Establishment of joint intervention in hospital-school-home model for developmental coordination disorder / 中国儿童保健杂志

Developmental coordination disorder (DCD) is a kind of movement disorder with lifelong adverse effects.According to motor learning and motor control theories, improving movement should be combined with individual, task and environment of children.Interventions for DCD children should not only be limited to the hospital, a more reasonable model should include the hospital, school and home three scenarios of combined treatment.This article expounds the importance and specific content of this intervention model, so as to provide reference for the healthy development of children with DCD.

Early screening and intervention of children with developmental coordination disorder / 中国儿童保健杂志

Developmental coordination disorder (DCD) is a neurodevelopmental disorder with high incidence, low diagnosis rate and early onset of symptoms, which hinders the development of physical and mental health in children.Early identification and intervention of DCD can help reduce the lifelong adverse effects of the disease.However, general public in China still lacks awareness of this condition,and healthcare workers do not pay enough attention to the early screening and intervention of DCD.This paper summarizes the clinical characteristics, early screening and diagnosis of DCD, and expounds the clinical treatment of DCD from the two aspects of western and Chinese medicine intervention, and proposes the intervention treatment of integrated Chinese and western medicine for the first time, hoping to promote the development of early screening work, provide a new method for the research and development of DCD intervention in China, and improve the effectiveness of treatment.

Effects of mirror neuron system theory on hand dexterity and fine motor function in preschool children with developmental coordination disorder / 中国儿童保健杂志

【Objective】 To observe the effects of mirror neuron system theory(MNST) on hand dexterity and fine motor function in preschool children with developmental coordination disorder(DCD), so as to provide reference for the rehabilitation of children with DCD. 【Methods】 A total of 51 children with DCD treated at Nantong Maternal and Child Health Care Hospital from June 2021 to April 2023 were enrolled in this study, and were randomly assigned to treatment group (n=26) and control group (n=25) except for 5 cases who missed in the follow-up. Both groups received conventional rehabilitation training, while the treatment group received MNST additionally. The hand dexterity and fine motor function of both groups were assessed using the hand dexterity subscale of the Movement Assessment Battery for Children-Second Edition (MABC-2), Peabody Developmental Motor Scale-Fine Motor (PDMS-FM), and Function Independence Measure for Children (WeeFIM) before and after 12 weeks of treatment. 【Results】 Before treatment, there were no significant differences in hand dexterity subscale of MABC-2, PDMS-FM, and WeeFIM scores between the two groups (P>0.05). After treatment, both groups showed improvements in hand dexterity subscale of MABC-2, PDMS-FM, and WeeFIM scores (treatment group: t=35.620, 42.084, 40.072; control group: t=14.000, 12.017, 14.054, P<0.001), with the treatment group showing significantly greater improvements compared to the control group (t=2.611, 3.120, 2.331, P<0.05). 【Conclusion】 MNST combined with conventional rehabilitation training can enhance hand dexterity and fine motor function in children with DCD, thereby improving children′s activities of daily living.

Visual Contribution to Motor Skill DCD Disorders & Walking Physiology Using Spatial Cognition and Linear Geometries as Landmark Coordination Cues

Problem: Awareness of children, who experience movement, particularly motor coordination difficulties, has increased dramatically over the last ten years. These motor coordination problems of children with Developmental Coordination Disorder (DCD) or/and Attention-Deficit / Hyperactivity Disorder (ADHD) have been frequently associated with poor visual and spatial eye-vision processing.Background: Motor control difficulties for DCD and ADHD children have been discussed in detail. However, just a little is known about the influence of the natural environment on these disorders. Even more, the built environment’s impact as a spatial cognition and coordination functionality has never been considered.Aim: This pilot and innovative study aim to identify the correlation between and evaluate the visual contribution of the so-called “spatial compound linear geometries” and DCD children’s motor/walking control.Methodology: Twenty children aged 5 to 8 years with DCD difficulties (two intervention groups, one with 10 boys and the other one with 10 girls) were assessed by a statistical structural evaluation in three built environments (two urban parks and one pocket park), under two conditions (rich or not in trees, flora, and PnP linear geometries), and different motor coordination control situations (static balance, dynamic balances, dark condition).Results: The worst performances (regarding movement disorders and motor coordination problems) were observed for both groups with DCD children playing in parks poor in or without trees, flora, and spatial compound linear geometries. Instead, a significant performance (strong statistical correlation) was found for the same intervention group (DCD children’s boys or girls) playing in parks rich in trees, flora, and vegetation (natural environment). The best performance (very strong statistical correlation) was detected in parks rich in a natural environment and linear geometries. Conclusions: While the natural environment contribution is bibliographically known, the best performance finding of the visual contribution of the spatial compound linear geometries, as spatial landmarks enriching the visual-spatial motor/walking functionalities for Children with DCD disorder, could provide new cognitive approaches towards an understanding of children’s Developmental Coordination Disorder and walking physiology. DCD children’s performance, scores, and cues were related to both the natural environment and the spatial compound linear geometries as spatial landmark motor coordination cues and spatio-temporal clues. The significant variability in sensory processing among children with DCD, ADHD, and co-occurring symptoms can contribute to understanding how neurological and social factors correlate across diagnoses. Also, derived observations for stepping errors, Gait analysis (variables), and spatio-temporal clues conclude that visual eye-based processing interrelates with motor coordination problems, performance, inattention, environmental conditions (dark), sex identity (boys, girls), and DCD hyperactivity. Applications: Development of interactive visual applications for (i) human spatial cognition and movement improvement; and (ii) children’s motor control and coordination refinement.

