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)
The hormone melatonin (5-methoxy-N-acetyltryptamine) is synthesized primarily in the pineal gland and retina, and in several peripheral tissues and organs. In the circulation, the concentration of ...melatonin follows a circadian rhythm, with high levels at night providing timing cues to target tissues endowed with melatonin receptors. Melatonin receptors receive and translate melatonin's message to influence daily and seasonal rhythms of physiology and behavior. The melatonin message is translated through activation of two G protein-coupled receptors, MT(1) and MT(2), that are potential therapeutic targets in disorders ranging from insomnia and circadian sleep disorders to depression, cardiovascular diseases, and cancer. This review summarizes the steps taken since melatonin's discovery by Aaron Lerner in 1958 to functionally characterize, clone, and localize receptors in mammalian tissues. The pharmacological and molecular properties of the receptors are described as well as current efforts to discover and develop ligands for treatment of a number of illnesses, including sleep disorders, depression, and cancer.
Developmental coordination disorder (DCD) affects around 5% of children and commonly overlaps with other developmental disorders including: attention deficit hyperactivity disorder (ADHD), autism ...spectrum disorders (ASDs) and specific language impairment (SLI). There is evidence to demonstrate the wide-ranging impact on all areas of functioning including psychiatric and learning domains. There is increasing evidence of the continuing impact into adulthood and the long-term negative effects on relationships and employment. There is a need for early identification and intervention to limit the likelihood of these secondary consequences from emerging. This paper addresses the diagnosis of DCD.
Aim
To better understand the neural and performance factors that may underlie developmental coordination disorder (DCD), and implications for a multi‐component account.
Method
A systematic review of ...the experimental literature published between June 2011 and September 2016 was conducted using a modified PICOS (population, intervention, comparison, outcomes, and study type) framework. A total of 106 studies were included.
Results
Behavioural data from 91 studies showed a broad cluster of deficits in the anticipatory control of movement, basic processes of motor learning, and cognitive control. Importantly, however, performance issues in DCD were often shown to be moderated by task type and difficulty. As well, we saw new evidence of compensatory processes and strategies in several studies. Neuroimaging data (15 studies, including electroencephalography) showed reduced cortical thickness in the right medial orbitofrontal cortex and altered brain activation patterns across functional networks involving prefrontal, parietal, and cerebellar regions in children with DCD than those in comparison groups. Data from diffusion‐weighted magnetic resonance imaging suggested reduced white matter organization involving sensorimotor structures and altered structural connectivity across the whole brain network.
Interpretation
Taken together, results support the hypothesis that children with DCD show differences in brain structure and function compared with typically developing children. Behaviourally, these differences may affect anticipatory planning and reduce automatization of movement skill, prompting greater reliance on slower feedback‐based control and compensatory strategies. Implications for future research, theory development, and clinical practice are discussed.
RESUMEN
Hallazgos cognitivos y de neuroimágenes en niños con TDC (trastornos del desarrollo de la coordinación): nuevas perspectivas en base a una revisión sistemática de investigaciones recientes
Objetivo
Mejorar la comprensión de los factores neuronales y de funcionamiento que pueden ser la base de los TDC (trastornos del desarrollo de la coordinación) y sus implicaciones para una descripción multifactorial.
MetodoSe realizó una revisión sistemática de la literatura científica publicada entre Junio de 2011 y Septiembre de 2016 utilizando un marco PICOS modificado (población, intervención, comparación, resultados y tipo de estudio). Se incluyeron un total de 106 estudios.
Resultados
Los datos de comportamiento motor de 91 estudios mostraron un amplio conjunto de déficits en el control anticipatorio del movimiento, en los procesos básicos de aprendizaje motor y en el control cognitivo. Es importante destacar que los problemas de rendimiento motor en TDC a menudo se ven moderados por el tipo de tareas y la dificultad de las mismas. Asimismo, en varios estudios vimos nuevos indicios de estrategias y procesos compensatorios. Los datos de neuroimagen (15 estudios, incluyendo electroencefalografía) mostraron un grosor cortical reducido en la corteza orbitofrontal medial derecha y patrones alterados de activación cerebral a lo largo de redes funcionales que implican regiones prefrontales, parietales y cerebelares en niños con TDC con respecto a los grupos control. Los datos de resonancia magnética por difusión (DTI) sugirieron una reducción de la organización de la materia blanca que involucra estructuras sensoriomotoras y una conectividad estructural alterada a través de toda la red cerebral.
Interpretación
Tomados en conjunto, los resultados apoyan la hipótesis de que los niños con TDC muestran diferencias en la estructura y función cerebral en comparación con los niños con un desarrollo típico. En lo que hace a comportamiento motor, estas diferencias pueden afectar la planificación anticipada y dificultar la automatización de las habilidades motoras, lo que lleva a una mayor dependencia de un control motor basado en sistemas de retroalimentación más lenta y de estrategias compensatorias. Se discuten las implicaciones para la investigación futura, el desarrollo teórico y la práctica clínica.
