ArticleLiterature Review

Developmental coordination disorder: A review and update

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Abstract

Present in approximately 5-6% of school-aged children, developmental coordination disorder (DCD) is a neuromotor disability in which a child's motor coordination difficulties significantly interfere with activities of daily living or academic achievement. These children typically have difficulty with fine and/or gross motor skills, with motor performance that is usually slower, less accurate, and more variable than that of their peers. In this paper, we review the history of various definitions leading up to the current definition of DCD, prevalence estimates for the disorder, etiology, common co-morbidities, the impact of DCD on the child's life, and prognosis. As well, we briefly describe current interventions for children with the disorder and results of recent neuroimaging studies of the brains of children with DCD, including research by the authors of this paper.

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... About 5-6% of age-school children have developmental coordination disorder (DCD), a neurodevelopmental disorder corresponding mainly to motor impairment ranging from gross to fine skill deficits that interfere with daily social and academic activities. DCD persists into adulthood in 30 to 70% of early detected cases and mainly affects males with a ratio ranging from 2 to 1 to 4-1 (Biotteau et al., 2020;Brown-Lum et al., 2020;Smits-Engelsman et al., 2020;Vaivre-Douret et al., 2016;Zwicker et al., 2012). Without apparent brain damage, but altered white matter ultrastructure and organization in the sensorimotor networks (Brown-Lum et al., 2020;Wilson et al., 2017), patients with DCD show reduced abilities in producing consistent movements, poor motor coordination and kinaesthetic acuity, broad impairments in sensorimotor representations and perception -each reflecting disrupted central networks (Coleman et al., 2001;Du et al., 2015;Gabbard & Bobbio, 2011;Kashuk et al., 2017;Vaivre-Douret et al., 2016;Zwicker et al., 2012). ...
... DCD persists into adulthood in 30 to 70% of early detected cases and mainly affects males with a ratio ranging from 2 to 1 to 4-1 (Biotteau et al., 2020;Brown-Lum et al., 2020;Smits-Engelsman et al., 2020;Vaivre-Douret et al., 2016;Zwicker et al., 2012). Without apparent brain damage, but altered white matter ultrastructure and organization in the sensorimotor networks (Brown-Lum et al., 2020;Wilson et al., 2017), patients with DCD show reduced abilities in producing consistent movements, poor motor coordination and kinaesthetic acuity, broad impairments in sensorimotor representations and perception -each reflecting disrupted central networks (Coleman et al., 2001;Du et al., 2015;Gabbard & Bobbio, 2011;Kashuk et al., 2017;Vaivre-Douret et al., 2016;Zwicker et al., 2012). DCD usually co-occurs with one or more other neurodevelopmental disorders, such as attention deficit and hyperactivity disorder (ADHD), specific language impairment, learning and memory deficits, autism spectrum disorder (ASD), developmental dyslexia, dysgraphia, altered executive functions and/or psychiatric disorders (Biotteau et al., 2020;Gomez & Sirigu, 2015;Paquet et al., 2019;Smits-Engelsman et al., 2020;Vaivre-Douret et al., 2016;Zwicker et al., 2012). ...
... Without apparent brain damage, but altered white matter ultrastructure and organization in the sensorimotor networks (Brown-Lum et al., 2020;Wilson et al., 2017), patients with DCD show reduced abilities in producing consistent movements, poor motor coordination and kinaesthetic acuity, broad impairments in sensorimotor representations and perception -each reflecting disrupted central networks (Coleman et al., 2001;Du et al., 2015;Gabbard & Bobbio, 2011;Kashuk et al., 2017;Vaivre-Douret et al., 2016;Zwicker et al., 2012). DCD usually co-occurs with one or more other neurodevelopmental disorders, such as attention deficit and hyperactivity disorder (ADHD), specific language impairment, learning and memory deficits, autism spectrum disorder (ASD), developmental dyslexia, dysgraphia, altered executive functions and/or psychiatric disorders (Biotteau et al., 2020;Gomez & Sirigu, 2015;Paquet et al., 2019;Smits-Engelsman et al., 2020;Vaivre-Douret et al., 2016;Zwicker et al., 2012). For instance, children with ASD or ADHD exhibit gross or fine motor abnormalities, motor learning deficiencies and difficulties executing sequences of actions likely related to deficits in the internal model (Arango-Tob on et al., 2023;Chinello et al., 2016;Smits-Engelsman et al., 2020). ...
Article
Children with neurodevelopmental disorders, such as developmental coordination disorder (DCD), exhibit gross to fine sensorimotor impairments, reduced physical activity and interactions with the environment and people. This disorder co‐exists with cognitive deficits, executive dysfunctions and learning impairments. Previously, we demonstrated in rats that limited amounts and atypical patterns of movements and somatosensory feedback during early movement restriction manifested in adulthood as degraded postural and locomotor abilities, and musculoskeletal histopathology, including muscle atrophy, hyperexcitability within sensorimotor circuitry and maladaptive cortical plasticity, leading to functional disorganization of the primary somatosensory and motor cortices in the absence of cortical histopathology. In this study, we asked how this developmental sensorimotor restriction (SMR) started to impact the integration of multisensory information and the emergence of sensorimotor reflexes in rats. We also questioned the enduring impact of SMR on motor activities, pain and memory. SMR led to deficits in the emergence of swimming and sensorimotor reflexes, the development of pain and altered locomotor patterns and posture with toe‐walking, adult motor performance and night spontaneous activity. In addition, SMR induced exploratory hyperactivity, short‐term impairments in object‐recognition tasks and long‐term deficits in object‐location tasks. SMR rats displayed minor alterations in histological features of the hippocampus, entorhinal, perirhinal and postrhinal cortices yet no obvious changes in the prefrontal cortex. Taken all together, these results show similarities with the symptoms observed in children with DCD, although further exploration seems required to postulate whether developmental SMR corresponds to a rat model of DCD.
... Dyspraxia is estimated to affect 5-6% of school children (Zwicker et al., 2012) with prevalence data affected by continuing debate on definitions and diagnosis methods (Gibbs et al., 2007) and accompanying variation in these across the world. A large UK study found a smaller prevalence of 1.8% in seven-year-old children using a stricter diagnostic threshold of impact on daily life (Lingam et al., 2009). ...
... A large UK study found a smaller prevalence of 1.8% in seven-year-old children using a stricter diagnostic threshold of impact on daily life (Lingam et al., 2009). Estimates of sex ratios vary from 1.9:1 to 7:1 male to female (Zwicker et al., 2012). A diagnosis of dyspraxia increases the likelihood of diagnoses for ADHD, dyslexia or autism (Lino & Chieffo, 2022). ...
Technical Report
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Executive summary 1. The aim of this report is to review whether A-Weighting accurately represents the hearing of the whole UK population, to explore the consequences if it does not, and to make recommendations for future research to address the problems identified. 2. The approach taken was to first research the construction of A-Weighting from its root in early research on loudness perception and the development of the equal loudness contours. We then identified three groups of interest, who may not be well represented by A-Weighting. These are people with age-related hearing loss, neurodivergent people, and noise-sensitive people. These groups were chosen because they each represent a different kind of hearing difference, and they are all a substantial size. 3. A detailed literature review was conducted to examine the available evidence of hearing differences in the three groups and to discuss how these relate to A-Weighting and its uses. We reviewed 540 papers and cite 182 in this report. This dataset was then analysed to identify significant research gaps and suggest future research to fill them. 4. A-Weighting was found to be a significant way in which the assumption of normal hearing is embedded in a very wide range of acoustic assessment and legislation. This is because A-Weighting was developed from the equal loudness contours, and the contours are produced from measurements on a relatively small sample of otologically normal people-18-25-year-olds with no hearing impairment. This is important because A-Weighting extends far beyond its original use to convert sound levels into loudness estimates and is now found in most assessments and control of noise worldwide, from product design to environmental noise. 5. People with age-related hearing loss represent 7.9% of the UK population. Age-related hearing loss is caused by degradation of the hair cells' transducer mechanism in the inner ear. Among other effects, this typically causes problems with masking, where it becomes harder to pick a target speech sound out of a noisy background. Because background noise is usually quantified using A-Weighting, and A-Weighting models normal hearing, this may mean that the enhanced need for reduced background interference is often not met for this group. 6. Neurodivergent people (who include autistic people, those with attention deficit hyperactivity disorder (ADHD), dyslexia, dyspraxia, dysgraphia, dyscalculia, and Tourette's) make up about 10% of the UK population. Evidence was found of auditory processing differences for autistic people, and for people with ADHD and dyslexia. The auditory processing differences occur at a low level in the brain and can result in difficulty separating out sound signals, especially when trying to listen to someone speak against a background of competing speech. It is likely that enhanced background noise targets would improve the experience of this group, but it is currently difficult to translate the laboratory findings on auditory processing into new noise assessment methods. There is too little evidence for people with dyspraxia, dyscalculia, dysgraphia and Tourette's to base a conclusion on. 7. People who are noise-sensitive represent 17-50% of the population. In this report, this group included people who are more sensitive to general noise, people with misophonia and people with hyperacusis. For this group, the widespread use of A-Weighted sound level to predict noise annoyance is likely to significantly underpredict their heightened response. Hyperacusis is very common in autistic people, and it is particularly likely that A-Weighted levels do not represent the experience of this group. 8. It is not possible to simply adapt the A-Weighting curve to better fit any of the groups at this time. Partly this is because of lack of data on how to adjust, but mostly it is because most of the differences in sound perception are not equivalent to a simple transformation in loudness. The exception is for people with hyperacusis, where more detailed data on their loudness responses might enable a new weighting to be derived. 9. The overarching research gap identified is a lack of translational research. There is a need for research that builds on existing laboratory studies of hearing differences and translates them into guidelines for practitioners to assess sound and design spaces suitable for people with atypical hearing. 10. We also identify nine specific research gaps and projects to address them: a. Acoustic guidelines for spaces for people with a hearing impairment b. Acoustic design guidelines for people with auditory processing problems c. Accurate estimate of the numbers of noise sensitive people in the UK d. Loudness for people with age-related hearing impairment e. Loudness functions for autistic people with hyperacusis f. Equal loudness contours for autistic people with hyperacusis g. Demographic factors as a modulating effect on neurodivergent hearing h. Loudness functions for people with hyperacusis i. Psychoacoustic factors in misophonia Of these, we suggest that the first three are the most important. 11. This report represents an initial exercise in a much larger project for acoustics to respond to the aural diversity movement-the idea that a wide range of different kinds of hearing differences exist, in contrast to the assumed binary division of normal hearing and impaired hearing. This project could be repeated with other groups of people, such as those with noise-induced hearing loss, Meniere's disease, or many other conditions.
... On the other hand, the Developmental Coordination Disorder (DCD) represents one of the most common movement disorders in developmental age [7][8][9], and it is characterized by a delay in the development of motor skills or difficulty in coordinating movements, which often leads to difficulties in carrying out daily activities [10]. The prevalence is 5-6% in children between 5 and 11 years and is more common in boys than girls, with a ratio ranging from 2:1 to 7:1 [11][12][13]. ...