Uso de jogos ativos na reabilitação de crianças e adolescentes: Uma revisão da literatura / Use of active videogames on rehabilitation of children and adolescents: a literature review / Uso de juegos activos en la rehabilitación de niños y adolescentes: revisión de la literatura

Introdução: O Transtorno do Desenvolvimento da Coordenação (TDC) tem prevalência de 5% a 6% nas crianças em idade escolar de cinco a onze anos. No Brasil, o TDC ainda é pouco reconhecido e as crianças, geralmente, recebem pouca ou nenhuma assistência. O transtorno pode persistir na adolescência e idade adulta. Tecnologias emergentes, como realidade virtual e videogames, têm sido o foco de pesquisas recentes de intervenção. Objetivos: Revisar a literatura para identificar estudos que abordam o uso de jogos ativos com crianças e adolescentes com transtorno do desenvolvimento da coordenação. Método: Revisão de escopo, cuja busca foi realizada entre os meses de maio e julho de 2021, na base de dados PubMed, com recorte de 10 anos de publicação, em inglês, português e espanhol, descritores "motor skills disorder", "virtual reality" e "transtorno do desenvolvimento da coordenação" nas três revistas brasileiras de Terapia Ocupacional. Foram excluídos editoriais e estudos com crianças e adolescentes com autismo associado. Resultados: Foram encontrados 16 artigos. Embora a literatura ainda seja escassa neste sentido, os estudos relataram ganhos significativos no desempenho motor de crianças com TDC. Foram identificadas algumas dificuldades em apontar e esclarecer sobre o jogo, instrumento ou mecanismo responsável pelas mudanças no desempenho. Conclusão: A utilização de protocolos sistematizados pode levar ao desenvolvimento de novos estudos para avaliar a eficácia dessas intervenções, bem como a sustentabilidade das melhorias obtidas a longo prazo.

Introduction. Developmental Coordination Disorder (DCD) has a prevalence of 5 to 6% in school-aged children from five to eleven years old. In Brazil, TDC is still poorly recognized, and children generally receive little or no assistance. The disorder can persist into adolescence and adulthood. Emerging technologies such as virtual reality and video games have been the focus of recent intervention research. Objectives. To perform a literature review to identify studies which used active games with children and adolescents with DCD. Method. Scoping review, between May and July 2021, at PubMed database, within 10 years of publication in English, Portuguese and Spanish, terms "motor skills disorder", "virtual reality", and "developmental coordination disorder" in the three Brazilian Occupational Therapy journals. Editorials and studies with children and adolescents with associated autism were excluded. Results. 16 articles were found. Although the literature is still scarce, studies have reported significant gains in the motor performance of children with DCD. Some difficulties were identified in pointing out and clarifying about the game, instrument or mechanism responsible for changes in performance. Conclusion. The use of systematized protocols can lead to the development of new studies to assess the effectiveness of these interventions as well as the sustainability of the improvements obtained in the long term.

Introducción. El trastorno del desarrollo de la coordinación (DCD) tiene una prevalencia del 5 al 6% en niños en edad escolar de cinco a once años. En Brasil, el DCD todavía es poco reconocido y los niños generalmente reciben poca o ninguna asistencia. El trastorno puede persistir hasta la adolescencia y la edad adulta. Las tecnologías emergentes, como la realidad virtual y los videojuegos, han sido el foco de investigaciones recientes sobre intervenciones. Metas. Revisar la literatura para identificar estudios que aborden el uso de juegos activos con niños y adolescentes con trastorno del desarrollo de la coordinación . Método. Revisión del alcance, cuya búsqueda se realizó entre mayo y julio de 2021, en la base de datos PubMed, con 10 años de publicación en inglés, portugués y español, descriptores "trastorno de las habilidades motoras", "realidad virtual" y "trastorno del desarrollo de la coordinación". en las tres revistas brasileñas de Terapia Ocupacional. Se excluyeron las editoriales y los estudios con niños y adolescentes con autismo asociado. Resultados. Se encontraron 16 artículos. Aunque la literatura todavía es escasa al respecto, los estudios han reportado ganancias significativas en el desempeño motor de los niños con DCD. Se identificaron algunas dificultades para señalar y aclarar sobre el juego, instrumento o mecanismo responsable de los cambios en el rendimiento. Conclusión. El uso de protocolos sistematizados puede conducir al desarrollo de nuevos estudios para evaluar la efectividad de estas intervenciones así como la sostenibilidad de las mejoras obtenidas en el largo plazo.

Interpretation to international clinical practice recommendations of developmental coordination disorder by the European Academy of Childhood Disability in 2019 / 中华实用儿科临床杂志

Developmental coordination disorder (DCD) is a developmental disorder that mainly affects children′s motor coordination.The prevalence of DCD in childhood is very high, and it seriously affects the physical and mental health of school-age children.In China, this disease has not yet been fully recognized and understood.There is a lack of standardized and unified diagnostic criteria, and the standardization of relevant clinical assessment tools and the establishment of normative models are insufficient.In addition, the clinical practice and experience of most health professionals in dealing with DCD appear to be limited.Based on international clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD issued by the European Academy of Childhood Disability in 2019, the recommendations related to the diagnosis, evaluation and intervention of DCD in the guidelines were compiled and interpreted in the light of the current clinical practice and research in China.The objective of this study is to bring DCD to the attention of more domestic medical experts through the interpretation of this international guideline and to provide preliminary guidance on the clinical diagnosis, assessment, and intervention of DCD.

