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LETTERS TO EDITOR

Developmental coordination disorder and its impact on health-related quality of life in school children

Baskaran, Sujatha; Alagesan, Jagatheesan; Lal, D. V.1; Rayna, A. Brite Saghaya

Author Information
doi: 10.4103/indianjpsychiatry.indianjpsychiatry_1315_2
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Sir,

There are few concerns that we would like to bring to light regarding the health-related quality of life (HRQOL) in children with Developmental Coordination Disorder (DCD). Prevalence of DCD has been estimated to be 3.8% in 9–14-year-old children.[1] It is well known that children with DCD exhibit motor problems with significant difficulties in language, reading, arithmetic, and perceptual skills compared to their peers. Reports state that 58% of DCD adults aged around 22 years are suffering from anxiety and personality disorders.[2] However, till date, very little is known concerning the impact of HRQOL in DCD children.

In an attempt to determine and explore the HRQOL in children with DCD, we conducted a study with 32 schoolchildren between ages 9–14 years, who were diagnosed with DCD, using the DSM 5 criteria. The study was done between May 2019 and January 2020; following ethical clearance, consent and assent was obtained from all parents and children who participated in the study; demographical data showed 34% of DCD children were under obese category; the Neuro QOL questionnaires were filled by parents during the parental interview. The Neuro QOL is a sensitively designed tool used to assess the HRQOL in pediatric population; it consists of ten measures; eight targeted scales (anxiety, depression, anger, social interaction, fatigue, pain, cognition, and stigma); and two generic scales (upper and lower extremity function).[3] To the best of our knowledge, this is the first study that has directly examined the relationship between DCD and HRQOL in Indian population; the purpose of this study is twofold, one is to find whether quality of life is disturbed in DCD children, and the other is to assess the most affected domains.

Collected data were analyzed by the “Scoring service” a web-based application for Neuro QOL; The analysed data are tabulated and shown in Tables 1 and 2 respectively results showed that DCD Children are significantly affected in domains such as lower and upper extremity function (fine motor and activities of daily living), social interaction, depression, anxiety, and cognition which can influence the HRQOL to a greater extent.

T1-18
Table 1:
Data analysis of social ineraction, stigma, upper limb functional skills and lower limb mobility
T2-18
Table 2:
Data analysis of anger, anxziety, cognition, depression, and fatigue

This research adds to the knowledge of awareness of DCD children and impact on their HRQOL. Using HRQOL questionnaires represents a step forward in the evaluation of treatment efficacy, these assessments can lead to better targeted interventions and more specific measures of response to treatment.[4] In order to provide comprehensive care for children with DCD, understanding issues in HRQOL is now a great concern, which will also help the clinicians to plan more holistic therapeutic targets and include treatments to improve the mental health and quality of life of these children beyond motor skill intervention.

Karras et al. have concluded that children with DCD and their parents reported a significant lower HRQOL across numerous domains including physical well-being, psychological well-being, moods, emotions, self-perception, parent relations, social support, school environment, and bullying. As the burden of psychosocial concern is high in children with DCD, the target of intervention needs to extend beyond motor skills and include treatment to improve the mental health and QOL of children with this common motor disorder.[5]

Pratt and Hill et al. stated that parents of DCD children reported poorer quality of life and lower psychosocial and emotional well-being outcomes compared to their peers; these results are consistent with reports that DCD children are at high risk to be socially isolated and experience depression and anxiety.[67] Hence, our study is in agreement with other studies that DCD children experience lower HRQOL.

Across the board, DCD is understood only as a developmental impairment disorder, the rooted problem is due to the lack of awareness that motor impairment and mental health are related and hence screening for mental health is important in DCD population.

This document might give useful ideas and recommends the experts and care givers to design and incorporate interventional protocols for DCD children holistically including goals that specifically address quality of life outcomes and mental health. Furthermore, to summarize children with DCD are at an increased risk of mental health difficulties.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

REFERENCES

1. Sujatha B, Alagesan J, Lal DV, Rayna AB. Prevalence of developmental co-ordination disorder in school children Indian J Pediatr. 2020;87:454–6
2. Rasmussen P, Gillberg C. Natural outcome of ADHD with developmental coordination disorder at age 22 years: A controlled, longitudinal, community-based study J Am Acad Child Adolesc Psychiatry. 2000;39:1424–31
3. Lai JS, Nowinski C, Victorson D, Bode R, Podrabsky T, McKinney N, et al Quality-of-life measures in children with neurological conditions: Pediatric Neuro-QOL Neurorehabil Neural Repair. 2012;26:36–47
4. Solanki RK, Singh P, Midha A, Chugh K. Schizophrenia: Impact on quality of life Indian J Psychiatry. 2008;50:181–6
5. Karras HC, Morin DN, Gill K, Izadi-Najafabadi S, Zwicker JG. Health-related quality of life of children with Developmental Coordination Disorder Res Dev Disabil. 2019;84:85–95
6. Jarus T, Lourie-Gelberg Y, Engel-Yeger B, Bart O. Participation patterns of school-aged children with and without DCD Res Dev Disabil. 2011;32:1323–31
7. Pratt ML, Hill EL. Anxiety profiles in children with and without developmental coordination disorder Res Dev Disabil. 2011;32:1253–9
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