... Long-term improvements may occur, but problems with movement coordination persist into adolescence in about 50-70% of children [22][23][24]. DCD cannot be diagnosed before 5 years of age because there is either age variation in the acquisition of many motor skills or a lack of stability of outcomes [7]. In most cases a careful clinical examination shows signs of neurodevelopmental immaturity, such as a choreiform limb movements, mirror movements, and other associated motor characteristics, as well as signs of impaired gross and fine motor skills. ...
Article
Attention deficit/hyperactivity disorder (ADHD) and developmental coordination disorder (DCD) represent two frequent neurodevelopmental disorders, which may be comorbid or have common characteristics with each other. The aim of the present study was to explore the presence of DCD or motor planning difficulties in children with behavioral disorders and/or ADHD, as already stated in the literature. Motor abilities were assessed in a sample of children which underwent a comprehensive neuropsychological evaluation. A total of 43 children were included in the study and were subdivided in three groups: those with ADHD and DCD, those with DCD, and those with ADHD but also presenting motor-praxic difficulties. The first group obtained clinical scores at the considered tests, with worse performances in the balance area; in the second and third groups lower scores were observed in the manual dexterity and balance, with more homogeneous profiles. Overall, 27.3% of ADHD subjects received a diagnosis of DCD as well, whereas 31.8% showed documented motor-praxic difficulties. Our results confirmed an increased prevalence of DCD or general motor difficulties in children with ADHD compared to the general population. Further research should investigate whether a poorer motor performance assessed by standardized tests could be either due to a comorbid neurodevelopmental condition or a direct consequence of the pivotal symptomatology of the disorder.
... 6-12 years old); however, in children with Developmental Coordination Disorder (DCD), this development might be affected [3,4]. DCD is a common neurodevelopmental disorder beginning in childhood [5]. Children with DCD are found to have difficulties in acquisition and execution of coordinated motor skills compared to their typically developing peers of the same chronological age, affecting their performance in daily activities and academic tasks [5][6][7]. ...
... DCD is a common neurodevelopmental disorder beginning in childhood [5]. Children with DCD are found to have difficulties in acquisition and execution of coordinated motor skills compared to their typically developing peers of the same chronological age, affecting their performance in daily activities and academic tasks [5][6][7]. An in-depth understanding of online motor control in children with DCD is necessary to inform early interventions, thereby avoiding possible irreversible effects on their future lives. ...
Article
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Background Children with developmental coordination disorder (DCD) have impaired online motor control. Researchers posit that this impairment could be due to a deficit in utilizing the internal model control process. However, there is little neurological evidence to support this view because few neuroimaging studies have focused specifically on tasks involving online motor control. Therefore, the aim of this study was to investigate the differences in cortical hemodynamic activity during an online movement adjustment task between children with and without DCD. Methods Twenty children with DCD (mean age: 9.88 ± 1.67 years; gender: 14M/6F) and twenty age-and-gender matched children with typical development (TD) (mean age: 9.87 ± 1.59 years; gender: 14M/6F) were recruited via convenience sampling. Participants performed a double-step reaching task under two conditions (with and without online adjustment of reaching). Cortical hemodynamic activity during task in ten regions of interest, including bilateral primary somatosensory cortex, primary motor cortex, premotor cortex, superior parietal cortex, and inferior parietal cortex was recorded using functional near-infrared spectroscopy. In the analyses, change in oxyhemoglobin (ΔHbO) concentration was used to characterize hemodynamic response. Two-way analyses of variance were conducted for each region of interest to compare hemodynamic responses between groups and conditions. Additionally, Pearson’s r correlations between hemodynamic response and task performance were performed. Results Outcome showed that children with DCD required significantly more time to correct their reaching movements compared to the control group (t = 3.948, P < 0.001). Furthermore, children with DCD have a significantly lower ΔHbO change in the left superior parietal cortex during movement correction, compared to children with TD (F = 4.482, P = 0.041). Additionally, a significant negative correlation (r = − 0.598, P < 0.001) was observed between the difference in movement time of reaching and the difference in ΔHbO between conditions in the left superior parietal cortex. Conclusions The findings of this study suggest that deficiencies in processing real-time sensory feedback, considering the function of the superior parietal cortex, might be related to the impaired online motor control observed in children with DCD. Interventions could target this issue to enhance their performance in online motor control.
... The early motor development of children with DCD may be delayed, and movement execution may appear more clumsy, slow, varied, or less accurate than their peers 2,4 . Alterations in the acquisition and performance of age-related motor skills restrain the activity and participation of these children 5 . The impact on quality of life is even more significant, with psychological and social aspects also compromised 6,7 . ...
... It is hypothesized that a poor ability to learn and perform motor skills is associated with a delay or dysfunction at the neuro-maturational level 12 . Some studies have pointed to the cerebellum as the core of DCD deficits 5,13 , mainly due to the classic signs of uncoordinated and clumsy behavior and altered postural balance 14 . Cortical brain areas also seem to be involved in the etiology of DCD deficits. ...
Article
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BACKGROUND: Developmental coordination disorder (DCD) is a neurodevelopmental disorder that affects around 5% of school-age children worldwide. DCD negatively impacts motor repertoire, quality of life, and overall health. One of the main motor impairments affecting activity and participation is poor postural balance. Although the neural basis of DCD is not yet clear, morphological and functional alterations have been found in children with DCD in crucial areas for postural control, such as the cerebellum and the primary motor cortex. Transcranial direct current stimulation (tDCS) is a noninvasive technique for inducing synaptic modulation, promoting neuromodulation that can help in understanding physiopathology and determining therapeutic strategies for people with DCD. AIM: The proposed randomized clinical trial will verify the immediate effects of tDCS in the primary motor cortex and the cerebellum on postural balance in children with and without DCD. METHOD: Fifteen children with DCD and 15 typically developing children will be randomized to receive a single session of anodal cerebellar tDCS, cathodal cerebellar tDCS, anodal primary motor cortex tDCS, or sham tDCS in a crossover design. Postural balance will be assessed by posturography with and without visual and somatosensory system manipulation immediately before and after each tDCS session. RESULTS AND INTERPRETATION: This paper presents a detailed description protocol of a double-blind, placebo-controlled, crossover clinical trial. The results can bolster understanding of the postural control of children with DCD compared to children with typical development as well as knowledge about the possible effects of tDCS on the postural balance of such children.
... One such group is children and adults with developmental coordination disorder (DCD). DCD is a neurodevelopmental disorder affecting 5-15% of school-aged children (Hamilton, 2002) that significantly impacts a child's ability to learn motor skills and perform everyday activities, including getting dressed, tying shoelaces, using cutlery, handwriting, playing games or sports, or riding a bicycle (Zwicker et al., 2012). Ultimately, these motor deficits harm academic performance, vocational choices and leisure pursuits (Zwicker et al., 2012). ...
... DCD is a neurodevelopmental disorder affecting 5-15% of school-aged children (Hamilton, 2002) that significantly impacts a child's ability to learn motor skills and perform everyday activities, including getting dressed, tying shoelaces, using cutlery, handwriting, playing games or sports, or riding a bicycle (Zwicker et al., 2012). Ultimately, these motor deficits harm academic performance, vocational choices and leisure pursuits (Zwicker et al., 2012). Secondary consequences of DCD include low self-esteem, depression, anxiety, loneliness, problems with peers and withdrawal from participating in physical and social activities (Zwicker et al., 2018;Izadi-Najafabadi et al., 2019;Harris et al., 2021). ...
Article
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This systematic review synthesizes the literature on physical activity amongst people with DCD using the COM-B framework. The review questions were: (1) what is the Capability (C), Opportunity (O) and Motivation (M) for physical activity and (2) what does physical activity behavior (B) look like? A mixed-methods systematic review was conducted by searching eight databases (PubMed, APA PsycINFO, EMBASE, Scopus, Child Development and Adolescent Studies, Cochrane Library, Web of Science, CINAHL) up to July 2023. Data were extracted, thematically analyzed, and mapped to the COM-B model. The quality of studies was assessed with the Joanna Briggs Institute (JBI) critical appraisal tool. The protocol was registered with PROSPERO (CRD42022319127). Forty-three papers, 42 of which related to children, were included. Fifteen aligned with physical activity behavior, nine with physical capability, thirteen with psychological capability, one with social opportunity, one with physical opportunity, one with reflective motivation and three with automatic motivation. Pre-school-aged children with DCD engage in comparable levels of physical activity behavior, but differences emerge from 6 years of age. Characteristics of DCD result in reduced physical capability and less varied participation in physical activity. This impacts psychological capability, whereby lower self-perceptions result in a negative feedback loop and reduce the motivation to participate. Barriers relating to social opportunities may result in poor reflective and automatic motivation, although there is evidence that interventions can enhance enjoyment in the short term.
... Studies have shown that impaired motor functions in children increase the risk to mental health (Harrowell et al., 2017;Lingam et al., 2012), psychological well-being (Piek et al., 2007), social integration (Missiuna et al., 2008;Sylvestre et al., 2013), and academic achievement (Harrowell et al., 2018;Zwicker et al., 2012). Notably, DCD tends to persist into adolescence and adulthood (Kirby et al., 2011;Losse et al., 1991). ...
... Thus, the brain uses internal models to control movements more accurately, such as by inducing movement adjustments to correct an error (Kawato & Wolpert, 1998;Shadmehr et al., 2010). The ability to generate internal models is an important factor for motor learning and motor control, because they predict movement outcome much faster, before sensorimotor feedback becomes available to the brain (Wolpert, 1997). Therefore, internal models provide stability to the motor system, reduce movement variability, and increase movement effectiveness (Izawa et al., 2008). ...
Article
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Background: Developmental coordination disorder (DCD) is one of the most prevalent developmental disorders in school-aged children. The mechanisms and etiology underlying DCD remain somewhat unclear. Altered visuomotor adaptation and internal model deficits are discussed in the literature. Aims: The study aimed to investigate visuomotor adaptation and internal modelling to determine whether and to what extent visuomotor learning might be impaired in children with DCD compared to typically developing children (TD). Further, possible compensatory movements during visuomotor learning were explored. Methods and procedures: Participants were 12 children with DCD (age 12.4 ± 1.8, four female) and 18 age-matched TD (12.3 ± 1.8, five female). Visuomotor learning was measured with the Motor task manager. Compensatory movements were parameterized by spatial and temporal variables. Outcomes and results: Despite no differences in visuomotor adaptation or internal modelling, significant main effects for group were found in parameters representing movement accuracy, motor speed, and movement variability between DCD and TD. Conclusions and implications: Children with DCD showed comparable performances in visuomotor adaptation and internal modelling to TD. However, movement variability was increased, whereas movement accuracy and motor speed were reduced, suggesting decreased motor acuity in children with DCD. What this paper adds? The underlying mechanisms and etiology of DCD remain somewhat unclear. Over the last decade, a great variety of hypotheses 2 have been advanced and investigated, all concluding that several processes of motor learning, especially visuomotor learning, seem to be impaired in DCD. Most research investigating visuomotor learning in DCD so far has focused on visuomotor adaptation. However, the successful recall of a previous visuomotor adaptation performance and its transfer to a recurring perturbation error through a successfully updated internal model has hardly been studied in DCD. Therefore, the present study adds to the limited research on internal modelling and on possible simultaneous compensatory movements, which may also underlie the movement deficits seen in DCD. Compensatory movements can reduce the efficiency of a movement. The novelty of this study was that investigating visuomotor adaptation, internal modelling, and compensatory strategies simultaneously in one multilevel study approach allowed us to observe possible interactions between these factors during the same visuomotor adaptation task. The results indicated that children with DCD exhibited comparable performances in visuomotor adaptation and internal modelling to age-matched TD controls. However, increased movement variability and decreased motor acuity suggest the presence of compensatory movements in DCD. Both movement accuracy and motor speed were reduced. This study raises awareness of ''hidden'' compensatory movements that may also underlie the movement deficits seen in DCD, as they reduce movement efficiency. Data availability Data will be made available on request.
