Diagnostic services for developmental coordination disorder: Gaps and opportunities identified by parents.

developmental coordination disorder diagnosis family physician motor skills disorder parent perspective pediatrician primary care provider

Journal

Child: care, health and development
ISSN: 1365-2214
Titre abrégé: Child Care Health Dev
Pays: England
ID NLM: 7602632

Informations de publication

Date de publication:
Jan 2024
Historique:
revised: 19 12 2023
received: 01 08 2023
accepted: 28 12 2023
medline: 24 1 2024
pubmed: 24 1 2024
entrez: 24 1 2024
Statut: ppublish

Résumé

Affecting one in 20 children, Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder impacting a child's ability to learn motor skills. Despite its high prevalence, DCD is under-recognized and under-diagnosed, causing unnecessary frustration and stress for families who are seeking help for their child. This study aimed to understand how parents procure diagnostic services and their perspectives on needed supports and services to improve early identification and diagnosis of DCD. Using a multi-pronged recruitment strategy, we circulated the impACT for DCD online questionnaire to parents of children (<18 years) in British Columbia with suspected or diagnosed DCD. Data were analysed descriptively using medians/interquartile ranges for continuous data and frequencies/percentages for categorical data. Open-ended questions were analysed using exploratory content analysis. A total of 237 respondent data were analysed. Parents identified poor awareness and understanding of health care professionals and educators regarding aetiology, symptomology, and impacts of DCD, affecting timely access to diagnostic services. Long waitlists were also a barrier that often led families with financial means to procure private diagnostic assessments. A standard of care is needed for streamlined diagnostic services, enabling early identification and early intervention. A publicly funded, family-centred, collaborative care approach is critical to assess, diagnose, and treat children with this disorder and to mitigate the secondary physical and mental health consequences associated with DCD.

Sections du résumé

BACKGROUND BACKGROUND
Affecting one in 20 children, Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder impacting a child's ability to learn motor skills. Despite its high prevalence, DCD is under-recognized and under-diagnosed, causing unnecessary frustration and stress for families who are seeking help for their child. This study aimed to understand how parents procure diagnostic services and their perspectives on needed supports and services to improve early identification and diagnosis of DCD.
METHODS METHODS
Using a multi-pronged recruitment strategy, we circulated the impACT for DCD online questionnaire to parents of children (<18 years) in British Columbia with suspected or diagnosed DCD. Data were analysed descriptively using medians/interquartile ranges for continuous data and frequencies/percentages for categorical data. Open-ended questions were analysed using exploratory content analysis.
RESULTS RESULTS
A total of 237 respondent data were analysed. Parents identified poor awareness and understanding of health care professionals and educators regarding aetiology, symptomology, and impacts of DCD, affecting timely access to diagnostic services. Long waitlists were also a barrier that often led families with financial means to procure private diagnostic assessments.
CONCLUSION CONCLUSIONS
A standard of care is needed for streamlined diagnostic services, enabling early identification and early intervention. A publicly funded, family-centred, collaborative care approach is critical to assess, diagnose, and treat children with this disorder and to mitigate the secondary physical and mental health consequences associated with DCD.

Identifiants

pubmed: 38265129
doi: 10.1111/cch.13230
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13230

Subventions

Organisme : CIHR
ID : FDN-143258
Pays : Canada
Organisme : CIHR
ID : AWD-025383
Pays : Canada
Organisme : CIHR
ID : PJV-179798
Pays : Canada

Informations de copyright

© 2024 The Authors. Child: Care, Health and Development published by John Wiley & Sons Ltd.

