Psychometric Properties of the Little Developmental Coordination Disorder Questionnaire-Taiwan.

IMPORTANCE: Early identification of young children at risk of developmental coordination disorder (DCD) can support early intervention and prevent secondary sequelae. OBJECTIVE: To examine the psychometric properties of a translated and cross-culturally adapted version of the Little Developmental Coordination Disorder Questionnaire-Taiwan (LDCDQ-TW). DESIGN: Prospective study. SETTING: Kindergartens and preschools in north, central, and south Taiwan. PARTICIPANTS: 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. RESULTS: 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. CONCLUSIONS AND RELEVANCE: 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.

Reliability and Validity of the Chinese Version of the Infant/Toddler Sensory Profile.

IMPORTANCE: In Chinese-speaking societies, a reliable and valid measure is needed to enable early identification of young children's challenges in sensory processing. OBJECTIVE: To examine the psychometric properties of the Chinese version of the Infant/Toddler Sensory Profile (ITSP-C) when used with Taiwanese children. DESIGN: Prospective study. SETTING: Multiple settings. PARTICIPANTS: Participants were 367 typically developing (TD) infants ages 0-6 mo (mean [M] age = 3.44 mo, standard deviation [SD] = 1.82) and 677 toddlers ages 7-36 mo (M age = 22.33 mo, SD = 8.15), along with 42 toddlers with developmental disabilities (DD; M age = 28.4 mo, SD = 6.7). OUTCOMES AND MEASURES: The ITSP, a caregiver questionnaire that measures how children respond to sensory events in daily life, was translated and cross-culturally adapted into a Chinese version (ITSP-C). RESULTS: Internal consistency was high for the 0-6 mo subscale (α = .80) and the 7-36 mo subscale (α = .82). Test-retest reliability was excellent for the 7-36 mo subscale (intraclass correlation coefficient = .94). Logistic regression analysis demonstrated that the ITSP-C discriminated between children with DD and TD children. CONCLUSIONS AND RELEVANCE: The ITSP was successfully adapted to Chinese with similar reliability and validity to the original ITSP. The 7-36 mo subscale had a higher level of reliability than the 0-6 mo subscale, and quadrant scores were more reliable than section scores. Moreover, the ITSP-C discriminated children with DD from TD children on the basis of their sensory processing patterns. WHAT THIS ARTICLE ADDS: The ITSP-C has sound psychometric properties and support for its use in early identification of sensory processing difficulties in young Chinese-speaking children.

Exploring Sensory Processing Dysfunction, Parenting Stress, and Problem Behaviors in Children With Autism Spectrum Disorder.

OBJECTIVE: We examined problem behavior in preschool- and school-age children with autism spectrum disorder and assessed whether sensory processing dysfunction (SPD) and parenting stress were differentially associated with problem behaviors in these groups of children. METHOD: Participants were 101 preschool- and 61 school-age children. An independent t test was used to examine group differences in problem behaviors. Pearson correlation analysis and multiple linear regression were conducted to identify associations among SPD, parenting stress, and problem behaviors. RESULTS: Preschool children had more social withdrawal than school-age children. Moderately negative correlations were found between SPD and problem behaviors among preschool children. Parenting stress was a factor associated with problem behaviors in both groups, whereas SPD was a factor specific to preschoolers. CONCLUSION: Understanding unique problem behaviors and the significant role of SPD and parenting stress in problem behaviors could help occupational therapy clinicians plan interventions accordingly.

The impact of coping behaviors on perceived competence and social anxiety in the everyday social engagement of autistic adolescents.

LAY ABSTRACT: Individuals who cope well with challenges may engage in social situations more successfully. We examined how well autistic adolescents coped, depending on how competent they felt and how much anxiety they experienced during social activities. We included 133 individuals (82 autistic, 51 neurotypical) between the ages of 10 and 16 years. Participants carried a mobile device that prompted them seven times a day for 7 days to record what they were doing, how competent they felt and how much anxiety they experienced. We used the Coping Inventory to understand how well participants coped with environmental challenges and met their needs for growth. Autistic adolescents were more likely than neurotypical peers to feel anxious while doing activities with adults. Autistic adolescents who had more difficulty coping with challenges were more likely to feel anxious when doing leisure activities with peers. Interestingly, autistic adolescents who coped better with challenges tended to feel less competent in social situations. However, those better able to meet their needs for growth tended to perceive their social competence positively. These findings can help practitioners develop strategies and programs to reduce the negative social experiences of autistic adolescents by helping them cope better.

