A comparison of characteristics, developmental disorders and motor progression between children with and without developmental coordination disorder.

BACKGROUND AND AIM: Children with Developmental Coordination Disorder (DCD) have difficulty in the development of motor coordination and with learning new motor skills. Studies demonstrate that children with DCD differ in terms of the nature and severity of their motor difficulties, the incidence of co occurring conditions and family background. However, little is known whether these profiles may relate to motor progression over time. The aim of this study was to describe the profiles of children with and without DCD and track motor progression over time. METHOD: The characteristics of thirty-four 7-14 year old children (M = 10.07, 85.3% boys) with and without DCD were compared and their motor progression monitored over a two academic years. DCD was identified using DSM5 criteria. The Movement Assessment Battery for Children-2 (MABC-2) was used to classify children as TD (≥25th percentile), having moderate motor coordination difficulties (6-16th percentile) or severe motor coordination difficulties (≤ 5th percentile). The Kaufman Brief Intelligence Test - 2 (KBIT-2) was used to measure full scale IQ. Parent questionnaires were used to gather information on socio economic status and co occurrence of other developmental disorders. We used ANOVA to assess whether there were differences in characteristics between the TD children, children with severe motor coordination difficulties and children with moderate motor coordination difficulties. Linear mixed effect modelling was used to estimate any change in motor performance over time and whether this differed between the three groups of children. RESULTS: Children with severe motor coordination difficulties had distinct profiles in motor and non-motor domains, lower IQ and a greater likelihood of having associated characteristics of 2 or more developmental disorders. We found significant differences between the poor motor performance of the severe group compared to the other two groups. Longitudinal analyses revealed stable, persistent and lower motor competence for the severe group. The rate of change in motor proficiency for the typical and severe groups was similar. However, the group with moderate motor difficulties gained on average more points per week compared to the typical group and achieved motor scores in the typically developing range over time. CONCLUSIONS: This is one of the first studies to compare the characteristics and rate of motor progression of children with and without DCD using different motor proficiency cut off scores. The children with severe motor coordination difficulties progressed at the same rate as typically developing peers but remained in the severe group over time, whereas the children with moderate motor coordination difficulties caught up to TDC. The results indicate that different intervention may be required according to the nature and severity of the characteristics in both the motor and non-motor domains of children with DCD.

An evaluation of the Movement ABC-2 Test for use in Italy: A comparison of data from Italy and the UK.

BACKGROUND: The standardized test within the Movement Assessment Battery for Children-2nd edition (MABC-2) is used worldwide to assess motor problems in children. Ideally, any country using a test developed in another country should produce national norms to ensure that it functions effectively in the new context. AIM: The first objective of this study was to explore the differences in motor performance between Italian and British children. The second was to examine the structural validity of the test for the Italian sample. METHOD: A total of 718 Italian (IT) and 765 British (UK) children, aged 3-10 years, were individually tested on the age-appropriate items of the MABC-2 Test. RESULTS: Developmental trends emerged on every task and differences between IT and UK children were obtained on 11 of 27 task comparisons. Interactions between age and country indicated that differences were not consistently in favor of one culture. Confirmatory factor analysis generally supported the proposed structure of the MABC-2 Test. CONCLUSION: Although the differences between the IT and the UK children were relatively few, those that did emerge emphasize the need for population specific norms and suggest that cultural diversity in motor experiences should be considered when evaluating motor abilities in children.

Adaptation and Extension of the European Recommendations (EACD) on Developmental Coordination Disorder (DCD) for the UK context.

BACKGROUND: Developmental Coordination Disorder (DCD) affects the learning and performance of everyday motor skills. It commonly co-occurs with other developmental disorders and a range of associated psycho-social impairments. Recent evidence-based guidelines on diagnosis, assessment, and intervention provide valuable information for practitioners. However these are directed primarily at German-speaking countries and focus on work with children. AIM: The aim of this project was to consider the application of these guidelines in the UK and to extend them for use with adults with DCD. METHODS: Individuals with DCD, parents, and professionals from a wide range of disciplines were invited to two workshops to discuss and debate the guidelines, to adapt them for the UK and produce dissemination materials. RESULTS: A working definition of DCD was agreed, minor revisions were made to the guidelines to reflect the UK context, an extension for adults was compiled and a series of leaflets was produced to disseminate this information to health and education professionals, parents, and employers. CONCLUSIONS: This work will raise awareness of the condition across different professional groups. It provides information to help those working with children and adults with DCD in the UK to assist in the process of diagnosis, assessment, and intervention.

