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Ophthalmic abnormalities in children with developmental coordination disorder

Alexandra L Creavin¹, Raghu Lingam, Kate Northstone

¹School of Social and Community Medicine, University of Bristol, Clifton, Bristol, UK.

Developmental Medicine and Child Neurology

|October 15, 2013

Insights

Children with severe developmental coordination disorder (DCD) often have associated vision problems, including issues with binocular vision and refractive errors. Early screening for these ophthalmic abnormalities is recommended to potentially improve long-term visual outcomes in affected children.

Area of Science:

Ophthalmology
Developmental Pediatrics
Public Health

Background:

Developmental Coordination Disorder (DCD) affects motor skill acquisition.
Ophthalmic abnormalities can impact a child's development and learning.
Understanding the co-occurrence of DCD and vision issues is crucial for early intervention.

Purpose of the Study:

To investigate the relationship between DCD and various ophthalmic abnormalities in 7- to 8-year-old children.
To identify specific visual deficits associated with DCD.
To inform clinical practice regarding the screening of children with DCD.

Main Methods:

Cross-sectional analysis of UK ALSPAC birth cohort data.
DCD diagnosed using DSM-IV criteria, excluding neurological issues or low IQ.
Ophthalmic assessments included visual acuity, refraction, and binocular function tests.

Main Results:

1.8% of 7154 children had severe DCD; 215 had moderate DCD.
Severe DCD associated with abnormal sensory and motor fusion, reduced stereoacuity, hypermetropia, and anisometropia.
Most children with DCD and refractive errors were already prescribed glasses.

Conclusions:

Children with severe DCD exhibit significant binocular vision, refractive, and ocular alignment abnormalities.
Routine ophthalmic assessment for children diagnosed with DCD is recommended.
Further research is needed to understand the impact of untreated ocular issues on DCD diagnosis.

Read full analysis

Abstract

Aim:

To explore associations between developmental coordination disorder (DCD) and ophthalmic abnormalities in children aged 7 to 8 years.

Method:

Cross-sectional analysis of data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort, was performed. DCD was defined according to DSM-IV criteria. Children with neurological difficulties or IQ less than 70 were excluded. Ophthalmic abnormalities including visual acuity, refraction, and binocular function were assessed using standard tests. Children who achieved less than the 5th centile in the ALSPAC coordination test and either failed the National Curriculum handwriting test, or achieved less than the 10th centile in the Activities of Daily Living scale (ADL) were defined as having severe DCD, while those who scored between the 5th and 15th centiles in the coordination test and either failed the handwriting test, or achieved less than the 15th centile in the ADL were defined as having moderate DCD.

Results:

Complete data were available for 7154 children. One hundred and twenty children (1.8%) met the criteria for severe DCD. A further 215 children had moderate DCD. Children with severe DCD were more likely to have the following: abnormal sensory fusion at near (odds ratio [95% confidence interval]) (1.98 [1.13-3.48]) and distance (2.59 [1.16-5.79]) and motor fusion (1.74 [1.07-2.84]); reduced stereoacuity (2.75 [1.78-4.23]); hypermetropia (2.29 [1.1-4.57]) and anisometropia (2.27 [1.13-4.60]). The majority of children found to have both DCD and a refractive error, had been previously prescribed glasses and wore them for the assessments (71%).

Interpretation:

Children with severe DCD had abnormalities in binocular vision, refractive error, and ocular alignment. We recommend that children with DCD be assessed for ocular abnormalities as early intervention may improve long-term visual outcome. The impact of untreated ocular abnormalities such as refractive error on the accuracy of the diagnosis of DCD is difficult to ascertain and further work would be of benefit.

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