To describe handwriting and executive control features and their inter-relationships among children with developmental dysgraphia, in comparison to controls.
Participants included 64 children, aged ...10-12 years, 32 with dysgraphia based on the Handwriting Proficiency Screening Questionnaire (HPSQ) and 32 matched controls. Children copied a paragraph onto paper affixed to a digitizer that supplied handwriting process objective measures (Computerized Penmanship Evaluation Tool (ComPET). Their written product was evaluated by the Hebrew Handwriting Evaluation (HHE). Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire about their child's executive control abilities.
Significant group differences were found for handwriting performance measures (HHE and ComPET) and executive control domains (BRIEF). Based on one discriminate function, including handwriting performance and executive control measures, 98.4% of the participants were correctly classified into groups. Significant correlations were found in each group between working memory and legibility as well as for other executive domains and handwriting measures. Furthermore, twenty percent of the variability of the mean pressure applied towards the writing surface among children with was explained by their 'emotional control' (BRIEF).
The results strongly suggest consideration of executive control domains to obtain better insight into handwriting impairment characteristics among children with dysgraphia to improve their identification, evaluation and the intervention process.
Aim
These international clinical practice recommendations (CPR) for developmental coordination disorder (DCD), initiated by the European Academy of Childhood Disability (EACD), aim to address key ...questions on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD relevant for clinical practice.
Method
Key questions in five areas were considered through literature reviews and formal expert consensus. For recommendations based on evidence, literature searches on ‘mechanisms’, ‘assessment’, and ‘intervention’ were updated since the last recommendations in 2012. New searches were conducted for ‘psychosocial issues’ and ‘adolescents/adults’. Evidence was rated according to the Oxford Centre for Evidence‐Based Medicine (level of evidence LOE 1–4) and transferred into recommendations. For recommendations based on formal consensus, two meetings of an international, multidisciplinary expert panel were conducted with a further five Delphi rounds to develop good clinical practice (GCP) recommendations.
Results
Thirty‐five recommendations were made. Eight were based on the evidence from literature reviews (three on ‘assessment’, five on ‘intervention’). Twenty‐two were updated from the 2012 recommendations. New recommendations relate to diagnosis and assessment (two GCPs) and psychosocial issues (three GCPs). Additionally, one new recommendation (LOE) reflects active video games as adjuncts to more traditional activity‐oriented and participation‐oriented interventions, and two new recommendations (one GCP, one LOE) were made for adolescents and adults with DCD.
Interpretation
The CPR–DCD is a comprehensive overview of DCD and current understanding based on research evidence and expert consensus. It reflects the state of the art for clinicians and scientists of varied disciplines. The international CPR–DCD may serve as a basis for national guidelines.
What this paper adds
Updated international clinical practice guidelines on developmental coordination disorder (DCD).
Refined and extended recommendations on clinical assessment and intervention for DCD.
A critical synopsis of current research on mechanisms of DCD.
A critical synopsis of psychosocial issues in DCD, with implications for clinical practice.
The first international recommendations to consider adolescents and adults with DCD.
Resumen
Recomendaciones internacionales para la práctica clínica sobre la definición, diagnóstico, evaluación, intervención y aspectos psicosociales del trastorno del desarrollo de la coordinación
Objetivo
Estas recomendaciones internacionales para la práctica clínica (RPC) sobre el trastorno del desarrollo de la coordinación (TDC), iniciadas por la Academia Europea de Discapacidad Infantil (EACD), tienen como objetivo abordar preguntas clave sobre la definición, diagnóstico, evaluación, intervención y aspectos psicosociales de TDC relevantes para la práctica clínica.
Método
Las preguntas clave en cinco áreas fueron tratadas a través de revisiones bibliográficas y consenso formal de expertos. Para las recomendaciones basadas en la evidencia, las búsquedas en la literatura sobre “mecanismos”, “evaluación” e “intervención” se actualizaron desde las últimas recomendaciones en 2012. Se realizaron nuevas búsquedas para “problemas psicosociales” y “adolescentes / adultos”. La evidencia se calificó de acuerdo con la gradación del Centro de Oxford para Medicina Basada en la Evidencia (nivel de evidencia LOE 1–4) y en ello se basaron las recomendaciones. Para recomendaciones basadas en el consenso formal, se llevaron a cabo dos reuniones de un panel multidisciplinario internacional de expertos con cinco rondas Delphi adicionales para desarrollar recomendaciones de buena práctica clínica (BPC).
