Objectively Measured Physical Activity in Children With Developmental Coordination Disorder: A Systematic Review and Meta-analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis to understand the difference in objectively measured physical activities (PAs) between children with and without developmental coordination disorder (DCD). DATA SOURCES: A systematic literature search of 4 databases (PubMed, Science Direct, Web of Science, and Cochrane library) was conducted in July 2023. STUDY SELECTION: Studies that met the following criteria were considered classified children with DCD based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), DSM-IV-Text Revision, or DSM-V diagnosis criteria, evaluated PA using objective measurements and provided the amount of time spent in PA and/or sedentary behavior, included a control group of typically developing children, and written in English. DATA EXTRACTION: Data extracted from all included studies were: first author's surname and publication year, study design, country, total sample size, the measure of PA, the intensity of PA, categories of PA level, and main finding(s). DATA SYNTHESIS: Twelve articles met the inclusion criteria for the systematic review, 10 of which were included in the meta-analysis. The overall mean difference in moderate-to-vigorous PA (MVPA) between 2 groups was -0.17 (95% CI, -0.25 to -0.09), (I2=48.7%, P=.029). A subgroup analysis by age (ie, school-aged vs. preschool) showed a significant pooled effect size with no heterogeneity in school-aged children (ie, 6-14y) (standardized mean difference=-0.27, 95% CI, -0.38 to -0.16, I2=43.1%, P=.08). CONCLUSIONS: Children with DCD spent significantly less time participating in MVPA, particularly those aged between 6 and 14 years. These findings highlight the need for increased awareness among parents and physicians regarding insufficient participation in PA among children with DCD.

Developmental Coordination Disorder and Unhealthy Weight Status in Taiwanese Children: The Roles of Sex and Age.

This study aimed to provide up-to-date information regarding the estimated prevalence of developmental coordination disorder (DCD) in Taiwanese children. Their unhealthy weight status was also examined, as well as the roles of sex and age. This cross-sectional study recruited 825 children aged between 4 and 12 years and categorized them into either typically developing children (TD, >16th percentile) or children at risk for DCD (rDCD, ≤16th percentile) based on the result of the Movement Assessment Battery for Children-2nd edition. Body mass index was calculated to determine weight status (i.e., normal weight, underweight, overweight, and obesity). The estimated prevalence of rDCD was 9.7%. There were significantly more boys in the rDCD groups (p < 0.001). Additionally, preschool children with rDCD were at greater risk for being underweight. However, there was no significant group difference which was found for overweight/obesity. A lower prevalence of rDCD was found in this study. Nevertheless, children with rDCD may be more likely to be underweight in early childhood. Early intervention should be provided to target this population.

Moderation of parental socioeconomic status on the relationship between birth health and developmental coordination disorder at early years.

Objective: This study investigated whether parental SES moderates the effect of birth health on Developmental Coordination Disorder (DCD) in preschool children. Methods: One hundred and twenty-two children aged 4 to 6 years were enrolled in the study. The Movement Assessment Battery for Children --2nd Edition (MABC-2) test was used to assess the motor coordination of children. They were preliminarily categorized into either the DCD (<=16th percentile, n = 23) or typically developing (TD) group (>16th percentile, n = 99) based on the testing results. All children in the DCD group were further confirmed to meet other diagnostic criteria of the DSM-V using the intellectual test and parental questionnaires. Moderation analysis was conducted using the PROCESS macro for SPSS, and 95% confidence intervals with a bootstrap procedure were calculated to identify the significant moderating effect. Results: Maternal education (unstandardized coefficient = 0.6805, SE = 0.3371, p < 0.05) and maternal employment status (unstandardized coefficient = 0.6100, SE = 0.3059, p < 0.05) were found to moderate the relationship between birth length and the probability of having DCD. Moreover, the relationship between birth weight and the probability of having DCD was moderated by the annual household income (unstandardized coefficient = -0.0043, SE = 0.0022, p < 0.05). Conclusion: The lower maternal education level and maternal unemployment strengthened the negative relationship between birth length and the probability of having DCD. Additionally, the negative relationship between birth weight and the probability of having DCD was statistically significant in high annual household salaries.