Références

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders-5th ed. American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596
Blank, R., Barnett, A. L., Cairney, J., Green, D., Kirby, A., Polatajko, H., Rosenblum, S., Smits-Engelsman, B., Sugden, D., Wilson, P., & Vinçon, S. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine & Child Neurology, 61(3), 242-285. https://doi.org/10.1111/dmcn.14132
Camden, C., Meziane, S., Maltais, D., Cantin, N., Brossard-Racine, M., Berbari, J., & Couture, M. (2019). Research and knowledge transfer priorities in developmental coordination disorder: Results from consultations with multiple stakeholders. Health Expectations, 22(5), 1156-1164. https://doi.org/10.1111/hex.12947
Camden, C., Wilson, B., Kirby, A., Sugden, D., & Missiuna, C. (2015). Best practice principles for management of children with developmental coordination disorder (DCD): Results of a scoping review. Child: Care, Health and Development, 41(1), 147-159. https://doi.org/10.1111/cch.12128
Eysenbach, G. (2004). Improving the quality of web surveys: The checklist for reporting results of internet surveys (CHERRIES). Journal of Medical Internet Research, 6(3), e34. https://doi.org/10.2196/jmir.6.3.e34
Gaines, R., Missiuna, C., Egan, M., & McLean, J. (2008). Educational outreach and collaborative care enhances physician's perceived knowledge about developmental coordination disorder. BMC Health Services Research, 8, 21. https://doi.org/10.1186/1472-6963-8-21
Harris, S. R., Mickelson, E. C. R., & Zwicker, J. G. (2015). Diagnosis and management of developmental coordination disorder. CMAJ, 187(9), 659-665. https://doi.org/10.1503/cmaj.140994
Ip, A., Mickelson, E. C. R., Zwicker, J. G., & Canadian Paediatric Society, Developmental Paediatrics Section. (2021). Practice point: Assessment, diagnosis, and management of developmental coordination disorder. Paediatrics & Child Health, 6(1), 366-374.
Jasmin, E., Tétreault, S., Larivière, N., & Joly, J. (2018). Participation and needs of children with developmental coordination disorder at home and in the community: Perceptions of children and parents. Research in Developmental Disabilities, 73, 1-13. https://doi.org/10.1016/j.ridd.2017.12.011
Karkling, M., Paul, A., & Zwicker, J. G. (2017). Occupational therapists' awareness of guidelines for assessment and diagnosis of developmental coordination disorder. Canadian Journal of Occupational Therapy, 84, 148-157. https://doi.org/10.1177/0008417417700915
Klein, E. S., Licari, M., Barbic, S., & Zwicker, J. G. (2023). Success or failure? Are therapy and school supports meeting the needs for children with developmental coordination disorder? Canadian Journal of Occupational Therapy, 6. https://doi.org/10.1177/00084174231197618
Licari, M. K., Alvares, G. A., Bernie, C., Elliot, C., Evans, K. L., McIntyre, S., Pillar, S. V., Reynolds, J. E., Reid, S. L., Spittle, A. J., & Whitehouse, A. J. (2021). The unmet clinical needs of children with developmental coordination disorder. Pediatric Research, 90(4), 826-831. https://doi.org/10.1038/s41390-021-01373-1
Maciver, D., Owen, C., Flannery, K., Forsyth, K., Howden, S., Shepherd, C., & Rush, R. (2011). Services for children with developmental co-ordination disorder: The experiences of parents. Child: Care, Health and Development, 37(3), 422-429. https://doi.org/10.1111/j.1365-2214.2010.01197.x
Missiuna, C., Gaines, R., & Soucie, H. (2006). Why every office needs a tennis ball: A new approach to assessing the clumsy child. CMAJ, 175(5), 471-473. https://doi.org/10.1503/cmaj.051202
Missiuna, C., Moll, S., King, S., King, G., & Law, M. (2007). A trajectory of troubles: Parents' impressions of the impact of developmental coordination disorder. Physical & Occupational Therapy in Pediatrics, 27(1), 81-101. https://doi.org/10.1080/J006v27n01_06
Missiuna, C., Moll, S., Law, M., King, S., & King, G. (2006). Mysteries and mazes: Parents' experiences of children with developmental coordination disorder. Canadian Journal of Occupational Therapy, 73(1), 7-17. https://doi.org/10.2182/cjot.05.0010
Montgomery I, Glegg S, Boniface G, Zwicker JG. DCD Advocacy Toolkit. Sunny Hill Health Centre for Children; 2018. Available from: https://www.cdrinfosource.ca/search?query=DCDadvocacytoolkit&menu%5BUserSpecific%5D=Everyone&page=1&resource=developmental-coordination-disorder-(dcd)-advocacy-toolkit