Interpretation on physical therapy management of children with developmental coordination disorder: an evidence-based clinical practice guideline from the Academy of Pediatric Physical Therapy of the American Physical Therapy Association in 2020 / 中华实用儿科临床杂志

Developmental coordination disorder (DCD) is a childhood-onset condition that primarily affects physical co-ordination.In China, DCD is not well recognized and is under-treated.Knowledge of the evaluation and intervention of DCD among physiotherapists (PT) is limited.In 2020, the Academy of Pediatric Physical Therapy of the American Physical Therapy Association published the Physical Therapy Management of Children with Developmental Coordination Disorder: An Evidence-Based Clinical Practice Guideline.From the perspective of PT, this review aims to make a comprehensive interpretation of the recommendations in the guideline regarding the physical examination and evaluation, physiotherapy planning and implementation, and family education of children at risk or diagnosed with DCD.This article aims to make DCD get more attention from domestic PT through the interpretation of the latest guidelines, and strengthen the knowledge of physiotherapy assessment and management in children with DCD to guide the clinical practice.

Developmental coordination disorder and the COVID-19 pandemic: Some considerations

Abstract Aims: Developmental Coordination Disorder (DCD) is a developmental disorder characterized by significant poor motor performance, interfering in children's health, participation, and quality of life at home, school, or playground contexts. According to the literature, children with DCD are at greater risk of anxiety and depression symptoms compared to their typically developing peers. Due to the COVID-19 pandemic, many children with DCD are isolated at home and diminishing their opportunity to participate in different types of activities. In addition, this scenario can increase the symptoms of anxiety and depression in these children, which warns us to state some important considerations in this brief communication. As well, some important recommendations about activities to perform at home with relatives, such as active video games or ball games, were made to help these children and their parents in this complex and challenging scenario worldwide. Therefore, this paper summarizes some considerations regarding DCD and the COVID-19 pandemic.

Concordância entre testes concorrentes para identificação de crianças com Transtorno do Desenvolvimento da Coordenação / Agreement between competing tests for the identification of children with Developmental Coordination Disorder

Resumo Objetivo Verificar a concordância dos resultados de diferentes instrumentos, Movement Assessment Battery for Children - checklist e teste motor (MABC-2) e Developmental Coordination Disorder Questionnaire (DCDQ-BR), utilizados para indicação de transtorno do desenvolvimento da coordenação (TDC). Método Estudo transversal, realizado no ano de 2017, com dados de crianças entre sete e 10 anos de idade, provenientes de escolas municipais de São José/SC. Elas foram avaliadas quanto ao desempenho motor por meio dos instrumentos MABC-2 (teste motor e checklist) e DCDQ-BR. A análise estatística incluiu o coeficiente Kappa (K) para verificar a concordância entre os resultados dos instrumentos, considerando um nível de significância de 5%. Resultados Participaram do estudo 302 crianças, com média de idade de 8,5±1,09 anos. Ao comparar o MABC-2 teste motor, MABC-2 checklist e o DCDQ-BR, foram observadas concordâncias de regular a fraca (K = 0,303 / 0,116 / 0,039). Conclusão O presente estudo não identificou concordância consistente entre os resultados dos instrumentos MABC-2 e DCDQ-BR para indicação de crianças com TDC, mas a combinação deles é a forma mais completa de avaliação.

Abstract Objective To verify the agreement of the results between different instruments, Movement Assessment Battery for Children - checklist and motor test (MABC-2) and Developmental Coordination Disorder Questionnaire (DCDQ-BR), used to indicate developmental coordination disorder (DCD). Method A cross-sectional study, carried out in 2017, with data from seven to 10-year-old children from municipal schools in São José/SC. They were evaluated for motor performance using the MABC-2 (motor test and checklist) and DCDQ-BR instruments. The statistical analysis included the Kappa coefficient (K) to verify the agreement between the results of the instruments, considering a level of significance of 5%. Results 302 children participated in the study, with a mean age of 8.5 ± 1.09 years old. When comparing the MABC-2 motor test, MABC-2 checklist, and the DCDQ-BR, we observed concordances from regular to weak (K = 0.303 / 0.116 / 0.039). Conclusion The present study did not identify consistent agreement between the results of the MABC-2 and DCDQ-BR instruments for an indication of children with DCD, but their combination is a more complete form of evaluation.

Symptoms of anxiety and depression in children with developmental coordination disorder: a systematic review / Sintomas de ansiedade e depressão em crianças com transtorno do desenvolvimentoda coordenação: uma revisão sistemática

Abstract Objective To find evidence of the symptoms of anxiety/depression in children with developmental coordination disorder as compared to their typically developing peers at both the group and individual level, and to identify how many different tools are used to measure anxiety and/or depression. Methods Electronic searches in eight databases (PubMed/MEDLINE, Scopus, Web of Science, ERIC, PsycINFO, Embase, SciELO and LILACS), using the following keywords: 'Developmental Coordination Disorder,' 'Behavioral Problems,' 'Child,' 'Anxiety,' 'Depression,' 'Mental Health,' and 'Mental Disorders.' The methodological quality was assessed by Newcastle-Ottawa Scale adapted for cross-sectional studies and the NOS for cohort studies. The studies were classified as low, moderate, or high quality. To provide clinical evidence, the effect size of the symptoms of anxiety and depression was calculated for each study. Results The initial database searches identified 581 studies, and after the eligibility criteria were applied, six studies were included in the review. All studies were classified as being of moderate to high quality, and the effect sizes for both anxiety and depression outcomes were medium. The evidence indicated that all of the assessed studies presented more symptoms of anxiety and depression in children with developmental coordination disorder than in their typically developing peers. On the individual level, this review found children with clinical symptoms of anxiety in 17-34% (developmental coordination disorder) and 0-23% (typically developing), and of depression in 9-15% (developmental coordination disorder) and 2-5% (typically developing) of the children. Conclusions Children with developmental coordination disorder are at higher risk of developing symptoms of anxiety and depression than their typically developing peers.

