AIM: To identify, qualify, and synthesize the characteristics of interventions for children with diagnosed and suspected developmental coordination disorder (DCD) worldwide.

METHOD: This was a scoping review, with searches in eight bibliographical databases without language restrictions. All interventions involving children and adolescents with motor coordination disorders were included, with content analyses involving the type and context of the intervention and interventionists, the outcomes addressed, and the findings reported and considered regarding the International Classification of Functioning, Disability and Health framework.

RESULTS: From 30 637 hits, 202 distinct studies were identified, including 206 interventions with a total of 4593 children or adolescents. The children included were often poorly defined. Movement activities were offered through task-oriented, motor skill, and sports training approaches with active video games and sensory-perceptual motor skills training reported the most frequently. Long-term psychosocial and participation outcomes were less explored.

INTERPRETATION: Future intervention studies need to be clearer on the diagnostic criteria and details of DCD, including individual(s) who delivered the training, the type of training, session intensity, and the delivery mode. Outcome measures should consider three critical domains: (1) practical application of learned motor skills in daily life; (2) environmental and psychosocial impacts; and (3) parental awareness and support.

Purpose of Review: Difficulties executing tasks involving movement skills are a primary feature in Developmental Coordination Disorder (DCD) and a common, but frequently overlooked feature in Autism Spectrum Disorder (ASD). This review discusses what we know about early development and the potential neurobiological underpinnings of movement skills and performance in these populations and explores the behavioural features of movement functions and performance associated with DCD and ASD, mapped to the ICF framework. How recent technological advances in motion analysis and machine learning may inform our understanding of these issues and the implications of current knowledge for research and clinical practice are also discussed.

Recent Findings: Research suggests that motor difficulties in individuals with DCD and ASD impact participation in activities of daily living, sports and social activities. Current evidence examining DCD and ASD is equivocal with respect to early development, neurobiological contributions, and movement function and behaviour across ICF domains of motor functions, motor performance and participation in movement activities. Findings are limited by small sample sizes as well as heterogeneity within the diagnostic presentations of both DCD and ASD. Technological advances provide novel opportunities to parse the similarities and differences in movement function and behaviour of individuals with these disorders.

Summary: There are few studies directly contrasting the movement functions and behaviour of children with DCD to those with ASD that allow for direct comparison of similarities and differences, which control for confounding factors. Movement difficulties are universal in DCD and can impact social participation. Arguments have been put forward that support screening for motor difficulties in autistic individuals, but there is insufficient evidence to support the inclusion of movement difficulties within the diagnostic criteria for this disorder. Recognition of the influence of motor problems on engagement in activities demanding movement and social skills for those with DCD and ASD is important in order to ensure interventions optimise opportunities for social participation in physical activities. 

Introduction

Loneliness and social isolation are a threat to older adults’ quality of life and well-being. Occupational therapists are well positioned to support it, however, there is a scarcity of evidence in the literature reporting their involvement.

Method

A scoping review was conducted to map occupational therapists’ involvement addressing loneliness and social isolation in older adults. Four databases and manual searches of references list were included and analyzed using inductive qualitative content analysis.

Findings

A total of 14 studies and 2 study protocols were identified from 422 hits. Two main categories were identified: “Features of the LSI interventions” and “Nature of Occupational Therapists’ involvement” with four and two sub-categories respectively.

Discussion

Occupational therapists’ involvement in interventions addressing LSI were primarily as researchers. The number of interventions involving occupational therapists has gradually increased with a focus on community and technological-based interventions.

Conclusion

Further research is needed to support occupational therapists’ practice.

Introduction: Occupational performance coaching is a collaborative, strengths-based approach used by occupational therapists working with children and families. This study evaluates the acceptability and feasibility of delivering an online occupational performance coaching programme for parents of children with disabilities in the United Kingdom.

Method: Mixed-methods feasibility study. Eight UK-based families with children with disabilities participated in four to eight online coaching sessions. The Canadian Occupational Performance Measure was used to measure changes in occupational performance. The Parenting Stress Index Fourth Edition (short form) was used to measure changes in parental stress. Six parents were interviewed, and four therapists participated in a focus group to explore their experiences of the programme.

Results: Parents and therapists reported a high level of acceptability for the telehealth coaching intervention. Parents reported positive changes in occupational performance (mean difference 3.29; p = 0.01) occupational satisfaction (mean difference 3.99; p = 0.01). Parents' average total stress decreased by 12.5 points with greatest reductions in the parental distress subscale. Therapist fidelity to intervention was relatively low.

Conclusion: The coaching programme was acceptable for parents who responded well to the intervention with noted gains in occupational performance and satisfaction. Programme delivery was feasible for therapists though further training in occupational performance coaching is recommended.

PurposeCerebral Palsy (CP) is the commonest cause of childhood motor disability. Transcranial direct current stimulation (tDCS) is a promising adjuvant therapy, but research targeting upper and lower limbs simultaneously is needed. We aimed to pilot tDCS with upper/lower limb motor training, estimate the potential effect on motor function, and investigate brain imaging correlates of function.Materials and methodsParticipants (10-16 years) with CP affecting upper and/or lower limbs were randomised (online software) to 10 sessions of active (n = 14) or sham (n = 13) tDCS combined with motor training. The primary outcomes were upper and lower limb function assessed at 1-week post-intervention using the Jebson Taylor hand function (JTT) and Timed Up and Go (TUG) tests. Secondary, imaging outcomes included baseline tractography, grey matter volume, and resting state connectivity.ResultsAdherence was good: 74% completed all intervention sessions, 100% completed the primary outcome assessment. There were no between-group differences (1-week post-intervention, intention-to-treat; group-by-time JTT: F(1,25)=1.189,p = 0.286, partial-eta-squared = 0.05; TUG: F(1,25)=1.605,p = 0.217, partial-eta-squared = 0.06). Imaging showed subtle associations between better JTT at baseline and higher grey matter volume (caudate nucleus) and stronger sensorimotor resting state connectivity.ConclusionsThe trial was well tolerated, but effect sizes were small. Larger studies are needed to further explore tDCS for CP.