Action Research on Applying Compound Stimulus Approach to Improve Empathetic Communication: The Case of Physical Therapy Students.

(1) Background: Empathetic communicative skills are the first step in establishing a good therapeutic relationship. The purpose of this study is to understand the effectiveness of improving the empathetic communicative skills applied to obtain accurate and precise information from patients via compound stimulus-drama in education. (2) Methods: A cross-sectional, one-group, pre- and post-test design was used for this study. In the two-day workshop, four clinical physiotherapists acted as tutors for the "Compound Stimulus-Drama in Education" module and assessed students' performances. The Standard Patient Rating Scale (SPRS), Objective Structured Clinical Examination Scale (OSCES), Professional and Communication Self-Assessment Scale (PCSS), Patients' Information (PI), and the Jefferson Scale of Empathy (JSE) were used to assess the students' empathy scores and communication skills, before and after the course. (3) Results: Fifty-seven students participated in this study. The results showed that there were significant improvements in the SPRS, OSCES, PCSS, PI, and JSE (p < 0.05). Both the quantitative data and the participants' reflection feedback suggest that this novel module was more helpful than traditional clinical practice courses for improving clinical empathy communication skills. (4) Conclusions: This study provided an innovative teaching model and assessment tools for learning clinic empathetic communicative skills in future education training.

Sensory Processing Impairments in Children with Developmental Coordination Disorder.

The two objectives of this systematic review were to examine the following: (1) the difference in sensory processing areas (auditory, visual, vestibular, touch, proprioceptive, and multi-sensory) between children with and without developmental coordination disorder (DCD), and (2) the relationship between sensory processing and motor coordination in DCD. The following databases were comprehensively searched for relevant articles: PubMed, Science Direct, Web of Science, and Cochrane library. There were 1107 articles (published year = 2010 to 2021) found in the initial search. Full-text articles of all possibly relevant citations were obtained and inspected for suitability by two authors. The outcome measures were sensory processing impairments and their relationship with motor coordination. A total of 10 articles met the inclusion criteria. Children with DCD showed significant impairments in visual integration, tactile integration, proprioceptive integration, auditory integration, vestibular integration, and oral integration processes when compared with typically developing children. Evidence also supported that sensory processing impairments were associated with poor motor coordination in DCD. Preliminary support indicated that DCD have sensory processing impairments in visual, tactile, proprioceptive, auditory, and vestibular areas, which might contribute to participation restriction in motor activities. It is important to apply sensory integration therapy in rehabilitation programs for DCD in order to facilitate participation in daily activities.

The Impact of Online Learning on Physical and Mental Health in University Students during the COVID-19 Pandemic.

Higher education organizations have been influenced by the COVID-19 pandemic. During school closures, online teaching and learning has become a new routine that may lead to changes in lifestyles and adversely affect university students' health. Therefore, this study was to understand the potential impact of online learning on physical and mental health by investigating the differences in physical activity, psychological distress, and student life stress in Taiwanese university students between the in-class learning and online learning periods. A total of 181 students were recruited from a local university. All participants were requested to complete an online survey and self-report physical activity, psychological distress, and life stress in the in-class learning and online learning periods, respectively. The results indicated a significant reduction in physical activity of various intensities (p < 0.05). Specifically, male university students showed a greater decrease in vigorous physical activity compared to their female peers. Yet, there was no significant increase in psychological distress and life stress from the in-class learning period to the online learning period. In summary, physical activity drastically reduces during the online learning period in Taiwanese university students. Notably, male students may be at greater risk of insufficient participation in vigorous physical activity.

Time-of-day effect on motor coordination in youth.