Resumo Objetivo Encontrar evidências dos sintomas de ansiedade/depressão em crianças com transtorno do desenvolvimento da coordenação em comparação com seus pares com desenvolvimento típico, a nível individual bem como em grupo, e identificar quantas ferramentas diferentes são utilizadas para medir a ansiedade e/ou depressão. Métodos Pesquisa eletrônica em oito bases de dados (PubMed/Medline, Scopus, Web of Science, Eric, PsycINFO, Embase, Scielo e Lilacs), utilizando as seguintes palavras-chave: 'Developmental Coordination Disorder', 'Behavioral Problems', 'Child', 'Anxiety', 'Depression', 'Mental Health' e 'Mental Disorders'. A qualidade metodológica foi avaliada pela escala de Newcastle-Ottawa (NOS) adaptada para estudos transversais e pela escala de Newcastle-Ottawa (NOS) para estudos de coorte. Os estudos foram classificados em: qualidade baixa, moderada e alta. Para fornecer evidência clínica, o tamanho do efeito dos sintomas de ansiedade e depressão foi calculado para cada estudo. Resultados As buscas iniciais nas bases de dados identificaram 581 estudos e, após a aplicação dos critérios de elegibilidade, seis estudos foram incluídos na revisão. Todos os estudos foram classificados como tendo qualidade moderada a alta e os tamanhos do efeito para os desfechos de ansiedade e depressão foram médios. As evidências indicaram que 100% dos estudos avaliados apresentaram mais sintomas de ansiedade e depressão em crianças com transtorno do desenvolvimento da coordenação do que em seus pares com desenvolvimento típico. No nível individual, encontramos crianças com sintomas clínicos de ansiedade em 17-34% (transtorno do desenvolvimento da coordenação) e 0-23% (desenvolvimento típico) e de depressão em 9-15% (transtorno do desenvolvimento da coordenação) e 2-5% (desenvolvimento típico) das crianças. Conclusões Crianças com transtorno do desenvolvimento da coordenação apresentam maior risco de desenvolver sintomas de ansiedade e depressão do que seus pares com desenvolvimento típico.

Effect of volume of practice in children with probable Developmental Coordination Disorder / Efeito do volume da prática por crianças com provável Transtorno do Desenvolvimento da Coordenação

Abstract Children with Developmental Coordination Disorder (DCD) demonstrate a slower and more gradual ability to acquire and learn motor skills with practice. One question then is whether a higher volume of practice for these children could match the performance of children with typical development (TD). The present study aims to examine the effects of a higher volume of practice by children with probable DCD (pDCD) in relation to a lower volume of practice by children with TD. The MABC-2 was used to identify the participants' level of motor difficulty and set the composition of the groups. Two active video games (Nintendo Wii) were used for the practice. Each group was composed of eight participants, paired up by gender and age, TD (M = 111.87 months; SD = 4.05) and pDCD (M = 115.87 months; SD = 4.96). The TD group participated in seven practice sessions and the pDCD group participated in eleven sessions. Results regarding performance on Wii console games showed significant improvement from the first day of practice to the last day in both groups (pDCD and TD). A higher volume of practice for children with pDCD compared to their TD peers helped to increase the performance of the former group. Therefore, the pDCD group achieved a performance similar to the TD group in both practiced games.

Resumo Crianças com Transtorno do Desenvolvimento da Coordenação (TDC) demonstram capacidade mais lenta e gradual para adquirir e aprender habilidades motoras com a prática. Uma questão então é se uma prática com maior volume para essas crianças poderia igualar o desempenho em relação às crianças com desenvolvimento típico (DT). O presente estudo teve como objetivo examinar o efeito do maior volume de prática por crianças com provável TDC (pTDC) em relação ao menor volume de prática por crianças com DT. A bateria de testes MABC-2 foi utilizada para identificar o nível de dificuldade motora dos participantes e compor os grupos. Dois jogos de videogame ativo (Nintendo Wii) foram utilizados para as sessões de prática. Cada grupo foi composto por oito participantes, pareados em gênero e idade, DT (M= 111.87 meses; DP= 4.05) e pTDC (M= 115.87 meses; DP= 4.96). O grupo DT participou de sete sessões de prática e o grupo pTDC participou de onze sessões de prática. Os resultados referentes ao desempenho nos jogos do console Wii apresentaram melhora significativa do primeiro para o último dia em ambos os grupos de prática (rTDC e DT). Um maior volume de prática para as crianças com pTDC em relação aos seus pares com DT auxiliou no aumento do desempenho desse grupo. Portanto, o grupo pTDC alcançou desempenho similar ao grupo DT em ambos os jogos praticados.

