Evaluating the impact of virtual reality game training on upper limb motor performance in children and adolescents with developmental coordination disorder: a scoping review using the ICF framework.

OBJECTIVE: This scoping review aims to explore published literature testing Virtual Reality (VR) interventions for improving upper limb motor performance in children and adolescents with Developmental Coordination Disorder (DCD). Our primary focus was on the types of VR systems used and the measurement tools employed within the International Classification of Functioning, Disability and Health Children and Youth Version (ICF-CY) domains in these studies. METHODS: A comprehensive search of six electronic databases up to 11th January 2024 was conducted using predefined terms. Inclusion and exclusion criteria were applied to determine study eligibility, with two authors independently assessing titles, abstracts, and full-text articles. RESULTS: Out of 788 potential studies, 14 met the eligibility criteria. Studies predominantly utilized non-immersive VR (nVR) systems, for example, commercial platforms such as Nintendo Wii. Most interventions targeted general motor coordination or balance, with only four studies specifically focusing on upper limb motor performance. The Movement Assessment Battery for Children-2 was the predominant assessment tool. However, the use of game scores and trial durations raised concerns about the accuracy of assessments. The majority of studies reported no significant improvement in upper limb motor performance following VR interventions, though some noted improvements in specific tasks or overall outcomes. CONCLUSION: The findings suggest that, while nVR interventions are being explored for paediatric motor rehabilitation, their impact on enhancing upper limb motor performance in children with DCD is unclear. The variability in intervention designs, outcome measures, and the predominant focus on general motor skills rather than specific upper limb improvements highlight the need for more targeted research in this area. IMPACT: This review underscores the importance of developing precise and clinically relevant measurement tools in a broader range of VR technologies to optimize the use of VR in therapy for children with DCD. Future research should aim for more rigorous study designs and emerging immersive technologies to maximize therapeutic benefits.

Is screening for motor skill deficits in Tyrolean preschool children warranted and feasible? A protocol for a two-stage cross-sectional study.

INTRODUCTION: Children with developmental coordination disorder (DCD) show deviations in motor development and motor skills in early childhood where the learning and execution of coordinated motor skills are below the level expected for their age. Early detection of DCD is critical to provide an opportunity for intervention and support, yet many cases remain undetected until school age. The study described aims to determine the warranty, feasibility and validity of a mobility screening in Tyrolean kindergartens and evaluate its potential benefit to enhance the motor development prospects of affected children. METHODS AND ANALYSIS: This research employs a two-stage cross-sectional approach with 6 months of follow-up assessments. The initial stage involves a playful mobility screening for all participating kindergarten children, followed by individual assessments for those displaying conspicuous motor skills. Motor skills will be evaluated using MobiScreen 4-6 and the Movement Assessment Battery for Children-2. Prior to the screening, informed consent is obtained from kindergarten bodies and authorities, parents and the children themselves. Parents are provided with information sheets and questionnaires to assess their attitudes and their child's eligibility. The study described aims to form a representative sample of kindergarten children, aged 4-6, in Tyrol. To target approximately 20-40 children with DCD for follow-up, the goal is to include 650 children, assuming an incidence of 3%-6%. For the follow-up, matching control groups will be formed and information about how identified motor deficits were addressed, including therapies or sports, will be gathered. Quantitative data will mainly be analysed descriptively, while feedback from kindergarten teachers regarding the practical implementation will be analysed using qualitative content analyses, according to Mayring. ETHICS AND DISSEMINATION: The study has been approved by the Research Committee for Scientific Ethical Questions (RCSEQ 3369/24). Findings will be disseminated through contributions, peer-reviewed journals, and conferences.

Predictive validity of the Developmental Coordination Disorder Questionnaire as a screening tool to identify motor skill problems: A systematic review and meta-analysis.