... This disorder is classified as a neuro-motor disability, and individuals affected typically encounter challenges in acquiring and executing both fine and gross motor skills. These difficulties can significantly impact their daily activities and academic achievements, potentially leading to feelings of isolation, depression, and a diminished quality of life (2,3). Children experiencing movement-related issues may exhibit traits such as delayed motor development, balance impairments, perceptual-motor difficulties, poor coordination, and, to a certain extent, mild neurological disorders (4,5). ...
... Dexterous manipulation follows a consistent hand-arm kinematic pattern, where hand aperture peaks according to object size before closing upon contact, as observed by Jeannerod [91] and confirmed in further studies exploring other object and kinematic factors. However, individuals with neurological conditions like Dyspraxia or Developmental Coordination Disorder (DCD) experience difficulty in planning and executing movements [92]. This impairment in hand-eye coordination often results in challenges during object interactions, such as unintentional dropping or breakage. ...
Article
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Studying the interactions between biological organisms and their environment provides engineers with valuable insights for developing complex mechanical systems and fostering the creation of novel technological innovations. In this study, we introduce a novel bio-inspired three degrees of freedom (DOF) spherical robotic manipulator (SRM), designed to emulate the biomechanical properties observed in nature. The design utilizes the transformation of spherical Complex Spatial Kinematic Pairs (CSKPs) to synthesize bio-inspired robotic manipulators. Additionally, the use of screw theory and the Levenberg–Marquardt algorithm for kinematic parameter computation supports further advancements in human–robot interactions and simplifies control processes. The platform directly transmits motion from the motors to replicate the ball-and-socket mobility of biological joints, minimizing mechanical losses, and optimizing energy efficiency for superior spatial mobility. The proposed 3DOF SRM provides advantages including an expanded workspace, enhanced dexterity, and a lightweight, compact design. Experimental validation, conducted through SolidWorks, MATLAB, Python, and Arduino, demonstrates the versatility and broad application potential of the novel bio-inspired 3DOF SRM, positioning it as a robust solution for a wide range of robotic applications.
... These other neuromotor deficits are likely underreported, as they are more subtle, may not present until preschool or school age, and are often not routinely assessed in at-risk children. However, motor deficits have a significant impact on children's lives, affecting academic achievement and daily activities, such as participation in sports [3]. ...
Article
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Background/Objectives: Motor deficits following neonatal brain injury, from cerebral palsy to subtle deficits in motor planning, are common yet underreported. Rodent models of motor deficits in neonatal hypoxia–ischemia (HI) allow improved understanding of the underlying mechanisms and neuroprotective strategies. Our goal was to test motor performance and learning in a mouse model of neonatal HI. Methods: We induced HI in postnatal day (p)10 C57/Bl6 mice through unilateral carotid ligation followed by 60 min of 8% oxygen exposure, or a sham procedure. At p30, we assessed complex motor performance and learning using the accelerating rotarod and complex running wheel tasks. Results: In the rotarod task, HI mice performed worse than sham mice, with shorter latencies to fall (n = 6 sham, 9 HI; day 1, p = 0.033; day 2, p = 0.013; day 3, p = 0.023). Sham mice demonstrated improved performance across days (p = 0.005), and HI mice did not (p = 0.44). During the simple running wheel task, we observed no difference in wheel rotation and speed between groups (n = 5/group; day 1, p = 0.67; day 4, p = 0.53). However, when navigating a wheel with a random pattern of spokes removed (complex task), HI mice took longer than sham mice to reach a plateau in performance (n = 5/group; day 1, p = 0.02; day 4, p = 0.77). Conclusions: Our findings demonstrate that young adult mice exposed to HI exhibit significant deficits and delayed learning in complex motor performance compared to sham mice. HI mice do not show deficits in gross motor performance; however, more subtle impairments are present in complex motor performance and learning. This HI model exhibits subtle motor deficits relevant to findings in humans and may be a useful tool in testing further neuroprotective strategies.
... Iako se RPK svrstava u najučestalije specifične poremećaje karakteristične za školski uzrast (Zwicker et al., 2012), pri čemu neretko biva udružen sa disleksijom, disgrafijom i disortografijom, tek se nekoliko studija bavilo razvojem fonologije kod dece sa RPK (Fletcher-Flinn et al., 1998;Janjić et al., 2019;Janjić, 2022). Dobijena ispodprosečna postignuća u fonološkoj obradi dece sa RPK upućuju na značajno kašnjenje u fonološkom razvoju ove grupe dece, kao i na povećan rizik za smetnje u ovladavanju čitanjem i pisanjem (Janjić, 2021;Janjić, 2022;Nišević, 2016). ...
Article
Introduction. Although the correlation between motor and language development has been analyzed through various studies, the correlation between phonological development and fine motor skills in younger school-age children has not been sufficiently investigated. Objective. The aim of the study was to determine the relationship between phonological awareness and visuomotor coordination in younger school-age children. Methods. The study included 60 children attending the third grade of primary schools in Belgrade. Developmental coordination disorder was observed in 27 children, while 33 children were without this disorder. The Questionnaire for Developmental Coordination Disorder was used to determine its presence. Phonological awareness was assessed by the Test of Phonological Awareness, and fine motor skills by subtests of the Acadia Test of Developmental Abilities - Visuomotor Coordination and Sequencing and Figure Copying. Results. The results show significant below-average achievements in visuomotor coordination, figure copying, and phonological awareness in children with developmental coordination disorder. Regression analysis showed that visuomotor coordination significantly predicts all elements of phonological awareness in children. In children with developmental coordination disorder, figure copying explains 26.3% of the variance in phonemic segmentation and 20.8% of the variance in initial phoneme identification. Conclusion. In younger school-age children, visuomotor coordination is an independent predictor of all levels of phonological processing. From the earliest school age, poor phonological awareness and fine motor skills follow children with developmental coordination. Different regression analysis results in children with and without developmental coordination disorder indicate that not all aspects of fine motor skills are equally important for phonological awareness.
... Dies lässt sich anhand von Befunden zu Entwicklungsstörungen eindrücklich darstellen. Kinder mit Körperkoordinationsstörungen zeigen Beeinträchtigungen in der Fein-und Grobmotorik (Zwicker et al., 2012). Gleichzeitig sind ihre exekutiven Funktionen im Vergleich zu gesunden Gleichaltrigen schlechter ausgeprägt bzw. ...
... Because there were no Greek norms in motor and cognitive level for the general student's population, norms of research sample had to be created (sample norms). 2. According to research data and the international scientific literature the incidence of DCD amounts to 6-10% of school-aged children 5-11 years [29] or 5-6% [45] with typical diagnosis in infancy or entering in primary education. On the other hand, children with and without DCD coexist in classrooms; therefore, we selected all children without DCD (N=54) and added six children with DCD (N=6). ...
Chapter
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The present study investigated the nature of possible cognitive-motor profiles of DCD using clustering methods. Dependent variables were selected on the basis of the characteristics of children with DCD and the specific difficulties observed in cognitive- motor domain according to the DCD literature. For the purpose of the study we adopted “PASS” neurocognitive theory (Planning, Attention, Simultaneous, Successive) and the norm-referenced Cognitive Assessment System. Based on this hierarchical agglomerative cluster analysis six (6) statistical sub-groups emerged with number of participants ranged from 5-43 students with or without DCD. Internal and external validity of the clustering solution was controlled by different clustering methods (Wards method analysis, Complete Linkage method, Centroid method, K-Means iterative partitioning method and split-sample replication), as well as other parametric methods (MANOVA, ANOVA and discriminant analyses). The impact of different DCD profiles may provide larger benefits for alternative and effective instructional methods and early intervention programs in order to avoid motor learning disabilities and low academic achievement. Future research in evaluating and designing intervention programs may be need to focus on the individual profiles of children across a broad range of areas (motor, cognitive, social and emotional), looking at their unique strengths and weaknesses.
... Not surprisingly, children's motor abilities have been found to affect their self-esteem, well-being, acceptance by peers, and academic achievement. 18,20,21 In the context of the current findings, CRF may be an indicator of children's day-to-day levels of physical activity, which are not only paramount for motor skills and overall health but also play an important role in social interactions and inclusion in games among children. In Visier-Alfonso et al.'s models, the one and only stable and significant association across both sexes is the path from CRF to psychological wellbeing. ...
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It is well known that physiological, psychological, and cognitive factors contribute to children’s wellbeing and school success, but studies assessing these domains simultaneously are surprisingly rare. Visier-Alfonso et al. expand on our existing knowledge base and report different pathways to academic achievement for girls and boys. Specifically, girls with higher cardiorespiratory fitness had better psychological wellbeing, and this was associated with higher academic achievement. Boys were more academically successful if they had higher cognitive flexibility. Boys with higher cardiorespiratory fitness also had better psychological wellbeing. According to this current evidence, cardiorespiratory fitness has both direct and indirect beneficial effects beyond physical health on psychological wellbeing and academic achievement. Health practitioners, education professionals, and parents should focus on increasing opportunities for daily physical activities that will benefit children’s cardiorespiratory fitness.
... The labels developmental dyspraxia, minimal brain malfunction, perceptual-motor dysfunction, physical awkwardness, and, very often, the clumsy kid syndrome have all been used to characterize these children in the past [23,24]. These children were referred to as having DCD as a group in 1994 during an international consensus conference in London, Ontario [24]. ...
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A prevalent long-term medical condition in children that is rarely understood and acknowledged in educational contexts is developmental coordination disorder (DCD), which is one of the most prevalent conditions in school-aged children. Mild-to-severe abnormalities in muscle tone, posture, movement, and the learning of motor skills are associated with motor disorders. Early detection of developmental abnormalities in children is crucial as delayed motor milestones during infancy might indicate a delay in both physical and neurological development. To overcome the current condition of motor impairment, obstructing their risk factors is important to prevent the development of disability, which is already determined in the prenatal and perinatal period. Concerning the relationship with gestational age, the majority of the studies reported a relationship between DCD and preterm children. However, the entire range of gestational age, including post-term birth, has not been studied. The risk of developmental consequences such as cognitive impairments, major mental diseases, attention-deficit/hyperactivity disorder, autism spectrum disorder, and other behavioral and emotional problems increases in post-term birth, according to prior studies. Thus, this review aims to provide an overview of information linking post-term birth to children’s motor impairment, with a focus on DCD. A thorough systemic review was conducted on online databases, and only a few studies were found on the association with post-term children. Insufficient evidence made it necessary to examine more post-term cohorts in adolescence to fully determine the long-term health concerns and develop therapies to mitigate the detrimental effects of post-term deliveries.
