Diagnostic services for developmental coordination disorder: Gaps and opportunities identified by parents.

BACKGROUND: Affecting one in 20 children, Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder impacting a child's ability to learn motor skills. Despite its high prevalence, DCD is under-recognized and under-diagnosed, causing unnecessary frustration and stress for families who are seeking help for their child. This study aimed to understand how parents procure diagnostic services and their perspectives on needed supports and services to improve early identification and diagnosis of DCD. METHODS: Using a multi-pronged recruitment strategy, we circulated the impACT for DCD online questionnaire to parents of children (<18 years) in British Columbia with suspected or diagnosed DCD. Data were analysed descriptively using medians/interquartile ranges for continuous data and frequencies/percentages for categorical data. Open-ended questions were analysed using exploratory content analysis. RESULTS: A total of 237 respondent data were analysed. Parents identified poor awareness and understanding of health care professionals and educators regarding aetiology, symptomology, and impacts of DCD, affecting timely access to diagnostic services. Long waitlists were also a barrier that often led families with financial means to procure private diagnostic assessments. CONCLUSION: A standard of care is needed for streamlined diagnostic services, enabling early identification and early intervention. A publicly funded, family-centred, collaborative care approach is critical to assess, diagnose, and treat children with this disorder and to mitigate the secondary physical and mental health consequences associated with DCD.

Caregiver burden and mental health: Parent perspectives when raising a child with developmental coordination disorder.

BACKGROUND: Children with Developmental Coordination Disorder (DCD) are at high risk for mental health disorders, stemming from challenges participating in motor activities. Parents of children with DCD report increased caregiver burden exacerbated by insufficient support and services for their child. A paucity of literature exists on parent and child mental health associated with a DCD diagnosis. AIMS: To explore parent perceptions of their child's mental health, and the impact of DCD on family and parental mental health. METHODS AND PROCEDURES: Implementation of a secondary analysis using the impACT for DCD, a cross-sectional online survey of parents of children with self-reported suspected or confirmed diagnosis of DCD living in British Columbia, Canada. Data analysis included descriptive and inferential statistics and content analysis. OUTCOMES AND RESULTS: Of the 237 participants, more than one third of parents (36%) rated their own mental health to be fair or poor, and the majority (90%) expressed concern for their child's mental health. Themes emerged on the impact of DCD on child, parent, and family, influenced by access to resources. CONCLUSIONS AND IMPLICATIONS: Standard of care for DCD needs to include services and supports that address caregiver burden and mental health of children with DCD and their families. WHAT THIS PAPER ADDS: This paper explores parent perceptions of their child(ren)'s and their own mental health when raising a child with DCD in British Columbia (BC). In BC, there is a lack of research on the mental health challenges families face when their child has a diagnosis of DCD. Amongst health care providers, there tends to be a focus on DCD as a motor disorder, with limited understanding and acknowledgement of the mental health component for children and their families. Thus, this study will inform health-care providers, parents, educators, and policy makers on parent-identified mental health needs and the essential services and supports. Unique to this study was the inclusion of a descriptive and exploratory content analysis, providing a holistic understanding of parents' perceptions regarding the impact of DCD on their children and themselves. Our results revealed that parents perceive significant inter-connected impacts of DCD on the child, parents, and family, leading to poor mental health for parents and their child(ren). Limited access to resources and supports results in a negative trajectory for family mental health and well-being. Study results indicate the critical importance of addressing mental health, in addition to motor challenges. Healthcare providers need to adopt a family-centred approach to address the physical and psychosocial impairments associated with DCD, ensuring positive outcomes for children and their families.

Success or Failure? Are We Meeting the Needs of Children With Developmental Coordination Disorder?

Background. Current international clinical practice guidelines indicate that children with developmental coordination disorder (DCD) should receive therapy, yet school and community-based occupational therapy is not standard of care. Purpose. To understand parent perspectives on best practice for treatment and what supports and services are required to meet their children's needs. Method. An online cross-sectional survey (impACT for DCD) was distributed to parents of children <18 years with self-reported suspected or diagnosed DCD living in British Columbia. Data analysis included descriptive statistics and contingency analyses to explore whether access to therapy differed with income, age of child, or geographical location. Open-ended questions were analyzed using content analysis. Findings. Of the 237 respondents, 194 children had suspected/confirmed DCD; however, only 20% (38/198) of the children had received therapy at school. Some parents (32/58) pursued private therapy. Geographic location and income had no relationship with therapy access (p > 0.05). Parents expressed frustration with poor awareness and understanding of the impact of DCD among educators, health-care professionals, and community members, and identified the need for funded and accessible school and community services and supports. Conclusion. Evidenced-based occupational therapy intervention should be standard of care for children with DCD as per clinical guidelines and parent-identified need.