RESUMO
Achados cognitivos e de neuroimagem em desordem do desenvolvimento da coordenação: novas descobertas a partir de uma revisão sistemática de estudos recentes
Objetivo
Compreender melhor of fatores neurais e de desemppenho que podem explicar a desordem do desenvolvimento da coordenação (DDC), e implicações para uma causa multi‐componentes.
Método
Uma revisão sistemática da literatura experimental publicada entre Junho de 2011 e Setembro de 2016 foi conduzida seguindo uma estrutura PICOS (população, intervenção, comparação, resultados e tipo do estudo) modificada. Um total de 106 estudos foi incluído.
Resultados
Dados comportamentais de 91 estudos mostraram um amplo grupo de deficits em controle antecipatório do movimento, processos básicos de aprendizagem motora, e controle cognitivo. No entanto, um achado importante foi que as dificuldades de desempenho em DDC foram frequentemente moderadas por tipo e dificuldade da tarefa. Também encontramos novas evidências de processos e estratégias compensatórios em vários estudos. Dados de neuroimagem (15 estudos, incluindo encefalografia) mostraram reduzida espessura cortical no córtex orbitofrontal medial direito, e padrões alterados de ativação cerebral em redes funcionais envolvendo regiões pré‐frontais, parietais e cerebelares em crianças com DDC do que nas crianças dos grupos de comparação. Dados de estudos com ressonância magnética por difusão sugerem reduzida organização da substância branca envolvendo estruturas sensório‐motoras, e alterada conectividade estrutural em toda a rede cerebral.
Interpretação
Juntos, os resultados dão suporte à hipótese de que crianças com DDC mostram diferenças na estrutura e função cerebral comparadas com crianças com desenvolvimento típico. Comportamentalmente, estas diferenças podem afetar o planejamento antecipatório e reduzir a automatização da habilidade motora, causando maior dependência em estratégias de controle mais lentas, baseadas no feedback, e estratégias compensatórias. Implicações para futuras pesquisas, desenvolvimento teórico e prática clínica são discutidas.
What this paper adds
A comprehensive systematic review of recent experimental research on developmental coordination disorder (DCD).
A current synthesis that informs international consensus guidelines on DCD.
Behavioural and neuroimaging findings are integrated with reference to current theory.
Evidence that motor control deficits in DCD depend on the nature of the task.
Evidence to show alterations of structural and functional neural connectivity in DCD.
Implications for clinical practice are provided, based on recent research.
What this paper adds
A comprehensive systematic review of recent experimental research on developmental coordination disorder (DCD).
A current synthesis that informs international consensus guidelines on DCD.
Behavioural and neuroimaging findings are integrated with reference to current theory.
Evidence that motor control deficits in DCD depend on the nature of the task.
Evidence to show alterations of structural and functional neural connectivity in DCD.
Implications for clinical practice are provided, based on recent research.
This article is commented on by Liégeois on page 1103 of this issue.
This article's has been translated into Spanish and Portuguese.
Follow the links from the to view the translations.
ABSTRACT Inheritance from prior exposure often complicates the interpretation of terrestrial cosmogenic nuclide (TCN) inventories in glaciated terrain. Lochnagar, a mountain in eastern Scotland, ...holds a clear geomorphological record of corrie glaciation and the thinning of the last Scottish ice sheet over the last ~15 ka. Yet attempts to date the main stages in deglaciation after sampling of 21 granite boulders for 10 Be, 26 Al and 14 C from corrie moraines, an ice sheet lateral moraine and boulder spreads revealed widespread, but variable, TCN inheritance. Only the youngest boulder ages fit within the range of expected deglaciation ages. To identify the sources of geological uncertainty, we provide simple models of ice cover duration and erosion histories for plateau, corrie and strath landscape domains, identify the variable nuclide inheritance that derives from different sources for boulders in these domains, and outline the effects of rotation, splitting and erosion of boulders during glacial transport. The combined effects increase clustering around arbitrary mean TCN values that exceed deglaciation ages. A further implication is that boulders have survived beneath overriding ice sheets. Such boulder trapping at Lochnagar may have resulted from topographic controls on katabatic winds and surface ablation acting on a thinning, cold‐based ice sheet.
