Evaluation of the psychometric properties of the developmental coordination disorder questionnaire for parents (DCD-Q): results from a community based study of school-aged children

In this study, we examine several key psychometric properties (reliability, construct validity, concurrent validity) of the Developmental Coordination Disorder Questionnaire (DCD-Q) using a large, school-based sample of children (n=523) and their parents. Children completed the Children's Self-perceptions of Adequacy in and Predilection toward Physical Activity (CSAPPA) and parents completed the DCD-Q. The internal reliability of the DCD-Q was high for both the full scale and the subscales. Confirmatory factor analysis established that the scale was multifactorial, but the fit of the hypothesized factor structure was poor. Finally, moderate correlations were observed between the CSAPPA and the DCD-Q, with the strongest correlation found between the "perceived adequacy" subscale of the CSAPPA and "control during movement" subscale of the DCD-Q. Implications for screening and further research are discussed in relation to both instruments.     

Aspects of the validity of the Movement Assessment Battery for Children

Does the Movement Assessment Battery for Children (M-ABC) measures what it claims to measure? The concurrent validity of the total impairment score and some of the item scores of the second and third age band of the M-ABC test were investigated. One hundred thirty three children, between 7- and 9-year-old, were assessed with the M-ABC test, a ball catching test and two tasks measuring dynamic balance. Ninety of these children were identified as children with a poor ball catching skill and 43 children were typically developing children. One hundred and seven children were assessed with the second age band of the M-ABC (the 7- and 8-year-old children) and 26 with the third age band (the 9-year-old children). The results of the correlation analysis between the ball catching test, the two dynamic balance tasks and the corresponding items of the M-ABC, varied from non-significant to a highly significant correlation coefficient of -0.74. For some items concurrent validity was established but other items seemed less valid, probably due to a lack of discriminative power. The concurrent validity of the total impairment score of the M-ABC was confirmed for the second age band. Correlation coefficients between the ball catching test, the dynamic balance skills and the M-ABC varied between -0.72 and -0.76. The results for the third age band have to be interpreted with prudence because they were based on only 26 children.     

Impaired re-weighting of sensory feedback for maintenance of postural control in children with developmental coordination disorder

To further the understanding of postural control impairments seen in children with developmental coordination disorder (DCD) and the effect of these impairments on motor performance in these children, 30 children with and without DCD (mean age=9 years, 7 months +/- 1 year, 10 months) were administered the Movement Assessment Battery for Children (M-ABC), Wechsler Abbreviated Scale of Intelligence and the Sensory Organization Test. Analyses of covariance revealed that children with DCD had greater difficulty maintaining postural control when visual and somatosensory feedback were compromised in sensory conflict environments (p=.031). Group differences in postural control were independent of age. Additionally, no correlation was seen between motor performance on the M-ABC and postural control measures for the Sensory Organization Test. Our results demonstrate that impaired ability to utilize vestibular feedback while re-weighting somatosensory and visual feedback for orientation may be responsible, in part, for the postural control impairments observed in some children with DCD.     

Identifying play characteristics of pre-school children with developmental coordination disorder via parental questionnaires

Motor coordination deficits that characterize children with Developmental Coordination Disorder (DCD) affect their quality of participation. The aim of the current study was to identify play characteristics of young children with DCD, compared to those of children with typical development in three dimensions: activity and participation, environmental factors and children’s impairments.MethodSixty-four children, aged four to six years, participated. Thirty were diagnosed as having DCD; the remaining 34 children were age, gender and socioeconomic level matched controls with typical development. The children were evaluated by the M-ABC. In addition, their parents completed a demographic questionnaire, the Children’s Activity Scale for Parents (CHAS-P), the Children’s Leisure Assessment Scale for preschoolers (CLASS-Pre), and My Child’s Play Questionnaire (MCP).ResultsChildren with DCD performed significantly poorer in each of the four play activity and participation domains: variety, frequency, sociability, and preference (CLASS-Pre). Furthermore, their environmental characteristics were significantly different (MCP). They displayed significantly inferior performance (impairments) in interpersonal interaction and executive functioning during play, in comparison to controls (MCP). Moreover, the children’s motor and executive control as reflected in their daily function as well as their activities of daily living (ADL) performance level, contributed to the prediction of their global play participation.DiscussionThe results indicate that the use of both the CLASS-Pre and the MCP questionnaires enables the identification of unique play characteristics of pre-school children with DCD via parents’ reports. A better insight into these characteristics may contribute to theoretical knowledge and clinical practice to improve the children’s daily participation.     

