Aim of the study was to investigate whether children aged 7–9 year old with severe motor difficulties had a greater risk of additional difficulties in activities in daily living (ADL), academic skills, attention and social skills than children with moderate motor difficulties.
Methods Children (N=6959) from a population based cohort, the Avon Longitudinal Study of Parents and Children (ALSPAC), were divided into three groups based on their scores on the ALSPAC Coordination Test at age 7: control children (scores above 15th centile; N=5719 (82.1%)), children with moderate (between 5th and 15th centile; N=951 (13.7%)) and children with severe motor difficulties (below 5th centile N=289 (4.2%)). Children with neurological disorders or an IQ < 70 were excluded. Logistic Regression was used to compare children with moderate and severe motor coordination difficulties with each other and with control children regarding their risk of coexisting difficulties (defined as significant (<10th centile) difficulties with Activities of Daily Living (ADL); academic skills (reading, spelling and handwriting); attention; social skills (social cognition and nonverbal skills)).
Results Children with severe motor difficulties demonstrated a higher risk of difficulties in ADL, handwriting, attention, reading, and social cognition than children with moderate motor difficulties, who in turn had a higher risk of difficulties than control children across domains (Figure 1). The prevalence of problems in three or more functional areas was 28% in the group with severe motor difficulties, 11% in the group with moderate motor difficulties, and 6% in the control group.
Which cut off should we choose? Is severity of motor coordination difficulties related to co-morbidity in children at risk for DCD?
See Figure 1
Percentage these groups having 0, 1–2, and 3 score in the clinical range (<10th centile).
Conclusions Children with severe motor difficulties have greatest number of difficulties across developmental domains. However, children with moderate motor difficulties also often have additional functional problems which would be missed if the 5th centile was adopted as cut-off criterion for referral. The benefit compared to the cost of expanding referral criteria needs to be considered.