Nível cognitivo e transtorno do desenvolvimento da coordenação: estudo com escolares de 7 a 10 anos de idade / Cognitive level and developmental coordination disorder: study with schoolchildren aged 7 to 10 years old

Resumo Introdução Crianças com Transtorno do Desenvolvimento da Coordenação (TDC) apresentam dificuldades para aprender tarefas motoras, o que sugere alteração cognitiva, mas evidências sobre a relação entre desempenho motor e nível cognitivo ainda são inconclusivas. Objetivo Investigar a relação entre nível cognitivo e desempenho motor em crianças de 7 a 10 anos de idade com e sem TDC. Método Foram avaliadas 402 crianças de escolas públicas com o teste de coordenação motora Movement Assessment Battery for Children 2ª ed. (MABC-2) e o teste cognitivo Matrizes Progressivas de Raven (Raven). Os pais preencheram o Developmental Coordination Disorder Questionnaire (DCDQ-Brasil), o Critério Brasil de classificação econômica e um histórico de saúde da criança. Os dados foram analisados com uso de estatística descritiva e testes de associação, comparação e correlação. Resultados Das 402 crianças avaliadas, 35 (8,7%) foram identificadas com TDC. Não foi encontrada diferença nos percentis cognitivos entre crianças com e sem TDC (p = 0,223), mas houve associação significativa entre desempenho motor e nível cognitivo no grupo TDC (p=0,023), com tendência para percentis cognitivos mais altos no grupo não-TDC. Houve associação significativa (p=0,009) entre o percentil global no MABC-2 e o Raven na amostra total. Nos grupos com TDC, houve correlação negativa significante apenas entre o MABC-2 e a idade. Conclusão Houve maior associação entre as pontuações nos testes motor e cognitivo do que entre TDC e nível cognitivo. Os resultados reforçam o perfil heterogêneo das crianças com TDC tanto no domínio motor como cognitivo.

Abstract Introduction Children with Developmental Coordination Disorder (DCD) have difficulties learning motor tasks, which suggests cognitive alteration, but evidence about the relationship between motor performance and cognitive level are still inconclusive. Objective To investigate the relationship between the cognitive level and motor performance of children 7 to 10 years old with and without DCD. Method We evaluated 402 children from public schools with the motor coordination test, Movement Assessment Battery for Children 2nd ed. (MABC-2) and the cognitive test, Raven's Progressive Matrices (Raven). Parents completed the Developmental Coordination Disorder Questionnaire (DCDQ-Brazil), the Brazil Criterion for Economic Classification and a child's health history. Data were analyzed using descriptive statistics and association, comparison and correlation tests. Results Of the 402 children evaluated, 35 (8,7%) were identified with DCD. No difference was found in cognitive percentiles among children with and without DCD (p = 0,223), but there was a significant association between motor performance and cognitive level in the DCD group (p = 0,023), with a trend towards higher cognitive percentiles in the non-DCD group. There was a significant association (p = 0,009) between the global percentile in MABC-2 and Raven in the total sample. In groups with DCD, there was a significant negative correlation only between MABC-2 and age. Conclusion There was a greater association between motor and cognitive tests' scores than between DCD and cognitive level. The results reinforce the heterogeneous profile of children with DCD in both motor and cognitive domain.

Desafío diagnóstico e importancia del abordaje clínico del trastorno del desarrollo de la coordinación / Diagnostic challenge and importance of the clinical approach of the Developmental Coordination Disorder

El trastorno del desarrollo de la coordinación es un trastorno del neurodesarrollo frecuente, pero poco conocido por profesionales de la salud. En consecuencia, los niños no suelen ser diagnosticados y es infrecuente que reciban algún abordaje terapéutico. Se presenta una síntesis actualizada del tema, que aporta recomendaciones para el diagnóstico y el abordaje, desde la perspectiva del profesional clínico, y considera una mirada de salud pública. Se incluyen brevemente las teorías que explican las dificultades motrices presentes; a continuación, se describen las características clínicas y las razones que dificultan el diagnóstico. Se enfatizan algunas de las recomendaciones existentes y se señalan las herramientas que podrían utilizarse para la evaluación. Finalmente, se determinan los abordajes terapéuticos para estos niños considerando que el trastorno afecta no solo el desempeño motor del menor, sino también su rendimiento académico, social, emocional e incluso su salud física.

The developmental coordination disorder is a common neurodevelopmental condition about which health professionals know very little. Consequently, children often go undiagnosed and are rarely treated. An updated synthesis of the topic is presented to provide recommendations for the diagnosis and treatment from the perspective of the clinician and from a public health approach. Theories explaining motor difficulties present in this disorder are briefly included. Clinical features and reasons rendering the diagnosis difficult are described as follows. Some of the existing recommendations are underscored and tools that could be used for the evaluation are described. Finally, treatment approaches for these children are determined considering that the disorder affects not only the child's motor performance, but also his or her academic, social and emotional performance and even his or her physical health.

Developmental Coordination Disorder (DCD): An overview of the condition and research evidence

Abstract Developmental Coordination Disorder (DCD) is a neurodevelopmental condition marked by impairments in the development of motor coordination. The uncoordinated movements of children with DCD lead to performance difficulties in daily life activities and academic settings. Despite the high prevalence of this condition (2-7%) and severe consequences associated with it, DCD is not well recognized in clinical and educational practices, particularly in Brazil. This review provides an overview of DCD and the research evidence - we present definitions and characteristics associated with the condition, the diagnostic criteria, associated difficulties, frequent co-morbidities and a summary of the possible causes. Finally, we review management strategies and intervention approaches for DCD. We also discuss some of the common challenges of the field - while DCD has been largely studied in the last decade, there are still many gaps between research and practice that need to be filled. Awareness and dissemination of relevant, scientific information is necessary. In conclusion, DCD is a significant condition with a clear diagnostic criteria, and requires intervention to improve motor and functional skills, which can improve the associated difficulties as well as the physical and mental health consequences of the condition.