Static balance and developmental coordination disorder

The development of static balance is a basic characteristic of normal motor development. Most of the developmental motor tests include a measure of static balance. Children with a developmental coordination disorder (DCD) often fail this item. Twenty-four children at risk for DCD with balance problems (DCD-BP) and 24 matched control children in the age range of 6-12 years participated in a detailed study of balance control. Additional groups of children (6-7 years, N=25; 10-11 years, n=16; with M-ABC scores >15th percentile) were selected randomly to study developmental changes in balance control in the age range of interest. Three experiments were conducted to examine developmental and clinical differences in the control of static balance. In the first, we measured the excursion of the centre of pressure (force-plate) in conditions with and without vision while standing still on one or two legs for 20 s. In the second experiment, EMGs were measured while standing on one leg. In the third experiment, in which only a subgroup of the DCD-BP and matched control children participated, a short unexpected force in the back lightly perturbed normal standing and EMG and force-plate responses were measured during balance recovery. In conditions of one-leg stance, children were not always able to maintain balance. Only epochs of stable postural control (7.5-20 s) were analysed. The results showed improvement of static balance with age, but only subtle differences between the DCD and control groups. Centre of pressure measures differed in the more difficult conditions. DCD-BP children had more difficulty standing on one leg with eyes closed. While standing on the non-preferred leg the EMGs of the DCD-BP children showed slightly more co-activation of the muscles of lower and upper leg. Perturbation of standing resulted in longer duration of recovery in the first trial in this group. Apparently DCD children learn to compensate for the perturbation within a few trials as well as control children do. The clear improvement with age shows that our measures of balance control are sensitive to detect changes. The general conclusion that may be drawn from this study is that under normal conditions static balance control is not a problem for children with DCD. Only in difficult or novel situations they seem to suffer from increased postural sway as a result of non-optimal balance control.     

Role of visual-perceptual skills (non-motor) in children with developmental coordination disorder

The purposes of this study were to examine test-retest reliability of the Test of Visual-Perceptual Skills (Non-Motor)-Revised (TVPS-R), to explore motor-free visual-perceptual skills, and to categorize subtypes thereof in children with developmental coordination disorder (DCD). One hundred and seventy-eight children, aged 9 and 10 years, identified as having DCD with the Movement Assessment Battery for Children (M-ABC), were assessed, along with 200 typically developing children. The results showed good test-retest reliability for the total perceptual quotient scores of the TVPS-R, but not for all subtests. Children with DCD performed significantly poorer compared to typically developing children on the visual-perceptual test, but the deficits were not common to all children with DCD. This study supported the stance that we should consider the heterogeneous characteristics of children with DCD when designing experimental studies or developing educational interventions.     

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.     

Motor and functional skills of children with developmental coordination disorder: a pilot investigation of measurement issues

This paper reports on the motor and functional outcomes of 20 children with developmental coordination disorder (DCD) aged 4-8 years consecutively referred to a pediatric physiotherapy service. Children with a Movement ABC (M-ABC) score less than the 15th percentile, and with no concurrent medical, sensory, physical, intellectual or neurological impairments, were recruited. The Motor Assessment Outcomes Model (MAOM) [Coster and Haley, Infants and Young Children 4 (1992) 11] provided the theoretical base for measurement selection, and preliminary findings at the activities and participation levels of the model are reported in this article. Children with DCD performed at the lower end of the normal range on the Peabody Developmental Motor Scales (fine motor total score) (M=85.65, SD=12.23). Performance on the Visual Motor Integration Test (VMI) standard scores was within the average range (M=96.15, SD=10.69). Videotaped observations of the children's writing and cutting indicated that 29% were left-handed and that a large proportion of all children (31%) utilized unusual pencil grasp patterns and immature prehension of scissors. Measurement at the participation level involved use of the Pictorial Scale of Perceived Competence and Social Acceptance (PCSA) and Pediatric Evaluation of Disability Inventory (PEDI). Overall, these young children rated themselves towards the more competent and accepted end of the PCSA over the dimensions of physical and cognitive competence and peer and maternal acceptance. The PEDI revealed generally average performance on social (M=49.98, SD=16.62) and mobility function (M=54.71, SD=3.99), however, self-care function was below the average range for age (M=38.01, SD=12.19). The utility of the MAOM as a framework for comprehensive measurement of functional and motor outcomes of DCD in young children is discussed.     

