Assessing the usefulness of the Little Developmental Coordination Disorder Questionnaire-Chinese in Chinese preschoolers: a sex-and age-specific analysis.

Aim: This study evaluated the sex-and age-specific usefulness of the Little Developmental Coordination Disorder Questionnaire-Chinese (LDCDQ-CH) in Chinese preschoolers. Method: A population-based sample of 51,110 children aged 3-5 years was recruited. Internal reliability, construct validity, concurrent validity with the Ages and Stages Questionnaire-third edition (ASQ-3), and discriminant validity with the Movement Assessment Battery for Children-second edition (MABC-2) were assessed. Age and sex effects on LDCDQ-CH scores were analyzed using ANOVA and t-tests. Results: The LDCDQ-CH exhibited excellent internal consistency and reliability across ages and genders. Confirmatory factor analysis supported the 15-item model's satisfactory fit. Positive and significant correlations were observed between LDCDQ-CH and ASQ-3 scores, indicating robust concurrent validity. Significant associations were found between LDCDQ-CH and MABC-2 scores. Higher scores were observed in older children and girls, indicating age- and sex-related differences in motor functional performance. Conclusion: The LDCDQ-CH is a reliable and valid tool to support early identification of motor coordination difficulty in Chinese preschoolers, and guiding interventions. Findings support its use across ages and genders, highlighting its potential in the Chinese context. Age- and sex-specific norms are needed for enhanced clinical applicability.

Research Knowledge Translation in Sensory Integration-Based Therapy: Exploring Subjectivity of Clinical Expertise.

Background. Clinical expertise is the mechanism through which practitioners implement other components of evidence-based practice (EBP). Within occupational therapy practice, intervention approaches that are both closely and loosely aligned with Ayres' Theory of Sensory Integration are widespread, offering a unique opportunity to investigate the subjective nature of clinical expertise in EBP. Purpose. This qualitative study explored motivations to offer sensory integration-based interventions, and factors informing occupational therapists' clinical decision making in relation to an arguably contentious evidence base. Method. Six post-graduate sensory integration trained UK occupational therapists participated in individual semi-structured interviews. Interviews were transcribed, member-checked and analyzed using thematic coding analysis. Findings. Despite sound understanding of theory and continuous efforts to develop clinical knowledge, non-traditional hierarchies of evidence notably inform clinical decisions. The clinical expertise required for integration of patient preferences, clinical state and circumstances, and research evidence is informed by pragmatic responses to facilitators and barriers across contexts, combined with unique profession-specific identity factors. Implications. While empirical healthcare research is ideally undertaken under controlled conditions, realities of clinical practice are rarely so clear cut. Study findings highlight important subjective factors that are central to real-world research knowledge translation and further understanding of the clinical expertise component of EBP.

Moving from theory to practice in occupational therapy education for planetary health: A theoretical view.

INTRODUCTION: There remains a dearth of easily implemented strategies for translating environmental and sustainability policy into practice within occupational therapy education. In this context, the research-implementation time lag is problematic because time is of the essence when seeking evidence-based educational strategies to address planetary health challenges. The undertaking of practical experimentation to develop strategies for policy implementation and translation is challenged by the urgency of the issues faced. PURPOSE: This paper aims to contribute to conversations around translating awareness of planetary health to practical action for occupational therapy education by proposing a framework for practical "doing" skills, based on conceptually sound, theoretical foundations that support likely efficacy. METHODS: Three skills are suggested as a means to close the theory-practice gap while incorporating what is known about educational processes supporting the transition from novice to expert occupational therapy practitioner. The first skill proposed is a rethinking of essential forms of clinical reasoning, with the introduction of environmental and sustainable reasoning as mandatory. Founded in an adoption of "two-eyed seeing," the second skill emphasises bidirectional questioning for climate-just, person-centred care. The third skill explores interprofessional educational collaboration for environmental sustainability. CONCLUSIONS: Acknowledging the centrality of novice practitioner as part of occupational therapy learner professional identity requires appropriate strategies for learning clinical reasoning skills related to environmental sustainability, planetary health, and the potential discomfort of authentic bidirectional questioning. Implications of adopting these strategies are discussed in relation to their potential contribution to positive change for the occupational therapy profession and wider society.

Psychometric Properties of the French European Little Developmental Coordination Disorder Questionnaire (LDCDQ-FE): A Pilot Study.