BACKGROUND: The Developmental Coordination Disorder Questionnaire (DCDQ) has been used to screen children who probably have developmental coordination disorder (DCD). AIMS: We systematically reviewed studies on the predictive validity of the DCDQ and performed a meta-analysis on its diagnostic accuracy. METHODS AND PROCEDURES: Literature was searched through four electronic databases: MEDLINE, Embase, CINAHL, and PsycArticles. A total of 27 studies was selected based on the inclusion criteria. The sensitivity and specificity of the DCDQ were assessed using summary receiver operating characteristic (sROC) curves. Subgroup analyses were conducted according to the DCDQ type, reference standard, and participant type. OUTCOMES AND RESULTS: Overall, the DCDQ has a sensitivity of 0.70 and a specificity of 0.77, showing moderate diagnostic accuracy (area under the curve, 0.80). Subgroup analysis showed that the revised version of the DCDQ had higher diagnostic accuracy than the original version. When the reference standard was the Diagnostic and Statistical Manual of Mental Disorders, the sensitivity and specificity of the DCDQ were 0.87 and 0.83, respectively. The diagnostic accuracy was higher in clinical samples compared to the general population. CONCLUSIONS AND IMPLICATIONS: This study demonstrated that the DCDQ has adequate diagnostic accuracy, suggesting it can help screen children with motor skill deficits.

Caregiver and youth inter-rater assessment agreement in autism spectrum disorder, developmental coordination disorder, and typical development.

Youth diagnosed with autism spectrum disorder (ASD) and those with developmental coordination disorder (DCD) are at heightened risk for co-occurring mental health diagnoses, especially anxiety and attention-deficit/hyperactivity disorder (ADHD). However, caregiver-child agreement on presence of related symptoms in populations with neurodevelopmental conditions is not well understood. Here, we examine the extent to which 37 ASD, 26 DCD, and 40 typically developing children and their caregivers agree on the degree of the child's symptoms of anxiety and ADHD. All caregiver-child dyads completed the Screen for Child Anxiety Related Emotional Disorders and Conners 3 ADHD Index. Across groups, intraclass correlations indicated generally poor agreement on anxiety and ADHD symptomatology. Although youth generally reported greater internalizing symptoms (i.e., anxiety), caregivers tended to report more observable externalizing behaviors (i.e., ADHD). Together, the results of this study support the need for a multi-informant approach in assessments of anxiety and ADHD in youth with neurodevelopmental disorders.

Investigating the impact of developmental coordination difficulties across home, school, and community settings: Findings from the Australian Impact for DCD survey.

AIM: To evaluate the participation difficulties experienced by children with developmental coordination disorder (DCD) in home, school, and community environments. METHODS: The Impact for DCD survey was completed by primary caregivers of 4-18-year-old children with DCD (or synonymous diagnosis) (n = 429). OUTCOMES AND RESULTS: The greatest participation difficulties experienced at home included dressing, eating with utensils, self-care tasks and drawing/writing reported by over 70% of families. At school, fine motor difficulties were also frequently reported, with additional difficulties keeping up or completing tasks, and not feeling supported at school. Socialisation challenges and bullying were also commonly reported (34.9%). As a result of participation difficulties at school, 5.4% were home schooled. Many children engaged in community activity, with 72.0% currently engaged in at least one organised sports-based activity. CONCLUSIONS AND IMPLICATIONS: Increased recognition of the widespread impact of DCD in a child's life is crucial at an individual and societal level. Parents reported their children experiencing significant participation restrictions and difficulties. The findings of this large-scale study have revealed that most children with DCD are not receiving the support they need to thrive, especially at school. This largely reflects a lack of understanding and recognition of the condition and its associated challenges.

The validity and reliability of school-based fundamental movement skills screening to identify children with motor difficulties.

