“Knowing my diagnosis was profoundly important in enabling self-knowledge and self-compassion. Holding myself to a reasonable standard has always been difficult for me, and knowing that I am the way that I am allows me to acknowledge both my strengths and my limitations, and treat myself with the kindness which every person deserves.” A – Adult with DCD/Dyspraxia.
We are most grateful to the Deloitte Impact Fund who kindly funded this project. The European Academy of Childhood Disability International clinical practice recommendations 2019 (Blank et al. 2019) made recommendations addressing Developmental Coordination Disorder (DCD) in relation to definition, diagnosis, assessment and intervention. It was concluded that there is sufficient evidence that DCD is a life-long condition and thus continues to impact self-care, productivity and leisure throughout adulthood). There is no existing assessment protocol for assessing adults for DCD (Mayes et al., 2024). Thus if a person has not been diagnosed in childhood it can be very difficult to get a diagnosis in adulthood. Dr Armstrong conducted a scoping review (Armstrong, 2024) using PRISMA guidelines (Tricco et al., 2018) to ascertain which assessment tools are used to assign participants into the group with Developmental Coordination Disorder in studies investigating this condition in adulthood. Peer reviewed literature published between January 2008 and April 2024 was searched using five databases: AMED, CINAHL Ultimate, Google Scholar, PubMed and Scopus. Data was extracted using the ‘Joanna Briggs Institute’ scoping review guidelines.
Findings: Thirty-six articles were identified as meeting the inclusion criteria for this review. The Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (Kirby et al., 2010) was the most frequent tool used to measure current and past impact on occupational performance. Level of motor skill was only measured in 51% of the studies and none of these studies used tests with norms for an adult population. The Movement Assessment Battery for Children 2 (Henderson et al., 2007) was the most commonly used tool to measure level of motor skill. This tool was revised in 2023 (Henderson et al., 2023) and provides standardised scores up to the age of 25 and 11 months.
The Royal College of Occupational Therapists UK (2021) recommends that occupational therapists should contribute to the design and promotion of local pathways for the diagnosis of DCD in both children and adults. Information from this scoping review could be used in the formation of a pilot assessment pathway for assessing adults for DCD with the MABC-3 and the ADC forming part of the assessment process. It has been established that DCD persists into adulthood (Blank et al., 2019) and thus it is hoped that further funding will be obtained so that the pathway could be piloted with people who are now adults but were diagnosed in childhood to ascertain its effectiveness.
Further Plans:
- Pending funding it is hoped to pilot the assessment protocol.
- A course for Occupational Therapist on the assessment of DCD/Dyspraxia in Adults.
References
•Armstrong D. (2024) Assessment of Developmental Coordination Disorder in Adulthood: A Scoping Review. Irish Journal of Occupational Therapy. Emerald Publishing Limited [ISSN 2398-8819] [DOI 10.1108/IJOT-08-2024-0033]
•Blank R, Barnett AL, Cairney J, Green D, Kirby A, Polatajko H, Rosenblum S, Smits-Engelsman B, Sugden D, Wilson P, Vincon S, (2019) International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder. Developmental Medicine and Child Neurology. 61: 242–285.
•Henderson SE, Sugden DA, Barnett A (2007) Movement Assessment Battery forChildren-Second Edition (Movement ABC-2). London: The Psychological Corporation.
•Henderson SE, Barnett A, (2023) Movement Assessment Battery for Children-Third Edition (Movement ABC-3). London: Pearson Education Inc.
•Kirby A, Edwards L, Sugden D, Rosenblum S (2010) The Development and Standardisation of the Adult Developmental Coordination Disorders/Dyspraxia Checklist (ADC). Research in Developmental Disabilities 31(1), 131-139.
•Mayes WP, Gentle J, Ivanova M, Violante IR (2024) Audio-visual multisensory integration and haptic perception are altered in adults with developmental coordination disorder. Human Movement Science Volume 93, 1-14.
•Royal College of Occupational Therapists (2021). A quick guide for occupational therapists: Diagnosis of Developmental Coordination Disorder in children and adults. Royal College of Occupational Therapists rcot.co.uk
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ, Horsley T, Weeks L, Hempel S, Akl EA, Chang C, McGowan J, Stewart L, Hartling L, Aldcroft Wilson AMG, Garritty C, Lewin S, Godfrey CM, Macdonald MT, Langlois EV, Soares-Weiser K, Moriarty J, Clifford T, Tunc OA, Straus SE. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine 169(7), 467-485.