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Measuring treatment outcome in children with developmental coordination disorder; responsiveness of six outcome
Inge Heus1, Daphne Weezenberg1, Sebastiaan Severijnen1
1Basalt Rehabilitation, Leiden/The Hague, The Netherlands.
Insights
The Canadian Occupational Performance Measure (COPM) and DCDdaily are more responsive for measuring rehabilitation outcomes in children with Developmental Coordination Disorder (DCD) than the widely used MABC-2. These instruments offer better sensitivity to clinical changes in DCD patients.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Developmental Psychology
Background:
- Measuring rehabilitation outcomes in children with Developmental Coordination Disorder (DCD) is crucial but lacks consensus on appropriate instruments.
- Instrument responsiveness, or sensitivity to clinical change, is a key attribute for effective outcome measurement in DCD rehabilitation.
Purpose of the Study:
- To prospectively investigate the responsiveness of six potentially suitable measurement instruments for DCD rehabilitation.
- To compare the sensitivity to change of the Movement Assessment Battery for Children-2 (MABC-2), Canadian Occupational Performance Measure (COPM), DCDdaily, Systematic Detection of Writing Problems (SOS-2-NL), Behavior Rating Inventory of Executive Function (BRIEF), and TNO-AZL Children's Quality of Life questionnaire (TACQOL).
Main Methods:
- A prospective, observational study included 41 children with DCD undergoing multidisciplinary rehabilitation.
- Six instruments (MABC-2, COPM, SOS-2-NL, DCDdaily, BRIEF, TACQOL) were administered before and after treatment.
- Change scores, effect sizes, and standardized response means were calculated to assess instrument responsiveness.
Main Results:
- The COPM (performance and satisfaction) and DCDdaily demonstrated significant responsiveness to change (p < 0.05) with moderate to large effect sizes.
- The MABC-2 showed some responsiveness, particularly for the total score, but less so than COPM and DCDdaily.
- SOS-2-NL, BRIEF, and TACQOL were not found to be responsive to clinical changes in this DCD cohort.
Conclusions:
- While the MABC-2 is commonly used, the COPM and DCDdaily appear more sensitive to clinical changes in DCD rehabilitation outcomes.
- The COPM and DCDdaily are valuable additions for comprehensively assessing rehabilitation progress in children with DCD.
- Further research may refine consensus on optimal measurement batteries for DCD, incorporating these more responsive tools.
Purpose:
Although measuring outcome of rehabilitation in children with Developmental Coordination Disorder is considered important no consensus exists on which instruments to use. An important attribute of a measurement instrument would be that it is sensitive to clinical changes. The aim of this prospective, observational study was therefore to investigate the responsiveness of six potentially suitable instruments.
Methods:
Forty-one children (34 boys, median age 7.8 years, Inter Quartile Range: 7.2-9.2) receiving multidisciplinary rehabilitation treatment for Developmental Coordination Disorder were included (mean treatment time: 32.8 h, Standard Deviation 7.3). The following instruments were applied before and after rehabilitation: Movement-Asessment-Battery-Children-2 (MABC-2), Canadian Occupational Performance Measure (COPM), Systematic detection writing problems (SOS-2-NL), DCD-daily, Behaviour Rating Inventory of Executive Function (BRIEF), and TNO-AZL children's Quality of Life questionnaire (TACQOL)). Change-scores (paired t-test/Wilcoxon-test) and responsiveness (Effect-sizes and Standardized-Response-Means) were calculated.
Results:
Significant differences over time were found for the Canadian Occupational Performance Measure, DCDdaily and Movement-Asessment-Battery-Children-2 (p < 0.05). The responsiveness of these instruments was moderate-high (Canadian Occupational Performance Measure-performance Effect-Size:1.70/Standardized-Response-Mean:1.81, Canadian Occupational Performance Measure-satisfaction Effect-Size:1.65/Standardized-Response-Mean 1.53; DCDdaily-total-score Effect-Size:0.40/Standardized-Response-Mean:0.62, DCDdaily-Quality-score Effect-Size:0.74/Standardized-Response-Mean:0.89, DCDdaily-time-score Effect-Size:0.21/Standardized-Response-Mean:0.43; MABC-2-total-score Effect-Size:0.42/Standardized-Response-Mean:0.43, MABC-2-Ball-skills-score Effect-Size:0.33/Standardized-Response-Mean:0.36). Systematic detection of writing problems (SOS-2-NL), Behaviour Rating Inventory of Executive Function (BRIEF) and TNO-AZL children's Quality of Life questionnaire (TACQOL) were not responsive to change.
Conclusion:
Although the Movement-Asessment-Battery-Children-2 test is the most widely used instrument when measuring rehabilitation outcome in Developmental Coordination Disorder, the Canadian Occupational Performance Measure and DCDdaily seem to be more responsive and constitute a valuable addition.Implications for rehabilitationCurrently, there is no consensus on the preferred measurement instruments to evaluate the outcomes of rehabilitation in children with Developmental Coordination Disorder.The responsiveness of the Canadian Occupational Performance Measure (COPM) was found to be large, of the DCDdaily moderate to large, and of the Movement-Assessment-Battery-Children-2 (MABC-2) small, whereas the systematic detection of writing problems (SOS-2-NL; Systematisch Opsporing Schrijfproblemen-2-NL), Behavior Rating Inventory of Executive Functioning (BRIEF) and TNO-AZL Questionnaire for Children's Health-Related Quality of Life (TACQOL) were not responsive to change.Although the Movement-Assessment-Battery-Children-2 (MABC-2) is commonly used in Developmental Coordination Disorder rehabilitation, applying the Canadian Occupational Performance Measure (COPM) and DCDdaily should be considered, as these instruments were more sensitive to clinical changes.