Resultados
Se realizaron 35 recomendaciones. Ocho de ellas se basaron en la evidencia de las revisiones de la literatura (tres en “evaluación”, cinco en “intervención”). Veintidós fueron actualizadas a partir de las recomendaciones de 2012. Las nuevas recomendaciones se relacionan con el diagnóstico y la evaluación (dos BPC) y las cuestiones psicosociales (tres BPC). Además, una nueva recomendación (LOE) trata acerca de los videojuegos activos como complemento de las intervenciones más tradicionales orientadas a la actividad y la participación, y se hicieron dos nuevas recomendaciones (una BCP, una LOE) para adolescentes y adultos con TDC.
Interpretación
Estas recomendaciones internacionales para la práctica clínica sobre TDC aportan una visión general completa sobre TDC y el conocimiento actual basado en evidencia de investigación y consenso de expertos. Brinda actualización para clínicos y científicos de diversas disciplinas. Las recomendaciones internacionales para la práctica clínica TDC pueden servir como base para recomendaciones nacionales.
Recomendações internacionais para a prática clínica na definição, diagnóstico, avaliação, intervenção e aspectos psicossociais do transtorno do desenvolvimento da coordenação
Objetivo
Essas recomendações internacionais para a prática clínica (RPC) no transtorno do desenvolvimento da coordenação (TDC), iniciadas pela Academia Européia de Deficiência Infantil (EACD), objetiva direcionar questões chave na definição, diagnóstico, avaliação, intervenção e aspectos psicossociais do TDC relevantes para a prática clínica.
Métodos
Questões chave em cinco áreas foram consideradas através de revisões da literatura e consensos formais de especialistas. Para recomendações baseadas em evidências, buscas na literatura em “mecanismos”, “avaliação” e “intervenção” foram atualizadas desde as últimas recomendações de 2012. Novas buscas foram conduzidas para “problemas psicossociais” e “adolescentes/adultos”. Evidências foram classificadas de acordo com o Centro Oxford para Medicina Baseada em Evidência (nível de evidência NE 1‐4) e transferidas em recomendações. Para recomendações baseadas em consensos formais, dois encontros de um painel de especialistas internacional e multidisciplinar foram conduzidos com posteriormente cinco sessões Delphi para desenvolver recomendações de boa prática clínica (BPC).
Resultados
Trinta e cinco recomendações foram feitas. Oito foram baseadas em evidências de revisões da literatura (três em “avaliação”, cinco em “intervenção). Vinte e duas foram atualizadas das recomendações de 2012. Novas recomendações são relacionadas com diagnóstico e avaliação (duas BPC) e problemas psicossociais (três BPCs). Adicionalmente, uma nova recomendação (NE) se refere a jogos de videogame ativos como adjuntos à mais tradicional terapia orientada à tarefa e intervenção orientada à participação, e duas novas recomendações (uma BPC, um NE) foram feitas para adolescentes e adultos com TDC.
Interpretação
A RPC‐TDC apresenta uma visão geral do TDC e o conhecimento atual baseado em evidências de pesquisas e consenso de especialistas. Reflete o estado de arte dos clínicos e cientistas de disciplinas variadas. A RPC‐TDC internacional deverá servir como uma base para as diretrizes nacionais.
What this paper adds
Updated international clinical practice guidelines on developmental coordination disorder (DCD).
Refined and extended recommendations on clinical assessment and intervention for DCD.
A critical synopsis of current research on mechanisms of DCD.
A critical synopsis of psychosocial issues in DCD, with implications for clinical practice.
The first international recommendations to consider adolescents and adults with DCD.
This article's has been translated into Spanish and Portuguese.
Follow the links from the to view the translations.
A pocket version of these guidelines is available as Appendix S1 (https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.14132#support-information-section)
This study was used to (1) develop an occupational therapy screening questionnaire (the Handwriting Proficiency Screening Questionnaire HPSQ) to identify handwriting difficulties among school-aged ...children and (2) examine its reliability and validity.
The questionnaire's content validity was established. Internal consistency, interrater and test-retest reliability, and concurrent and construct validity were initiated. Participants included 7- to 14-year-old (N = 230) typically developing school-aged children.