... This motor disorder affects approximately 450,000 Canadian school-aged children (American Psychiatric Association, 2013;Statistics Canada, 2021). The related gross and fine motor difficulties affect important childhood activities such as tying shoelaces, printing, or riding a bicycle (Kirby and Sugden, 2007;Zwicker et al., 2012;Blank et al., 2019). Early intervention is important, as children with DCD typically continue to experience motor difficulties well into adolescence and adulthood if adequate intervention is not provided throughout childhood (Kirby et al., 2013). ...
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Introduction: Cognitive Orientation to daily Occupational Performance (CO-OP) is a cognitive-based, task-specific intervention recommended for children with developmental coordination disorder (DCD). We recently showed structural and functional brain changes after CO-OP, including increased cerebellar grey matter. This study aimed to determine whether CO-OP intervention induced changes in cortical grey matter volume in children with DCD, and if these changes were associated with improvements in motor performance and movement quality. Methods: This study is part of a randomized waitlist-control trial (ClinicalTrials.gov ID: NCT02597751). Children with DCD (N = 78) were randomized to either a treatment or waitlist group and underwent three MRIs over 6 months. The treatment group received intervention (once weekly for 10 weeks) between the first and second scan; the waitlist group received intervention between the second and third scan. Cortical grey matter volume was measured using voxel-based morphometry (VBM). Behavioral outcome measures included the Performance Quality Rating Scale (PQRS) and Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2). Of the 78 children, 58 were excluded (mostly due to insufficient data quality), leaving a final N = 20 for analyses. Due to the small sample size, we combined both groups to examine treatment effects. Cortical grey matter volume differences were assessed using a repeated measures ANOVA, controlling for total intracranial volume. Regression analyses examined the relationship of grey matter volume changes to BOT-2 (motor performance) and PQRS (movement quality). Results: After CO-OP, children had significantly decreased grey matter in the right superior frontal gyrus and middle/posterior cingulate gyri. We found no significant associations of grey matter volume changes with PQRS or BOT-2 scores. Conclusion: Decreased cortical grey matter volume generally reflects greater brain maturity. Decreases in grey matter volume after CO-OP intervention were in regions associated with self-regulation and motor control, consistent with our other studies. Decreased grey matter volume may be due to focal increases in synaptic pruning, perhaps as a result of strengthening networks in the brain via the repeated learning and actions in therapy. Findings from this study add to the growing body of literature demonstrating positive neuroplastic changes in the brain after CO-OP intervention.
... Developmental coordination disorder (DCD), also known as developmental dyspraxia, is a chronic and usually permanent condition prevalent in 5-6% of children [1]. These children experience numerous functional difficulties due to motor coordination [2]. A primary concern in many children and adolescents with DCD is impaired upper limb function, which particularly affects their ability to perform Activities of Daily Living (ADLs) using their hands, fingers, and arms [3]. ...
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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.
... Positive experiences of inclusion are important in order to continue with an active lifestyle [9,10]. Children with MC below the 5th percentile often meet the criterion for developmental coordination disorder (DCD), which is a defined neurodevelopmental disorder affecting motor coordination and the development of motor skills [11]. However, less severe motor difficulties, i.e., MC below the 15th percentile, may impede participation in PA and recreation, and should be considered for support [12]. ...
Article
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Low motor competence (MC) has been associated with lower physical activity (PA) and long-term health risks in children. Less is known about sex-specific patterns and associations during early school age. The aim of this study was to explore how motor difficulties are associated with PA levels, screen time, and organised sports participation (OSP). Data from 479 children, seven years of age, participating in the Swedish Environmental, Longitudinal, Mother and child, Asthma, and allergy (SELMA) pregnancy cohort study were used. MC and activity-related outcomes were assessed with questionnaires answered by parents. Associations between MC and outcomes were evaluated using logistic regression models adjusted for sex, overweight, and parental education level. Sex differences were investigated with interaction analyses and in stratified models. Children with motor difficulties had the same level of PA as their peers, but more screen time and lower OSP. Compared with children with normal MC, boys with motor difficulties had lower rates of OSP, but girls did not. This indicates that the identification and compensatory support for motor difficulties for boys at an early age, as well as the development of inclusive leisure time activities, are of importance to facilitate health-promoting activities on equal terms.
... Hypoactivity is also a common situation in children with developmental coordination disorder [2,3]. This neurodevelopmental disorder, which concerns approximately 5-6% of school-aged children [4], mainly corresponds to motor impairments ranging from gross-to fine-skill deficits that interfere with daily social and academic activities [5]. Developmental coordination disorder results in an atypical sensorimotor experience and poor interaction with the environment affecting the entire sensorimotor pathway. ...
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Interaction with the environment appears necessary for the maturation of sensorimotor and cognitive functions in early life. In rats, a model of sensorimotor restriction (SMR) from postnatal day 1 (P1) to P28 has shown that low and atypical sensorimotor activities induced the perturbation of motor behavior due to muscle weakness and the functional disorganization of the primary somatosensory and motor cortices. In the present study, our objective was to understand how SMR affects the muscle–brain dialogue. We focused on irisin, a myokine secreted by skeletal muscles in response to exercise. FNDC5/irisin expression was determined in hindlimb muscles and brain structures by Western blotting, and irisin expression in blood and cerebrospinal fluid was determined using an ELISA assay at P8, P15, P21 and P28. Since irisin is known to regulate its expression, Brain-Derived Neurotrophic Factor (BDNF) levels were also measured in the same brain structures. We demonstrated that SMR increases FNDC5/irisin levels specifically in the soleus muscle (from P21) and also affects this protein expression in several brain structures (as early as P15). The BDNF level was increased in the hippocampus at P8. To conclude, SMR affects FNDC5/irisin levels in a postural muscle and in several brain regions and has limited effects on BDNF expression in the brain.
... While these differences may be partially rooted in social experiences and opportunities for motor skill development in boys and girls, it is known that girls have shown lower motor competence overall. In DCD, studies have reported a higher prevalence in boys overall [60]. However, it is not clear yet if there is a true sex ratio or if other factors contribute to a higher prevalence of boys in DCD (such as a lower detection and investigation rate in girls, for example). ...
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Developmental coordination disorder (DCD) is a condition defined by poor motor proficiency in children in the absence of neurological conditions or other diseases. This review provides an overview of low motor competence (LMC) and DCD in children and a framework to understand the differences and similarities between LMC and DCD. While the prevalence of DCD is fairly high (up to 5–6% of school-age children), research in the last few decades has documented a significant level of low motor competence (LMC) in the school-age children (~ 30–77%). These numbers represent an epidemic of poor motor skills that need proper assessment, intervention, and sometimes a referral for an investigation of a potential DCD diagnosis. Low motor competence is typically established after a one-time measurement of motor skills using a standardized assessment. DCD, on the other hand, is a chronic condition—that is, it persists from childhood, through adolescence, and into adulthood.
... It is known throughout the world that the majority of children in the preschool to elementary school stages are not encouraged to carry out adequate movement and physical activity or are not even facilitated at all (Chaput et al., 2016;Berglind & Tynelius, 2017). Studies reveal that up to 19% of children in the world suffer from impaired motor coordination development and the ratio of males to females is 2:1, so intervention and planned action are needed, including control and monitoring during motor execution for children (Gomez & Sirigu, 2015;Zwicker et al., 2012). ...
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The main predictor that supports motor skills is the mastery of motor coordination that is effectively developed through learning programs at elementary school ages. This study aims to analyze the differences in coordination skills of children who live in urban and rural areas. This study used a cross-sectional design, and the research subjects were elementary school students aged between 7-9 years (N=640; male=320 and female=320) spread across urban and rural areas in West Sumatra Province, Indonesia. Samples were collected through a purposive sampling technique. Coordination data were measured using the Körperkoordinations Test für Kinder (KTK): balance beam, moving sideways, jumping sideways and eye-hand coordination. The data were analyzed using the IBM SPSS statistical program version 25. The results of the analysis revealed that Urban students had a superior motor coordination average score compared to rural students. Based on the t-test, there was a significant difference in general coordination abilities between urban and rural students (p value< 0.05). The motor coordination skills of students in urban settings are superior to those of students in rural settings, both male and female. It is believed that by having adequate facilities and equipment, schools in Urban have more opportunities to practice coordination both structured and independently. It is recommended to optimize movement coordination training for students in a structured manner in physical education and extracurricular learning at school.
... 20 Note also that 2 % of students had scores less than 1 in all assessed skills. This points to a substantial need for targeted strategies due to a potential risk of developmental delay or coordination disorders, 27 and it may necessitate medical diagnosis or intervention. This negative picture may be attributed to several factors, 28 including limited public awareness of the importance of motor competence for promoting healthy lifestyles, parental involvement in teaching FMS beyond school-related activities, low participation in sports communities, and the prevalent sedentary lifestyle and engagement in screen-based activities across all age groups in Poland. ...
Article
Objectives: With the premise that physical education classes should promote physical activity by teaching and learning fundamental motor skills, this study aimed to evaluate the fundamental motor skill proficiency of primary school students and determine the level of achievement of established learning outcomes for fundamental motor skills, as specified in the Polish National Physical Education Curriculum. Design and methods: A cross-sectional design was used for this study. The sample consisted of 2605 children and adolescents enrolled in grades 1–3 (ages 7–9, n = 1165), 4–6 (ages 10–12, n = 837), and 7–8 (ages 13–14, n = 603), including 1353 boys and 1252 girls. The Fundamental Motor Skills in Sport test, a qualitative and process-oriented assessment tool, was used to evaluate fundamental motor skills. The Fundamental Motor Skills in Sport test evaluates the following movement skills: hurdles, jumping rope, forward roll, ball bouncing, ball throwing and catching, and kicking and stopping a ball. Results: The desired level of overall fundamental motor skill proficiency was achieved by only 2 % of students. An elementary level of fundamental motor skill proficiency was demonstrated by an additional 3.5 % of students. Further, the results showed that only 10–30 % of students had achieved mastery or were close to achieving mastery in a given fundamental motor skill. The skill with the lowest level of proficiency was jumping rope, which only 11 % of students had mastered or were near to mastering. Conclusions: The present study of a large, nationally representative sample of primary school students in Poland indicates that the vast majority (approximately 94 %) of them demonstrated insufficient fundamental motor skill proficiency. This may greatly hinder effective, safe, and healthy participation in lifelong physical activity. ***In addition to our research findings, I highly recommend checking out our 'FUS Test' application, available on both the App Store and Google Play Store. The app facilitates the execution of the FUS test and assessment of both overall and individual FMS.