Motor characteristics of students with Attention Deficit Hyperactivity Disorder / Características motoras de escolares com Transtorno de Déficit de Atenção com Hiperatividade

Abstract Introduction: Children with Attention Deficit Hyperactivity Disorder (ADHD) present accented motor difficulties and possibly present the Developmental Coordination Disorder (DCD) as co-occurring. Objective: Identify the motor profile of students with interdisciplinary diagnosis of ADHD, compare with students with good academic performance, and to verify the incidence of DCD in this population. Method: 46 students of both genders participated in the study, in the age range of 7 to 10 years and 11 months, attending from the 1st to the 5th year of elementary school at public schools in cities of São Paulo state. The students were divided into two groups: Group I (GI) included 23 students with ADHD; Group II (GII) included 23 students with good academic performance. The students were paired according to gender and age. The groups experienced motor assessment (Movement Assessment Battery for Children-Second Edition / MABC-2). MABC Test consisted of eight items grouped into three sections (manual dexterity, aiming and catching, and balance), parents/caregivers responded questions about the Economic Classification questionnaire. Results: The results were statistically analyzed in order to characterize and compare the motor profile of the students, intra, and intergroup. The results showed that 43.38% in GI presented indicative of DCD, whereas, in GII, none of the students presented indicative of DCD. However, it is possible to highlight an incidence of DCD in the population with ADHD in about 43%. Conclusion: These findings emphasize the importance of actions to assist and early diagnose this population by teachers, health professionals, and family, improving the life quality of these children.

Resumo Introdução: Crianças com Transtorno do Déficit de Atenção com Hiperatividade (TDAH) apresentam dificuldades motoras acentuadas e possivelmente apresentam o Transtorno do Desenvolvimento da Coordenação (TDC) como coocorrente. Objetivo: Identificar o perfil motor de escolares com diagnóstico interdisciplinar de TDAH. Método: Participaram do estudo 46 escolares, de ambos os gêneros, na faixa etária de 7 a 10 anos e 11 meses de idade, de escolas públicas municipais de cidades do interior de São Paulo, distribuídos em dois grupos: Grupo I (GI) - composto por 23 escolares, com diagnóstico interdisciplinar de TDAH; Grupo II (GII) - composto por 23 escolares com desenvolvimento típico e com bom desempenho acadêmico. Os escolares foram pareados segundo gênero e faixa etária. Os grupos passaram por avaliação motora (Moviment Assessment Battery for Children - Second Edition - Movement ABC-2). Os dados foram analisados estatisticamente visando à caracterização e comparação intra e intergrupos do perfil motor dos escolares. Resultados: Os resultados mostraram que no GI estiveram presentes 43,48% com indicativo de Transtorno do Desenvolvimento da Coordenação (TDC), sendo a Habilidade do Equilíbrio a mais acometida. No GII, não foram encontrados escolares com indicativo de TDC. É possível destacar uma incidência de TDC na população com TDAH, em aproximadamente 43%. Conclusão: Esses achados reforçam a importância de ações voltadas ao atendimento e diagnóstico precoce desta população pelos professores e profissionais da saúde, objetivando uma melhora na qualidade de vida dessas crianças e familiares envolvidos.

Motor Coordination Performance Differences Between School Children With And Without Developmental Coordination Disorder Attending Integrative Special Education In Klang Valley

@#Children with Developmental Coordination Disorder (DCD) have impairments in gross and fine motor skills consequently limit their participation in school activities. The aim of this study was firstly to evaluate motor coordination performance of children with DCD in manual dexterity, hand-eye coordination and balance skills, and secondly, to compare the motor coordination performance between children with DCD and age-matched children without DCD. A total of 47 children with DCD (32 boys, 15 girls) and 16 children without DCD (15 boys, 1 girl) aged between 7 to 10 years old participated in this study. They were recruited from integrative special education classes from six selected primary schools within Klang Valley. The Movement Assessment Battery for Children-2 (MABC-2) evaluated their motor coordination performance. Group differences on the MABC-2 subtest scores and total test score were analysed using independent t-test. Cohen’s d was calculated to obtain the effect size of clinical differences. Children with DCD showed significantly lower score in manual dexterity (p=0.001), aiming and catching (p=0.001), balance test (p=0.001) and total test score (p=0.001) compared to the children without DCD. Effect sizes on manual dexterity (d=0.52), balance (d=0.68), and total test score (d=0.73) indicated moderate clinical differences between the two groups. In conclusion, children with DCD showed deficits in both gross and fine motor skills performance based on the MABC-2 subtests and total test score, in comparison with children without DCD. School-based rehabilitation to improve gross and fine motor problems among the children is warranted.