Evidence-based practice and research utilisation: perceived research knowledge, attitudes, practices and barriers among Australian paediatric occupational therapists.

BACKGROUND/AIM: Evidence-based practice (EBP) and research utilisation (RU) are promoted as ways for clients to receive the best level of care. However, limited research has evaluated the use of these approaches by occupational therapists. This study investigated the knowledge, attitudes, practices of and barriers to EBP and RU of a group of paediatric occupational therapists from Australia. METHODS: Questionnaires were received from 138 participants (response rate 46%) who completed the Research Knowledge, Attitudes and Practices of Research Survey, the Edmonton Research Orientation Survey and the Barriers to Research Utilisation Scale. RESULTS: The participants held positive attitudes towards research, and were willing to access new information to guide practice approaches. However, participants were less confident in their research knowledge and practices and implemented research findings into clinical practice. Multiple barriers to RU were perceived, particularly associated with the presentation and accessibility of research. Participants reported limited engagement in conducting research studies, although the majority of the participants reported implementing the findings of research into their clinical practice to some extent. CONCLUSION: Additional research education and support within organisations would be beneficial to ensure that children and families are receiving occupational therapy services that are based on sound, high-quality research evidence. The findings of this study provide insight into the perceived research knowledge, attitudes, practices of and barriers to Australian paediatric occupational therapists, enabling specific strategies to be implemented to increase the use of EBP and RU within the profession.

The impact of caregiver stigma on real-life social experience of Taiwanese adolescents with autism spectrum disorder.

LAY ABSTRACT: Caregivers of people with autism spectrum disorder commonly experience stigma. As a result, they may avoid contact with others, in turn, influencing their child's social participation. This study aimed to explore the impact of stigma perceived by the caregivers on the everyday social experience of Taiwanese adolescents with autism spectrum disorder. We asked 76 adolescents with autism spectrum disorder who did not have intellectual disability (69 males, aged 10-16 years) to carry a mobile device for 7 days. The device prompted them 7 times each day to record who they were interacting with, what they perceived, and how they felt about their social interactions. In addition, we asked their caregivers to complete the Affiliate Stigma Scale to measure their experience of stigma. We found that participants whose caregivers perceived high levels of stigma were more likely to spend time with family members and less likely to be interested in interacting with people at school. Those participants also were more likely to experience anxiety while interacting with family. Our study suggests that it is important for clinicians to implement support services for adolescents with autism spectrum disorder and help caregivers in managing stigma to promote their child's social participation.

Collaborative Home-Visit Program for Young Children With Motor Delays in Rural Taiwan: A Pilot Randomized Controlled Trial.

BACKGROUND: Caregiver engagement and collaborative team early childhood intervention (ECI) services are international trends; however, relevant evidence of collaborative home-visiting ECI in rural areas is as yet undetermined. OBJECTIVE: The study aimed to investigate the effectiveness of a collaborative ECI program in a rural area of Taiwan. DESIGN: The study was a pilot randomized control led trial. METHODS: Children aged 6 to 33 months experiencing motor delays and their caregivers were enrolled in Taitung, Taiwan. Using stratified randomization, 24 participants were allocated to either experimental or control groups, and both received 5 home visits within 3 months. The experimental group received ECI services based on the International Classification of Functioning, Disability and Health framework and family-centered approaches. The control group received regular home visits by local social workers. Child outcomes included Pediatric Evaluation of Disability Inventory Chinese Version and Peabody Developmental Motor Scale, 2nd edition. Family outcomes included the Disability-Adapted Infant-Toddler version of Home Observation for Measurement, and Chinese versions of the Knowledge of Infant Development Inventory and Parental Stress Index-Short Form. A tester blinded to the study conducted assessments at baseline, postintervention, and 3-month follow-up. Two-way mixed analysis of variance was used with α = .05 (2-tailed). RESULTS: The experimental group improved scores on the Disability-Adapted Infant-Toddler version of Home Observation for Measurement significantly more than the control group with an effect size of 0.64 at follow-up. In other outcomes, both groups showed no significant differences. The follow-up rate was 69%, and adherence to the ECI program was acceptable. LIMITATIONS: A limitation of the study was the heterogeneity of the sample. CONCLUSIONS: This pilot study revealed possible effectiveness in implementing collaborative ECI programs based on family-centered approaches and the International Classification of Functioning, Disability and Health in rural areas. Larger field studies are needed to confirm our findings.

