Early intervention for children with/at risk of developmental coordination disorder: a scoping review

To summarize current evidence for early identification and motor-based intervention children aged 5 years younger of age with/at risk developmental coordination disorder (DCD). Using scoping review methodology, we independently screened over 11 000 articles selected those that met inclusion criteria. Of the 103 included articles, 78 were related to are summarized in a companion article. Twenty-two focused on intervention, with an additional three covering both intervention. Most studies at low level evidence, but provide encouraging is beneficial young DCD. Direct can be provided whole classes, small groups, or individuals according tiers service delivery model. Educating building capacity parents childhood educators also key elements Evidence DCD emerging promising results. Further needed determine best practice whether intervening prevent negative trajectory secondary psychosocial consequences associated Recapitular la evidencia actual acerca de identificación temprana y intervención motora para niños hasta años inclusive con/ en riesgo trastorno del desarrollo coordinación (TDC). Utilizando metodología revisión alcance, examinamos forma independiente más 11.000 artículos seleccionamos aquellos que cumplían con los criterios inclusión. De incluidos, estaban relacionados se resumen un artículo aparte. Veintidós centraron temprana, otros tres abordan tanto como temprana. La mayoría estudios muestran todavía nivel bajo, pero brindan alentadora es beneficiosa pequeños TDC o padecer TDC. directa puede brindar clases completas, grupos individuos acuerdo modelo prestación servicios por niveles. Educar desarrollar capacidad padres educadores también son elementos clave Están surgiendo pruebas (o de) resultados prometedores. Se necesitan determinar las mejores prácticas si prevenir trayectoria negativa consecuencias psicosociales secundarias asociadas el Sintetizar evidência disponível atualmente sobre identificação precoce e intervenção crianças com idade até anos vida com/em risco transtorno do desenvolvimento da coordenação Usando metodologia revisão escopo, avaliamos independente artigos selecionamos os atenderam critérios inclusão. Dos incluídos, relacionaram são sintetizados em um artigo paralelo. Vinte dois foracam precoce, três adicionais cobrindo quanto precoces. A maior parte dos estudos tiveram baixo nível evidência, mas fornecem evidências encorajadoras é benéfica pequenas (em para) direta pode ser fornecida sala toda, pequenos grupos, ou indivíduos, acordo as características prestação serviços. fomentar capacidade pais infantis também elementos-chave precoce. voltada emergente, promissores. Mais necessários melhores práticas intervir precocemente evitar uma trajetória desenvolvimental consequências psicossociais secundárias associadas This article commented by Damiano page 630 this issue. article's abstract has been translated into Spanish Portuguese. Follow links from view translations. Video Podcast: https://youtu.be/mxbRMQaH3ck Affecting 5% 6% children, (DCD) common neurodevelopmental interferes child’s ability perform learn motor skills.1 While present period, it often not identified until school age,2, 3 leaving missed opportunities shows time,4 including adverse mental health poorer health-related quality life childhood.5-7 Without up 75% continue have difficulties adults.8 several systematic reviews conducted examining effectiveness school-age DCD,9-13 no explicitly As therapists treat preschool-aged impairments consistent DCD,14 imperative examine evidence-based interventions appropriate effective group. The purpose was (?5y) Given volume literature unearthed, manuscript solely intervention; summarizes identification.15 We scholarly grey using six-stage process outlined literature.16-18 Our overall aim answer following research question: what DCD? Current international guidelines generally recommend diagnosis before years.3 Lee Zwicker explored below age,15 focus paper considered entry (i.e. preschool years), wanted highlight occur even earlier infancy) high Stage 2 identifying relevant confirmed lack published specific our question. Search strategies traditional databases (MEDLINE, CINAHL, Embase, PsycINFO, ERIC), literature, hand-searching. Preliminary search terms expanded assistance librarian DCD-related terms;19 final executed January 2018 (see Appendix S1, online supporting information, example terms). Citations exported Refworks duplications removed. Grey via thesis emails known researchers, sought decrease publication bias, introduce alternative perspectives, capture evidence.20 Lastly, hand-searching special journal issues, guidelines, conference proceedings, occurred iteratively throughout process. involved selection review. Two researchers materials each stage (title, abstract, full review). Inclusion exclusion criteria determined outset further refined. Three were: (1) use similar (e.g. dyspraxia issues); (2) participants younger; (3) assessment research, (or both). Articles excluded if they too general, other diagnoses cerebral palsy), only descriptive, school-aged pertained older versions skill tests original Movement Assessment