The tool demonstrated good internal consistency (alpha = .90). Test-retest reliability for the score revealed an intraclass correlation coefficient (ICC) of .84 and interrater reliability of ICC = .92 for the total questionnaire score. Construct and concurrent validity were also confirmed.
The HPSQ is suitable for use by occupational therapists for identification of handwriting deficiency among school-aged children and is appropriate for varied academic and clinical uses. More studies with larger samples of varied age groups are required to further support the questionnaire's reliability and validity.
Essential tremor (ET) is a movement disorder that may cause functional disability in daily activities, such as drinking from a cup or drawing. This study aims to characterize effects of varied ...cup-grip types and measured axes on the actual performance of people with ET and find correlations between cup-grip type and measured axes, and spiral drawing measures. Participants (20 with ET and 18 controls) held a cup of water in a steady position in three grip types and drew a spiral. The cup acceleration was measured by the cup triaxial accelerometer, analyzed in X, Y and Z axes (directions); deviation of the measured acceleration from the desired steady position acceleration was computed. Significant group differences were found for outcome measures in all grip types. Among participants with ET, significantly higher measured values were found in the cup’s horizontal plane (X and Y axes) compared to the vertical direction (Z axis) and for on-the-handle versus around-the-cup grips in the X and Y axes. Significant correlations were found between this grip’s measures and spiral-drawing actual performance measures, indicating the measurement axis and grip type may affect actual performance. These findings may support the future development of assistive devices for tremor suppression and personalized supportive therapy.
Sensory processing is essential for the interaction with the environment and for adequate daily function. Sensory processing may deteriorate with aging and restrict daily activity performance. Aging ...may also affect Executive functions (EFs) which are critical for daily activity performance. Yet, most studies refer separately to the impacts of sensory processing or EFs and use clinical evaluations that do not necessarily reflect functional restrictions in real life. This study aims to describe the prevalence of altered sensory processing in the elderly as expressed in daily life scenarios and explore whether EFs mediate between altered sensory processing and daily activity performance in older adults.
This cross-sectional study included 167 healthy independently functioning people aged 65 and above who were living in the community, had sufficient cognitive status and no symptoms of depression (based on the GDS and the MMSE). All participants completed a socio-demographic-health questionnaire, the Adolescent/Adult Sensory Profile, the Behavior Rating Inventory of Executive Function-Adult Version and the Daily Living Questionnaire.
Altered sensory processing, and mainly by the reduced ability to register and modulate sensory input from daily environment, were prevalent in older adults. Their impacts on daily activity performance were mediated by executive dysfunctions.
Executive dysfunctions may worsen the negative effects of altered sensory processing on daily activity performance in older adults. The interaction between EFs and sensory processing should receive growing attention in intervention and prevention programs for older adults, with the emphasis on their expressions and implications on peoples' function in real life context.
Adults with specific learning disabilities (e.g., dyslexia, dysgraphia, and dyscalculia) reveal limitations in daily functioning in various life domains. Following previous evidence of deficient ...executive functions and unique sensory patterns in this population, this study examined how relationships between these two domains are expressed in daily functioning. Participants included 55 adults with specific learning disabilities and 55 controls matched by age, gender, socioeconomic status, and education. Participants completed a sociodemographic questionnaire, the Behavioral Rating Inventory of Executive Functions-adult version, and the Adolescent/Adult Sensory Profile. Results indicated significant relationships between executive functions (per the Behavioral Rating Inventory of Executive Functions-adult version) and sensory patterns (per the Adolescent/Adult Sensory Profile) as reflected in daily functioning. The low sensory registration pattern predicted 12% to 16% of the variance in the behavioral regulation index, metacognitive index, and general executive composite scores and was a significant predictor of specific executive function abilities. Results indicated that the difficulties of adults with specific learning disabilities in using executive function abilities efficiently might be tied to a high sensory threshold and passive self-regulation strategies. A deeper understanding of this population's sensory-executive mechanisms may improve evaluation and intervention processes. This understanding can consequently increase executive abilities for improved daily functioning and life satisfaction.
