Cognitive, perceptual, and motor profiles of school-aged children with developmental coordination disorder

Abstract

Developmental coordination disorder (DCD) is a heterogeneous condition. Besides motor impairments, children with DCD often exhibit poor visual perceptual skills and executive functions. This study aimed to characterize the motor, perceptual, and cognitive profiles of children with DCD at the group level and in terms of subtypes. A total of 50 children with DCD and 31 typically developing (TD) peers (7-11 years old) underwent a comprehensive neuropsychological (15 tests) and motor (three subscales of the Movement Assessment Battery for Children-2) assessment. The percentage of children with DCD showing impairments in each measurement was first described. Hierarchical agglomerative and K-means iterative partitioning clustering analyses were then performed to distinguish the subtypes present among the complete sample of children (DCD and TD) in a data-driven way. Moderate to large percentages of children with DCD showed impaired executive functions (92%) and praxis (meaningless gestures and postures, 68%), as well as attentional (52%), visual perceptual (46%), and visuomotor (36%) skills. Clustering analyses identified five subtypes, four of them mainly consisting of children with DCD and one of TD children. These subtypes were characterized by: (i) generalized impairments (8 children with DCD), (ii) impaired manual dexterity, poor balance (static/dynamic), planning, and alertness (15 DCD and 1 TD child), (iii) impaired manual dexterity, cognitive inhibition, and poor visual perception (11 children with DCD), (iv) impaired manual dexterity and cognitive inhibition (15 DCD and 5 TD children), and (v) no impairment (25 TD and 1 child with DCD). Besides subtle differences, the motor and praxis measures did not enable to discriminate between the four subtypes of children with DCD. The subtypes were, however, characterized by distinct perceptual or cognitive impairments. These results highlight the importance of assessing exhaustively the perceptual and cognitive skills of children with DCD.

Keywords: Developmental coordination disorder; cluster analysis; executive functions; subtypes; visual perceptual skills.

FIGURE 1

Cluster profiles from K-means iterative partitioning analysis. Performance is expressed in z-score based on the normative data available for each motor, perceptual, and cognitive measures included in the clustering analysis. Performance is expressed in z-score based on the normative data available for each cognitive and motor measures included in the clustering analysis. Five clusters resulted from K-means analysis: Cluster 1 = 8 children with developmental coordination disorder (DCD), Cluster 2 = 15 children with DCD and 1 typically developing (TD) child, Cluster 3 = 11 children with DCD, Cluster 4 = 15 children with DCD and 5 TD children, Cluster 5 = 25 TD children and 1 child with DCD.