To review the longitudinal trajectories – and the factors influencing their development – of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.

AIM: This study aimed to (1) quantify attention and executive functioning in children with developmental coordination disorder (DCD), (2) assess whether some children with DCD are more likely to show attention difficulties, and (3) characterize brain correlates of motor and attention deficits.

METHOD: Fifty-three children (36 with DCD and 17 without) aged 8 to 10 years underwent T1-weighted and diffusion-weighted magnetic resonance imaging, and standardized attention and motor assessments. Parents completed questionnaires of executive functioning and symptoms of inattention and hyperactivity. We assessed regional cortical thickness and surface area, and cerebellar, callosal, and primary motor tract structure.

RESULTS: Analyses of covariance and one-sample t-tests identified impaired attention, non-motor processing speed, and executive functioning in children with DCD, yet partial Spearman's rank correlation coefficients revealed these were unrelated to one another or the type or severity of the motor deficit. Robust regression analyses revealed that cortical morphology in the posterior cingulate was associated with both gross motor skills and inattentive symptoms in children with DCD, while gross motor skills were also associated with left corticospinal tract (CST) morphology.

INTERPRETATION: Children with DCD may benefit from routine attention and hyperactivity assessments. Alterations in the posterior cingulate and CST may be linked to impaired forward modelling during movements in children with DCD. Overall, alterations in these regions may explain the high rate of non-motor impairments in children with DCD.

This study explores the expectations of dance therapists/practitioners and parents and teachers of autistic children engaging in a developmental dance programme. Information gathered will support development of an evaluation tool aligned with the International Classification of Functioning Disability and Health (ICF) Core Sets for autism spectrum disorders (ASD). A qualitative study included a convenience cohort of teachers (n = 6), parents (n = 2) of children with ASD and therapists (n = 3). Three role specific focus groups were undertaken considering potential benefits and challenges of the programme. Content and thematic analysis was undertaken using NVivo12. Findings reflected four positive themes relating to behaviour, skills, social interaction and environmental supports. Therapists, teachers and parents focused differently on stereotypical and restricted behaviours, environmental supports and habits and routines respectively. These themes also emerged as challenges (to implement/achieve); with parents identifying more emotional and behavioural restrictions. A fourth challenge theme of transferability of skills emerged from teachers and therapists. Items mapped against 28 ICF Core Sets (across the lifespan) and six to ICF categories, with creativity and imagination mismatched. Findings highlight need for a specific outcome measure for dance and/or movement programmes for autistic individuals that captures meaningful functions across ICF domains for differing stakeholders.

Background: In children with unilateral cerebral palsy (uCP), bimanual assessments mostly focus on qualitative assessments of the impaired upper limb during bimanual tasks, which do not capture the spatiotemporal coordination between both hands. Hence, we aimed to advance our understandings in spatiotemporal coordination in children with uCP compared to typically developing children (TDC) using a bimanual, asymmetrical, goal-directed task. Participants and methodology: In this observational study, thirty-seven children with uCP (11y8m±2y10m, 20 males, 16 right-sided uCP, Manual Ability Classification System level I = 23, II = 11, III = 3) and 37 age and sex-matched TDC opened a box with one hand and pressed a button inside using the opposite hand. Spatiotemporal bimanual (movement time, temporal coupling, movement overlap, goal synchronisation) and unimanual (movement time, path length and smoothness) parameters were extracted. Between groups comparisons were investigated using a two-way mixed ANCOVA with age as covariate (α < 0.05). Additionally, correlation coefficients between unimanual and bimanual parameters were calculated. Results: Compared to TDC, children with uCP were slower (p = 0.01, ηp2 = 0.13) and presented unimanual spatiotemporal deficits in both upper limbs (p < 0.03, ηp2>0.10), which worsened in children with lower manual abilities (p < 0.04, ηp2>0.19). However, they did not differ in bimanual coupling (p > 0.31, ηp2<0.03). Furthermore, slower movement time was related with increased unimanual spatiotemporal deficits bilaterally (r = 0.34–0.80, p = 0.001–0.04), suggesting that reduced performance at both upper limbs contributes to bimanual difficulties in children with uCP. Conclusions: The bilateral reduced spatiotemporal performance, related to longer bimanual movement time, stresses the importance to assess and treat both upper limbs in children with uCP.

This longitudinal study modeled children's complex executive function (EF) development using the Groton Maze Learning Task (GMLT). Using a cohort-sequential design, 147 children (61 males, 5.5–11 years) were recruited from six multicultural primary schools in Melbourne and Perth, Australia. Race/ethnicity data were not available. Children were assessed on the GMLT at 6-month intervals over 2-years between 2010 and 2012. Growth curve models describe age-related change from 5.5 to 12.5 years old. Results showed a quadratic growth trajectory on each measure of error—that is, those that reflect visuospatial memory, executive control (or the ability to apply rules for action), and complex EF. The ability to apply rules for action, while a rate-limiting factor in complex EF, develops rapidly over early-to-mid childhood.