De Roubaix Amy, Zwicker Jill G, Onderbeke Katleen, Janssen Anjo, Van de Velde Dominique, Roeyers Herbert, Van Waelvelde Hilde, Bar-On Lynn
Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
Department of Occupational Science & Occupational Therapy and Department of Pediatrics, University of British Columbia, Vancouver, Canada.
J Autism Dev Disord. 2025 May 26. doi: 10.1007/s10803-025-06848-2.
Developmental Coordination Disorder (DCD) is a neurodevelopmental condition affecting coordinated motor skill acquisition usually diagnosed after 5y. However, parents and clinicians report poorer movement quality at earlier ages. Using the 'Observable Movement Quality' scale (OMQ), we compared movement quality between children with typical development (TD), with DCD, and with DCD and Autism Spectrum Disorder (ASD). Using blinded retrospective video analysis, a trained physical therapist observed 5-min compilations of home videos at 6-12 m (n = 53), 12-18 m (n = 54), and 18-24 m (n = 47) followed by OMQ-scoring and a three-point scale for clinical judgement (will/might/will not develop DCD). A 15% sample was re-evaluated to assess intra-rater reliability using Spearman coefficients. OMQ group performance was assessed using Kruskal-Wallis tests, while dichotomized (good/poor quality) data were examined with Fisher exact tests. OMQ scores' association with later motor performance (MABC-2 and DCDQ) was analysed via Spearman coefficients. Cramer's V determined the strength of association between clinical judgment and diagnostic outcome. Intra-rater reliability for total OMQ score was strong (r = 0.79, p ≤ 0.001). Reduced movement quality was found at 18-24 m in children with DCD (median 69, interquartile range [IQR] 10) and DCD+ASD (median 69, IQR 14) compared to TD children (median 74, IQR 2) (p ≤ 0.001). Five times more compilations in the DCD groups demonstrated poor overall movement quality at 18-24 m. At 18-24 m, movement quality correlated strongly with MABC-2 (r = 0.66) and DCDQ (r = 0.67). The therapist correctly identified 63-67% of DCD and DCD+ASD children respectively (Cramer's V = 0.62, p ≤ 0.001). These findings underscore the importance of investigating movement quality as a potential early feature of DCD.
发育性协调障碍（DCD）是一种神经发育状况，影响协调性运动技能的习得，通常在5岁后确诊。然而，家长和临床医生报告称，儿童在更小的年龄时运动质量就较差。我们使用“可观察运动质量”量表（OMQ），比较了发育正常（TD）儿童、患有DCD的儿童以及患有DCD和自闭症谱系障碍（ASD）的儿童之间的运动质量。通过盲法回顾性视频分析，一名经过培训的物理治疗师观察了6至12个月（n = 53）、12至18个月（n = 54）和18至24个月（n = 47）的家庭视频5分钟合集，随后进行OMQ评分和临床判断的三点量表评估（将/可能/不会发展为DCD）。对15%的样本进行重新评估，以使用斯皮尔曼系数评估评分者内部信度。使用Kruskal-Wallis检验评估OMQ组的表现，而对二分法（质量好/差）数据使用Fisher精确检验进行检查。通过斯皮尔曼系数分析OMQ评分与后期运动表现（MABC-2和DCDQ）之间的关联。克莱姆V系数确定临床判断与诊断结果之间的关联强度。OMQ总分的评分者内部信度很强（r = 0.79，p≤0.001）。与TD儿童（中位数74，四分位间距[IQR]2）相比，患有DCD的儿童（中位数69，IQR 10）和患有DCD+ASD的儿童（中位数69，IQR 14）在18至24个月时运动质量降低（p≤0.001）。在18至24个月时，DCD组中整体运动质量差的合集数量是TD组的五倍。在18至24个月时，运动质量与MABC-（r = 0.66）和DCDQ（r = 0.67）密切相关。治疗师分别正确识别了63%至67%的患有DCD和患有DCD+ASD的儿童（克莱姆V系数 = 0.62，p≤0.001）。这些发现强调了将运动质量作为DCD潜在早期特征进行研究的重要性。