AIM: Assess whether school-based teacher-led screening is effective at identifying children with motor difficulties. METHODS: Teachers tested 217 children aged between 5 and 11 years old, after a one hour training session, using a freely available tool (FUNMOVES). Four classes (n = 91) were scored by both researchers and teachers to evaluate inter-rater reliability. Researchers assessed 22 children using the Movement Assessment Battery for Children (MABC-2; considered to be the 'gold standard' in Europe for use as part of the diagnostic process for Developmental Coordination Disorder) to assess concurrent and predictive validity. RESULTS: Inter-rater reliability for all individual activities within FUNMOVES ranged from 0.85-0.97 (unweighted Kappa; with 95%CI ranging from 0.77-1). For total score this was lower (κ = 0.76, 95%CI = 0.68-0.84), however when incorporating linear weighting, this improved (κ = 0.94, 95%CI = 0.89-0.99). When evaluating FUNMOVES total score against the MABC-2 total score, the specificity (1, 95%CI = 0.63-1) and positive predictive value (1; 95%CI = 0.68-1) of FUNMOVES were high, whereas sensitivity (0.57, 95%CI = 0.29-0.82) and negative predictive values (0.57, 95%CI = 0.42-0.71) were moderate. Evaluating only MABC-2 subscales which are directly related to fundamental movement skills (Aiming & Catching, and Balance) improved these values to 0.89 (95%CI = 0.52-1) and 0.93 (95%CI = 0.67-0.99) respectively. INTERPRETATION: Teacher-led screening of fundamental movement skills (via FUNMOVES) is an effective method of identifying children with motor difficulties. Such universal screening in schools has the potential to identify movement difficulties and enable earlier intervention than the current norm.

Test-Retest Reliability, Criterion-Related Validity, and Ecological Validity of the Test of Visual-Motor Skills, Third Edition, in Kindergarten Children With Developmental Coordination Disorder.

IMPORTANCE: Establishing empirical evidence on the psychometric properties of the Test of Visual-Motor Skills (3rd ed.; TVMS-3) is helpful for guiding its use as an assessment of visual-motor integration (VMI) skills in kindergarten children with developmental coordination disorder (DCD). OBJECTIVE: To investigate the test-retest reliability, criterion-related validity, and ecological validity of the TVMS-3 in Taiwanese kindergarten children with DCD. DESIGN: A nonexperimental, descriptive, correlational design. SETTING: A hospital in Central Taiwan. PARTICIPANTS: Fifty-seven kindergarten children with DCD were recruited in the study. OUTCOMES AND MEASURES: Intraclass correlation coefficient, percentage of minimal detectable change, and paired t test (Wilcoxon signed rank test) were used to investigate the test-retest reliability of the TVMS-3. The correlations (Pearson's r) between the TVMS-3 accuracy score and the scores of each of the four domains and the adaptive behavior composite score of the Vineland Adaptive Behavior Scales (3rd ed.; Vineland-3) were calculated, respectively, to examine criterion-related validity and ecological validity. RESULTS: The accuracy score of the TVMS-3 had excellent test-retest reliability and acceptable random measurement error. Moreover, it showed good criterion-related validity and sufficient ecological validity with the Vineland-3 in Taiwanese kindergarten children with DCD. CONCLUSIONS AND RELEVANCE: The accuracy score of the TVMS-3 is applicable to Taiwanese kindergarten children with DCD in clinical and research settings. Plain-Language Summary: The accuracy score of the Test of Visual-Motor Skills (3rd ed.; TVMS-3) is a useful assessment tool to detect deficits in visual-motor integration for Taiwanese kindergarten children with developmental coordination disorder. The TVMS-3 has excellent test-retest reliability, good criterion-related validity, and sufficient ecological validity.

The impact for DCD - USA study: The current state of Developmental Coordination Disorder (DCD) in the United States of America.