Efecto del entrenamiento de la fuerza por procesos sobre el equilibrio de los niños con trastorno del desarrollo de la coordinación / The effect of strength training based on process approach intervention on balance of children with developmental coordination disorder

Introducción. El equilibrio es uno de los problemas más importantes de los niños con trastorno del desarrollo de la coordinación (TDC). Según el enfoque por procesos, además del entrenamiento de la fuerza, las adaptaciones neuromusculares pueden mejorar el equilibrio. Objetivo. Evaluar los efectos del entrenamiento de la fuerza sobre el equilibrio estático y dinámico de los niños con TDC. Métodos y población. En el estudio participaron niños de 7 a 9 años de edad de Teherán, y el diseño utilizado fue el de un ensayo controlado aleatorizado. A los sujetos se los separó aleatoriamente en dos grupos: experimental (n= 15) y de referencia (n = 15). Los participantes tuvieron 24 sesiones de ejercicio a lo largo de 12 semanas. El grupo experimental realizó el entrenamiento de la fuerza con ejercicios con la banda elástica flexible Thera-band®, mientras que el grupo de referencia hizo los ejercicios de rutina de la clase de educación física. Se midió la fuerza isométrica de los músculos abductores de la cadera y de los flexores plantares con un dinamómetro manual, y se utilizó la prueba de destrezas motoras de Bruininks-Oseretsky, segunda edición (BOT-2, por sus siglas en inglés) para medir el equilibrio estático y dinámico. Los datos se analizaron con pruebas t para muestras independientes y emparejadas. Resultados. El entrenamiento de la fuerza aumentó significativamente la fuerza muscular de los niños con TDC (P < 0,001) y mejoró su equilibrio estático (P < 0,05); sin embargo, estos ej ercicios no tuvieron un efecto significativo sobre el equilibrio dinámico (P > 0,05). Conclusión. El entrenamiento de la fuerza mejora el equilibrio estático de los niños con TDC. No se observó una mejoría del equilibrio dinámico como resultado del entrenamiento de la fuerza en estos niños.

Introduction. Balance is one of the main problems of children with developmental coordination disorder (DCD). According to process-oriented approach, besides strength training, neuromuscular adaptations can improve balance. Objective. To evaluate the effects of strength training on improving static and dynamic balance in DCD children. Methods and population. Children between 7 to 9 years old in Tehran participated in the study through randomized controlled trial design. Subjects were randomly divided into two experimental (n = 15) and control (n= 15) groups. The participants exercised for 12 weeks and 24 sessions. The experimental group received strength training using flexible Thera-band elastic exercise and control group received routine exercises in physical education class. Isometric strength of hip abductor muscles and plantar flexors were measured using hand held dynamometer, and Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) was used for measurement of static and dynamic balance. Data were analyzed using independent and paired sample t-tests. Results. Strength training significantly increased muscle strength in DCD children (P <0.001) and improved their static balance performance (P <0.05); however, these exercises had no significant effect on their dynamic balance performance (P >0.05). Conclusion. The strength training leads to static balance improve in DCD children. There was not an improvement in dynamic balance through the strength training in these children.

Percepção materna do desempenho de crianças com transtorno do desenvolvimento da coordenação / Mother's perception of the performance of children with developmental coordination disorder / Percepción materna de rendimiento de niños con trastorno de desarrollo de la coordinación

Crianças com dificuldades na realização de tarefas rotineiras que requerem habilidades motoras podem ter problemas específicos de coordenação motora, atualmente denominados Transtorno do Desenvolvimento da Coordenação (TDC). No Brasil esse diagnóstico ainda é pouco comum, embora seja muito utilizado na literatura internacional. O objetivo deste estudo foi investigar a percepção de mães brasileiras sobre o desempenho nas atividades diárias de crianças com transtorno da coordenação motora. Foram realizadas cinco entrevistas, seguidas por análise de conteúdo. Os relatos evidenciaram que todas as informantes percebem alguma dificuldade de seus filhos na realização de atividades cotidianas e na relação com os colegas, sendo essas dificuldades acentuadas principalmente pela entrada na escola. Os relatos também destacaram o desconhecimento sobre os problemas de coordenação motora e possibilidades de auxílio existentes, apontando para a necessidade de mais informação e maior valorização das percepções maternas.

Children who have difficulty doing daily tasks that require motor skills may have specific motor coordination problems, known nowadays as Developmental Coordination Disorder (DCD). In Brazil, this diagnosis is used very seldom although it is much used in the international literature. The aim of this study was to investigate the perception of Brazilian mothers concerning the daily performance of children with motor coordination disorder. Five interviews were conducted and submitted to content analysis. The narratives showed that all informants perceive difficulties in the performance of daily activities in their children and in the relationship with peers, and these difficulties are more evident with the entrance in school. These findings highlight the unawareness about motor coordination problems and opportunities for getting help, as well as reinforce the need for more information and to value mother's perceptions.

Niños con dificultades en el desempeño de las tareas rutinarias que requieren habilidades motoras pueden tener problemas específicos de coordinación, actualmente conocidos como trastorno de desarrollo de la coordinación (TDC). En Brasil este diagnóstico es infrecuente, aunque se usa ampliamente en la literatura internacional. El objetivo de este estudio fue investigar la percepción de las madres brasileñas en el desempeño diario de niños con trastorno de la coordinación motora. Cinco entrevistas se llevaron a cabo, seguido de análisis de contenido. Los informes muestran que los encuestados perciben cierta dificultad a sus hijos en la realización de las actividades diarias y las relaciones con los colegas, y estas dificultades acentuadas principalmente por la entrada de la escuela. Los informes también destacó la falta de conocimiento acerca de los problemas de coordinación y las posibilidades de ayuda existentes, apuntando la necesidad de más información y una mayor apreciación de las percepciones maternas.