The evaluation of motor coordination is important for diagnosing children and adolescents with motor impairments. However, motor coordination may be affected by time-of-day effects, and thus, the intra-day variation could subsequently influence the assessment accuracy of the standardized test used in the diagnostic process. To the best of our knowledge, no study has been conducted to examine this possibility. Therefore, the purpose of this study was to investigate the time-of-day effect on motor coordination. A convenience sample of 25 youth (17-21 years) were recruited from local high schools and a local university. The Bruininks-Oseretsky Test of Motor Proficiency - Second Edition (Short Form) was administered at three different times (morning, noon, and afternoon) over three days to explore the potential time-of-day effect on motor coordination. The starting time of the test on the first day was counterbalanced. Other factors that could potentially impact motor performance were also measured, including physical activity, chronotype, and time-since-awakening. A statistically significant main effect of time-of-day was found on overall motor coordination (p< .01) and the domain of Manual Coordination (p< .01). The time-of-day effect on the domain of Strength & Agility (p = .055) was just above the threshold of statistical significance. Further analysis showed that overall motor coordination was better at noon (p< .01) and in the afternoon (p= .052) than in the morning, whereas manual coordination was the worst in the morning (p's < .01). Strength and agility were also significantly better at noon than in the morning (p< .01). In addition, poor motor coordination in the morning was also related to longer time-since-awakening. Overall, this study identifies the time-of-day effect on motor coordination that could lead to the inconsistent classification of motor performance. Therefore, in order to avoid the potential misclassification of motor coordination, health professionals should take into account the time-of-day effect on motor coordination and the possible impact of time-since-awakening while administering the assessment in the morning.

Inferior Auditory Time Perception in Children With Motor Difficulties.

Accurate time perception is crucial for hearing (speech, music) and action (walking, catching). Motor brain regions are recruited during auditory time perception. Therefore, the hypothesis was tested that children (age 6-7) at risk for developmental coordination disorder (rDCD), a neurodevelopmental disorder involving motor difficulties, would show nonmotor auditory time perception deficits. Psychophysical tasks confirmed that children with rDCD have poorer duration and rhythm perception than typically developing children (N = 47, d = 0.95-1.01). Electroencephalography showed delayed mismatch negativity or P3a event-related potential latency in response to duration or rhythm deviants, reflecting inefficient brain processing (N = 54, d = 0.71-0.95). These findings are among the first to characterize perceptual timing deficits in DCD, suggesting important theoretical and clinical implications.

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 PURPOSE: Young 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. METHODS: Young 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. RESULTS: Children 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. CONCLUSION: The 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.

Motor Coordination and Moderate-to-Vigorous Physical Activity in Emerging Adults: Mediating Effect of Physical Self-Concept.

Little research has investigated the relationships among motor coordination, perceived physical self-concept (PSC), and physical activity during emerging adulthood. The purpose of this study was to investigate whether PSC mediates the relationship between motor coordination and moderate-to-vigorous physical activity (MVPA) in emerging adults. This was a cross-sectional study with 218 undergraduate students aged 17-23 years (167 females, 76.6%). Participants were asked to complete a questionnaire including self-reported measures of motor coordination, PSC and MVPA. The mediating effects of both overall and domain-specific PSC were tested on the relationship between motor coordination and MVPA. Motor coordination was found to have a significant indirect effect on MVPA through overall PSC. Exploratory analyses specifically showed a mediating effect of domain-specific PSC of activity on the relationships between motor coordination and MVPA during chores and leisure-time. Findings from the current study highlight the importance of PSC on the relationship between motor coordination and MVPA and showed that university students with poor motor coordination exhibit lower levels of PSC, specifically, the perception of activity. Future interventions targeting the enhancement of MVPA should focus on improvement in the self-perception of physical activity alongside motor skills training.

External focus of attention concurrently elicits optimal performance of suprapostural pole-holding task and postural stability in children with developmental coordination disorder.

The aim of this study was to determine the effects of different attentional focus conditions (external focus (EF) vs. internal focus (IF) vs. no focus (NF)) on the performance of a pole-holding task and postural stability in children with developmental coordination disorder (DCD) and typically developing children (TDC), while addressing previous study limitations. A total of 186 participants were enrolled in the analysis comprising 91 children with DCD (28 in the EF, 32 in the IF, and 31 in the NF condition) and 95 TDC (31 in the EF, 33 in the IF, and 31 in the NF condition). Participants were required to hold a pole with their hands still and parallel to the floor while focusing on pole movement (EF), focusing on hands (IF), or without focus instructions (NF), while pole movements and postural sway were recorded. Results showed that pole movements were significantly smaller during the EF condition (p < 0.05) compared with IF and NF conditions for both the DCD and TDC groups. In addition, postural sway was significantly lower during the EF condition compared with IF and NF conditions (p < 0.05). This study verified that the EF condition can not only facilitate better performance in holding a pole horizontal and immobile, but also concurrently promote greater postural stability than both IF and NF conditions for children with DCD and TDC.

