Background: The difficulties to perform self-care or basic activities of daily life are among the concerns of families, and rehabilitation professionals. In this issue, culturally adapted assessment tools help in the accurate assessment and treatment planning in rehabilitation. Objectives: The present study aimed to survey the validity, and reliability of Activities of Daily Living Inventory for Children with Disabilities (ADLIC-D) in preschool children with autism spectrum disorder (ASD), cerebral palsy (CP), intellectual disability (ID), and typical children. Methods: The face validity examined by 60 parents of children with disabilities. Content validity studied by 10 occupational therapists. The sample included 205 (70 normal, 45 ASD, 45 CP, and 45 ID) children aged 3 - 6 years whose parents completed ADLIC-D. Face and content validity, convergent validity with the Pediatric Evaluation of Disability Inventory (PEDI), discriminant validity, test-retest reliability, and the internal consistency of instrument were examined. Result: Intra-class correlations coefficient for test-retest reliability was excellent (above 0.9). Cronbach's alpha for all items was excellent (0.977). The ADLIC-D had convergent validity with the PEDI (r = 0.95). The discriminant validity demonstrated that the measure distinguishes between normal and disabled groups. In addition, the number of final items on the new scale grew from 73 in the original to 76. Conclusions: ADLIC-D had validity, and reliability for children with ASD, CP, and ID. It measured the desired construct, i.e., the activities of daily living in children with the disabilities and differentiated between normal groups, and groups with disabilities.

Cross-replicating findings on unique motor impairments of children with ASD using confirmatory factor analysis and a novel SPARK study sample.

A series of recent reports have shed light on the pervasive nature of motor impairments in children with ASD (Bhat, 2020, 2021, Bhat et al., 2022), underscoring the importance of providing ASD clinicians efficient and accurate tools for motor screening. The Developmental Coordination Disorder-Questionnaire (DCD-Q) is a widely used motor screening tool, yet scant evidence exists regarding its psychometric properties in children with ASD. In a recent Exploratory Factor Analysis (EFA) of the 15-item DCD-Q in a large sample of children with ASD (SPARK study), we found a 5-factor latent structure that identified unique motor impairments in a large sample of children with ASD (Bhat et al., 2022). In the current study, we extend this work by cross-replicating the EFA findings of unique ASD-related motor issues using Confirmatory Factor Analysis (CFA) in a new, more recent wave of children with ASD from the SPARK study (N=9721). The fits and interpretability of 11 hypothesis-driven CFA models, including 8 correlated-factors, 1second-order, and 2 bifactor models were compared. Our findings supported the previous 5-factor model with 2 gross motor subdomains, 1 fine motor domain (similar to the original DCD-Q) and 2 general coordination subdomains. This model demonstrated acceptable fit in the new sample as well as superior fit compared to several other parsimonious correlated-factors models. However, the second-order and bifactor models fit slightly better and supported the presence of a general motor skills factor, although 38% of the common variance in the DCD-Q items remained attributable to the 5 subdomains. Using one of the bifactor models, measurement invariance was also supported for DCD-Q across sex, race, and co-occurring conditions of language disorder and intellectual disability. Only partial invariance was supported when testing DCD-Q scores across different age groups. These findings reveal a more complex dimensional picture of the DCD-Q in children with ASD. Results suggest that the DCD-Q can be used in two ways, total scores adequately assess general motor skills for brief screening and subdomain scores offer unique information on the multidimensional motor problems of children with ASD. If subdomain data are of interest, our findings call into question the practice of relying on 3 original subscales of the DCD-Q when screening for ASD-related motor difficulties, whereas 4 out of 5 subscale scores may better highlight domain-specific motor problems. Future studies should continue to further validate DCD-Q's ability to screen for multidimensional motor problems.