... Children with this disorder have significant challenges regarding intellectual and adaptive skills compared to their peers (Gohel et al., 2011). These children often have delays in reaching developmental milestones, struggle academically and have difficulties such as dyslexia (Zwicker et al., 2012). In severe cases, people with profound intellectual disabilities may need constant care and help with daily activities. ...
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Introduction: Intellectually disabled children upset the mental, physical, social, and financial outlooks of the family in terms of their rearing and future. The support systems surrounding the parents of mentally retarded children play a vital role in lessening the burden associated with their special child. This study sheds some light on the psychosocial impacts on parents of mentally challenged children who were attending special schools at Mangaluru. Objective: The study's main objective was to assess the psychosocial impacts on parents of mentally challenged children. Furthermore, we aimed to find the association between the psychosocial impact on parents of mentally challenged children and selected demographic variables. Method: This study used a cross-sectional survey design, and participants were selected by using the purposive sampling technique. The sampling frame consisted of parents of clinically diagnosed mentally disabled children in which 80 parents were selected for this study. A structured psychosocial impact scale was used to collect data, which were analyzed using descriptive and inferential statistics. Results: The analysis of the results showed that 59 [73.75%] female respondents had more psychosocial problems than their male counterparts. Forty respondents [50%] had a moderate psychosocial impact, followed by 30 (37.5%) respondents who had a severe psychosocial impact and 10 (12.5%) respondents who had a mild psychosocial impact. The total mean percentage of the psychosocial impacts score was 60.5%, with a mean and standard deviation of 30.25 and 7.87, respectively. Conclusion: This study indicates that parents, especially mothers with intellectually disabled children, experience various psychological and social problems. Parent-focused early intervention and counselling services, especially for mothers, should be included in the mental retardation management protocol.
... Second, we explored the tissue expression patterns of the genes associated with DCD. Because DCD is a central cause of motor incoordination [36], we investigated whether the genes associated with DCD were specifically expressed in any central nervous system (CNS) structure, using the multi-gene query function of Genotype-Tissue Expression (GTEx) Portal (Analysis Release V8, available at: https://www.gtexportal.org; accessed on 24 May 2022) [37]. ...
Article
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Developmental Coordination Disorder (DCD) is a neurodevelopmental condition characterized by non-progressive central motor impairments. Mild movement disorder features have been observed in DCD. Until now, the etiology of DCD has been unclear. Recent studies suggested a genetic substrate in some patients with DCD, but comprehensive knowledge about associated genes and underlying pathogenetic mechanisms is still lacking. In this study, we first identified genes described in the literature in patients with a diagnosis of DCD according to the official diagnostic criteria. Second, we exposed the underlying pathogenetic mechanisms of DCD, by investigating tissue- and temporal gene expression patterns and brain-specific biological mechanisms. Third, we explored putative shared pathogenetic mechanisms between DCD and frequent movement disorders with a known genetic component, including ataxia, chorea, dystonia, and myoclonus. We identified 12 genes associated with DCD in the literature, which are ubiquitously expressed in the central nervous system throughout brain development. These genes are involved in cellular processes, neural signaling, and nervous system development. There was a remarkable overlap (62%) in pathogenetic mechanisms between DCD-associated genes and genes linked with movement disorders. Our findings suggest that some patients might have a genetic etiology of DCD, which could be considered part of a pathogenetic movement disorder spectrum.
... Developmental coordination disorder (DCD) is a movement disorder characterized by reduced motor competence and poor motor coordination, in the absence of other identifiable neurological and/or medical disorders (American Psychiatric Association, 2013). Affecting 5-6% of school-aged children (Zwicker et al., 2012), children with DCD experience significant problems in their fine and/or gross motor skills (Geuze et al., 2001). Most children with DCD also experience significant difficulties with both static and dynamic balance, which can lead to secondary issues such as non-participation in physical activity (Fong et al., 2011) and an increased risk of tripping and falling (Scott-Roberts and Purcell, 2018). ...
Article
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The majority of children with developmental coordination disorder (DCD) struggle with static and dynamic balance, yet there is limited understanding of the underlying neuromechanical mechanisms that underpin poor balance control in these children. Eighteen children with DCD and seven typically developing (TD) children aged 7–10 years stood with eyes open on a moveable platform progressively translated antero-posteriorly through three frequencies (0.1, 0.25 and 0.5 Hz). Myoelectric activity of eight leg muscles, whole-body 3D kinematics and centre of pressure were recorded. At each frequency, postural data were divided into transition-state and steady-state cycles. Data were analyzed using a linear mixed model with follow-up Tukey’s pairwise comparisons. At the slowest frequency, children with DCD behaved like age-matched TD controls. At the fastest frequency, children with DCD took a greater number of steps, had a greater centre of mass variability, had a greater centre of pressure area, and tended to activate their muscles earlier and for longer than TD children. Children with DCD did not alter their postural response following prolonged exposure to platform movement, however they made more, non-structured postural adjustments in the medio-lateral direction as task difficulty increased. At the faster oscillation frequencies, children with DCD adopted a different muscle recruitment strategy to TD children. Activating their muscles earlier and for longer may suggest that children with DCD attempt to predict and react to postural disturbances, however the resulting anticipatory muscle excitation patterns do not seem as finely tuned to the perturbation as those demonstrated by TD children. Future work should examine the impact of balance training interventions on the muscle recruitment strategies of children with DCD, to ensure optimal interventions can be prescribed.
... Secondly, we explored the tissue expression patterns of the genes associated with DCD. Because DCD is a central cause of motor incoordination [36], we investigated whether the genes associated with DCD were specifically expressed in any central nervous system (CNS) structure, using the multigene query function of Genotype-Tissue Expression (GTEx) Portal (Analysis Release V8, available at: https://www.gtexportal.org) [37]. ...
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Developmental Coordination Disorder (DCD) is a neurodevelopmental condition characterized by non-progressive central motor impairments. Mild movement disorder features have been observed in DCD. Until now, the etiology of DCD remains unclear. Recent studies suggested a genetic substrate in some patients with DCD, but comprehensive knowledge about associated genes and underlying pathogenetic mechanisms is still lacking. In this study, we first identified genes described in literature in patients with a diagnosis of DCD according to the official diagnostic criteria. Second, we exposed the underlying pathogenetic mechanisms of DCD, by investigating tissue- and temporal gene expression patterns and brain-specific biological mech-anisms. Third, we explored putative shared pathogenetic mechanisms between DCD and frequent movement disorders with a known genetic component, including ataxia, chorea, dystonia, and myoclonus. We identified 12 genes associated with DCD in literature, which are ubiquitously expressed in the central nervous system throughout brain development. These genes are involved in cellular processes, neural signaling and nervous system development. There was a remarkable overlap (62%) in pathogenetic mechanisms between DCD-associated genes and genes linked with movement disorders. Our findings suggest that some patients might have a genetic etiology of DCD, which could be considered part of a pathogenetic movement disorder spectrum.
... Although each condition is defined by a distinct constellation of features, NDDs are often comorbid with one another, posing challenges in treatment planning and care (American Psychiatric Association, 2013). Attention-deficit/hyperactivity disorder (ADHD) and developmental coordination disorder (DCD) are among the most common NDDs, with ADHD present in approximately 7% (Polanczyk et al., 2014;Sayal et al., 2018) and DCD in 6% of school-age children (APA, 2000;Zwicker et al., 2012). While ADHD is characterized by inattention, hyperactivity and impulsivity, children with DCD exhibit difficulties with motor control, including motor planning, coordination, and learning (APA, 2013;World Health Organization, 2019). ...
Article
Attention-deficit/hyperactivity disorder (ADHD) and developmental coordination disorder (DCD) co-occur in approximately 50% of cases. This study aimed to characterize the behavioral, cognitive, and neurobiological profiles of co-occurring ADHD and DCD diagnoses by mapping, synthesizing, and providing a critical appraisal of the existing literature. A systematic search was conducted across four databases (MEDLINE, PsycINFO, Embase, and Scopus) to identify studies comparing a coexisting ADHD+DCD diagnosis to ADHD and DCD alone. From 2353 screened articles, 15 behavioral and 10 neuroimaging studies were included. Collectively, these studies suggest that the comorbid ADHD+DCD presentation constitutes a more severe phenotype characterized by neurocognitive differences associated with both conditions. Despite sharing some common neural features, our findings support the separate etiology hypothesis indicating that neural network alterations in individuals with ADHD+DCD represent a unique neural pattern rather than a sum of ADHD and DCD characteristics. Considering the heterogeneity inherent to both ADHD and DCD, future studies should involve rigorous and comprehensive assessment procedures to delineate how different subtypes of each diagnosis relate to distinct performance characteristics.
Article
Pelvic ring fractures (PRF) are high energy fractures with an incidence of 20/100,000 among all fractures and significant associated morbidity and mortality. PRF are often classified using Young-Burgess classification, and Tile AO classification. This project aims to review the literature comparing the two classification systems for reliability, clinical implications and guide for treatment plan. Google Scholar search was performed with the following words: “Young”, “Burgess”, “Tile”, “presentation”, “treatment”, “pelvic ring” in the Title/Abstract. After review of 828 results, 11 articles are included in this systematic review. Reliability of the classification systems positively correlated with an increase in years of experience. When comparing the reliability, Young-Burgess is shown to have moderate-to-substantial level of agreement for classifying pelvic fractures when accounting for expertise level, while Tile showed substantial agreement between specialists only. Young-Burgess better predicted mortality as compared to Tile, while another study found no significant difference. Tile B and LC fractures are found to have higher frequency of hemodynamic instability and undergo laparotomies more frequently. When comparing treatment options, there is a moderate level of agreement for the treatment option solely based on images. However, the question of how the classifications guide treatment outcomes remains unanswered. After review of current literature, it appears that Young-Burgess classification has slightly higher reliability and better prediction for mortality than Tile. However, there is a need for further research on how the classification systems can determine the treatment and outcomes to improve morbidity and mortality.
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Developmental coordination disorder (DCD) is one of the most frequently observed movement disorders in childhood, yet data on its prevalence are still unclear. This two-stage epidemiological study aims to determine the prevalence of DCD in children between 6 and 10 years of age according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). In the first stage, the Developmental Coordination Disorder Questionnaire (DCDQ’07) were given to primary school students. In the second stage, clinicians conducted psychiatric interviews with children who had an indication of DCD or were suspected of having DCD according to the DCDQ’07 and their parents. The interviews utilized the DSM-5 diagnostic criteria for DCD and applied the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-Turkish Adaptation (K-SADS-PL) and Wechsler Intelligence Scale for Children (WISC-R) to identify co-occurring disorders. In the first stage, 2,306 children were evaluated, and 205 were invited for a clinical interview. Of the 198 children interviewed, 49 met the diagnostic criteria for DCD. The prevalence of DCD in Türkiye was found to be 2.1%. High parental education level, a previous psychiatric admission of the child, mother’s postpartum depressive symptoms, co-occurring disorders, and co-occurring attention deficit hyperactivity disorder (ADHD) were significantly more common among children with DCD. Potentially associated factors were evaluated by logistic regression analysis. The mother’s education level, the presence of postpartum depressive symptoms, and co-occurring disorders in the child were found to be associated factors.
