Developmental coordination disorder in children: assessment, identification and intervention
Du Plessis, Aletta Margaretha (Alretha)
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Introduction: Developmental coordination disorder (DCD) is a motor skill disorder that affects children worldwide, with various prevalence rates reported in the literature. Approximately 60% of children in South Africa (SA) come from low socio-economic (SE) environments. It is, therefore, essential to determine the prevalence of possible DCD in these environments. Although various screening tools are available for identifying possible DCD, teachers' ability to use the Movement Assessment Battery for Children-2 (MABC-2) Checklist has not been established. Furthermore, children with DCD and possible DCD will continue to experience motor difficulties if motor intervention is not provided. A motor intervention guideline for children with DCD in SA in the field of Kinderkinetics has not been established. Objectives: The first objective was to determine the prevalence of possible DCD in Grade 1 (Gr. 1) learners in a low SE environment in Mangaung, SA, using the MABC-2 Performance Test. Secondly, the study aimed to establish teachers' ability to identify Gr. 1 learners with possible DCD in low SE environments using the MABC-2 Checklist. Finally, an e-Delphi survey was used to develop a motor intervention framework as a guideline for Kinderkineticists to help children with DCD or possible DCD within the South African context. Methodology: Two hundred and forty-two (N=242; 51.2% boys, 48.8% girls) Gr. 1 learners, 6–8-year-old from a low SE environment (quintile 1–3 schools) in Mangaung Metro, Motheo District, Free State (FS) Province, participated in study objective one. Possible DCD prevalence was determined using the MABC-2 Performance Test. For the second objective, the study was conducted in the same environment. Gr. 1 learners 6–8-year-old (N=200; 49.5% boys, 50.5% girls) and 29 female class teachers of the Gr.1 learners participated in the study. The convergent validity of the MABC-2 Performance Test and Checklist completed by teachers was determined. Lastly, for objective three, 29 Kinderkineticists in SA with expert experience participated in a three-round online e-Delphi survey by answering questions related to motor intervention for children with possible DCD. Results: The results of objective one showed that the prevalence of possible DCD found in the Gr. 1 learners was 9.9%. The gender results indicated a possible DCD prevalence of 10.5% for boys and 9.3% for girls. No statistically significant difference between the boys and girls was found (p=0.94). The results concerning objective two indicated that the movement specialists identified more learners (90%) in the non-DCD group (> 15th percentile) than the teachers (54%). The teachers wrongfully identified 46% of the learners with possible DCD, who were not identified with possible DCD according to the movement specialists. The movement specialists identified 10% of the learners with possible DCD. Only a slight agreement (=0.17) was found between the MABC-2 Performance Test and Checklist when the ≤ 15th percentile was used as a cut-off score. The sensitivity was 85% and the specificity 58%. In the e-Delphi survey, consensus (80%) was reached on 51/89 questions in round one, 89/144 for round two, and 12/30 in round three. A motor intervention framework was developed using the feedback of each round from the participants where consensus was reached. Conclusion: The prevalence of possible DCD in low SE environments in Mangaung of Gr. 1 learners was higher than the worldwide estimated prevalence of DCD (5–6%). It is recommended that when teachers use the MABC-2 Checklist, the Performance Test should be performed in conjunction with the Checklist to obtain the most reliable results. A motor intervention framework was developed as a first draft to use as a guideline by Kinderkineticists, focusing on intervention planning, goal-setting, intervention approaches, intervention apparatus, intervention delivery mode, additional role players, settings, dosage, and evaluation.