The relationship between bullying and self‐worth in children with movement coordination problems

Background. Past research has indicated that there is a negative relationship between victimization and self‐worth. Furthermore, children with movement problems such as developmental coordination disorder (DCD) are considered at risk of both victimization and low self‐worth. Aims. This study investigated the relationship between peer‐victimization and self‐worth in a group of children with DCD and control children. Sample. Forty‐three children aged 7–11 years were identified as at risk of DCD, and were matched on age and gender with 43 control children. Method. Children were individually assessed using the Multi‐dimensional peer victimization scale (MPVS; Mynard & Joseph, 2000 ) to assess the degree and type of bullying, and the self perception profile for children (SPPC; Harter, 1985 ) to determine self‐worth. Results. The two groups did not differ significantly on mean reported self‐worth or mean peer‐victimization. The relationship between these two measures, however, differed across group and gender. Peer victimization and self‐worth were negatively correlated only for the children at risk of DCD. Furthermore, peer victimization accounted for a greater and statistically significant proportion of the variance in the self‐worth of girls at risk of DCD compared with boys. This effect of peer‐victimization on self‐worth in girls with DCD was uniquely attributed to the effects of verbal victimization. Conclusions. Although children with and without motor coordination problems reported equivalent amounts of victimization, there were differences in the impact of that bullying. Specifically, self‐worth was negatively affected by bullying for the girls with DCD. Teachers and parents should not only focus on the amount of bullying a child receives, but should also be aware of how bullying impacts differently on self‐worth across groups.     

Children's Moods,Fears and Worries Questionnaire: Validity with Young Children at Risk for Internalizing Problems

This study tested psychometric properties of the Children's Moods, Fears and Worries Questionnaire (CMFWQ) with a population sample of children at risk for developing internalizing problems. The CMFWQ was completed by 489 parents of 5‐year‐old children who had been screened for temperamental inhibition in preschools across eight government areas of Melbourne, Australia. Parents also completed the Strengths and Difficulties Questionnaire (SDQ) and Anxiety Diagnostic Interview Schedule (ADIS‐P‐IV). In this inhibited sample of children, the CMFWQ showed high internal consistency of items (α = .95). The CMFWQ demonstrated convergent validity with the SDQ ‘emotional symptoms’ subscale and discriminant validity with the ‘conduct problems’ subscale. Supporting criterion validity, the CMFWQ significantly distinguished between groups of inhibited children with versus without ADIS anxiety disorders. Psychometric properties of the CMFWQ now extend to young inhibited children who are at risk for developing internalizing problems as they grow. Copyright © 2016 John Wiley & Sons, Ltd.     

A new protocol for assessing action observation and imitation abilities in children with Developmental Coordination Disorder: A feasibility and reliability study