Functional performance of children with developmental coordination disorder at home and at school.

This study investigated the functional performance of daily activities at home and at school in a population-based sample of children with different degrees of motor coordination impairment and competence. Sixteen children (seven males, nine females; mean age 8 y, SD 9 mo) with developmental coordination disorder (DCD), 25 with suspected DCD ([sDCD] 17 males, eight females; mean age 7 y 6 mo, SD 8 mo), and 63 children without motor problems (39 males, 24 females; mean age 7 y 9 mo, SD 7 mo) were recruited from public schools (Grades 1-3, age 6 y 4 mo-9 y 10 mo) using the Chinese version of the Developmental Coordination Disorder Questionnaire, the Movement Assessment Battery for Children, and the Bruininks-Oseretsky Test of Motor Proficiency. Functional performance was assessed using the Chinese versions of the Vineland Adaptive Behavior Scales and the School Function Assessment-Chinese version. The functional performance of children with DCD and sDCD was statistically significantly lower than those without DCD (p's<0.05). chi(2) and logistic regression analyses showed significant differences among all groups in the proportion of children scoring at the 'inadequate' adaptive level of home performance (p's<0.05). There were also significant differences among the groups in the proportion of children scoring below the cut-off in school performance (p's<0.05). The findings show the pervasive impact of DCD on children's functional performance in daily activities at home and at school.

The Influence of Pre-Exercise Glucose versus Fructose Ingestion on Subsequent Postprandial Lipemia.

Ingestion of low glycemic index (LGI) carbohydrate (CHO) before exercise induced less insulin response and higher fat oxidation than that of high GI (HGI) CHO during subsequent exercise. However, the effect on the subsequent postprandial lipid profile is still unclear. Therefore, the aim of this study was to investigate ingestion of CHO drinks with different GI using fructose and glucose before endurance exercise on the subsequent postprandial lipid profile. Eight healthy active males completed two experimental trials in randomized double-blind cross-over design. All participants ingested 500 mL CHO (75 g) solution either fructose (F) or glucose (G) before running on the treadmill at 60% VO2max for 1 h. Participants were asked to take an oral fat tolerance test (OFTT) immediately after the exercise. Blood samples were obtained for plasma and serum analysis. The F trial was significantly lower than the G trial in TG total area under the curve (AUC; 9.97 ± 3.64 vs. 10.91 ± 3.56 mmol × 6 h/L; p = 0.033) and incremental AUC (6.57 ± 2.46 vs. 7.14 ± 2.64 mmol/L × 6 h, p = 0.004). The current data suggested that a pre-exercise fructose drink showed a lower postprandial lipemia than a glucose drink after the subsequent high-fat meal.

Cooccurrence of problems in activity level, attention, psychosocial adjustment, reading and writing in children with developmental coordination disorder.