The aim is to investigate the evolution of the subglacial landscape of Antarctica using an ice sheet and erosion model. We identify different stages of continental glaciation and model the erosion ...processes associated with each stage. The model links erosion to the basal thermal regime and indicates that much of the Antarctic interior may have been subject to less than 200
m of erosion. The depth of erosion reflects the presence or absence of warm-based ice and the consistency of ice flow direction. This information, linked with knowledge about landscapes of glaciation in the northern hemisphere and some simple but robust assumptions about initial topography, is used to generate a map of the subglacial Antarctic landscape in which much of the lowland interior resembles the landscapes of areal scouring typical of the Laurentian and Scandinavian shields. Near the continental margins selective linear erosion has overdeepened pre-existing river valleys by as much as 2.8
km. High elevation plateaus adjacent to such drainage systems have survived largely unmodified under cold-based ice. High erosion rates result from steep thermal gradients in basal ice. Mountain regions such as the Gamburtsev Mountains, uplands in Dronning Maud Land and massifs in West Antarctica are likely to bear features of local alpine glaciation. Such landscapes may have been protected under cold-based ice for the last 34
Myrs or possibly longer.
The Scottish Alliance of Geoscience, Environment and Society (SAGES) was launched in May 2007 and thrives to this day (
https://www.sages.ac.uk
). It is a major research partnership between ten ...institutions in Scotland squarely focused on the prime problem of our time, namely understanding how the natural world works and how it interacts with human society. The inspiration driving SAGES is that we can all contribute more if we collaborate. Paul Bishop was a staunch believer in collaboration and played a pivotal role in the building of SAGES. The early history of SAGES and Paul's contribution is little known and it seems fitting to address this in a special issue in his name.
The first Cenozoic ice sheets initiated in Antarctica from the Gamburtsev Subglacial Mountains and other highlands as a result of rapid global cooling ∼34 million years ago. In the subsequent 20 ...million years, at a time of declining atmospheric carbon dioxide concentrations and an evolving Antarctic circumpolar current, sedimentary sequence interpretation and numerical modelling suggest that cyclical periods of ice-sheet expansion to the continental margin, followed by retreat to the subglacial highlands, occurred up to thirty times. These fluctuations were paced by orbital changes and were a major influence on global sea levels. Ice-sheet models show that the nature of such oscillations is critically dependent on the pattern and extent of Antarctic topographic lowlands. Here we show that the basal topography of the Aurora Subglacial Basin of East Antarctica, at present overlain by 2-4.5 km of ice, is characterized by a series of well-defined topographic channels within a mountain block landscape. The identification of this fjord landscape, based on new data from ice-penetrating radar, provides an improved understanding of the topography of the Aurora Subglacial Basin and its surroundings, and reveals a complex surface sculpted by a succession of ice-sheet configurations substantially different from today's. At different stages during its fluctuations, the edge of the East Antarctic Ice Sheet lay pinned along the margins of the Aurora Subglacial Basin, the upland boundaries of which are currently above sea level and the deepest parts of which are more than 1 km below sea level. Although the timing of the channel incision remains uncertain, our results suggest that the fjord landscape was carved by at least two iceflow regimes of different scales and directions, each of which would have over-deepened existing topographic depressions, reversing valley floor slopes.
► The factor analyses undertaken support the structure of the Movement ABC 2 Test. ► Results suggest a developmental process towards specialization in movement abilities. ► The results have clinical ...as well as theoretical significance.
The Movement ABC test is one of the most widely used assessments in the field of Developmental Coordination Disorder (DCD). Improvements to the 2nd edition of the test (M-ABC-2) include an extension of the age range and reduction in the number of age bands as well as revision of tasks. The total test score provides a measure of motor performance, which can be used to help make a diagnosis of DCD. M-ABC-2 also provides 3 sub-scales for Manual Dexterity, Aiming and Catching and Balance but the validity of these conceptually derived sub-scales has not previously been reported.
To examine the factor structure of the M-ABC-2 test across the three age bands (AB): AB1 (3–6-year olds), AB2 (7–10-year olds) and AB3 (11–16-year olds).
Data from the 2007 standardisation sample (
N
=
1172) were used in this study. Confirmatory factor analyses (CFA) and structural equation modelling (LISREL 8.8) were employed to explore the relationship between the tasks within each of the 3 age bands. A model trimming approach was used to arrive at a well fitting model.
In AB1 a complex factor structure emerged providing evidence for an independent general factor, as well as specific factors representing the 3 test components. In AB2 a final model emerged with four correlated factors, an additional distinction being drawn between static and dynamic balance. In addition, a 2nd order general factor explained a considerable amount of variance in each primary factor. In AB3 CFA supported the 3-factor structure of the M-ABC-2, with only modest correlations between each factor.
The confirmatory factor analyses undertaken in this study further validate the structural validity of the M-ABC-2 as it has developed over time. Although its tasks are largely associated with the three sub-components within each age band, there was also clear evidence for a change in the factor structure towards differentiation in motor abilities with age.
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