Motor coordination problems and psychological distress in young adults: A test of the Environmental Stress Hypothesis.

BACKGROUND AND AIMS: The Environmental Stress Hypothesis (ESH) has been used to examine how the relationship between poor motor coordination and psychological distress is affected by physical health and psychosocial factors. However, work applying the ESH is still limited, and no studies have used this framework with adults. The current investigation aims to examine the association between motor coordination and psychological distress among emerging adults, and examine potential mediators to this relationship based on the ESH. METHODS: 225 young adults aged 17-23 years completed a survey of motor coordination, physical activity, secondary stressors (i.e., general stress and global relationships), perceived social support, self-concept, and psychological distress. Structural equation modeling was conducted to examine mediating pathways and overall model fit. RESULTS: The final model of the ESH showed good model fit (x2 = 83.24, p < .01; RMSEA=0.056; NNFI = 0.927; CFI = 0.954; GFI = 0.947), and indicated that the relationship between poor motor coordination and psychological distress was mediated by secondary stressors, perceived social support, and self-concept. CONCLUSIONS: This study highlights the effect of poor motor coordination on psychological distress in young adults, and suggests that interventions should target psychosocial well-being, in addition to motor coordination, to prevent psychological distress.

Moderating Effects of Physical Activity and Global Self-Worth on Internalizing Problems in School-Aged Children With Developmental Coordination Disorder.

School-aged children with developmental coordination disorder (DCD) are at greater risk for physical inactivity, lower global self-worth, and internalizing problems, such as depression and anxiety. Based on the environmental stress hypothesis (ESH), recent research has shown that physical inactivity and lower global self-worth sequentially mediate the relationship between DCD and internalizing problems, suggesting that DCD leads to lower levels of physical activity, which in turn leads to lower levels of global self-worth, and ultimately, a greater amount of internalizing problems. However, physical activity and global self-worth may also buffer (i.e., moderate) the adverse effect of DCD on internalizing problems. To date, this has yet to be tested. Participants were 1206 children aged 12-14 years [611 boys, 79 with probable DCD (pDCD)]. All children received assessments of motor coordination, physical activity, global self-worth, and internalizing problems. Children with pDCD were less physically active, had lower self-worth, and experienced more internalizing problems compared to typically developing (TD) children (p's < 0.05). Furthermore, the moderated moderating effect (three-way interaction) of physical activity and global self-worth was also evident (p < 0.05), indicating that internalizing problems in both TD and pDCD groups decreased with concurrent increases in physical activity and global self-worth. Importantly, when compared to TD children, increases in physical activity and global self-worth were associated with a greater reduction in internalizing problems among children with pDCD. The findings support several pathways in the ESH and highlight that, in addition to improving motor skills, interventions should also target both physical activity and global self-worth to mitigate potential mental health issues for children with motor difficulties.

Effects of Cognitive Control Exertion and Motor Coordination on Task Self-Efficacy and Muscular Endurance Performance in Children.