AIMS. To develop a new protocol for the assessment of action observation (AO) abilities and imitation of meaningful and non-meaningful gestures, to examine its psychometric properties in children with DCD and typically developing (TD) children. BACKGROUND. For learning manual skills, AO and imitation are considered fundamental abilities. Knowledge about these modalities in children with DCD is scarce and an assessment protocol is lacking. METHOD. The protocol consists of 2 tests. The AO test consists of two assembly tasks. The imitation test includes 12 meaningful and 20 non-meaningful gestures. Items of both tests are rated on a 4-point scale. Twelve children with DCD (mean age 8y3m, SD, 1.30) and 11 TD children (mean age 8y2m, SD 1.52) were enrolled. For inter-rater reliability, intraclass correlation coefficients (ICC) were calculated for the total score, weighted kappa and percentage agreement for single items. Known group validity was assessed by comparison of DCD and TD group (Wilcoxon rank sum test). For construct validity, the mABC-2 test was used. The protocol was adapted and confirmed by an intra and inter-rater reliability study (new sample of 11 DCD children, mean age 7y5m, SD 1.37). RESULTS. Excellent ICCs were reported for intra and inter-rater reliability for the final protocol. A significant difference between DCD and TD group was found for AO abilities (p < .01), for nonmeaningful gestures (p < .001). A significant correlation was reported between the AO test and the mABC-2 test (r = 56;p ≤0.0001). No significant correlations were revealed for the imitation tests. DISCUSSION AND CONCLUSION. The results support the psychometric properties of this protocol. When fully validated, it may contribute to map the deficits in AO abilities and imitation, to evaluate treatment effects of imitation and AO interventions.     

A longitudinal study of motor ability and kinaesthetic acuity in young children at risk of developmental coordination disorder

Several studies have linked poor kinaesthetic ability with poor motor coordination in school-aged children. However, few studies have investigated kinaesthesis in younger children. The aim of this study was to determine if preschool aged children who have been identified as at risk of developing developmental coordination disorder (DCD) have poorer kinaesthetic ability than matched controls. Kinaesthetic ability and performance IQ were examined in a group of children aged between 4 and 5 years. Following individual assessment of 291 children, 31 were identified as at risk of DCD at this age. One year later, 30 of these children were retested, and 23 were still found to be at risk. These children were matched on verbal IQ, age and sex with control children and their performance compared on the kinaesthetic acuity test (KAT) [D.J. Livesey and N.A. Parkes, Aust. J. Psychol., 47 (1995) 160] and three subtests of the WPPSI-R performance IQ (D. Wechsler, Manual for the Wechsler preschool and primary scale of intelligence--revised, Psychological Corporation, New York, 1989). Both the KAT and the performance subtest scores were found to be significantly poorer in the children at risk of DCD. Follow-up testing one year later showed that both groups improved their kinaesthetic acuity score although the control children remained significantly better than the children with poor motor coordination.     

Comparison of motor praxis and performance in children with varying levels of developmental coordination disorder

The praxis test is a less well-documented method to determine functional manifestations of childhood dyspraxia. For this study, children aged 6–8 years were recruited as follows: 17 children with DCD, 18 at risk of DCD and 35 without obvious problems in motor coordination. The Movement Assessment Battery for Children (MABC-2) was used to measure motor performance and identify the motor incoordination. This study developed a battery of tests to assess limb praxis using a praxis imagery questionnaire, gesture representation, and questions about knowledge of object use. In the comparison of subtests within the praxis test, significant differences were observed across groups on the praxis imagery questionnaire and gesture representation tests but not on knowledge of object use. Similar results were observed in the correlation analyses, in which a weak relationship between MABC-2 and praxis tests was observed. The DCD group had lower scores on the praxis imagery questionnaire, whereas the group at risk of DCD had lower scores on most gesture production tests. Our study provides a better understanding of the nature of the childhood dyspraxia and sheds light on its effect on motor coordination to identify praxis tests with specific clinical meanings in children with movement disorders.     

A study of EEG coherence in DCD children during motor synchronization task

This paper investigates the hypothesis that the coordination difficulties of DCD children are associated with an increased coherence in the cortical motor regions, which persists with age. Forty-eight children participated in the study (24 DCD and 24 Controls). Their ages ranged from 8 to 13 years, divided into three groups (8-9, 10-11, and 12-13 years old). Children were required to perform finger flexion or extension either in synchrony or in syncopation with a rhythmic metronome, while a 32-channel EEG was recorded. Along with stability measures of motor performance, we analyzed the spectral EEG coherence between intrahemispheric (left frontal/left central; left central/left parietal) and interhemispheric (left central/right central) sites. Spectral coherence assesses functional coupling between distant areas of the brain. Two frequency bands related to sensorimotor activation were chosen: alpha (8-12 Hz) and beta (12-30 Hz). The synchrony task was chosen as a rest condition against which the two syncopation conditions at 0.5 Hz and 1.3 Hz were contrasted. For intrahemispheric comparison, 8-9-year-old DCD children showed that coherence between fronto-central regions increased for both rhythms and conditions, as compared to controls. No difference was found for interhemispheric comparisons. As frontal sites are related to motor planning, our results suggest that youngest DCD children were forced to maintain a high level of pre-programming to compensate for the difficulties caused by the perceptual-motor requirements of the task in light of their coordination disorder.     

