Article Text
Abstract
Aim To investigate the relationships between Developmental Coordination Disorder (DCD) and mental health outcomes in late adolescence.
Methods Data were obtained from the Avon Longitudinal Study of Parents and Children, a large longitudinal birth cohort enrolled in 1991–2. Cases of DCD were defined at 7 years old, according to the DSM-IV, using tests of motor coordination, functional limitations on activities of daily living and appropriate exclusion criteria. Self-reported mental health outcomes were measured using the Strengths and Difficulties Questionnaire (SDQ) at 16.5 years old and the Moods and Feelings Questionnaire (MFQ) and Warwick-Edinburgh Mental Well-being Scale (WEMWBS) at 17.5 years old. Logistic regressions assessed the associations between DCD and mental health outcomes. Multivariate models were used to adjust for potential socioeconomic confounders and mediating factors such as IQ, social communication difficulties, friendships and bullying.
Results A total of 3950 children previously assessed for DCD at 7 years had outcome data at 16–18 years. Children with DCD (n = 169, 4%) had increased odds of total difficulties on the SDQ (OR 2.15, 95% CI 1.38–3.34). In particular, they had more difficulty with hyperactivity (OR 2.12, 95% CI 1.41–3.21) and peer problems (OR 2.87, 95% CI 1.88–4.40). They also had greater odds of self-reported depression (OR 1.51, 95% CI 1.00–2.28) and low mental well-being (OR 1.48, 95% CI 1.03–2.14). The odds of experiencing difficulty in each of these measures were attenuated after adjusting for social communication difficulties, lack of supportive friendships, frequent bullying and low self-esteem; good social communication skills had the most consistent protective effect. When children with DCD were compared to their same-sex peers, girls were more vulnerable than boys to poor mental health in adolescence, particularly depression and low mental well-being.
Conclusions Children with DCD, especially girls, had increased risk of difficulties with mental health and social relationships in late adolescence compared to their peers. Good social communication skills, supportive friendships, absence of bullying and higher self-esteem were all protective factors. Clinicians should consider these factors when assessing and managing these children; interventions to promote resilience in DCD should involve improving social communication skills and promoting self-esteem as well as developing motor coordination.