BACKGROUND: Developmental Coordination Disorder (DCD) is among the most under-recognized and under-supported disorders worldwide. AIMS: To present a preliminary national study that evaluated the unmet needs of children with DCD in the USA using the Impact for DCD survey. METHODS AND PROCEDURES: 232 parents of individuals aged 5-18 years provided responses from 36 items in five domains (diagnosis, activity/participation, education, therapy, and social/emotional health). OUTCOMES AND RESULTS: Most children (81.9%) had a formal diagnosis for movement difficulties, and 91.6% of parents reported that receiving a diagnosis was helpful, but most had not heard of the diagnosis before. The most common co-occurring diagnoses were childhood apraxia of speech and other speech-language disorders (24.6%), ADHD (23.1%), and anxiety (18.8%). Most parents reported that their children withdrew from or avoided movement-related activities (53%), and nearly all (94.8%) were concerned about the impact of motor difficulties on their children's social and emotional health. Only 37% of parents reported feeling that their child received sufficient therapy. CONCLUSIONS AND IMPLICATIONS: Generally, parents reported feeling frustrated with others' understanding and awareness of the condition and with therapy services. The results shown here provide timely data that can support efforts for increased awareness, improved diagnosis, and increased availability of services for DCD in the USA.

Short- and Long-Term Changes in Balance After Active Video Game Training in Children With and Without Developmental Coordination Disorder: A Randomized Controlled Trial.

Active video games (AVG) have been used as training tools and are known to ameliorate balance performance in children with Developmental Coordination Disorder (DCD). Our aim was to evaluate balance using clinical tests and by measuring body sway using a force plate with a mixed design of vision (eyes open/eyes closed), surface (rigid/soft), and support (stance/semitandem) before, and after, training and 4 months later (follow-up). Thirty-six DCD children and 40 typically developing children participated in the study, of which 50 children (26 DCD; 24 typically developing) were retested after 4 months. Balance improved on the clinical measures after the training, which was independent of type of AVG (Wii-Fit and Xbox Kinect) used, and this effect was still present after 4 months. The AVG training did not influence general sway behavior, but only sway in the eyes-open condition, corresponding with task demands of the training and indicating a training-specific effect. Overall, DCD children and typically developing children responded comparably to the AVG training, thereby maintaining the gap in performance between the two groups. The changes in postural sway are interpreted as a sign of more confidence and less freezing of the joints, enabling greater flexibility of movements and balance strategies as supported by the improved performance on balance tests in the DCD children. This is the first study that showed long-term effects of AVG training on balance performance. However, these follow-up results should be interpreted with caution given that 35% of the children were lost in follow-up.

How developmental coordination disorder affects daily life: The adolescent perspective.

BACKGROUND: Few studies have focused on the implications of developmental coordination disorder (DCD) in the teen years. Understanding the unique needs of adolescents with DCD and the challenges they face are imperative to inform clinical care. AIM: To understand how DCD affects daily life from adolescents living with the disorder. METHODS: Participants were recruited from a database of adolescents who were formally diagnosed with DCD in childhood. Nineteen semi-structured interviews of adolescents with DCD (13-18 years) were conducted and analyzed using an interpretive description approach. RESULTS: Data analysis revealed four overarching themes: (1) Through the years; (2) Standing out, left out, opting out; (3) Rising into Resilience; and (4) Help me to be me. Adolescents with DCD face challenges in physical, cognitive, social, emotional, and mental health domains, but their success can be optimized through provision of support, fostering social connections, the use of strategies, and increasing public understanding. Few services currently exist for adolescents with DCD, as treatment is not standard of care. CONCLUSIONS AND IMPLICATIONS: Insights gained from this study provide client-centred evidence to advocate for intervention for adolescents with DCD, and guide recommendations for clinical care and community support to meet the needs of this under-served population. WHAT THIS PAPER ADDS?: This paper qualitatively explores the lived experience of adolescents with DCD, adding to the limited research within this population. Expanding beyond the typical focus of motor challenges, this paper highlights the widespread influence of DCD on daily life, including in cognitive, mental health, and social-emotional domains. Common environmental contexts that exacerbate challenges during adolescent years are explored, including high school PE class and electives, learning to drive, beginning employment, and preparing for post-secondary education. Through an interpretive description methodology, this paper delves into clinical and practical solutions to support adolescents with DCD, from an individualized and client-centered perspective.

Reliability of Selected Health-Related Fitness Tests for Children With Developmental Coordination Disorder.