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Numerous efforts have been made to test the OPTIMAL theory of motor learning in healthy children and adult populations. However, only a small number of studies have tested this theory in children with cognitive-motor disorders, such as developmental coordination disorder (DCD). The present study aims to examine the individual and additive effects of a visual illusion and self-controlled practice on a golf putting task in children at risk for DCD based on the OPTIMAL theory. Forty children at risk for DCD (mean age = 8.57 ± 1.05 years) were randomly assigned to four experimental groups (1—small visual illusion + self-controlled practice; 2—big visual illusion + self-controlled practice; 3—small visual illusion + yoked; 4—big visual illusion + yoked). Following 12 pretest trials of a golf putting task, the participants completed 5 blocks of 12 trials of practice on the first day. A retention test (12 trials) and a transfer dual-task test (12 trials) were conducted on the second day. The results indicated that in retention test the big visual illusion + self-controlled practice group was significantly better than the small visual illusion + yoked group (p = 0.01), while there was not any other significant difference between groups at retention test as well as between all groups at practice phase and transfer test (p > 0.05 for all comparisons). In other words, an additive effect has been observed just in the retention test but not the practice phase as well as transfer test. In general, the results of this study support the OPTIMAL theory of motor learning in children at risk for DCD and suggests to all educators who work with these children to use the combination of the visual illusion with self-controlled practice to improve the motor learning of children at risk for DCD.
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Introduction Developmental coordination disorder (DCD) is one of the most prevalent pediatric chronic conditions. Without proper intervention, significant delays in motor skill performance and learning may persist until adulthood. Moderate-to-vigorous physical exercise has been proven to improve motor learning (adaptation and consolidation) in children with or without disorders. However, the effect of a short bout of physical exercise on motor adaptation and consolidation in children with DCD has not been examined. Furthermore, the role of perceptual-motor integration and attention as mediators of learning has not been examined via neuroimaging in this population. Objectives Therefore, the primary aims of this project will be to compare children with and without DCD to (a) examine the effect of acute exercise on motor learning (adaptation and consolidation) while performing a rotational visuo-motor adaptation task (rVMA), and (b) explore cortical activation in the dorsolateral- and ventrolateral-prefrontal cortex areas while learning the rVMA task under rest or post-exercise conditions. Methods One hundred twenty children will be recruited (60 DCD, 60 controls) and within-cohort randomly assigned to either exercise (13-minute shuttle run task) or rest prior to performing the rVMA task. Adaptation and consolidation will be evaluated via two error variables and three retention tests (1h, 24h and 7 days post adaptation). Cortical activation will be registered via functional near-infrared spectroscopy (fNIRS) during the baseline, adaptation, and consolidation. Discussion We expect to find exercise benefits on motor learning and attention so that children with DCD profiles will be closer to those of children with typical development. The results of this project will provide further evidence to: (a) better characterize children with DCD for the design of educational materials, and (b) establish acute exercise as a potential intervention to improve motor learning and attention.
Article
Introduction: Coordination and balance are progressive motor skills that guide physical therapists in recognizing abnormal patterns during childish neurodevelopment. We aim to compare the efficacy of craniosacral therapy (CST) together with balance and coordination therapy (BCT) vs traditional BCT during neurodevelopment. Methods: Longitudinal, observational, and descriptive study with 111 apparently healthy children divided into 4 groups: craniosacral-balance and coordination therapy placebo (CS-BCTp), craniosacral-balance and coordination therapy (CS-BCT), balance and coordination therapy placebo (BCTp), and balance and coordination therapy (BCT). Results: Significant changes have been observed with the CS-BCT from the fourth session. Balance and coordination therapy is less effective. There are differences in the Battelle Scale at the beginning and after the 7 therapy sessions in the CS-BCT group. Conclusions: The study shows that CST together with balance and coordination exercises can be a more effective and faster treatment to improve these motor skills, correcting and improving alterations during child neurodevelopment.
Article
Background and Aims The present study aims to investigate the effect of the SPARK training program on some neuropsychological and motor performance variables in the Movement Assessment Battery for Children - Second Edition (MABC-2) in male children with developmental coordination disorder (DCD). Methods This is a quasi-experimental study with a pre-test/post-test design. Participants were 28 school-aged boys diagnosed with DCD (based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders) from elementary schools (1-4th grades) in District 22 of Tehran, Iran. They underwent the MABC-2 tests as a pretest assessment. Then, they were divided randomly assigned to training (n=14, mean age: 8.6±1.39 years) and control (n=14, mean age: 8.11±1.15 years) groups. The training group performed the SPARK training program at 16 sessions of 45 minutes, three sessions per week. At the end of the training sessions, participants completed the posttest assessment. Data analysis was performed using analysis of covariance. Results The training significantly improved motor performance in domains of manual dexterity (Placing pegs, drawing a trail), ball skills (catching with both hands, throwing a bean bag onto mat), and balance (One-board balance, heel-to-toe walking forwards, hopping on mats) (P<0.05), but there was no significant change in manual dexterity test of threading lace (P>0.05). Conclusion It seems that the SPARK training program can improve some neuropsychological and motor performance indices in male children with DCD.
Article
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.
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This paper reports the follow-up at age 15 of a group of children who were diagnosed at age 5 as having delayed motor development. The group of children who were clumsy and the control group still differed in motor performance 10 years later: 46% of the members of the early motor delay group were classified as different from the control group on motor and perceptual tasks. The remainder made up an intermediate group that could not be clearly distinguished from the other groups. Adolescents with stable motor problems had fewer social hobbies and pastimes and had lower academic ambitions for their future than the controls, although the lower academic ambitions also reflect their lower academic achievements. The adolescents who were clumsy believed they were less physically and scholastically competent than the controls. However, they did not have poor opinions of their social acceptance or self-worth. The intermediate group, although they showed motor delay at age 5, had good school performance and high ambitions and engaged in social sports at age 15.
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This study investigated the link between cognitive processes and neural structures involved in motor control. Children identified as clumsy through clinical assessment procedures were tested on tasks involving movement timing, perceptual timing, and force control. The clumsy children were divided into two groups: those with soft neurological signs associated with cerebellar dysfunction and those with soft neurological signs associated with dysfunction of the basal ganglia. A control group of age-matched children who did not exhibit evidence of clumsiness or soft neurological signs was also tested. The results showed a double dissociation between the two groups of clumsy children and the tests of timing and force. Clumsy children with cerebellar signs were more variable when attempting to tap a series of equal intervals. They were also more variable on the time perception task, indicating a deficit in motor and perceptual timing. The clumsy children with basal ganglia signs were unimpaired on the timing tasks. However, they were more variable in controlling the amplitude of isometric force pulses. These results support the hypothesis that the control of time and force are separate components of coordination and that these computations are dependent on different neural systems.
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Reviews 7 studies investigating the effects of sensory integration (SI) treatment on the academic and motor performance of children with, or at risk for, learning disabilities. SI is defined as the brain's capacity to organize sensory information for making adaptive responses. The review concludes that the status of the literature 20 yrs later after A. J. Ayres's (1972) original article does not support SI treatment as an effective treatment for the academic problems of learning-disabled children. With respect to sensory or motor variables, it is not clear whether or not SI treatment is more effective than perceptual-motor approaches. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The aim of this review was to investigate the selection criteria used in the past in studies of children with developmental motor problems (excluding those suffering from neurological dysfunctions such as cerebral palsy, muscular dystrophy, etc.). We therefore conducted an extensive analysis of 176 publications. First, an overview of the main characteristics of these studies (terminology, population, type and purpose) and the selection criteria that are reported in these publications are presented. Following this, the DSM-IV selection criteria for developmental coordination disorder (DCD) are contrasted with the selection criteria reported in 41 publications that have used this terminology to classify the children. The results of this comparison show that the inclusion criteria are largely followed, albeit with little consistency concerning selection instruments and quantitative cut-offs, while adherence to the exclusion criteria is not common practice. Strengths and weaknesses of the DSM-IV criteria, complementary to the previous discussion by Henderson and Barnett in the HMS special issue on DCD in 1998 on this same topic, are discussed. The results of the review also show that many studies have used additional selection criteria related to the specific research questions of the study concerned. In the broader context of clinical practice as well as basic research, the latter result suggests the usefulness of a distinction between Clinical Diagnostic Criteria and Research Diagnostic Criteria. This distinction helps to develop a unifying view on the use of diagnostic criteria for research and clinical practice. We conclude with a number of recommendations concerning the selection criteria for children with DCD.
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To determine whether male gender has an effect on survival, early neonatal morbidity, and long-term outcome in neonates born extremely prematurely. Retrospective review of the New South Wales and Australian Capital Territory Neonatal Intensive Care Unit Data Collection of all infants admitted to New South Wales and Australian Capital Territory neonatal intensive care units between January 1998 and December 2004. The primary outcome was hospital mortality and functional impairment at 2 to 3 years follow-up. Included in the study were 2549 neonates; 54.7% were male. Risks of grade III/IV intraventricular hemorrhage, sepsis, and major surgery were found to be increased in male neonates. Hospital mortality (odds ratio 1.285, 95% confidence interval 1.035-1.595) and moderate to severe functional disability at 2 to 3 years of age (odds ratio 1.877, 95% confidence interval 1.398-2.521) were more likely in male infants. Gender differences for mortality and long-term neurologic outcome loses significance at 27 weeks gestation. In the modern era of neonatal management, male infants still have higher mortality and poorer long-term neurologic outcome. Gender differences for mortality and long-term neurologic outcome appear to lose significance at 27 weeks gestation.
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Movement clumsiness (or Developmental Coordination Disorder - DCD) has gained increasing recognition as a significant condition of childhood. However, some uncertainty still exists about diagnosis. Accordingly, approaches to assessment and treatment are varied, each drawing on distinct theoretical assumptions about the aetiology of the condition and its developmental course. This review evaluates the current status of different approaches to motor assessment and treatment for children with DCD. These approaches are divided according to their broad conceptual origin (or explanatory framework): Normative Functional Skill Approach, General Abilities Approach, Neurodevelopmental Theory, Dynamical Systems Theory, and the Cognitive Neuroscientific Approach. Each conceptual framework is shown to support assessment and treatment methods with varying degrees of conceptual and psychometric integrity. The normative functional skill approach supports the major screening devices for DCD and cognitive (or top-down) approaches to intervention. The general abilities approach and traditional neurodevelopmental theory are not well supported by recent research. The dynamical systems approach supports promising trends in biomechanical or kinematic analysis of movement, ecological task analysis, and task-specific intervention. Finally, and more recently, the cognitive neuroscientific approach has generated some examples of process-oriented assessment and treatment based on validated (brain-behaviour) models of motor control and learning. A multi-level approach to movement assessment and treatment is recommended for DCD, providing a more complete representation of motor development at different levels of function - behavioural, neurocognitive, and emotional.
