1. Progression and participation in children with and without DCD and associated characteristics: A longitudinal study
Vicky McQuillan David Sugden Mary Chambers Ruth Swanwick
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Background
Results
DCD often occurs with other non-motor associated characteristics (Lingam et al., 2010), but it is unclear whether children with DCD plus associated characteristics progress or participate in the same way as those without them, or as their typically developing peers do. Leeds REC granted ethical approval for the study.
Aim: To describe the different profiles of children with & without DCD and identify their progression in motor ability over time. A second aim was to identify their participation in physical activity.
Participants: Schoolchildren n=34 from NW England aged 7-14 years, mean age120 m (sd 19.8) identified by teachers with either movement difficulties or typically developing and no known medical condition. Recruited 5 girls and 29 boys, assessed by DSM5 criteria for DCD & categorized as Red, Amber or Green by MABC2 then followed for 2 academic years.
RED: 100% of the Red group remained in this group. Their motor performance remained stable ≤ 5th percentile on MABC2 over time. All bar one of this group had 2 or more associated characteristics.
AMBER: 0% of the children who started in Amber remained in this group. They changed to the Green Group over time.
GREEN: 82% of the Green group remained > 25th percentile, despite fluctuations in their motor performance, 3 in the Green group changed to Amber over time (2 of them had associated characteristics).
Progression
Method
Teachers identify children with movement difficulties but no medical condition 1
Parents consent & return questionnaires: Snap IV, CCC2, DCDQ 07, family history 2
Children consent & individually assessed by OT with MABC2, KBIT2, CSAPPA 3
Data point 3 MABC2
Data point 2 MABC2
Data point 1 MABC2
Mean KBIT2 IQ
Red group had lower mean IQ, but no sig. difference in CSAPPA scores or family SES. All 3 groups were in same school.
Red group had > occurrence of 2 or more Associated Characteristics.
It appeared that the children in the RED group showed little variability in their motor performance ability over time in contrast to the typically developing children in the GREEN group. 2 exceptions were 2 boys, one with ASD & one with ODD who started in Green group but ended in Amber group.
The children who started in the Amber group showed a great deal of variability, but all improved over time.
Table of characteristics at baseline
Participation
Range
Total n=34
sDCD n=10
mDCD n=7
TDC n=17
MABC2
16-94
61.6
(20.8) 34
(13)
61.9
(3.7)
77.5
(7.7) MD
4-18
19.9
(7.9)
10.7
(4.1)
17.9
(4.5) 26
(3.9)
A&C
8-16
15.1
(5.1) 10
(2.8)
15.4
18.1
(4.3)
Balance
4-26
26.9
(9.5)
14.7
(6.9)
28.9
33.3
(3.6)
CSAPPA
59.4
55.4
(12.3)
56.4
(17.2)
62.8
(11.1) IQ
55-131
95.2
(20.5)
81.4
91.3
(21.8)
106.5
(14.6)
Many factors are known to influence the rate of children’s participation in PA, not least parental attitude, family resources & car ownership (King, Law et al. 2013), in addition to child preference and physical ability. Therefore this data was collected. However, despite the RED group having similar resources & parental attitude they participated less in extracurricular PA than children in the other groups. Furthermore, children with AC participated least in each group.
Discussion
In this study the children in the RED group, met the criteria for DCD and had characteristics that were distinctive from the other groups. They had a higher proportion of children with ≥2 AC, a lower mean IQ and they had the lowest motor performance ability, which remained low over time. Moreover, their participation rate in extra curricular physical activity was the lowest of all the groups, but with notable exceptions. This has important implications for practice, as both their progression & participation were different from the other groups. However, the majority of children in the study, including those in the RED group, indicated that they enjoyed PA and did not rate themselves poorly. Given that the local environment was the same and there was no difference in SES between the groups this presents opportunity to explore in greater depth some of the factors important in child participation and non-participation in PA by interviewing children from selected case studies to help inform future policy and intervention.
Child self rating of PA
There was no significant difference in CSAPPA scores between the groups either at baseline or over time. The majority rated their enjoyment of PA high.
Acknowledgements: Thank you to all the staff, parents & especially the children involved in the study
Grants:
RCOT Constance Owens Trust
University of Liverpool School of Health Sciences
References:
Bronfenbrenner (1977) Toward an experimental ecology of human development. American Psychologist, 32,
King, Law, Petrenchik & Hurley (2013) Psychosocial determinants of out of school activity participation for children with and without disabilities. Physical & Occupational Therapy in Pediatrics, early online: 1-21, 2013.
Lingam, Golding, Jongmans, Hunt, Ellis & Emond, (2010) The Association between DCD and other developmental traits. Pediatrics, vol. 128, no.5,