Effectiveness of Cognitive Orientation to Occupational Performance intervention in improving motor skills of children with developmental coordination disorder: A randomized waitlist-control trial

Abstract

Objectives: To determine if Cognitive Orientation to Occupational Performance was effective in improving performance and transfer of motor learning in children with developmental coordination disorder (with/without attention deficit hyperactivity disorder); and whether outcomes were maintained three months post-intervention.

Design: Randomized waitlist-control trial (ClinicalTrials.gov ID: NCT02597751).

Setting: BC Children's Hospital, Vancouver, Canada.

Subjects: Thirty-seven children with developmental coordination disorder and 41 children with co-occurring attention deficit hyperactivity disorder (all 8-12 years), randomized to treatment or waitlist groups.

Interventions: One-hour of intervention once weekly for 10 weeks.

Main measures: (1) Canadian Occupational Performance Measure to measure self-perceived performance of motor goals (10-point scale); (2) Performance Quality Rating Scale to measure therapist-observed movement quality (10-point scale); and (3) Bruininks-Oseretsky Test of Motor Proficiency - 2nd ed. to measure overall motor skill ability/transfer of motor learning (percentile).

Results: Both groups showed significant improvement (p < 0.001) in motor performance (developmental coordination disorder: pre: 2.7 ± 2.2, post: 7.0 ± 1.0; developmental coordination disorder with attention deficit hyperactivity disorder: pre: 2.3 ± 1.7, post: 7.0 ± 1.5) and movement quality (developmental coordination disorder: pre: 3.0 ± 1.5, post: 6.3 ± 1.7; developmental coordination disorder with attention deficit hyperactivity disorder: pre: 3.0 ± 1.9, post: 5.7 ± 2.3). Three months after treatment, children maintained their gains, but only children with developmental coordination disorder showed transfer of learning to overall motor skills (pre:12 ± 15, post:12 ± 12, follow-up:14 ± 20, p < 0.001).

Conclusion: Intervention was similarly effective for children with developmental coordination disorder with/without attention deficit hyperactivity disorder in achieving and maintaining functional motor goals, but only children with developmental coordination disorder showed transfer of learning to other motor skills.

Keywords: Randomized controlled trial; developmental coordination disorder; motor skills disorder; occupational therapy; paediatric rehabilitation.

Figure 1.

Schematic of study design. [Adapted by permission from: SpringerLink Nature Switzerland, Current Developmental Disorder Reports, Training-induced neuroplasticity in children with developmental coordination disorder by Izadi-Najafabadi et al., Copyright © 2020]. ADHD: attention deficit hyperactivity disorder; BOT-2: Bruininks-Oseretsky Test of Motor Proficiency-2^nd edition.; CO-OP: Cognitive Orientation to daily Occupational Performance; COPM: Canadian Occupational Performance Measure; DCD: developmental coordination disorder; PQRS: Performance Quality Rating Scale.

Figure 2.

CONSORT flowchart of participants. ADHD: attention deficit hyperactivity disorder; ASD: autism spectrum disorder; CO-OP: Cognitive Orientation to daily Occupational Performance; DCD: developmental coordination disorder; MABC-2: Movement Assessment Battery for Children – 2^nd ed.

Figure 3.

PQRS outcomes for treatment group. ADHD: attention deficit hyperactivity disorder; DCD: developmental coordination disorder; PQRS: Performance Quality Rating Scale. * significant after Bonferroni correction; x represents mean; line represents median.

Figure 4.

BOT-2 outcomes for treatment group. ADHD: attention deficit hyperactivity disorder; BOT-2: Bruninks-Oseretsky Test of Motor Proficiency – 2^nd ed.; DCD: developmental coordination disorder. * significant after Bonferroni correction; x represents mean; line represents median.