Vens N1,2, Dewitte G1,2, Oostra A2, De Roubaix A1, Van Waelvelde H1
1Ghent University, Rehabilitation Sciences, Ghent, Belgium, 2Center for Developmental Disabilities, Ghent, Belgium
Background: Developmental Coordination Disorder (DCD) is mostly identified and diagnosed after the age of five.
Purpose: This study investigates to what extent qualitative elements of motor development before the age of three, are associated with a diagnosis of DCD after the age of three.
Methods:
Participants: The data of 503 children born between 2006 and 2011 and multidisciplinary followed up in the Centre of Developmental Disabilities Ghent, have been collected (data of 1507 assessments). Inclusion criteria were
(1) to be assessed at least once before and once after the age of three;
(2) no diagnosis known to have an impact on motor development (eg. Cerebral Palsy, Down syndrome );
(3) an IQ above 70.
Procedure: Motor assessments before the age of three were categorized in assessments between 0-6m (N=223), 6-12m (N=221), 12-18m (N=111) and 18m-3y (N=440) and screened for terms describing atypical movement quality. By consensus, these terms were organized in 13 different categories, dichotomously scored as present or not. Categories were: hypotonia, hypertonia, laxity, force, asymmetry, regulation, control, organization, dissociation, coordination, balance, planning and soft neurological signs. The presence of all the different qualitative terms was also added up to calculate one continuous variable. This variable represent the number of concerns regarding the movement quality and is indicated as 'movement quality concerns'. The results of the AIMS test were also recorded.
The records of the assessments after the age of three, were screened for diagnoses (or at risk) of DCD, autism spectrum disorder, ADHD and speech and language disorder. The results of the Movement-ABC-2 tests were recorded.
Results: One hundred fifty seven children (31,4%) had a diagnosis of DCD and another 89 children (17,7%) were at risk for DCD after the age of three. Bivariate logistic regression analysis by age group, with DCD or at risk for DCD versus no DCD as outcome variable and the qualitative categories, gender and prematurity as factors, revealed several significant associations. The best model have been identified for each age group. Between 0-6m the model contained gender, prematurity, asymmetry, dissociation and hypertonia; between 6-12m: gender, hypotonia, control and dissociation; between 12-18m: gender and asymmetry and between 18m-3y: gender, hypotonia, control, balance, coordination and hypertonia. The male to female Odds Ratio's varied between 2.8 and 3.3. Nagelkerke R square of the models varied between 0.12 (12-18m) and 0.19 (0-6m). The association between the AIMS results and a diagnosis of DCD could not be established. The Pearson correlation coefficient between the continuous variable 'movement qualtity concerns' and M-ABC-2 scores was -.256 (p .001) in the age group 0-6m, -.271 (p .001) at 18m-3y and not significant at 6-12m and 12-18m.
Conclusion(s): Observation of deviant movement quality in children before the age of three is associated with a diagnosis of DCD after the age of three. The age range of 0-6m and 18m-3y seem to be the most sensitive.
Implications: Concerns of an experienced paediatric physiotherapist regarding movement quality at early age are reason to monitor the motor development of a child and to start early intervention when necessary.
Keywords: Developmental Coordination Disorder, Movement quality, Early motor assessment
Funding acknowledgements: No external funding
Purpose: This study investigates to what extent qualitative elements of motor development before the age of three, are associated with a diagnosis of DCD after the age of three.
Methods:
Participants: The data of 503 children born between 2006 and 2011 and multidisciplinary followed up in the Centre of Developmental Disabilities Ghent, have been collected (data of 1507 assessments). Inclusion criteria were
(1) to be assessed at least once before and once after the age of three;
(2) no diagnosis known to have an impact on motor development (eg. Cerebral Palsy, Down syndrome );
(3) an IQ above 70.
Procedure: Motor assessments before the age of three were categorized in assessments between 0-6m (N=223), 6-12m (N=221), 12-18m (N=111) and 18m-3y (N=440) and screened for terms describing atypical movement quality. By consensus, these terms were organized in 13 different categories, dichotomously scored as present or not. Categories were: hypotonia, hypertonia, laxity, force, asymmetry, regulation, control, organization, dissociation, coordination, balance, planning and soft neurological signs. The presence of all the different qualitative terms was also added up to calculate one continuous variable. This variable represent the number of concerns regarding the movement quality and is indicated as 'movement quality concerns'. The results of the AIMS test were also recorded.
The records of the assessments after the age of three, were screened for diagnoses (or at risk) of DCD, autism spectrum disorder, ADHD and speech and language disorder. The results of the Movement-ABC-2 tests were recorded.
Results: One hundred fifty seven children (31,4%) had a diagnosis of DCD and another 89 children (17,7%) were at risk for DCD after the age of three. Bivariate logistic regression analysis by age group, with DCD or at risk for DCD versus no DCD as outcome variable and the qualitative categories, gender and prematurity as factors, revealed several significant associations. The best model have been identified for each age group. Between 0-6m the model contained gender, prematurity, asymmetry, dissociation and hypertonia; between 6-12m: gender, hypotonia, control and dissociation; between 12-18m: gender and asymmetry and between 18m-3y: gender, hypotonia, control, balance, coordination and hypertonia. The male to female Odds Ratio's varied between 2.8 and 3.3. Nagelkerke R square of the models varied between 0.12 (12-18m) and 0.19 (0-6m). The association between the AIMS results and a diagnosis of DCD could not be established. The Pearson correlation coefficient between the continuous variable 'movement qualtity concerns' and M-ABC-2 scores was -.256 (p .001) in the age group 0-6m, -.271 (p .001) at 18m-3y and not significant at 6-12m and 12-18m.
Conclusion(s): Observation of deviant movement quality in children before the age of three is associated with a diagnosis of DCD after the age of three. The age range of 0-6m and 18m-3y seem to be the most sensitive.
Implications: Concerns of an experienced paediatric physiotherapist regarding movement quality at early age are reason to monitor the motor development of a child and to start early intervention when necessary.
Keywords: Developmental Coordination Disorder, Movement quality, Early motor assessment
Funding acknowledgements: No external funding
Topic: Paediatrics
Ethics approval required: Yes
Institution: Ghent University
Ethics committee: Medical Ethical Committee Ghent University Hospital UZ P704
Ethics number: B670201730764
All authors, affiliations and abstracts have been published as submitted.