Battery Children [MABC]),21 dated (earlier than year 2000), unrelated tools. total included: pertaining identification, 22 (Fig. information). Studies discussing presented elsewhere.15 focuses 25 which evaluated outcomes after One non-English record because English.22 Intervention retained reviewed ensure important messages (n=10). Data entered two tables. Table S1 (online information) types reference(s), (individual, group, community), target based International Classification Functioning, Disability Health (ICF),23 main study limitations. divides children. S2 provides detailed information about younger. Extracted data include following: reference citation, country, design, number sex participants, how identified, type dose measured, collated, summarized, reported preschool-age primary ICF: body structure function; activity participation. Results limited infants born preterm then highlighted. Finally, results discussed context tiered model concluded general guidelines. consultation ongoing. stakeholders Conference July 2017, Canadian Occupational Therapy Association June 2018, UK regional paediatric therapy symposium May 2019, Early Years 2020. Advocacy Toolkit (http://www.childdevelopment.ca/DCDAdvocacyToolkit/DCDAdvocacyToolkitIntro.aspx). emerged last decade. Several (n=11 publications) specifically examined age, lowest Sackett’s (Table S1).24 majority classified V their sample size design case study, pilot control group);25-33 remaining incorporated group.34, 35 Additional along children; these studies, younger, insights DCD.12, 22, 36-39 stage, there cumulating will first discuss state classification ICF.23 propose fit model40, 41 some 12-week strength training programme 5-year-old child DCD.27 scheduled twice-a-week 20 30 minutes. Improvements observed muscle strength, gross function, proprioception S2). However, outside activities measurement error may accounted changes. Despite limitation, potential positive impact Future area could participation.42 effect attention structure/function outcomes,22, 25, 34, 37-39 whereas others primarily level.26, 28-32, Only one assessed participation level.33 Each described (further details Tables Animal Fun designed improve social skills 4- 6-year-old imitating animal movements fun, non-competitive way.37 authors describe task-specific approach; however, consider grounded fundamental movement skills, targeting ICF hopping scissor use) while addressing balance strength). In randomized cluster-controlled trial, delivered class-wide kindergarten teachers across six Australian schools;37 such, likely such included. embedded minutes per day, 4 days week, minimum 10 weeks (n=450 children). Compared comparison group schools, showed improved ability, greater effects males compared females.37 Another balancing foot throwing.39 Improved prosocial behaviours reduced symptoms inattention hyperactivity noted.43 Although delivery, evaluation small-group would worthwhile. Bardid et al. four preschools rural urban Belgium.34 delay randomly allocated (n=93 3y 7mo–5y 1mo). continued usual curriculum (two 60-min physical education classes/wk); received 60-minute sessions week equally locomotor ball jumping balance, play, rhythm, dance) weeks. obtained significantly higher scores Test Gross Motor Development, Second Edition44 pre- post-test improving females, females saw improvement object skills. appears beneficial, unclear extra received. Almost half scored within average range suggesting had underlying difficulty. investigation warranted. group-based goals postural 24 4-year-old extremely (born <28wks’ gestational and/or birthweight <1000g) ‘minimal mild impairment’.25 comprised core stability sensorimotor skills) task-oriented approaches action games drawing), once weekly 6 Parents encouraged complete home daily. goals, possible maturation, home-based influenced outcomes. addition above targeted outcomes; samples so relevance should interpreted caution. Ashkenazi virtual reality nine DCD.38 They consisting 45 playing Eye Toy PlayStation® 15 individual goal. promising, significant controlled movement; part (virtual intervention) improvements. Ability, Skills, Task Training, combined bottom-up top-down approach, DCD, whom months age.22 once-weekly resulted improvements manual dexterity performance satisfaction ratings previous version Performance Measure (COPM).45 Other called Magic piloted class implemented 12 centres Australia.31, 32 10-week co-facilitated occupational therapist teacher groups 8 fine sensory processing difficulties. involves structured activities, support access curriculum, staff parents.31 Qualitative five parents31 staff32 suggested benefits developed pre-academic increased activities), relationship parental stress), confidence working warranted, particularly parent treatment cluster trial 36 preschools.35 ecological originally Sugden Henderson,46 elements: session (30–40min) development, impacts poor performance, reasons difficulties, help; set child; coach, therapist) goal-based suggestions (four 15-min sessions/wk) sessions/wk); (4) coach monitored progress phone 3-weekly intervals; (5) visited site twice. 