Novak, C., Lingam, R., Coad, J., & Emond, A. (2012). ‘Providing more scaffolding’: Parenting a child with developmental co-ordination disorder, a hidden disability. Child: Care, Health and Development, 38(6), 829-835. https://doi.org/10.1111/j.1365-2214.2011.01302.x
Pentland, J., Maciver, D., Owen, C., Forsyth, K., Irvine, L., Walsh, M., & Crowe, M. (2016). Services for children with developmental co-ordination disorder: An evaluation against best practice principles. Disability and Rehabilitation, 38(3), 299-306. https://doi.org/10.3109/09638288.2015.1037464
Province of British Columbia. Early childhood intervention programs; 2020. Available from: https://www2.gov.bc.ca/gov/content/health/managing-your-health/child-behaviour-development/assessing-child-development-38610
Rihtman, T., Wilson, B. N., & Parush, S. (2011). Development of the Little Developmental Coordination Disorder Questionnaire for preschoolers and preliminary evidence of its psychometric properties in Israel. Research in Developmental Disabilities, 32(4), 1378-1387. https://doi.org/10.1016/j.ridd.2010.12.040
Rodger, S., & Mandich, A. (2005). Getting the run around: accessing services for children with developmental coordination disorder. Child: Care, Health and Development, 31(4), 449-457. https://doi.org/10.1111/j.1365-2214.2005.00524.x
Sainani, K. L. (2015). Dealing with missing data. Physical Medicine and Rehabilitation, 7(9), 990-994. https://doi.org/10.1016/j.pmrj.2015.07.011
Soriano, C. A., Hill, E. L., & Crane, L. (2015). Surveying parental experiences of receiving a diagnosis of developmental coordination disorder (DCD). Research in Developmental Disabilities, 43-44, 11-20. https://doi.org/10.1016/j.ridd.2015.06.001
Statistics Canada. Population estimates on July 1st, by age and sex. Published Online 2022. Accessed July 30, 2023. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1710000501
Tal Saban, M., & Kirby, A. (2018). Adulthood in developmental coordination disorder (DCD): A review of current literature based on ICF perspective. Current Developmental Disorders Reports, 5(1), 9-17. https://doi.org/10.1007/s40474-018-0126-5
Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing & Health Sciences, 15(3), 398-405. https://doi.org/10.1111/nhs.12048
Wilson, B. N., Creighton, D., Crawford, S. G., Heath, J. A., Semple, L., Tan, B., & Shannon, H. S. (2015). Psychometric properties of the Canadian Little Developmental Coordination Disorder Questionnaire for preschool children. Physical & Occupational Therapy in Pediatrics, 35(2), 116-131. https://doi.org/10.3109/01942638.2014.980928
Wilson, B. N., Neil, K., Kamps, P. H., & Babcock, S. (2013). Awareness and knowledge of developmental coordination disorder among physicians, teachers and parents. Child: Care, Health and Development, 39(2), 296-300. https://doi.org/10.1111/j.1365-2214.2012.01403.x
Zwicker, J. G., Harris, S. R., & Klassen, A. F. (2013). Quality of life domains affected in children with developmental coordination disorder: A systematic review. Child: Care, Health and Development, 39(4), 562-580. https://doi.org/10.1111/j.1365-2214.2012.01379.x
Zwicker, J. G., Missiuna, C., Harris, S. R., & Boyd, L. A. (2012). Developmental coordination disorder: A review and update. European Journal of Paediatric Neurology, 16(6), 573-581. https://doi.org/10.1016/j.ejpn.2012.05.005
Zwicker, J. G., Montgomery, I., & Mickelson, E. DCD Toolkit for Pediatricians. Sunny Hill Health Centre for Children; 2018. Available from: https://www.cdrinfosource.ca/search?query=DCDphysiciantoolkit&menu%5BUserSpecific%5D=Everyone&resource=developmental-coordination-disorder-(dcd)-toolkit-for-pediatricians

Auteurs

Erin S Klein (ES)

Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
Brain, Behaviour, & Development Theme, BC Children's Hospital Research Institute, Vancouver, Canada.

Melissa Licari (M)

Telethon Kids Institute and University of Western Australia, Perth, Australia.

Skye Barbic (S)

Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada.

Jill G Zwicker (JG)

Brain, Behaviour, & Development Theme, BC Children's Hospital Research Institute, Vancouver, Canada.
Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, Canada.
Department of Pediatrics (Division of Developmental Pediatrics), University of British Columbia, Vancouver, Canada.
CanChild Centre for Childhood Disability Research, Hamilton, Canada.

Classifications MeSH