Aim: To quantify test-retest reliability and minimal detectable change for 90 and 95% confidence levels (90MDC, 95MDC) for health-related fitness tests in children with developmental coordination disorder (DCD). Methods: Lower limb muscle strength [hand-held dynamometry (HHD), unilateral heel rise test (UHRT), standing broad jump (SBJ)], muscle endurance [Muscle Power Sprint Test (MPST)] and cardiorespiratory endurance [20-metre Shuttle Run Test (20mSRT)] were evaluated twice (2-7 day interval) in 31 children with DCD (20 males, 9.4 years old ± 2.0). Results: Test-retest reliability was reported as intraclass correlation coefficient (ICC) (2, 1) 95% confidence interval lower bounds. Values were excellent for MPST (peak and mean power: 0.93, 0.95), good for HHD (0.81-0.88), SBJ (0.82), and the 20mSRT (0.87) and moderate for UHRT (0.74). For HHD, the 90MDC and 95MDC were the largest for hip extensors (14.47, 12.14 Nm) and the smallest for ankle dorsiflexors (1.55, 1.30 Nm). For UHRT, SBJ, MPST and the 20mSRT, these MDC values were 11.90, 9.98 repetitions; 25.49, 21.38 cm; 4.70, 3.94 W (mean power), and 6.45, 5.42 W (peak power) and 0.87, 0.73 (number of stages), respectively. Conclusion: These tests yield reliable test-retest results that can be used to evaluate fitness changes in this group.

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.

Motor problems in autism: Co-occurrence or feature?

Motor features of autism have long been acknowledged by clinicians, researchers, and community stakeholders. Current DSM-5 and ICD-11 guidelines allow clinicians to assign a co-occurring diagnosis of developmental [motor] coordination disorder (DCD) for autistic individuals with significant motor problems. DCD is characterized by poor motor proficiency with an onset of symptoms in early development. Studies have shown considerable overlap in the behavioral motor features observed in autism and DCD. However, others indicate that motor problems in autism and DCD may stem from different underlying sensorimotor mechanisms. Regardless of whether autism has a unique motor phenotype or an overlap with DCD, changes need to be made in the clinical pipeline to address motor problems in autism at the stages of recognition, assessment, diagnosis, and intervention. Consensus is needed to address unmet needs in research on the etiology of motor problems in autism and their overlap with DCD, to optimize clinical practice guidelines. The development of screening and assessment tools for motor problems that are valid and reliable for use with autistic individuals is essential, and an evidence-based clinical pipeline for motor problems in autism is urgently needed. WHAT THIS PAPER ADDS: Motor problems in autism are highly prevalent, yet underdiagnosed and poorly managed. An evidence-based clinical pipeline for motor problems in autism is urgently needed.

Motion sense sensitivity of the ankle is abnormal and correlated with motor performance in children with and without a probable developmental coordination disorder.

This study systematically examined ankle motion sense sensitivity and its relation to motor functions in children with and without a probable developmental coordination disorder (pDCD). Seventy-two children aged 10-11 years were recruited, including thirty-six children with pDCD and 36 age- and sex-matched typically developing (TD) children. Children placed their dominant foot on a passive ankle motion apparatus that induced plantar flexion of the ankle under nine constant velocities ranging between 0.15 and 1.35°/s. The adjusted movement detection time (ADT) to passive ankle motion was obtained to measure ankle motion sense sensitivity. The results showed that, in comparison to that in the TD group, ankle ADT was significantly increased by 22-59% for the range of velocities in the pDCD group. A correlation analysis showed that mean ADTs were significantly correlated with the manual dexterity (r = -0.33, p = 0.005) and balance (r = -0.24, p = 0.046) scores on the Movement Assessment Battery for Children (MABC-2) in the combined group. Similar correlations were found between the ADTs and the manual dexterity (r = -0.37, p = 0.028) and total motor (r = -0.34, p = 0.047) scores in the TD group. This study documents that ankle motion sense sensitivity to passive foot motion is reduced and is likely to contribute to poor motor performance in children with and without pDCD.