18 care preschools. who 15th percentile MABC21 (ranging preschool) participated study. There difference between MABC care, children’s perception maternal acceptance. addition, parent-rated COPM47 nature Hawthorne cannot ruled out expect perceive intervention).48 did COPM compared. Ecological studied (aged 3–6y) no-intervention group.36 specialists teachers. graded times/wk) components: exposure skills; experience, ensuring showing preceding actually experienced All remained 5th second edition (MABC-2).49 suggest require specialist longer period order meet needs.36 Kennedy-Behr Munich, DCD.33 adapted parent-based collaborative approach Coaching finding solutions issues environmental adaptations. An individually taught coaching asked child, play-based goal, rate goal COPM.47 Concurrent coaching, (twice 4wks; 45min sessions) scaffolding modelling play After rated clinically (?2-point increase) seven goals. measured Revised Knox Preschool Play Scale,50 all beyond expectations 4-week timeframe. Patterns engagement shifted decreased onlooking behaviour, solitary play). promise functional future work assess larger components—Occupational Coaching, both—are active ingredient(s) led educator sessions, totalling 3h).12 Participants 5- exhibited problems eight ball, 14 tasks, informed results, them task home. sessions. borderline (scores percentiles MABC)21 significantly, scoring little change noted definite ?5th MABC) perceived competence.51 Kane Staples 5–7y) challenges;26 participants). consisted 2-hour therapist, exercise assistant. aerobic performed attended (30min) healthy eating, activity, teaching exercises. mixed interest. caution standardized ratings. Cognitive Orientation (CO-OP) CO-OP initially 7 years,52 modified shorter (40–45min instead 60min), direction (vs guided discovery), variation maintain focus, more repetition Taylor 7-year-old DCD.29 noticeable chosen baseline post-test, 5-year-old, interest Liu single-participant female DCD.28 jointly run speech-language pathologist (to address verbal respectively). one-leg standing time, jump distance, sequential hops. third diagnosed months.30 meaningful tying shoelaces, printing name, cutting scissors, catching throwing ball. These show designs, development/maturation time frame. necessary evaluate years. DCD53 infancy,54 Cochrane programmes preterm.55 review, none MABC(-2)21, 49 outcome measure diagnostic Interventions nurses, therapists, psychologists, enhancing parent–infant monitoring infant development. Overall, differences follow-up preschool-age. impairments, palsy, required. infancy. few replicated; accumulating suggests risk) disorder. Limited exist note used different measures cut-off identify indicate that, addressed strength), Thus, preliminary practices reducing limitations restrictions.42, 56, 57 dearth It crucial encourage years, well documented participate less peers.58-61 Encouraging leisure repetitive predictable movements, swimming, martial arts, running, recommended competitive team sports DCD; adequate helping necessary.62 formats: (n=8 studies);22, 27-30, 33, 35, 38 (n=5 publications);12, 26, 31, 32, 34 classes (n=2 studies).37, 39 began progressed required.36 practice56, delivering services DCD.40 Consistent Response framework,41 Tier 1 preschool- community-based Fun37, intervention36). For offered format al.,34 Staples,26 Pless al.,12 Priest31) introducing 1). clinical tiers, level, community level. best-practice principles, its needs systematically evaluated. example, largely unknown ‘prevent’ requiring intensive services. Similarly, (Tier 2) insufficient MABC-2.3, 12, required treatment.26, 31-33, Involvement critical development children63 build caregivers, teachers, coaches manage home, school, community.57, 64, 65 Education easily perfect Missiuna Partnering Change,66 successfully schools Ontario, Canada. Pilot providers educators, daycare environments.67, 68 explicit element Dreiling Bundy consultative direct ‘mild’ impairments.69 intervention.3, Parent any building. exception module increase parents’ knowledge of, in, managing DCD.64 Significant post-intervention/follow-up noted. sharing physicians teachers), trialing strategies, noticing child. 12.9% 15.5% 0 old, well. short- long-term fully thorough conducting without First, question concepts: located, findings manuscripts, intention. better priori look separately. Second, context, realize same countries. extend countries, (data separated ?5y) recognize around world. expansive narrowed since 2000; decision allowed us report most excluded. conclusion, emerging. get diagnosing ages,15 affected.1 parents, larger, well-defined account maturation effects, longitudinal evaluations cost–benefit analyses investigate prevents next steps help mitigate affected thank Charlotte Beck (librarian) her guidance search, Shie Rinat Sara Izadi-Najafabadi extraction referencing. Emily completed partial fulfilment Master Rehabilitation Science degree University British Columbia. Dr funded Michael Smith Foundation Research, Child Clinician Scientist Program, BC Children’s Hospital Research Institute, Sunny Hill Foundation, Institutes Research. stated interests might posing conflict bias. applicable – new generated Please note: publisher responsible content functionality supplied authors. Any queries (other missing content) directed corresponding author