AIMS: The Little Developmental Coordination Disorder Questionnaire (LDCDQ) is a parental questionnaire designed to identify preschool children at risk of Developmental Coordination Disorder (DCD). This study aimed to translate and cross-culturally adapt the LDCDQ for French European informants (Little Developmental Coordination Disorder Questionnaire-French European [LDCDQ-FE]) and to undertake a pilot examination of its psychometric properties on a French sample. METHODS: A thorough process of cultural adaptation was completed. The psychometric properties were examined with a sample of 154 French children aged to 5y11m (control = 121; clinically referred = 33). A sub-group of 34 children was assessed using the MABC-2 to measure convergent validity. RESULTS: Principal component analysis demonstrated a four-component structure, accounting for 67.5% of the variance. Internal consistency was acceptable to good (α = 0.74-0.89). Significant correlation between the LDCDQ-FE and the MABC-2 total scores showed convergent validity. Discriminant validity was supported by significant score differences between the clinically referred and a matched control sub-group. Using ROC curves, a cutoff of 67 was proposed for a sensitivity of 81.3% and a specificity of 77.8%. CONCLUSIONS: Results show initial evidence of the psychometric properties of the LDCDQ-FE and are encouraging of its use to identify young preschoolers at risk for DCD. In future studies, the test-retest reliability should be investigated, and study sample sizes expanded.

Cross-cultural validation of the Brazilian Little Developmental Coordination Disorder Questionnaire (LDCDQ-BR) for preschool children.

INTRODUCTION: Motor difficulties associated with Developmental Coordination Disorder (DCD) are frequently apparent before the accepted diagnostic age of 5. Tools to support identification of DCD markers would allow provision of early intervention to reduce negative sequelae. OBJECTIVE: Establish psychometric properties and define preliminary cut-off scores for the Brazilian Little Developmental Coordination Disorder Questionnaire - Brazil (LDCDQ-BR). METHODS AND PROCEDURES: Parents of 3- and 4-year-old children (n = 312; 154 girls) from Belo Horizonte/MG, Brazil, completed the LDCDQ-BR, the Brazil Economic Classification Criterion and a demographic questionnaire. One sub-set of children (n = 119) was assessed with the Movement Assessment Battery for Children-2nd Edition; another sub-set (n = 77) completed the LDCDQ-BR a second time. RESULTS: Rasch analysis indicated good item functioning with only one erratic item, suggesting unidimensionality. Item calibration reliability was excellent (0.97), children's measures reliability was low (0.72), but implying separation of 2.46 motor ability levels. Significant, low correlations were found between the LDCDQ-BR and MABC-2 (r = 0.30, p < 0.01). Test-retest reliability was 0.77 (total score) and 0.44-0.78 (individual items). ROC curve analysis revealed sensitivity of 68% at a cut-off score of 64. CONCLUSION: The LDCDQ-BR shows promising psychometric properties to support early identification of DCD.

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.

The impact of hearing loss on speech outcomes in 5-year-old children with cleft palate ± lip: A longitudinal cohort study.

OBJECTIVES: To investigate the impact of hearing loss (using longitudinal measurements of hearing) on speech outcomes at age 5 (5 years 0 months-5 years 11 months) in children born with cleft palate ± lip. Other variables which may impact upon the speech outcomes at age 5 in this population were also investigated. METHODS: A retrospective longitudinal cohort study of children, without a named syndrome, born with cleft palate ± lip, and treated at a Cleft Centre in the United Kingdom. Data collected from infancy to 5 years 11 months, included hearing test results from three specific time points (7 months-1 year 2 months [age A]; 2 years 0 months-2 years 11 months [age B]; 5 years 0 months-5 years 11 months [age C]) and speech outcome data at age 5 years (5 years 0 months-5 years 11 months). Hearing test results at each age were compared to identify how hearing changes with age. Correlations between hearing test results and speech outcomes at age 5 were analysed. RESULTS: Hearing loss was frequent but predominantly mild. There were no significant correlations between speech outcomes and hearing results at any age. Mild hearing loss remained prevalent at age 5, although a significant age-related hearing improvement was found. A significant relationship between cleft type and cleft speech characteristics was found (P < .001); children with Bilateral Cleft Lip and Palate achieved the poorest articulation outcomes. CONCLUSION: Although mild hearing loss was common in the cohort, there was no association between hearing loss and the speech outcomes investigated. In contrast, the type of cleft was significantly associated with the presence of cleft speech characteristics. Further longitudinal measurement of hearing is required to substantiate the findings of this study.

Assessing speech at three years of age in the cleft palate population: a scoping review of assessment practices.

