Brenda N. Wilson

DCD may not be a discrete disorder

The primary aim of this paper is to explore some of the issues surrounding the concept of DCD as a ‘‘specific’’ learning diAculty. Questions relating to the assessment and identification of DCD are addressed. The arguments we present are derived from data obtained in a study which compared 224 children referred because of learning and attention problems (but not motor diAculties) and 155 typically developing children. These 379 children were all assessed on a range of formal and informal tests, including several sensorimotor tests. Working criteria for classifying a child as DCD were derived. In addition to the high prevalence figures obtained for DCD in this group of children, the degree of comorbidity observed between DCD and the other developmental disorders (reading disability and attention-deficit/hyperactivity disorder) was also striking. These results prompted us to re-evaluate the usefulness of discrete diagnostic categories, and to consider a reconceptualization of childhood disorders in general. It is proposed that the comorbidity found in childhood disorders reflects a single underlying etiology: Atypical Brain Development. This deficit may be manifested in a variety of ways, including DCD, and explains why some childhood disorders are so often seen together. ” 1998 Elsevier Science B.V. All rights reserved. PsycINFO classification: 2221; 2330; 3230; 3253; 3270

Developmental coordination disorder: Associated problems in attention, learning, and psychosocial adjustment

This study investigated the problems of attention, learning and psychosocial adjustment evidenced by children with developmental coordination disorder (DCD). Forty-five children identified with DCD, 51 children identified as being suspect for DCD and 78 comparison children without motor problems on standardized tests of motor function participated in this study. Results revealed that both children with DCD and children suspect for DCD obtained significantly poorer scores on measures of attention and learning (reading, writing and spelling) than comparison children. Children with DCD and those suspect for DCD were also found to evidence a relatively high level of social problems and display a relatively high level of somatic complaints based on parent report. These findings indicate that all children with movement problems are at risk for problems in attention, learning and psychosocial adjustment. Assessment of children with movement problems, regardless of the degree or severity of these problems should examine a wide range of functions in addition to motor functioning. Such an approach, would assist in determining the types of intervention that would provide the most benefit to these children.

Psychometric Properties of the Revised Developmental Coordination Disorder Questionnaire

The Developmental Coordination Disorder Questionnaire (DCDQ) is a parent-completed measure designed to identify subtle motor problems in children of 8 to 14.6 years of age. The purpose of this study was to extend the lower age range to children aged 5 to 7 years, revise items to ensure clarity, develop new scoring, and evaluate validity of the revised questionnaire. Additional items with improved wording were generated by an expert panel. Analyses of internal consistency, factor loading, and qualitative/quantitative feedback from researchers, clinicians, and parents were used to select 15 items with the strongest psychometric properties. Internal consistency was high (alpha =. 94). The expanded questionnaire was completed by the parents of 287 children, aged 5–15 years, who were typically developing. Logistic regression modeling was used to generate separate cutoff scores for three age groups (overall sensitivity = 85%, specificity = 71%). The revised DCDQ was then compared to other standardized measures in a sample of 232 children referred for therapy services. Differences in scores between children with and without DCD (p <. 001) provide evidence of construct validity. Correlations between DCDQ scores and Movement Assessment Battery for Children (r =. 55) and Test of Visual-Motor Integration (r =. 42) scores support concurrent validity. The results provide evidence that the revised DCDQ is a valid clinical screening tool for DCD.

Identifying developmental coordination disorder: consistency between tests.

Summary In the absence of a gold standard to identify the presence of developmental coordination disorder in children, it is useful to examine the consistency of different tests used in physical and occupational therapy. This study examined three measures of motor skills to determine whether they consistently identified the same children. In total, 379 children participated in this study. The final matched samples consisted of 202 children ranging in age from 8 to 17 years: 101 met criteria for DCD and 101 children did not show any evidence of DCD. The results indicated that the overall agreement between the Bruininks Oseretsky Test of Motor Proficiency (BOT), the Movement Assessment Battery for Children (M-ABC) and the Developmental Coordination Disorder Questionnaire (DCDQ) was less than 80%. The difference in structure and style of administration between the BOT and the M-ABC appears to contribute to their tendency to identify different children. This studyemphasizes the need for therapists to use clinical reasoning to examine multiple sources of information about a childs abilities.

Focus on function: a cluster, randomized controlled trial comparing child‐ versus context‐focused intervention for young children with cerebral palsy

Aim  This study evaluated the efficacy of a child‐focused versus context‐focused intervention in improving performance of functional tasks and mobility in young children with cerebral palsy.

Developmental Coordination Disorder

Summary This paper begins with a discussion of the historical basis for the concept of developmental coordination disorder (DCD). The definition of this disorder as it appears in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) is then provided. The four diagnostic criteria proposed by the DSM-IV are used to describe the disorder. Problems associated with the assessment of DCD are discussed and suggestions for further research are identified. This is followed by a discussion of intervention approaches that can be used with children identified with DCD.

Evaluation of the Developmental Coordination Disorder Questionnaire as a screening instrument

Reliability and validity of the Developmental Coordination Disorder Questionnaire (DCD-Q) was assessed using a population-based sample of 608 children (311 males, 297 females; mean age 7 y 8 mo [SD 2 y 4 mo]), a sample of 55 children with DCD referred to a rehabilitation clinic, and a control sample of 55 children matched for age and sex (48 males, seven females in each sample; mean age 8 y 3 mo [SD 2 y]). The DCD-Q is reliable and valid in the age range for which the questionnaire was developed(8 y-14 y 7 mo) and in a younger age range (4-8 y). Sensitivity and specificity of the DCD-Q was assessed using the Movement Assessment Battery for Children as the criterion standard. The DCD-Q met the standard for sensitivity (80%) in the clinic-referred sample (81.6%), but not in the population-based sample (28.9%). Specificity almost reached the standard of 90%: 89% in the population-based sample and 84% in the clinic-referred sample.

Context therapy: a new intervention approach for children with cerebral palsy

Aim  To describe the development of context therapy, a new intervention approach designed for a randomized controlled trial.

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 8y, SD 9mo) with developmental coordination disorder (DCD), 25 with suspected DCD ([sDCD] 17 males, eight females; mean age 7y 6mo, SD 8mo), and 63 children without motor problems (39 males, 24 females; mean age 7y 9mo, SD 7mo) were recruited from public schools (Grades 1–3, age 6y 4mo–9y 10mo) 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). χ2 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.

Is Questionnaire-Based Screening Part of the Solution to Waiting Lists for Children with Developmental Coordination Disorder?

This study was undertaken to determine whether questionnaire-based screening could be part of the solution to a long waiting list of referrals for occupational therapy assessment by identifying the requirement for clinical assessments. The performance of two questionnaires – the Developmental Coordination Disorder Questionnaire (DCDQ) completed by parents and the Checklist of the Movement Assessment Battery for Children (C-ABC) completed by teachers – was compared with a more traditional clinical assessment for the identification of DCD in children already referred to occupational therapy. It was found that the parent report was quite reliable in the identification of DCD if no other developmental problem was present. However, there was little benefit to using the teacher report to screen children. Several confounding variables, including an unequal proportion of children with DCD in the sample and the inclusion of children who were younger than the age range of the DCDQ, may have influenced how well the questionnaires performed. Although questionnaires cannot replace a full clinical assessment, the results showed that there may be some value in including the parent report in the identification of DCD.