Assessment of motor coordination and dexterity of six years old children: A psychometric analysis / Avaliação da coordenação e destreza motora de crianças de seis anos: Análise psicométrica / Evaluación de la coordinación motora y la destreza de los niños de seis años de edad: Un análisis psicométrica

Motor coordination of six-year-old children was examined using the Assessment of Motor Coordination and Dexterity, AMCD (Avaliação da Coordenação e Destreza Motora - ACOORDEM), in order to verify test-retest reliability and investigate whether motor performance is influenced by gender, type of school and residence location. Eighty-five children were evaluated, and their parents and teachers completed questionnaires. For test-retest reliability, the AMCD was repeated with 10 children. Mann-Whitney and chi-square tests identified significant influence of sex, type of school and residence location in just a few of the test items. The test-retest reliability was moderate in the items performance, and good to excellent in the majority of the questionnaires' items. We conclude that some items should be revised and normative tables for the identification of motor delay could be created considering only the age variable. Future studies should continue the process of validating the AMCD instrument with the assessment of younger children...

A coordenação motora de crianças de seis anos foi examinada através do teste de Avaliação da Coordenação e Destreza Motora, ACOORDEM (em desenvolvimento) com objetivo de avaliar a confiabilidade teste-reteste e investigar se o desempenho motor é influenciado pelo sexo, tipo de escola e local de moradia. Foram avaliadas 85 crianças e seus pais e professores responderam questionários. Para detectar a confiabilidade teste-reteste, a ACOORDEM foi reaplicada em 10 crianças. Testes de Mann-Whitney e Qui-quadrado identificaram influência significativa do sexo, tipo de escola e local de moradia em apenas alguns itens. A confiabilidade teste-reteste foi moderada para os itens de desempenho, e de boa a excelente para maioria dos itens dos questionários. Conclui-se que alguns itens devem ser revisados e tabelas normativas de desempenho para identificação de atraso motor podem ser criadas considerando apenas a variável idade. Estudos futuros devem dar continuidade ao processo de criação do instrumento com avaliação de crianças mais jovens...

La coordinación motora en desarrollo del niños de seis años fue examinada por la Evaluación de la coordinación y destreza motora (Avaliação da Coordenação e Destreza Motora - ACOORDEM) con objetivo de evaluar la confiabilidad prueba-reprueba e investigar si el desempeño motor es influenciado por el sexo, tipo de escuela y sitio de la morada. Fueron evaluados 85 niños y sus padres y profesores respondieron cuestionarios. Para confiabilidad prueba- reprueba, la ACOORDEM fue aplicada de nuevo en 10 niños. Pruebas de Mann-Whitney y Chi-cuadrado identificaron significativa influencia del sexo, tipo de escuela y sitio de morada solo en algunos ítems. La confiabilidad prueba-reprueba fue moderada para los ítems de desempeño y de buena a excelente para la mayoría de los ítems del los cuestionarios. Se concluye que algunos ítems deben ser revisados y tablas normativas de desempeño para la identificación del atraso motor pueden ser creadas considerando solo la variable edad. Estudios futuros deben dar continuad al proceso de creación del instrumento con evaluación de niños más jóvenes...

Perspectiva dos pais sobre as consequências funcionais do Transtorno do Desenvolvimento da Coordenação (TDC): revisão da literatura / The perspective of parents on the functional consequences of Developmental Coordination Disorder (DCD): a literature review

In general, the difficulties presented by children diagnosed with Developmental Coordination Disorder (DCD) are first noticed by parents in the daily routine. Although the discussion about the functional impact of DCD is expanding in some countries, it is still poorly explored in Brazil. The purpose of this study was to review the literature that describes the perception of parents concerning the impact of DCD on the daily life of these children and their families. An electronic search for the evidence available in the literature was conducted in major databases using, as keywords, the terms commonly adopted by researchers and practitioners working with children with DCD. The inclusion criteria were articles that used qualitative methodology, studies published from January 1995 to February 2012, and data collected through interviews with parents and/or caregivers, which described children with specific signs of DCD. Of the 594 articles found, only eight used qualitative methodology - all in English. The data presented in these articles show the concern of parents regarding the socialization process of their children with DCD and the lack of preparation of the educational system to deal with the motor difficulties that characterize this disorder. In conclusion, it is essential, especially for rehabilitation professionals who deal with children with DCD, to value how parents perceive the motor coordination difficulties of their children in order to develop actions and services that are adequate to the reality of Brazilian families.

As dificuldades de crianças com Transtorno do Desenvolvimento da Coordenação geralmente são percebidas primeiramente pelos pais durante a realização de atividades que fazem parte da rotina diária de seus filhos. Embora a discussão sobre o impacto funcional do TDC tenha sido ampliada em alguns países, no Brasil esse tema ainda é incipiente. O objetivo deste estudo foi revisar a literatura que descreve a percepção dos pais sobre o impacto do TDC no cotidiano da criança e da família. Realizou-se levantamento das evidências disponíveis na literatura por meio de busca eletrônica nas principais bases de dados, tendo sido usados como palavras-chave os termos comumente adotados pelos pesquisadores e profissionais que trabalham com crianças com TDC. Os critérios para inclusão dos artigos foram uso de metodologia qualitativa, trabalhos publicados no período de janeiro de 1995 a fevereiro de 2012, dados coletados por meio de entrevistas com pais e/ou cuidadores e que se referiam a crianças com sinais específicos de TDC. Foram localizados 594 artigos sobre o transtorno motor, sendo apenas oito qualitativos e todos em inglês. Os dados obtidos nesses artigos evidenciam a preocupação dos pais quanto ao processo de socialização de suas crianças com TDC e a falta de preparo do sistema educacional para lidar com as dificuldades características desse transtorno motor. Conclui-se ser imprescindível, especialmente para profissionais de reabilitação que lidam com crianças com TDC, considerar como os pais percebem as dificuldades de coordenação motora de seus filhos, a fim de desenvolver serviços e ações adequados à realidade das famílias brasileiras.