Developmental coordination disorder in geographic cohorts of 8-year-old children born extremely preterm or extremely low birthweight in the 1990s

Abstract

ABBREVIATIONS CHQChild Health Questionnaire DCD Developmental coordination disorder EP ⁄ ELBW Extremely preterm ⁄ extremely low birthweight Movement-ABC Movement Assessment Battery for Children AIM The aim of the study was to examine the prevalence of developmental coordination disorder (DCD) at the age of 8 years in a geographic cohort of extremely preterm or extremely-low-birthweight (EP ⁄ ELBW) children and a term-born comparison group, as well as associated academic outcomes, parents' perceptions of motor performance, and changes in prevalence during the 1990s.METHOD Moderate DCD was defined as a score below the 5th centile on the Movement Assessment Battery for Children in children without cerebral palsy or intellectual impairment. DCD rates were compared in a group of 132 8-year-old children born in 1997 at 22 to 27 weeks' gestation or birthweight of less than 1000g (49% male, 51% female) and a comparison group of 154 term-born children (55% male, 45% female). The Wechsler Intelligence Scale for Children -4th edition and the Wide Range Achievement Test -3rd edition were used to measure academic and cognitive outcomes. Parental perceptions of motor performance were measured using the physical function scale of the Child Health Questionnaire, parent-report form (CHQ PF50). The results for children with and without DCD were then compared. To assess changes in prevalence throughout the 1990s, DCD rates were compared with those found in children from the same region born in 1991 to 92. RESULTSThe mean number of completed weeks of gestation in the EP ⁄ ELBW children and in the comparison group of term-born children for whom data were available for analysis was 26.5 (SD 1.9) and 39.2 (SD 1.1) respectively, and the mean birthweight was 830g (SD 163) and 3511g (SD 462) respectively. Almost one in two children who are born extremely preterm or with an extremely low birthweight (EP ⁄ ELBW; <28 completed weeks' gestation ⁄ birthweight <1000 g) experience academic and behavioural difficulties at school age; 1 in contrast only 10 to 15% experience severe neurosensory difficulties. 2,3 EP ⁄ ELBW children are also known to have multiple areas of developmental vulnerability. 1,4 The cumulative effect of these multiple areas of vulnerability is adverse long-term outcomes, such as poor academic functioning. 4,5 Research on functional outcomes has resulted in an improved understanding that success at school has multiple determinants and relies on competence in several developmental domains, including physical function, social ⁄ emotional skills, cognitive and executive function abilities, and communication. 6,7 The proportion of the most preterm and lowest birthweight EP ⁄ ELBW children who survive is continuing to rise. 8 Within this high-risk group, adverse developmental outcomes increase in prevalence as gestational age and birthweight decrease. 4,9 Motor difficulties, such as developmental coordination disorder (DCD), are particularly prevalent and are associated with a high incidence of comorbidities, including academic ...

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