BACKGROUND: There is no consensus in the UK regarding the types of speech samples or parameters of speech that should be assessed at 3 years of age in children with cleft palate ± cleft lip (CP±L), despite cleft units routinely assessing speech at this age. The standardization of assessment practices would facilitate comparisons of outcomes across UK cleft units; earlier identification of speech impairments-which could support more timely treatments; and more reliable recording of therapy impacts and surgical interventions. AIMS: To explore assessment practices used to assess speech in 3-year-old children with CP±L, including speech parameters, methods of assessment and the nature of the speech sample used. METHODS & PROCEDURES: A broad examination of the literature was undertaken through the use of a scoping review conducted in accordance with Joanna Briggs Institute guidelines. Search terms were generated from a preliminary search and then used in the main search (Medline, CINAHL, Embase, AMED and PsycINFO). MAIN CONTRIBUTION: A combination of approaches (medical, linguistic, developmental and functional) is required to assess CP±L speech at age 3. A developmental approach is recommended at this age, considering the complexity of speech profiles at age 3, in which typically developing speech processes may occur alongside cleft speech characteristics. A combined measure for both nasal emission and turbulence, and an overall measure for velopharyngeal function for speech, show potential for assessment at this age. Categorical ordinal scales are frequently used; the use of continuous scales has yet to be fully explored at age 3. Although single-word assessments, including a subset of words developed for cross-linguistic comparisons, are frequently used, more than one type of speech sample may be needed to assess speech at this age validly. The lack of consensus regarding speech samples highlights a need for further research into the types of speech samples 3-year-olds can complete; the impact of incomplete speech samples on outcome measures (particularly relevant at this age when children may be less able to complete a full sample); the impact of different speech samples on the validity of assessments; and the reliability of listener judgements. CONCLUSIONS & IMPLICATIONS: Whilst a medical model and linguistic approaches are often central in assessments of age-3 cleft speech, this review highlights the importance of developmental and functional approaches to assessment. Cross-linguistic single-word assessments show potential, and would facilitate the comparison of UK speech outcomes with other countries. Further research should explore the impact of different speech samples and rating scales on assessment validity and listener reliability.

Suitability of the Miller Function and Participation Scales (M-FUN) for use with Israeli Children.

OBJECTIVE. Our aim was to generate a Hebrew translation of the Miller Function and Participation Scales (M-FUN) and assess the validity of U.S. norms for Israeli children. METHOD. All components of the M-FUN were translated, and a pilot study revealed a need for further investigation. The Hebrew M-FUN's fine, gross, and visual-motor (VM) components and M-FUN participation questionnaires were administered to 267 Israeli children (128 boys, 139 girls; mean age = 59.21 mo, standard deviation = 17.84). RESULTS. Significant correlations supported construct validity between age and all motor and participation scores as well as age-group differences. Significant differences between the U.S. and Israeli samples were found only for the VM score. Participation and motor scores were significantly correlated. CONCLUSION. Although VM score results should be interpreted with caution, we provide evidence for use of the fine and gross motor norms and the U.S. criterion-referenced participation scores of the M-FUN with Israeli children.

Developmental outcomes at preschool age after fetal exposure to valproic acid and lamotrigine: cognitive, motor, sensory and behavioral function.

This prospective, observational study assessed the development of preschool children aged 3-6 years, 11 months (n=124) after in-utero anti-epileptic drug (AED) monotherapy exposure to valproic acid (VPA) (n=30, mean age 52.00[±15.22] months) and lamotrigine (LT) (n=42, mean age 50.12[±12.77] months), compared to non-exposed control children (n=52, mean age 59.96[±14.51] months). As a combined group, AED-exposed children showed reduced non-verbal IQ scores, and lower scores on motor measures, sensory measures, and parent-report executive function, behavioral and attentional measures. When the VPA- and LT-exposed groups were analyzed separately, no cognitive differences were found, but control-VPA and control-LT differences emerged for most motor and sensory measures as well as control-VPA parent-report behavioral and attentional differences. No differences were noted between the VPA and LT groups. These findings suggest that VPA- and LT-exposed children should be monitored on a wider range of developmental measures than currently used, and at differing developmental stages.

Preliminary findings of the developmental effects of in utero exposure to topiramate.