Parental report of early features of developmental coordination disorder: A qualitative study.

BACKGROUND: Developmental Coordination Disorder (DCD) is a neurodevelopmental condition usually diagnosed after five years of age. AIMS: To evaluate parent-reported early markers of DCD between birth and six years of age. METHODS AND PROCEDURES: In-depth semi-structured interviews were conducted with parents of twelve children diagnosed with DCD. Up to three interviews were performed per family. The interviews were then transcribed ad-verbatim and analyzed using an inductive thematic analysis approach. OUTCOMES AND RESULTS: The first theme 'Child-specific features' discusses the children's challenges in diverse developmental domains (motor milestones, activities of daily living, play and exploration, fatigue and sleep, participation, sensory processing, coping skills and friendships, and verbal skills), varying in severity for each child and each domain. The second theme 'Features in the context' discusses subtle markers in the direct environment of the children such as quests for explanations and therapy, specific participation choices, concerns by other caregivers, and the emergence of secondary consequences. CONCLUSIONS AND IMPLICATIONS: This study reports the presence of early features of DCD from the first year of life and suggests important topics to discuss with parents in the diagnostic process of DCD.

Cross-cultural Adaptation and Psychometric Properties of Nepali Version of Developmental Coordination Disorder Questionnaire.

Background Revised developmental coordination disorder questionnaire (DCDQ'07) is the best available population-based screening tool to identify developmental coordination disorder and being a parent reported tool, it needs to be available in Nepali language for its application in Nepali population. Objective The objective of this study was to cross-culturally adapt developmental coordination disorder questionnaire into Nepali (DCDQ-NP). The psychometric properties of Nepali version of Developmental coordination disorder questionnaire were established. Method The adaptation was done following Beaton's guideline and the psychometric properties was studied in the community sample of 165 parents of school going children of 5-15 years. Fifty parents were asked to refill the questionnaire after the two weeks period. The study determines internal consistency, test retest reliability, floor and ceiling effect and construct validity. Result Significant cultural adaptation was required to obtain relevant Nepali version. The Nepali version of Developmental coordination disorder questionnaire demonstrates high internal consistency (α = 0.912), excellent test-retest reliability (IC = 0.901) and the floor and ceiling effect were acceptable. Principal component analysis showed three factor structure accounting 62% of variance. Conclusion The developmental coordination disorder questionnaire into Nepali were successfully translated and culturally adapted preserving its original concept. It showed good psychometric properties in a Nepali population. The adapted questionnaire shall be of significance in carry out further research in developmental coordination disorder in Nepal.

Exploring Executive Functioning of Adults With Probable Developmental Coordination Disorder Using the Jansari Assessment of Executive Functions.

Many individuals with Developmental Coordination Disorder (DCD) demonstrate executive functioning difficulties on standardized assessments, yet these difficulties have not been investigated using ecologically-valid measures. 26 adults with probable DCD (pDCD), and 26 typically developing (TD) adults completed selected background measures and the Jansari assessment of Executive Functions (JEF©). JEF© is an ecologically-valid measure that provides measures of Planning, Prioritization, Selective-Thinking, Creative-Thinking, Adaptive-Thinking, and Action-, Event- and Time-Based Prospective Memory. pDCD participants were impaired relative to TD participants, with difficulties in Planning, Action-, and Event-Based Prospective Memory. These findings are consistent with self-reported difficulty and provide avenues for research investigating intervention.

A multimodal approach can identify specific motor profiles in autism and attention-deficit/hyperactivity disorder.