Practical methods for early identification of Parkinson's disease (PD) mild cognitive impairment (PD-MCI) through changes in real-life daily functioning are scarce. The aim of the study was to ...examine whether the cognitive functional (CF) feature, comprising of seven self-reported Movement Disorder Society's (MDS) Unified Parkinson's Disease Rating Scale (UPDRS) items, predicts PD patients' cognitive functional status after a year. We conducted a 1-year follow-up of 34 PD patients (50-78 year; 70.6% men) suspected of MCI using the following measures: the MDS-UPDRS, UPDRS-CF feature, Beck Depression Inventory (BDI), Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Parkinson's Disease Cognitive Functional Rating Scale (PD-CFRS), and Daily Living Questionnaire (DLQ). The first and second UPDRS-CF feature scores, and additional measures at the 1-year follow-up significantly correlated. Hierarchical regression revealed that the initial MoCA, TMT, and BDI scores predicted the second UPDRS-CF, and the first UPDRS-CF predicted 31% of the second PD-CFRS score variance. Depression moderated the relationship between the first UPDRS-CF score and the DLQ Part A. These results suggest practical, self-reported, daily functional markers for identifying gradual decline in PD patients. They consider the patients' heterogeneity, underlying cognitive pathology, and implications on daily functioning, health, and well-being.
Essential tremor (ET) is a common movement disorder affecting the performance of various daily tasks, including drawing. While spiral-drawing task characteristics have been described among patients ...with ET, research about the significance of the drawing direction of both spiral and lines tasks on the performance process is scarce. This study mapped inter-group differences between people with ET and controls related to drawing directions and the intra-effect of the drawing directions on the tremor level among people with ET. Twenty participants with ET and eighteen without ET drew spirals and vertical and horizontal lines on a digitizer with an inking pen. Time-based outcome measures were gathered to address the effect of the drawing directions on tremor by analyzing various spiral sections and comparing vertical and horizontal lines. Significant group differences were found in deviation of the spiral radius from a filtered radius curve and in deviation of the distance curve from a filtered curve for both line types. Significant differences were found between defined horizontal and vertical spiral sections within each group and between both line types within the ET group. A significant correlation was found between spiral and vertical line deviations from filtered curve outcome measures. Achieving objective measures about the significance of drawing directions on actual performance may support the clinical evaluation of people with ET toward developing future intervention methods for improving their functional abilities.
Within a few years, 1 in 6 people will be aged 60 years or older. Extreme situations, such as the COVID-19 crisis, constitute a challenge to older adults. However, the literature on the daily ...functional characteristics of older adults in the past and during the COVID-19 crisis and their relationships to their physical and mental health is scarce. This study aimed to examine the past and present daily functional factors associated with physical and mental health in older adults. Using an online platform, 204 Israelis aged 60 years and older reported their physical health symptoms and anxiety levels. They completed questionnaires about past (negative life events and childhood daily functional self-actualization) and present (adulthood daily functional self-actualization, functional cognition and sleep quality) factors. Structural equation modeling revealed correlations between functional cognition and childhood daily functional self-actualization (β = -.18) and anxiety (β = .15); adulthood daily functional self-actualization and past negative life events (β = -.18), anxiety (β = -.50), and physical symptoms (β = -16); and sleep quality and past childhood daily functional self-actualization (β = -.19), negative life events (β = .22), anxiety (β = .18), and physical symptoms (β = .40). These findings shed light on potential functional factors for older adults' health, indicating that these functional factors play a vital role in reducing health problems in later life.
'Learning disabilities' (LD) refer to a wide group of neurological disorders caused by deficits in the central nervous system which influence the individual's ability to maintain-, process or convey ...information to others in an efficient way. A worldwide discussion about the definitions of LD continues while a conceptual framework for studying the diverse life outcomes of adults with LD is still missing.
The aim was to review the literature on the activity and participation of adults with LD based on the International Classification of Functioning, Disability and Health (ICF) concepts.
"PsychInfo", "Eric" and "PubMed" were searched for relevant literature according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). After a three-stage process, 62 articles relevant for domains of activity and participation of adults with LD were included in the review.
Thirty-two articles focused on the domain of major life areas of education, work and employment and twelve articles focused on the domain of learning and applying knowledge. Limitations in activity and participation of the population with LD in these domains are recognized and discussed. Eighteen additional articles demonstrated that adults with LD confront difficulties in various life domains (e.g., communication, interpersonal interactions, mobility, and domestic life), however literature concerning these domains is scarce.
The ICF can be useful for further exploration of activity and participation characteristics of adults with LD in various life domains. Such exploration is required in order to gain a wider perspective of their functional characteristics and daily needs.
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