There are relatively few studies that have looked at the longer-term developmental effects of intra-uterine topiramate exposure. The purpose of this report is to describe preliminary findings of the developmental outcomes of a group of nine children of preschool age (3-6 years, 11 months), exposed in utero to topiramate (TX) monotherapy, as compared to a control group of 18 children. The groups were compared on developmental measures of visual, fine and gross motor function as well as measures of behavior and cognitive functions. Results showed that the TX group performed significantly worse than the control group for almost all measures, with the most clearly delineated differences in the area of cognitive functioning. While the study group is small, and only preliminary conclusions may be inferred, it appears that TX exposure may have subtle effects on the development of children in a range of areas including motor function, cognition, and behavior.

Development of the Little Developmental Coordination Disorder Questionnaire for preschoolers and preliminary evidence of its psychometric properties in Israel.

PURPOSE: The early identification of motor coordination challenges before school age may enable close monitoring of a child's development and perhaps ameliorate some of the social, psychological and behavioral sequela that often accompany unrecognized Developmental Coordination Disorder (DCD). The purpose of this study was to develop and assess the initial psychometric properties of a screening tool, the Little DCD Questionnaire (Little DCDQ), designed to identify DCD amongst preschoolers aged 3 and 4. METHODS: The suitability of the items of the DCDQ'07 for 3- and 4-year-old children was assessed. Four items were found to be suitable and new items were generated. Content validity was ensured using a Table of Specification and the items were categorized into three sub-categories (Control During Movement, Fine Motor and General Coordination). The Little DCDQ was administered to 146 children (91 boys) aged 3 and 4 (mean age=49.39±7.16 months). Ninety-one typically developing children were included (mean age=47.80±7.05 months; 46 boys) while 55 children had been referred or were being treated for some form of developmental delay (mean age=52.02±6.60 months; 45 boys). Of this sample, 28 parents completed the questionnaire twice within a 2-week interval. RESULTS: Test-retest reliability was evidenced by moderate to good intraclass correlation coefficient values between scores on the two administrations for the total and the three sub-category scores. Evidence of internal consistency was provided by adequate to high Cronbach's alpha co-efficients calculated for each item, each sub-category score and the total score for the total group, and separately for the control group and the clinically referred group. Validity evidence based on relations to other variables was provided by the finding of significant group differences (clinically referred and control) for the total and sub-category scores for both the age groups and the total group. CONCLUSIONS: Based on the preliminary psychometric evidence, it appears that the Little DCDQ meets many of the necessary standards for validity and reliability as a screening instrument, and shows promise as a useful clinical and research tool.

Are the cognitive functions of children with Down syndrome related to their participation?

AIM: There is a lack of investigation into the functional developmental profile of children with Down syndrome. On the basis of current international health paradigms, the purpose of this study was to assess the developmental profile of these children. METHOD: Sixty children (33 males, 27 females) with Down syndrome (age range 6-16y; mean age 9y 3mo, SD 28.8mo), who had received standard, holistic, early intervention, were assessed. Of these, 42 (70%) had congenital anomalies, 12 had severe congenital heart defects. Participants were assessed on measures of cognitive function (Beery-Buktenica Developmental Test of Visual-Motor Integration; Stanford-Binet Intelligence Scale) and participation (Vineland Adaptive Behaviour Scales). RESULTS: No difference was found on any measure on the basis of severity of congenital anomaly. Results showed improvements in age-related body function and correlations between specific body functions and participation. No decline in IQ was found with age, and significant correlations between IQ and all other measures were noted. Although sex differences were found in the body functions of short-term memory and motor function, no difference in measures of activity performance and participation was found. INTERPRETATION: Our findings emphasize the need for paediatric Down syndrome intervention to encourage improved body functions while emphasizing the acquisition of functional skills that enable enhanced participation in age-appropriate activities.

The Participation in Childhood Occupations Questionnaire (PICO-Q): a pilot study.

There is a need, among practitioners and researchers, for a feasible, user-friendly assessment tool that evaluates overall participation and guides intervention. This paper describes the process of construction and development of the Participation in Childhood Occupations Questionnaire (PICO-Q) and the establishment of its primary psychometric properties. The 22-item instrument measures the level, enjoyment, and frequency of performance for children's participation in daily occupations in a variety of environments. The questionnaire was completed by the mothers of 41 children between the ages of 6 and 10 years (24 children with and 17 children without sensory modulation disorder). Cronbach's alpha varied from. 86 to. 89, indicating internal consistency of items. Test-retest reliability varied from. 69 to. 86, indicating that the instrument provides a stable measurement over time. The PICO-Q was found to differentiate between children with and without participation restrictions. The PICO-Q shows initial reliability and validity and has both research and clinical application potential.