The purpose of this paper was to investigate the cooccurrence of problems in activity level, attention, reading, writing and psychosocial adjustment of children with developmental coordination disorder (DCD). A parent-report questionnaire, the Developmental Coordination Disorder Questionnaire - Chinese version (DCDQ-C), was used to screen first to third graders from 13 mainstream schools in Taipei. Two standardized motor tests were then administered to those who scored below 10% on the DCDQ-C. Tests of activity level, attention, reading, writing and psychosocial adjustment were then administered to this sample. Thirty-eight children identified as DCD, 32 as suspect for DCD and 82 as normal comparison were included in the final sample. Multivariate analysis of variance comparing the three groups (DCD, suspect DCD, and comparison) revealed that both children with DCD and suspect for DCD obtained significantly poorer scores on measures of attention and reading, and were more hyperactive than comparison children. Children with DCD and suspect for DCD were also reported to have more internalizing and social problems than children without motor problems. No significant differences, however, were noted between children with different degree of motor coordination problems (categorized as DCD and suspect for DCD) on any measure. Furthermore, a high percentage of children in both the DCD and suspect groups fell in the clinical range of attention, activity level and psychosocial adjustment problems. The results revealed a high risk for these problems in nonreferred children with motor coordination problems. The high percentage of clinical range behavioral problems warrants attention of clinicians who work with children with motor coordination difficulties to the need to promote early identification and referral.

Child characteristics, caregiver characteristics, and environmental factors affecting the quality of life of caregivers of children with cerebral palsy.

PURPOSE: The study aimed to investigate comprehensively the determinants of the quality of life (QOL) of caregivers of children with cerebral palsy (CP) based on the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). METHODS: A total of 167 children with CP (mean age 9.06 years, SD 2.61 years) and their caregivers (mean age 40.24 years, SD 5.43 years) participated in this study. The QOL of caregivers was measured with the World Health Organization Quality of Life-BREF-Taiwan version (WHOQOL-BREF-TW). The potential determinants of QOL were collected, including child characteristics, caregiver characteristics, and environmental factors from all dimensions of the ICF-CY and analysed using multiple regression models. RESULTS: Four multiple regression models revealed that determinants of the QOL of caregivers of children with CP was multidimensional, encompassing child characteristics (age, type of CP, fine motor impairment, other diseases, behaviour and emotions, visual impairment, hearing impairment), caregiver characteristics (general mental health, parenting stress, marital status, family coping patterns, and socio-economic status), and environmental factors (child's medication, school setting, and current rehabilitation service, caregiver's spouse's age, family life impacts, and domestic helper). CONCLUSIONS: Knowledge of the determinants of QOL could serve as a guide in a holistic approach to evaluation and intervention and help plan interventions targeted at these determinants to improve the QOL of caregivers of children with CP. Implications for Rehabilitation Caregivers of children with CP had lower QOL, except the environment QOL. The QOL determinants of caregivers of children with CP are multidimensional, including child characteristics, caregiver characteristics, and environmental factors. In addition to child characteristics of severity of fine motor impairments and emotional and behavioural problems, caregiver characteristics of general mental health, parenting stress, and coping patterns, and environmental factors of family life impacts, and school setting demonstrated important relationships with caregiver QOL.

Determinants of quality of life in children with cerebral palsy: a comprehensive biopsychosocial approach.

This study investigated the determinants of quality of life (QOL) of children with cerebral palsy (CP) considering possible variables comprehensively from a biopsychosocial perspective by adopting the International Classification of Functioning, Disability and Health (ICF) and using a CP-specific QOL questionnaire. A total of 167 children with CP (mean age 9.06 years, SD 2.61 years) and their caregivers participated in this study. Children's QOL was measured by the Cerebral Palsy Quality of Life for Children (CP QOL-Child) - primary caregiver proxy-report form. The potential determinants of QOL were collected based on all ICF dimensions. Results of seven multiple regression models showed that the determinants of QOL in children with CP were multidimensional and biopsychosocial in nature, i.e., encompassing the domains of health condition, body functions and structures, and contextual factors of the ICF. Children's behavioral and emotional problems as well as caregiver's psychological and family-related factors were important determinants of QOL in children with CP. Knowledge of the determinants of QOL could serve as a guide in a holistic approach to evaluation and intervention targeted at these determinants to improve the QOL of children with CP.

Impacts of autistic behaviors, emotional and behavioral problems on parenting stress in caregivers of children with autism.

This study examined the effects of autistic behaviors and individual emotional and behavioral problems on parenting stress in caregivers of children with autism. Caregivers were interviewed with the Childhood Autism Rating Scale and completed the Strength and Difficulties Questionnaire and the Parenting Stress Index Short Form. Results revealed that caregivers of children with mild/moderate autistic behavior problems perceived lower parenting stress than did those of children with no or severe problems. In addition, prosocial behaviors and conduct problems respectively predicted stress in the parent-child relationship and child-related stress. The findings can provide guidance in evaluations and interventions with a focus on mitigating parenting stress in caregivers of children with autism.