Does physical activity and BMI mediate the association between DCD and internalizing problems in early childhood? A partial test of the Environmental Stress Hypothesis

Background and purposeYoung children with Developmental Coordination Disorder (DCD) are more likely to experience internalizing problems, such as depression and anxiety, than typically developing (TD) children. Currently, the underlying mechanisms resulting in increased internalizing problems in DCD remains unknown; however, a previous study based on the Environmental Stress Hypothesis (ESH) indicated that physical inactivity and obesity may mediate the relationship between DCD and internalizing problems. The purpose of this study is to investigate the relationships among DCD, internalizing problems, physical activity, and BMI, and the role of sex in these relationships in preschool children, a population for which we currently have very limited data.MethodsYoung children between the ages of 4 and 5 years enrolled in the Coordination and Activity Tracking in CHildren (CATCH) study comprised the sample (n = 589). Of these, 288 (193 boys, 67.0%) were classified as at risk for DCD (rDCD), based on scoring at or below 16th percentile on the Movement Assessment Battery for Children – Second Edition. Physical activity was measured using accelerometers and height and weight were measured by trained research assistants, while parents completed the Child Behavior Checklist to rate internalizing problems. The mediating effects of physical activity and BMI were tested on the relationship between rDCD and internalizing problems.ResultsChildren with rDCD reported more internalizing problems than TD children. While there was a direct effect of rDCD on internalizing problems, neither physical activity nor BMI were found to mediate this relationship.ConclusionThe findings from this study support co-occurring internalizing problems in preschool children with DCD, and extend these findings to demonstrate that this relationship is not explained by physical activity or BMI in early childhood. Further research should be directed toward other psychosocial factors identified in the ESH to better understand the underlying mechanisms between DCD and co-occurring internalizing problems.     

Contributions of trunk muscles to anticipatory postural control in children with and without developmental coordination disorder

Current evidence suggests that movement quality is impacted by postural adjustments made in advance of planned movement. The trunk inevitably plays a key role in these adjustments, by creating a stable foundation for limb movement. The purpose of this study was to examine anticipatory trunk muscle activity during functional tasks in children with and without developmental coordination disorder (DCD). Eleven children with DCD (age 7 to 14 years) and 11 age-matched, typically-developing children performed three tasks: kicking a ball, climbing stairs, and single leg balance. Surface electromyography (EMG) was used to examine the neuromuscular activity of bilateral transversus abdominis/internal oblique, external oblique and L3/4 erector spinae, as well as the right tibialis anterior and rectus femoris muscles. Onset latencies for each muscle were calculated relative to the onset of rectus femoris activity. In comparison to the children with DCD, the typically-developing children demonstrated earlier onsets for right tibialis anterior, bilateral external oblique, and right transversus abdominis/internal oblique muscles. These results suggest that anticipatory postural adjustments may be associated with movement problems in children with DCD, and that timing of both proximal and distal muscles should be considered when designing intervention programs for children with DCD.     

Reliability and validity of the Finnish version of the motor observation questionnaire for teachers

