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. METHOD: Sixty-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). RESULTS: Children 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. DISCUSSION: The 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.

Pre-placement screening in international adoption.

BACKGROUND: The number of child adoptions from abroad is increasing, but the adverse living conditions of these children prior to the adoption raise questions on their medical and neurodevelopmental status, particularly since there are no guidelines for pre- or post-adoption medical evaluation. OBJECTIVES: To describe the condition of a cohort of young children who were candidates for adoption in East European orphanages and foster homes, and to determine those attributes associated with a family's decision to adopt or refuse a particular child. METHODS: Eighty-two young children, median age 11 months, were evaluated by Israeli pediatricians in Eastern Europe between 3 weeks and 6 months prior to their adoption. The evaluation consisted of comprehensive medical and neurodevelopmental testing on site using a battery of standardized assessment tools, and observation of free play and social interactive behaviors recorded on videotape. Laboratory tests included complete blood count, chemistries, serology screening, and metabolic and genetic testing. RESULTS: The children were growth-retarded. Medical problems were classified as resolved (pneumonia and diarrhea) in 32.8%; or ongoing, such as hepatitis B and C, failure to thrive, organomegaly, and visual and hearing disorders, in 14.8%. Neuromotor status was grossly abnormal in 13.4%. Twenty-two percent of the children were rejected for adoption by families in Israel. Factors associated with the adoption decision were performance skills on developmental testing (P = 0.0001), present medical status (P = 0.002), and weight (P = 0.016). CONCLUSIONS: Pre-placement comprehensive screening of children eligible for foreign adoption, which includes developmental screening, helps to identify a wide variety of strengths and impairments in a child's background before the adoption procedure is finalized. A family's decision to adopt or not was associated with the child's performance on Bayley Scales, weight, and current medical status, but not with language delays, serious past medical history or suspect family background.

Isolated orofacial dyskinesia: a methylphenidate-induced movement disorder.

We report a case of orofacial dyskinesia in a 6-year-old female with attention-deficit-hyperactivity disorder who received a low dose of methylphenidate. The orofacial dyskinesia appeared immediately and subsided rapidly on the same day in an "on-off" fashion and on 3 separate days when methylphenidate was taken. To our knowledge this particular side effect has not been described previously and might represent an unusual type of brain response or sensitivity.