It is still unclear whether and to what extent the motor difficulties are specific to autism. This study aimed to determine whether a multimodal assessment of motor skills could accurately discriminate autistic children from attention-deficit/hyperactivity disorder (ADHD) and typically developing (TD) peers. Seventy-five children, aged 7-13, equally divided into three groups, were assessed with the developmental coordination disorder questionnaire (DCDQ), the movement assessment battery for children 2 (MABC2), the sensorimotor subtests of NEPSY-II, and the kinematic analysis of a reach-to-drop task. Principal component analysis (PCA) on DCDQ subscales revealed one factor-Caregiver Report-, whereas MABC2/NEPSY-II scores identified three factors-namely, Object Interception and Balance, Motor Imitation, and Fine-Motor Skills-. Lastly, PCA on kinematic variables identified four factors: PC1, loaded by the parameters of velocity and acceleration throughout the task, PC2 and PC3 involved the temporal parameters of the two submovements, and PC4 accounted for the wrist inclination at ball drop. When comparing autistic and TD children, Caregiver Report and Motor Imitation factors predicted membership with 87.2% of accuracy. In the model comparing ADHD and TD groups, Caregiver Report and Fine-Motor Skills predicted membership with an accuracy of 73.5%. In the last model, the Object Interception and Balance factor differentiated autistic children from ADHD with an accuracy of 73.5%. In line with our previous findings, kinematics did not differentiate school-aged autistic children from ADHD and TD peers. The present findings show that specific motor profiles in autism and ADHD can be isolated with a multimodal investigation of motor skills.

Predictive validity of the Denver developmental screening test (Denver-II) to detect risk of developmental coordination disorder in preterm children.

INTRODUCTION: The Denver-II is widely used as a screening tool, however, no studies were found about its validity to predict the risk of Developmental Coordination Disorder (DCD) in preterm children. OBJECTIVE: To verify the predictive validity and accuracy of the Denver-II to identify the risk of DCD in preterm children. METHODS: Methodological study with 121 preterm children, evaluated with the Denver-II at ages 1, 2, 3, 4 and/or 5 years and with the Movement Assessment Battery for Children (MABC-2) at 7 years. Univariate binary logistic regression analyses were performed and ROC curves were derived. RESULTS: Children classified as suspect by Denver-II at 2, 3, and 4 years were, respectively, 3.45, 7.40 and 6.06 times more likely to have a risk of DCD on the MABC-2 (p < 0.05). The area under the ROC curve was considered fair for ages 2 (0.60, 95 % CI 0.50-0.70), 3 (0.61, 95 % CI 0.51-0.71) and 4 (0.64, 95 % CI 0.54-0.74) years. The greater the number of suspects in Denver-II over time, the greater the probability of risk of DCD in the MABC-2 (p < 0.001). CONCLUSIONS: Global developmental assessment with the Denver-II at ages 2 to 4 years is considered to have fair accuracy to discriminate risk of DCD at school age in children born preterm.

Insights on action observation and imitation abilities in children with Developmental Coordination Disorder and typically developing children.

BACKGROUND: Children with Developmental Coordination Disorder (DCD) face difficulties in motor learning. Action observation and imitation are strategies frequently used to teach motor skills. AIMS: (1) To study action observation and imitation abilities in children with DCD compared with typically developing peers with a new protocol. (2) To gain insights in the relation between action observation, imitation, motor performance and activities of daily living (ADL). METHOD: Twenty-one children with DCD (mean age 7 years 9 months, range 6-10 years) and 20 age-matched controls (mean age 7 years 8 months, range 6-10 years) were included. A newly developed protocol was used for testing action observation and imitation proficiency. Motor performance were evaluated with the Movement Assessment Battery for Children-2. ADL were investigated with DCD Questionnaire'07. RESULTS: Children with DCD presented significantly lower action observation (p = .037) and imitation abilities (p < .001) than peers. Worse action observation and imitation abilities were related to lower motor performance and ADL skills and a younger age. Non-meaningful gestures imitation proficiency had predictive value for global motor performance (p = .009), manual dexterity (p = .02) and ADL (p = .004). CONCLUSIONS: The new protocol for action observation and imitation abilities can be helpful for detecting motor learning difficulties and for delineating new opportunities for motor teaching approaches in children with DCD.