Emerging research shows a strong connection between brain areas governing cognition and motor behavior. Indeed, research based on the Strength Model has shown that people perform worse on physical tasks following the exertion of high (compared to low) cognitive control which has been attributed to the dysregulation of neurophysiological processes within areas of the brain responsible for cognition. Yet, research investigating the negative aftereffects of high cognitive control (HCC) exertion on task performance has not considered the potential role of areas governing motor behavior. The present study investigated the effects of HCC exertion on task self-efficacy and exercise performance in children. A secondary purpose was to investigate whether motor coordination influences the change in exercise performance differently following low versus HCC exertion. Participants (N = 70) performed two isometric handgrip endurance trials separated by a Stroop task, which was either congruent low cognitive control (LCC) or incongruent (HCC). Motor coordination was assessed prior to the first endurance trial. Task self-efficacy for performing the second endurance trial was assessed following the Stroop task. Participants in the HCC condition reported lower task self-efficacy and showed a reduction in endurance exercise performance. Task self-efficacy mediated the cognitive control-performance relationship. Participants scoring lower on motor coordination showed the greatest declines in exercise performance following HCC, whereas motor coordination did not affect performance following LCC. The results of this study provide evidence that task self-efficacy and exercise performance are also negatively affected in children following HCC, and interestingly, these effects are exacerbated among those scoring lower in motor coordination. We recommend future research investigate motor coordination as a potential mechanism for the reductions in both cognitive and physical task performance following the prolonged exertion of HCC.

Is auditory perceptual timing a core deficit of developmental coordination disorder?

Time is an essential dimension for perceiving and processing auditory events, and for planning and producing motor behaviors. Developmental coordination disorder (DCD) is a neurodevelopmental disorder affecting 5-6% of children that is characterized by deficits in motor skills. Studies show that children with DCD have motor timing and sensorimotor timing deficits. We suggest that auditory perceptual timing deficits may also be core characteristics of DCD. This idea is consistent with evidence from several domains, (1) motor-related brain regions are often involved in auditory timing process; (2) DCD has high comorbidity with dyslexia and attention deficit hyperactivity, which are known to be associated with auditory timing deficits; (3) a few studies report deficits in auditory-motor timing among children with DCD; and (4) our preliminary behavioral and neuroimaging results show that children with DCD at age 6 and 7 have deficits in auditory time discrimination compared to typically developing children. We propose directions for investigating auditory perceptual timing processing in DCD that use various behavioral and neuroimaging approaches. From a clinical perspective, research findings can potentially benefit our understanding of the etiology of DCD, identify early biomarkers of DCD, and can be used to develop evidence-based interventions for DCD involving auditory-motor training.

Are Canadian-born Major League Baseball players more likely to bat left-handed? A partial test of the hockey-influence on batting hypothesis.

It has been suggested that Canadian-born Major League Baseball (MLB) players are more likely to bat left-handed, possibly owing to the fact that they learn to play ice hockey before baseball, and that there is no clear hand-preference when shooting with a hockey stick; approximately half of all ice hockey players shoot left. We constructed a database on active (i.e., October, 2016) MLB players from four countries/regions based on place of birth (Canada, United States of America [USA], Dominican Republic and South Asia [i.e., Japan, Taiwan and South Korea]), including information on which hand they use to bat and throw. We also extracted information on all Canadian-born MLB players, dating back to 1917. Our results confirm that the proportion of left-handed batters born in Canada is higher when compared to the other countries selected; also, since 1917, the proportion of Canadian MLB players who bat left has been consistently higher than the league average. We also compared the proportion of left-handed batters in Canada with players born in states in the USA grouped into high, average and low based on hockey participation. The proportion of MLB players born in states with a high level of hockey participation were more likely to bat left, although the differences were significant at trend level only (p < .10). Lastly, we found that while Canadians were more likely to bat left-handed, this did not correspond with a greater left-hand dominance, as determined by throwing hand. In conclusion, the present study confirms that Canadian-born MLB players are more likely to bat left-handed when compared to American, Dominican Republic and South Asian-born MLB players, providing partial support for the hockey influence on batting hypothesis.

The longitudinal relationship between generalized self-efficacy and physical activity in school-aged children.