Age as a factor in sensory integration function in Taiwanese children.

OBJECTIVE: Sensory integration progresses along a normal developmental sequence. However, few studies have explored how age difference affects the way sensory integration functions in Taiwanese children as they develop. Therefore, this study aims to pinpoint the role of age in sensory integration. METHOD: A purposive sampling plan was employed. The study population comprised 1,000 Chinese children aged 36 to 131 months (mean = 74.48 months, standard deviation = 25.69 months). Subjects were scored on seven subsets of the Test of Sensory Integration Function (TSIF). An analysis of variance (ANOVA) was used to identify differences between four age groups (ages 3-4, 5-6, 7-8, and 9-10 years), in the categories of the TSIF. RESULTS: ANOVA revealed that age is a significant factor in each of the seven tasks of sensory integration associated with various stages of development. The effect of age was significant in all four groups for the subscale of Bilateral Integration Sequences. The function of sensory integration for the children aged 5-8 years did not produce statistically significant results for the subscale of Postural Movement, Sensory Discrimination, Sensory Seeking, or Attention and Activity. For the subscale of Sensory Modulation and Emotional Behavior, the effect of age was significant in only group 1 (children aged 3-4 years) and group 2 (children aged 5-6 years). CONCLUSION: There was significant difference between group 1 and group 2 for seven categories. Significant differences were contributed by the differences from group 1 (3-4 years) and group 4 (9-10 years) in five subscales (Postural Movement, Bilateral Integration Sequences, Sensory Discrimination, Sensory Seeking, and Attention and Activity). There were three developmental trends in the seven categories of the TSIF.

Determinants of school activity performance in children with cerebral palsy: a multidimensional approach using the ICF-CY as a framework.

This study aimed to identify the determinants of activity performance in children with cerebral palsy (CP) in school by considering factors from the entire scope of the International Classification of Functioning, Disability, and Health for Child and Youth (ICF-CY). A sample of 167 school-aged children with CP and their caregivers were recruited in the study. Activity performance in school settings was assessed with part 3 of the School Functional Assessment - Chinese version, which divides activity performance into performance of physical activities and cognitive/behavioral activities. Possible determinants were collected according to all dimensions of the ICF-CY. Multiple regression analyses showed that the determinants of performance of physical activities were receiving speech therapy in school, diplegia, having a domestic helper, and severity of gross and fine motor impairments, explaining 83% of the total variance; the determinants of performance of cognitive/behavioral activities were intellectual impairment, prosocial behavior, having an assistant in school, educational placement, severity of fine motor impairment, accounting for 73% of the total variance. Results of the study provide clinicians a holistic understanding of factors influencing school activity performance, and enable clinicians to make appropriate evaluations and interventions targeted at the determinants to enhance children's activity performance in school.

The Cerebral Palsy Quality of Life for Children (CP QOL-Child): evidence of construct validity.

The Cerebral Palsy Quality of Life for Children (CP QOL-Child) is the first health condition-specific questionnaire designed for measuring QOL in children with cerebral palsy (CP). However, its construct validity has not yet been confirmed by confirmatory factor analysis (CFA). Hence, this study assessed the construct validity of the caregiver proxy-report version of the Chinese version of the CP QOL-Child in children with CP using CFA. A total of 312 children with CP (mean age: 8.59 years, SD: 2.52 years) and their caregivers participated in this study. The Chinese version of the CP QOL-Child was completed by the caregivers of children with CP. Then, CFA was applied to evaluate the seven-factor measurement structure of the CP QOL-Child. The seven-factor CFA model had an adequate fit to our data as judged by χ(2) statistic and various goodness-of-fit (GOF) indices, including the root mean square error of approximation (RMSEA). This study provided empirical evidence of the construct validity of the CP QOL-Child to support its use with children with CP in the Chinese speaking society.