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Prevalence of children with developmental coordination disorder (DCD) is high (6-13% of all school children) and the negative impact of their movement difficulties on their participation in recreation and academic pursuits is well documented. This secondary research systematically reviewed the available literature for evidence of effectiveness of interventions that aim to improve the movement capability of children with DCD. Specified databases were searched for appropriate studies, these were retrieved and two reviewers appraised the level and quality of evidence. Thirty one studies were included between levels I and III-3 of the NH & MRC protocol. Scoring using an established critical appraisal tool demonstrated variable quality. Meta-analysis was not possible due to the clinical heterogeneity of the primary studies. A best evidence synthesis of results was conducted, producing clear evidence that no intervention has poor results when compared to any intervention. The high number of purportedly different interventions and variable quality make definitive conclusions about the merits of specific approaches difficult. There may be generic qualities or factors in the studied interventions that are more important for effectiveness than specific content. More information is needed on the underlying mechanisms of DCD, factors influencing effectiveness and the broader pragmatics of intervention delivery.
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An activity deficit hypothesis was posited that children with movement difficulties are less physically active during recess than age- and gender-matched controls without movement difficulties. Criteria used in identifying children with movement difficulties were (a) a score of at least 4 on the Test of Motor Impairment, (b) regular physical education student, and (c) age 80 to 109 months. An observational study was conducted over a 2-month period in recess settings with 52 subjects. Findings revealed that during recess time, children with movement difficulties were vigorously active less often, played less often with large playground equipment, were not observable for significantly more time, and spent less time in positive social interactions with others of their own gender. Accordingly, it was concluded that the data support the activity deficit hypothesis.
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This investigation examined the effects of eight sessions of intensive teaching of motor tasks on children with poor coordination. The 24 children, aged 5 to 9 years, were grouped by age and assigned to 1 of 10 teachers. These teachers were then randomly assigned to either Task Treatment Group 1 (TTG1) to teach both the overarm throw and hopping to their allocated children or Task Treatment Group 2 (TTG2) to teach target kicking and the volleyball bounce and catch. Each group acted as the other group's control. Repeated measures ANOVA of pretest-posttest scores showed that intensive teaching of the overarm throw, target kicking, and the bounce-and-catch task resulted in significant gains for the respective groups.
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The purpose was to determine whether evidence exists in published research from 1970 to 1996 to support motor skill intervention for children with developmental coordination disorder (DCD) or equivalent conditions. The following questions were addressed: (a) Which (if any) of three theoretical approaches to motor skill interventions is supported by evidence? (b) How do age of participants, research design, intervention setting, and intervention duration affect motor outcomes? (c) What are the results of meta-analysis? Twenty-one relevant studies were identified, and 13 (all that reported means and standard deviations) were subjected to meta-analysis. Findings indicated that motor skill intervention is most effective when applied with (a) children with DCD over age 5, (b) the specific skill theoretical approach, (c) intervention conducted in a group setting or as a home program, and (d) intervention frequency of at least 3 to 5 times per week. No clear findings emerged in regard to other variables.
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Child clumsiness results not from a single cause, but from a complex interaction of numerous dysfunctional subsystems. Research has identified differences between clumsy and non-disabled children in sensory functioning, information processing, and general motor control. The heterogeneity of this condition has made diagnosis and assessment difficult. Long-term studies indicate this is not a benign developmental delay that the child will outgrow. Motor problems appear to persist even into late adolescence with concomitant academic, social, and emotional problems. Intervention appears to be beneficial to some children; however, the gains are often not maintained when support is withdrawn. Some treatment techniques are suggested to therapists working with children with clumsiness.
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For many years it has been the custom among child guidance workers to attribute the behavioral and learning deviations seen in children almost exclusively to the rearing patterns and interpersonal relationships experienced by such youngsters. We, as well as an increasing number of clinical child workers, feel that when evaluating a disturbed child, we must search as carefully among the myriad possibilities of organic causation as we have in the past among the interpersonal, deprivation, and stress factors; and certainly without sacrificing the important knowledge which has accumulated in the latter areas. In many clinics, it has become habitual to assume psychogenicity when no easily recognizable organic deviation can be found in the child. Undoubtedly this has been due, in part, to the difficulty in delineating the contribution to symptomatology and personality structure of subtle organic and central nervous system deviations, and to the
Article
Objective: To explore parent perspectives regarding the early experiences of their children with Developmental Coordination Disorder (DCD).Methods: A phenomenological approach was used to explore the meaning of developmental experiences for children with DCD and their families. Parents of 13 children with DCD, aged 6–14, were recruited through purposeful sampling. Parents completed two indepth interviews, and a set of questionnaires. Transcripts and questionnaires were systematically coded to identify emergent themes.Results: There was an evolution over time in the differences that parents noticed and the concerns that they had for their child. There seemed to be a progression from motor and play concerns in the early years, to self-care, academic and peer problems in middle childhood, to significant challenges with self-esteem and emotional health in later childhood.Conclusions: Defining the developmental trajectory of children with DCD highlights the importance of understanding the impact of this disorder as it relates to developmental age and environmental expectations. Implications for early screening and increased awareness of health care professionals are discussed.
Article
Children with developmental coordination disorder (DCD) have a motor impairment that affects their ability to perform everyday tasks. Although severity of motor impairment can be measured, methods for assessing the perceived impact of DCD on daily activities have not been established. The purpose of this study was to use a child-focused approach to understand children's views of the impact of DCD on the activities that they perform daily. Children aged 5–10 years, referred with coordination difficulties to occupational therapists, were assessed using the Movement Assessment Battery for Children: children who received scores below the 15th percentile were included. The Perceived Efficacy and Goal Setting System (PEGS), a pictorial scale validated as a method for engaging children with disabilities, was administered to examine the children's perceptions of their competence in performing everyday activities and to identify goals for therapy. Parent and teacher concerns were collected by a questionnaire. The children, parents and teachers shared many concerns about the impact of DCD on physical tasks and on academic activities such as handwriting. The children expressed additional concerns, however, about their ability to perform daily self-care tasks and leisure activities, which were rarely recognised by the adults. Children require specialised methods to enable them to express their views and the PEGS appears to be suitable for this purpose.
Article
Developmental coordination disorder (DCD) is a problem for a significant proportion of children during school years and may result in more enduring social and emotional problems. Both occupational therapists and physiotherapists provide services for children with DCD. However, there are few studies examining the effectiveness of interventions for this client group. This has resulted in continuing uncertainty over the most effective treatment for this condition. This paper examines past problems with regard to definitions of the disorder, research design and ethical barriers. The results of a pre-test, post-test single-group study of an occupational therapy intervention for DCD are then presented. Outcomes were measured by the Movement ABC and the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery 1982) at one-year follow-up. The results are discussed in relation to the shortcomings of research design used in the study. It is concluded that the intervention, consisting of combined sensory integration and perceptual-motor training, is likely to be ineffective at 12-month follow-up.
Article
A dynamic pattern approach is used to examine the relative phase stability of rhythmic coordination in 24 children with a Developmental Coordination Disorder (DCD) and 24 matched controls in two functionally different tasks – a within-subject task (bimanual coordination) and a subject-environment task (visuomanual coordination). The stability of basic rhythmic coordination patterns (in-phase and antiphase patterns) was tested by applying perturbations, and by increasing the movement frequency towards the frequency where a loss of stability occurred. Coordination patterns of children with DCD were less stable than those of controls, both in the bimanual and the visuomanual task. According to the dynamic model (Haken, H., Kelso, J.A.S., Bunz, H., 1985. Biological Cybernetics 51, 347–356; Kelso, J.A.S., Delcolle, J.D., Schöner, G., 1990. In: Jeannerod, M. (Ed.), Attention and Performance XIII: Motor Representation and Control. Lawrence Erlbaum, Hillsdale, NJ, pp. 139–169), this reduced stability is due to a weaker coupling strength between the oscillators that represent the rhythmic units involved in the tasks. Further, within the DCD group three subtypes were found on the basis of particularly poor stability in bimanual rhythmic coordination (N=2), visuomanual rhythmic coordination (N=4), or both (N=7). These data were related to the presence of neurological soft signs in the DCD group, which did not reveal specific patterns of minor neurological dysfunction in these children. Theoretical and practical implications of these findings were discussed.PsycINFO classification: 2323; 2330; 3250; 3297
Article
Child clumsiness results not from a single cause, but from a complex interaction of numerous dysfunctional subsystems. Research has identified differences between clumsy and non-disabled children in sensory functioning, information processing, and general motor control. The heterogeneity of this condition has made diagnosis and assessment difficult. Long-term studies indicate this is not a benign developmental delay that the child will outgrow. Motor problems appear to persist even into late adolescence with concomitant academic, social, and emotional problems. Intervention appears to be beneficial to some children; however, the gains are often not maintained when support is withdrawn. Some treatment techniques are suggested to therapists working with children with clumsiness.
Chapter
The majority of the present chapter focuses upon a description of the child with developmental dyspraxia, highlighting characteristics, etiology, theories, evaluation and treatment. The need for early identification and remediation of developmental dyspraxia is emphasized and various treatment approaches are discussed. The concept of developmental dyspraxia is compared to and contrasted with that of adult apraxia. The two definitions are shown to contrast in that dyspraxia involves an impairment in new learning of motor patterns and sequences, whereas apraxia is characterized as a disorder of learned movements. The nature of the disorder also differs in that developmental dyspraxia is seen as a disorder of sensory integration, characterized by problems in planning the movement sequences, while apraxia is seen as largely a problem in execution. Evaluation of apraxia in the adult has emphasized the execution of symbolic gestures and pantomime, primarily to verbal command. In contrast, evaluation of developmental dyspraxia in the child emphasizes the imitation of non-symbolic gestures. An attempt is made to highlight and clarify the nature of apraxia in adults and children.
Article
A population study of 409 seven-year-old children in a middle-sized Swedish town was performed. All children were examined by the same doctor and evaluated by means of parent interview, motor examinations, and teacher reports on behaviour in the classroom. Follow-up was carried out 8 months later. The rate of severe problems in the fields of attention deficit-hyperactivity disorder (ADHD), developmental coordination disorder (DCD), and deficits in attention, motor control, and perception (DAMP) (the combination of ADHD and DCD) was 6.1%, with boys being affected more frequently than girls. There was considerable overlap between ADHD and DCD, with about half of each diagnostic group also meeting criteria for the other diagnosis. Attention deficits at diagnosis strongly predicted attention deficits at follow-up. If parents had noted attention deficits in the home setting, then teachers almost always independently agreed that there were similar problems in the classroom. However, the reverse did not always apply. Clumsiness also showed striking stability over time. The diagnosis of DAMP, particularly severe DAMP, had a stronger association with classroom dysfunction and with high Conners scores than did diagnoses of ADHD or DCD. It is concluded that DAMP may be a clinically valid diagnostic construct.