Our understanding of the longitudinal relationship between generalized self-efficacy (GSE) and physical activity in children and youth is limited. The purpose of this study was to investigate the effect of GSE towards physical activity on sedentary behaviours and physical activity in school-aged children over time. A total of 2278 nine-year-old children (1120 girls and 1158 boys) were recruited at baseline and followed for seven waves of data collection from 2005 to 2008. All children completed questionnaires at each wave assessing their GSE (adequacy, predilection, and enjoyment), sedentary behaviours, free play, and organized activity. Mixed-effects models were used to estimate changes in physical activity and GSE within individuals over time, controlling for gender and motor ability. The results showed that participation in free play significantly increased over time, whereas organized activity significantly decreased over the same period. Children with high perceived adequacy and predilection had higher free play and organized activity participation relative to other children over time. However, the effect of perceived adequacy diminished over time, while the gaps between groups with different levels of predilection widened over time. While sedentary behaviours were lower over time in children with high predilection, these behaviours were consistently higher in children with high enjoyment. The differences in sedentary behaviours between groups increased over time for both predilection and enjoyment. This study highlights the importance of different components of GSE on physical activity participation. In addition, interventions targeting the enhancement of predilection may facilitate physical activity and reduce sedentary behaviours.

Suprapostural effects of light digital touch on the modulation of postural sway can be modified by fingertip sensitivity.

We investigated whether the suprapostural effects of light digital touch on the modulation of postural sway can be modifiedby fingertip sensitivity. To achieve this, we recruitedthree types of athleteswith various fingertip sensitivity levels, including swimmers (high sensitivity), basketball players (intermediate sensitivity), and rowers (low sensitivity). We recorded the center of pressure (COP) excursions in 21 swimmers (20.57±0.42years), 22 basketball players (20.79±0.75years), and 22 rowers (20.32±0.49years) during light-touch (LT) and precision light-touch (PLT) conditions. In the LT conditions, participants touched a force plate while standing with their feet shoulder-width apart. In the PLT condition, participants were instructed to precisely touch a fixed point on the plate. Compared to the LT condition, the execution of the PLT condition significantly reduced the magnitude of COP excursion in the AP axis for all groups. This effect was most pronounced in swimmers, followed by basketball players, then rowers. These findings suggest that the suprapostural effects of precision light-touch on postural control can be modified as a function of fingertip sensitivity.

Postural Control of Anteroposterior and Mediolateral Sway in Children With Probable Developmental Coordination Disorder.

PURPOSE: To examine postural control of anteroposterior (AP) and mediolateral sway of children with probable developmental coordination disorder (pDCD) and children with typical development (TD). METHODS: Forty-eight children (24 in each group) aged 11 to 12 years performed an aiming task, maintaining a laser beam within targets placed in 2 locations (front/side). Precision was compromised primarily by the control of mediolateral sway for the front target and by the control of AP sway for the side target. The task was performed with large and small targets. RESULTS: In the side target condition, only (1) the TD group showed reduced AP sway in response to reduced target size, whereas the pDCD group increased AP sway, and (2) aiming performance for reduced target sizes deteriorated to a greater degree in the pDCD group than in the TD group. CONCLUSION: These findings suggest children with pDCD have specific deficits in controlling AP sway.

High risk for obesity in children with a subtype of developmental coordination disorder.

The purpose of this study was to compare the prevalence of overweight and obesity in typically developing (TD) children, children with developmental coordination disorder (DCD) and balance problems (DCD-BP), and children with DCD without balance problems (DCD-NBP). Two thousand and fifty-seven children (1095 boys, 962 girls) ages 9-12 years were recruited from 18 elementary schools in Taiwan. The Movement Assessment Battery for Children was used to assess motor coordination ability. International cut-off points for body mass index were used to classify participants into the following groups: normal-weight, overweight or obese. Compared with TD children, children in the DCD-BP group were more than twice as likely to be obese (OR=2.28; 95% CI=1.41-3.68). DCD-BP children were also more likely to be obese compared to DCD-NBP children (OR=1.79; 95% CI=1.02-3.16). Boys in the DCD-BP group were more likely to be obese when compared to DCD-BP girls (OR=3.12; 95% CI=1.28-7.57). Similarly, DCD-NBP boys were more likely to be obese when compared to DCD-NBP girls (OR=2.67; 95% CI=1.21-5.89). Children with both DCD and BP were significantly more likely to be obese when compared to TD and DCD-NBP children. From an intervention perspective, the inclusion of regular physical activity, including activities that encourage development of both balance and energy expenditure, may be required to prevent obesity in this population.