Docetaxel and 5-fluorouracil induce human p53 tumor suppressor gene transcription via a short sequence at core promoter element.

The p53 tumor suppressor protein is involved in cellular defense against agents that can cause genetic damage. Induction of p53 gene expression at transcriptional and post-transcriptional levels by such agents results in p53-regulated gene activation or suppression. Docetaxel (DOC), a member of the taxanes family that is widely used in cancer chemotherapy, activates p53 at the transcriptional level. We demonstrated that p53 is induced by low dose DOC treatment, resulting in MDR-1 gene suppression in human lung cancer cells. To identify the cis-element of p53 promoter that responds to DOC, p53 promoter region was cloned and promoter activity was analyzed on luciferase gene reporter assay. Promoter region (-78 to +129) contained the highest basal p53 promoter activity and deletion of +86 to +129 severely reduced basal promoter activity. Basal promoter region included the 21-bp element (PE21) that determines UV-inducible expression of p53 and mediates DOC-inducible p53 expression. On site-specific mutagenesis of PE21 (-78 to -58), with mutation of ATTG (-62 to -59) to CGGT, completely diminished the response to DOC. The same mutations also inhibited 5-fluorouracil (5-FU)-inducible p53 expression. Our data revealed that a sequence located at PE21 of p53 core promoter regulates p53 induction by chemotherapeutic agents.

The determinants of daily function in children with cerebral palsy.

The aim of this study was to identify determinants of daily function in a population-based sample of children with cerebral palsy (CP). The study took into consideration factors from the entire scope of the International Classification of Functioning, Disability, and Health (ICF). Furthermore, the determinants of daily function were examined from the perspectives of capacity and performance respectively. A total of 216 children with CP (mean age 8.19 years, SD 3.39 years) and their caregivers participated in the study. The potential determinants of daily function from the dimensions of health condition, body functions and structures, environmental and personal factors of the ICF were collected. Stepwise multiple regression models showed that child's age, grade, preferred hand, educational placement, severity of gross and fine motor impairment, and prosocial behavior were important determinants, accounting for 88.29% of the variance of daily capacity. The aforementioned variables together with birth order were determinants of performance of daily function, and accounted for 89.53% of the variance in that performance. Knowledge of determinants of daily function helps clinicians and educators to plan intervention and educational programs targeted at these determinants to improve capacity and performance in daily function for children with CP.

Responsiveness of the psychoeducational profile-third edition for children with autism spectrum disorders.

The aim of this study was to examine the responsiveness of the Psychoeducational Profile-third edition (PEP-3) in children with Autism Spectrum Disorders (ASD). We investigated the responsiveness in terms of three types of scores (i.e., raw scores, developmental ages, and percentile ranks) of the subtests and composites of the PEP-3 and three methods of analysis were used: effect size, standardized response mean, and paired t test. The findings generally support the use of the PEP-3 as an outcome measure. We suggest using the raw scores and developmental ages of the PEP-3 when evaluating program effectiveness and developmental changes for children with ASD.

Psychometric properties of a Chinese version of the Developmental Coordination Disorder Questionnaire in community-based children.

The aim of this study was to adapt and evaluate the Developmental Coordination Disorder Questionnaire (DCDQ) for use in Chinese-speaking countries. A total of 1082 parents completed the DCDQ and 35 parents repeated it after 2 weeks for test-retest reliability. Two items were deleted after examination of test consistency. Cronbach's alpha for the total score was 0.89 and test-retest reliability was 0.94. Exploratory and confirmatory factor analyses showed this version to be compatible with the original and two adaptations of the DCDQ. One-way ANOVA and the post hoc tests revealed that the non-DCD group scored significantly higher than the DCD group and the suspect DCD group, but the latter two did not differ significantly. Sensitivity and specificity of the DCDQ were 73% and 54%. The estimated area under the Receiver Operating Characteristic curve was 0.68. Compared to the dichotomized grouping in assessing sensitivity and specificity, which provides clinicians with all or none information about a child's probability of being DCD, the informative conditional effect plot could alert clinicians to the child with less conspicuous movement problems. This adaptation of the DCDQ could be used for identifying motor coordination problems in Chinese-speaking societies.