Article
The aims of this study were to determine the motor outcome of extremely-low-birthweight (ELBW; <1000g) or very preterm (<28wks) children compared with normal birthweight (NBW) children, to establish the perinatal associations of developmental coordination disorder (DCD) and its cognitive and behavioural consequences. Participants were consecutive surviving ELBW or very preterm children and randomly selected NBW(>2499g) children born in the state of Victoria, Australia, in 1991 or 1992. Main outcomes were: (1) results of the Movement Assessment Battery for Children (MABC) at 8 years of age; (2) cognitive function; (3) academic progress; and (4) behaviour. Of 298 consecutive ELBW/very preterm survivors, 255 (85.6%; 117 males, 138 females) had the MABC at a mean age of 8 years 8 months. More ELBW/very preterm children (9.5%) had DCD than the NBW group (2%, p=0.001). Only male sex increased the likelihood of DCD in ELBW/very preterm children (p=0.017). ELBW/very preterm children with DCD had worse cognitive function and academic test scores (up to 1SD below those without DCD); they also had more adaptive behaviour and externalizing problems, but not internalizing problems. DCD is more common in ELBW/very preterm children, has few perinatal correlates, and is associated with poor cognitive and academic performance as well as increased behaviour problems.
Article
The prevalence of Developmental Coordination Disorder (DCD) among 6‐ to 9‐ year‐old Singaporean primary school children was studied from a random sample (N=427) through a two‐step identification procedure contained within Henderson's and Sugden's Movement Assessment Battery for Children. The prevalence rate from this two step procedure was 4% when the first step included the bottom 15% of the random sample. The two‐step procedure moves towards fulfilling the diagnostic criteria for DCD set out by the American Psychiatric Association (DSM‐IV) and the World Health Organisation (ICD‐10) of a serious motor impairment in the development of motor coordination and significant interference with the activities of daily living not due in children to mental retardation or a known physical disability. RÉSUMÉ Procédure en deux étapes pour identifier les enfants avec trouble développemental de la coordination, utilisée à Singapour La prévalence d'un trouble développemental de la coordination (DCD) parmi les enfants de 6 à 9 ans des écoles primaires de Singapour a été etudtée à partir d'un échantillon tire au hasard (N=427) par une procédure d'identification en deux étapes tirée de la Movement Assessment Battery for Children de Henderson et Sugden. Le taux de prévalence avec cette procédure en deux étapes a été de 4% lorsque la première étape incluait le seuil de 15% de l'échantillon de hasard. La procédure en deux étapes suivait les critères diagnostiques de DCD etablis par 1'American Psychiatric Association (DSM IV) et par l'OMS (ICD‐10) pour une atteinte motrice sérieuse dans le développement de la coordination et une intérference significative avec les activités de la vie joumalière, non due à un retard mental chez I'enfant ou a une incapacité physique connue. ZUSAMMENFASSUNG Zwei Stufen Verfahren zur Identifizierttng von Kindern mil entwicklungsbedingien Koordinationsstöningen in Singapur Die Autoren untersuchten die Häufigkeit von entwicklungsbedingten Coordinatiönsstorungen (DCD) in einer randomisierten Gruppe von 6‐ bis 9‐jahrigen Grundschulkindem (N=427) in Singapur mil einem zwei Stufen Verfahren, das in der Movement Assessment Battery für Kinder Henderson and Sugden enthalten ist. Nach diesem zwei Stufen Verfahren betrug die Häufigkeit 4%, wenn die erste Stufe die unteren 15% der randomisierten Gruppe einschloß. Das zwei Stufen Verfahren versucht, die diagnostischen Kritcrien für DCD, herausgegeben von der amerikanischen Psychiatriegesellschaft (DSM‐IV) und der Weltgesundhcitsorganisation (ICD‐10), zu erfüllen, die eine schwerc motorische Stöning in der Entwicklung der motorischen Koordination und eine signifikante Bceinträchtigung der Aktivitäten des täglichen Lebens der Kinder, die nicht durch geistige Rctardierung oder eine bekanntc korperliche Bchindcrung bedingt ist, bezeichnen. RESUMEN Método en dos liempos para la identificatión de niños con alteraciones en el desarrollo de la coordinación de Singapore Se cstudió la prevalencia de la alteración del desarrollo de la coordinación (ADC) en niños de escuela primaria de 6 a 8 años de edad, en Singapore, a partir de una mucstra a 1 azar (N=427) utilizando un procedimiento en dos etapas contenido en la Batcría de Evaluación del Movimiento para Niños de Henderson y Sugden. El porcentaje de prevalencia de este procedimiento fue del 4% cuando la primera etapa incluia el fondo del 15% de la mucstra al azar. El procedimiento de las dos etapas se mueve hacia el cumplimiento dc los criterios diagnosticos para la ADC, de la Asociacion Psiquiátrica Americana (DSM‐IV) y la OMS (ICD‐10), para la alteracion motora grave en el desarrollo de la coordinación y la interferencia significativa con las actividades de la vida real, no debida, en niños, a un retraso mental o a una discapacidad física conocida.
Article
The aim of this study was to evaluate neuromotor task training (NTT), a recently developed child-centred and task-oriented treatment programme for children with developmental coordination disorder (DCD). A treatment and a non-treatment control group of children with DCD were included. Children were selected if they scored below the 15th centile on the Movement Assessment Battery for Children (MABC). The children in the treatment group were recently referred for physiotherapy (n=26; 20 males, 6 females; mean age 7y 2mo [SD 1y 3mo]). The parents of the non-treated children were concerned about their children's motor performance and responded to advertisements for free testing (n=13; 10 males, 3 females; mean age 7y 2mo [SD 2y 1mo]). Before and after nine weekly 30-minute sessions of NTT or at least 9 weeks of no intervention, the MABC and the Test of Gross Motor Development - 2 (TGMD-2) were administered. Therapists reported per session on treatment goals and tasks trained. The results indicate that motor performance does not improve spontaneously and that NTT is effective. During the intervention period, only the treated group improved on the MABC and the TGMD-2. Children improved most on tasks similar to those trained. In older children with poorer motor patterns, NTT's treatment success was higher. The Child Behavior Checklist subscales withdrawn, thought problems, anxious/depressed, and delinquency were determinants of effects on motor patterns.
Article
Diffusion magnetic resonance imaging (MRI) is one of the most rapidly evolving techniques in the MRI field. This method exploits the random diffusional motion of water molecules, which has intriguing properties depending on the physiological and anatomical environment of the organisms studied. We explain the principles of this emerging technique and subsequently introduce some of its present applications to neuroimaging, namely detection of ischemic stroke and reconstruction of axonal bundles and myelin fibers. Anat Rec (New Anat) 257:102–109, 1999. © 1999 Wiley-Liss, Inc.
Article
The question of whether problems of motor co‐ordination in early childhood recede with age has rarely been addressed. This paper reports the findings from a follow‐up study of 17 children, identified by their teachers as having poor motor co‐ordination at age six. Now age 16, these children and their matched controls completed a battery of assessments. The results suggest that the majority of children still have difficulties with motor co‐ordination, have poor self‐concept and are experiencing problems of various kinds in school. However, there are individual differences in the extent to which the children have learned to cope with their continuing difficulties over the years. RÉSUMÉ Maladresse chez l'enfant: disparait‐elle? Etude de suivi durant dix ans La question de savoir si les problèmes de coordination de l'enfance régressent avec l'ǎge a été rarement posée. L'article rapporte les données d'une étude longitudinale de 17 enfants, chez qui les enseignants avaient détecté une coordination motrice médiocre à l'ǎge de six ans. Ces sujets ont étéévalués par une batterie, avec des contrǒles appariés, a l'ǎge de 16 ans. Les résultats suggèrent que la majorité des sujets présentaient encore des difficultés en rapport avec une mauvaise coordination motrice, avaient une mauvaise image de leurs capacités et avaient eu des problèmes variés à l'école. Il y avait cependant des différences individuelles dans I'aptitude à intégrer les difficultés au cours des annees. ZUSAMMENFASSUNG Ungeschicklichkeit bei Kindern: wie stehen die Chancen für eine Normalisierung? Eine Verlaufstudie über 10 Jahre Es ist selten die Frage gestellt worden, ob Probleme der motorischen Koordination im frühen Kindesalter im Laufe der Jahre verschwinden. In dieser Arbeit werden die Ergebnisse einer Verlaufsstudie bei 17 Kindern dargestellt, die im Alter von sechs Jahren von ihren Lehrern eine schlechte Beurteilung ihrer motorischen Koordination bekommen hatten. Jetzt, im Alter von 16 Jahren, wurden diese Kinder, sowie ihre Kontrollen, einer Reihe von Untersuchungen unterzogen. Die Ergebnisse zeigen, da8 die Mehrzahl der Kinder noch immer Schwierigkeiten bei der motorischen Koordination, sowie ein mangelhaftes Selbstwertgefühl und verschiedene Probleme in der Schule hat. Es gibt jeoch individuelle Unterschiede, wie die Kinder gelernt haben, ihre fortbestehenden Schwierigkeiten im Verlaufe der Jahre zu meistern. RESUMEN Torpeza en niños:? Ilegan con la edad a libererse de ella? Estudio a lo largo de diez años Sólo muy raramente se ha planteado la pregunta de si los problemas de coordinación Ilegan a desaparecer con la edad. Este trabajo expone los hallazgos obtenidos en un estudio continuado de 17 niños, identificados por sus maestros como teniendo una coordinacion pobre a la edad de seis años. Ahora, con 16 años estos niños y un grupo control sa ha completado una bateria de exámenes. Los resultados sugieren que la mayoria de niños tienen todavia dificultades en la coordinacion motora. Tienen un autoconcepto pobre y sufren problemas de distinto tipo en la escuela. Sin embargo hay diferencias individuales concerniendo a lo aue el niño ha aprendido para adaptarse a sus continuas dificultades a lo largo de los años.
Article
The quality of life (QOL) of children with developmental coordination disorder (DCD) is largely unknown, but evidence suggests that multiple QOL domains are affected by the disorder. While DCD is primarily considered a motor disorder, multiple studies have reported psychological and social concerns in children with this condition. Our primary aim was to present the current state of the evidence regarding the physical, psychological, and social QOL domains that can be affected in children with DCD. Systematic review of articles from seven databases through November 2010 (MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, CDSR, DARE) was conducted. Search terms included developmental coordination disorder, dyspraxia, quality of life, life satisfaction, well-being, activities of daily living, and participation. Two independent reviewers screened titles, abstracts, and full-text articles. Studies meeting the following criteria were selected: (1) sample comprised solely of individuals with coordination difficulties consistent with DCD; (2) outcome measures related to physical, psychological, or socials domains of QOL; and (3) articles published in English. Data were extracted by one author and verified by a second. Outcomes were categorized according to physical, psychological and social domains of QOL and study quality was rated by case definitions of DCD based on diagnostic criteria as per the Diagnostic and Statistical Manual - 4th edition. Forty-one articles were included. Most studies reported significantly poorer results in physical, psychological and social functioning in children with DCD compared with peers. Despite the impact of DCD on multiple domains, only one study used a QOL measure as an outcome. Although DCD impacts several QOL domains, the QOL of children with this disorder remains largely unknown. The next critical step is for clinicians and researchers to use QOL measures to gather information on how DCD may affect the QOL of children with this disorder.