Measuring the functional impact of developmental coordination disorder beyond childhood: a COSMIN systematic review

Difficulties in daily performance and participation become increasingly relevant for the identification of Developmental Coordination Disorder (DCD) beyond childhood. Several questionnaires have been developed to assess Criterion B in adolescent and adult populations; however, their measurement properties have not been systematically synthesized. This systematic review aimed to (1) identify instruments designed to assess Criterion B of DCD in adolescents and adults, (2) evaluate their measurement properties following COSMIN methodology, and (3) provide evidence-based recommendations for their use in clinical practice and research.

A systematic review was conducted according to PRISMA and COSMIN guidelines. Six electronic databases were searched from inception to August 2026. Methodological quality was assessed using the COSMIN Risk of Bias checklist, measurement properties were evaluated against the COSMIN criteria for good measurement properties, and the certainty of evidence was graded using the COSMIN-modified GRADE approach.

Nineteen studies evaluating five instruments were included: the Adult Developmental Coordination Disorder/Dyspraxia Checklist (ADC), the Adolescents and Adults Coordination Questionnaire (AAC-Q), the Functional Difficulties Questionnaire-9 (FDQ-9), the Developmental Coordination Disorder Questionnaire (DCDQ), and the Adolescent Motor Competence Questionnaire (AMCQ). Internal consistency and construct validity were the most frequently examined properties, whereas measurement error, and measurement invariance were rarely or never assessed. The ADC was the most extensively investigated instrument; structural validity was insufficient with moderate-quality evidence, whereas sufficient evidence was found for content validity and some aspects of test-retest reliability and construct validity. The AAC-Q showed a promising overall psychometric profile, although evidence for content validity, structural validity and internal consistency remained inconsistent. Evidence for the AMCQ was generally weaker despite its sufficient content validity, while findings for the FDQ-9 and DCDQ were based on only two studies each.

Evidence supporting instruments designed to assess Criterion B of DCD in adolescents and adults remains limited and heterogeneous. No single instrument currently has sufficiently robust evidence to support firm recommendations across populations and cultural contexts. Further COSMIN-aligned validation studies are needed to strengthen confidence in instrument selection for clinical and research use beyond childhood.