ObjectivesObservational screening instruments are often used as an effective, economical first step in the identification of children with Developmental Coordination Disorder (DCD). The aim was to investigate the psychometric properties of the Finnish version of the Motor Observation Questionnaire for Teachers (MOQ-T-FI).MethodsThe psychometric properties were tested using two separate samples (S1: age range 6–12, M 9y 5mo, females 101, males 92; S2: age range 6–9, M 7y 7mo, females 404, males 446). Teachers completed the MOQ-T-FI in both samples, and in sample 2 teachers’ ratings were compared to student’s performance on the Movement Assessment Battery for Children-Second Edition (MABC-2). Internal consistency was investigated by using Cronbach’s alpha, predictive validity by receiver operating characteristic (ROC) analysis, concurrent validity by correlation analysis, and construct validity by factor analysis.ResultsThe MOQ-T-FI behaves consistently with its original Dutch version. The internal consistency was excellent (α = 0.97). The bifactor model, with one general factor and two specific factors, fit the data significantly better than the first-order model. The concurrent validity with the MABC-2 was moderate (r = 0.37 p < 0.001). Sensitivity was 82.5% and specificity 44.5%, respectively.ConclusionNotwithstanding the low specificity the MOQ-T-FI can be considered as a promising screening tool in the school environment for Finnish children at risk of motor learning problems.     

Do motor ability and handwriting kinematic measures predict organizational ability among children with Developmental Coordination Disorders?

Background and aimChildren with Developmental Coordination Disorders (DCD) exhibit deficient daily performance concealed in their perception–action mechanism. The aim of this study was to analyze behavior organization of children with DCD, in varied tasks that require generating and monitoring mental representations related to space and time inputs/requirements, for achieving better insight about their perception–action mechanism.MethodParticipants included 42 children aged 7–10, half of whom were defined with DCD and half were typically developing (TD). The children were matched for age, gender and school. They were evaluated using the Movement–ABC and performed three handwriting tasks on an electronic tablet that is part of a computerized system (ComPET – Computerized Penmanship Evaluation Tool). In addition, their teachers completed the Questionnaire for Assessing Students’ Organizational Abilities-Teachers (QASOA-T) to assess the children’s daily organizational ability.ResultsSignificant group differences (DCD versus controls) were found for all handwriting kinematic measures across the three handwriting tasks and for the children’s organizational abilities. Motor ability predicted a considerable percentage of the variance of the kinematic handwriting measures (30–37%), as well as a high percentage of the variance of their organizational abilities (67%). The coefficient of variance of the pen tilt added an additional 3% to the prediction of their organizational abilities.ConclusionsThe results of this study exhibited deficient ability among children with DCD in organizing their behavior in varied real-world tasks requiring generation and monitoring representation related to space and time. The significance of the results to understanding the performance mechanism and implication to the clinical field are discussed.     

Children with developmental coordination disorder are equally able to generate force but show more variability than typically developing children

Several studies have suggested that children with developmental coordination disorder (DCD) have difficulties in the fine-tuning of manual force. However, parameterization of the generated force per se is hard to test under normal circumstances as movement planning and execution are also involved. In the present study, an isometric force production task was used to test the hypothesis that children with DCD have a decreased ability to scale force to a required force level and to maintain steady low to submaximal forces. We also tested if the developmental trends were different between the children with DCD and typically developing (TD) children. Twenty-four children with DCD and 24 matched TD children, divided over three age groups (7-9-11 years) participated in this study. Analysis of the data showed that DCD and TD children are equally able to adapt their generated force to the required levels, however DCD children produced a less steady force, even more variable than in the youngest TD children. These results suggest that problems in force control in children with DCD are caused by a higher level of inherent noise of the output system. Since younger DCD children are much more affected than older ones it is suggested that these children are able to learn a strategy to cope with their increased stochastic variability, especially at higher force levels.     

A Preliminary Investigation of Quality of Life Satisfaction Reports in Emerging Adults With and Without Developmental Coordination Disorder

Developmental coordination disorder (DCD) affects around 5% of the population and is diagnosed on the basis of poor motor coordination. Although we know rather little about the lifetime consequences of this disorder, it is clear that significant difficulties remain through adolescence and into adulthood for the majority. It is also clear that significant psychosocial consequences exist for many individuals with DCD. In the current study, quality of life satisfaction was investigated in a group of emerging adults with and without DCD using the Quality of Life Satisfaction Questionnaire (Endicott et al. Psychopharmacology Bulletin, 29, 321–326, 1993). Overall, the group of adults with DCD reported significantly lower levels of quality of life satisfaction across all domains on the scale. This finding has important implications for consideration of early and later intervention for these individuals, as well as for studies to consider the risk and protective factors at play in long-term outcome with respect to both the motor skills and psychosocial aspects of this disorder.