International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder

Rainer Blank, Anna L Barnett, John Cairney, Dido Green, Amanda Kirby, Helene Polatajko, Sara Rosenblum, Bouwien Smits-Engelsman, David Sugden, Peter Wilson, Sabine Vinçon, Rainer Blank, Anna L Barnett, John Cairney, Dido Green, Amanda Kirby, Helene Polatajko, Sara Rosenblum, Bouwien Smits-Engelsman, David Sugden, Peter Wilson, Sabine Vinçon

Abstract

Aim: These international clinical practice recommendations (CPR) for developmental coordination disorder (DCD), initiated by the European Academy of Childhood Disability (EACD), aim to address key questions on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD relevant for clinical practice.

Method: Key questions in five areas were considered through literature reviews and formal expert consensus. For recommendations based on evidence, literature searches on 'mechanisms', 'assessment', and 'intervention' were updated since the last recommendations in 2012. New searches were conducted for 'psychosocial issues' and 'adolescents/adults'. Evidence was rated according to the Oxford Centre for Evidence-Based Medicine (level of evidence [LOE] 1-4) and transferred into recommendations. For recommendations based on formal consensus, two meetings of an international, multidisciplinary expert panel were conducted with a further five Delphi rounds to develop good clinical practice (GCP) recommendations.

Results: Thirty-five recommendations were made. Eight were based on the evidence from literature reviews (three on 'assessment', five on 'intervention'). Twenty-two were updated from the 2012 recommendations. New recommendations relate to diagnosis and assessment (two GCPs) and psychosocial issues (three GCPs). Additionally, one new recommendation (LOE) reflects active video games as adjuncts to more traditional activity-oriented and participation-oriented interventions, and two new recommendations (one GCP, one LOE) were made for adolescents and adults with DCD.

Interpretation: The CPR-DCD is a comprehensive overview of DCD and current understanding based on research evidence and expert consensus. It reflects the state of the art for clinicians and scientists of varied disciplines. The international CPR-DCD may serve as a basis for national guidelines.

What this paper adds: Updated international clinical practice guidelines on developmental coordination disorder (DCD). Refined and extended recommendations on clinical assessment and intervention for DCD. A critical synopsis of current research on mechanisms of DCD. A critical synopsis of psychosocial issues in DCD, with implications for clinical practice. The first international recommendations to consider adolescents and adults with DCD.

© 2019 The Authors Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Figures

Figure 1
Figure 1
From international recommendations to national guidelines. [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
Figure 2
Figure 2
International expert panel. aServed in the intervention group until May 2016. [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
Figure 3
Figure 3
Literature review. DCD, developmental coordination disorder; MABC, Movement Assessment Battery for Children; BOT, Bruininks‐Oseretsky Test of Motor Proficiency; DCDQ, Developmental Coordination Disorder Questionnaire; SD, standard deviation. [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
Figure 4
Figure 4
Multi‐component account of motor skill development showing correlates of performance in developmental coordination disorder (DCD). IMD, internal modeling deficit; EF, executive function; WMN, white matter network; MNS, mirror neuron system. [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
Figure 5
Figure 5
Prevalences in a population of 7‐year‐old children with attention‐deficit/hyperactivity disorder (ADHD) only, developmental coordination disorder (DCD) only, and ADHD/DCD combined.16
Figure 6
Figure 6
Overlap between emotional and behavioural disorders in children with developmental coordination disorder (DCD).185, 220
Figure 7
Figure 7
Flow chart assessment, treatment indication, and planning. DCD, developmental coordination disorder; ADL, activities of daily living; R, recommendation. [Colour figure can be viewed at http://www.wileyonlinelibrary.com]
Figure 8
Figure 8
Flow chart treatment planning, intervention, and evaluation. DCD, developmental coordination disorder; R, recommendation; S, statement.

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Source: PubMed

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