Gesture production in school vs. clinical samples of children with Developmental Coordination Disorder (DCD) and typically developing children.

Dyspraxia, a difficulty in executing an operationalised act, has been associated with Developmental Coordination Disorder (DCD). However, issues relating to the area such as comparisons across modalities, comparisons of school vs. clinical populations, and developmental delay vs. pathology have not been addressed in the same, comprehensive study. In the current study, therefore, familiar gesture production in DCD was addressed in a comprehensive manner to follow-up outstanding issues from previous studies: The production of familiar gestures and praxis imagery in a school (n=26) vs. clinic sample (n=19) of children with DCD was examined in relation to typically developing age matched (n=24) all aged from 9 to 11 years, and two groups of younger children within the age ranges of 5-6 (n=23) and 4-5 (n=26) years. Overall, children with Developmental Coordination Disorder showed an impaired ability to produce familiar gestures compared to their typical peers, and this was dependant on the type of gesture and presentation modality. Differences were found between school and clinic samples of children with DCD, suggestive of the recruitment of different underlying mechanisms in the two samples. The results have a bearing on our understanding of the relationship of developmental dyspraxia to DCD, as well as of the issue of developmental delay vs. pathology.

Structural validity of the Movement ABC-2 test: factor structure comparisons across three age groups.

BACKGROUND: The Movement ABC test is one of the most widely used assessments in the field of Developmental Coordination Disorder (DCD). Improvements to the 2nd edition of the test (M-ABC-2) include an extension of the age range and reduction in the number of age bands as well as revision of tasks. The total test score provides a measure of motor performance, which can be used to help make a diagnosis of DCD. M-ABC-2 also provides 3 sub-scales for Manual Dexterity, Aiming and Catching and Balance but the validity of these conceptually derived sub-scales has not previously been reported. AIM: To examine the factor structure of the M-ABC-2 test across the three age bands (AB): AB1 (3-6-year olds), AB2 (7-10-year olds) and AB3 (11-16-year olds). METHOD: Data from the 2007 standardisation sample (N=1172) were used in this study. Confirmatory factor analyses (CFA) and structural equation modelling (LISREL 8.8) were employed to explore the relationship between the tasks within each of the 3 age bands. A model trimming approach was used to arrive at a well fitting model. RESULTS: In AB1 a complex factor structure emerged providing evidence for an independent general factor, as well as specific factors representing the 3 test components. In AB2 a final model emerged with four correlated factors, an additional distinction being drawn between static and dynamic balance. In addition, a 2nd order general factor explained a considerable amount of variance in each primary factor. In AB3 CFA supported the 3-factor structure of the M-ABC-2, with only modest correlations between each factor. CONCLUSIONS: The confirmatory factor analyses undertaken in this study further validate the structural validity of the M-ABC-2 as it has developed over time. Although its tasks are largely associated with the three sub-components within each age band, there was also clear evidence for a change in the factor structure towards differentiation in motor abilities with age.

Intervention in children with Developmental Coordination Disorder: the role of parents and teachers.

BACKGROUND: Children with Developmental Coordination Disorder (DCD) are a heterogeneous group who have a marked impairment in the performance of functional skills. Provision for these children is usually made via a paediatrician through occupational or physiotherapy though, with a prevalence rate of 5%, regular provision is not possible due to limited professional resources. AIMS: The study aimed to determine the extent to which parents and teachers, with guidance, can assist in the management of children with DCD; whether children with DCD are helped in this way and how this may contribute to our understanding of the condition. SAMPLE: Thirty-one children with DCD aged 7 to 9 years participated in the study. METHODS: Following assessment, individual profiles were developed and each week teachers and parents were given guidelines for working with the children and each child had three to four sessions a week lasting approximately for 20 minutes. In Phase 1, one group of children worked with teachers and the other group worked with parents. In Phase 2, the two groups of children swapped over. The children were assessed regularly throughout the project using the Movement ABC, together with diaries and comments from teachers and parents. RESULTS: At the end of the 40-week study, 27 children showed significant improvement in their motor skills. CONCLUSIONS: Both teachers and parents were able to provide effective intervention for the majority of the children. It is possible that the children who did not improve have difficulties that are of a more complex type which require more specialist therapy to meet their need.