Development and Psychometric Properties of A Screening Tool for Assessing Developmental Coordination Disorder in Adults.

Abstract

Background: Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder affecting motor coordination. Evidence suggests this disorder persists into adulthood and may be associated with biomechanical dysfunction and pain. We report on the development and initial validation of a questionnaire to assess for DCD in adults. Methods: An initial item pool (13 items) was derived from the American Psychiatric Association criteria and World Health Organisation definition for DCD. An expert panel assessed face and content validity which led to a 9-item Functional Difficulties Questionnaire (FDQ-9) with possible scores ranging from 9-36 (higher scores indicating greater functional difficulties). The FDQ-9 was piloted on individuals recruited from convenience samples. The underlying factor structure and aspects of reliability, validity and accuracy were tested. The Receiver Operating Characteristic Curve was employed to evaluate the diagnostic accuracy of the test using self-reported dyspraxia as the reference standard. Results: Principal Axis Factoring yielded a two factor solution relating to gross and fine motor skills; for conceptual parsimony these were combined. Internal reliability was high (0.81), the mean inter-item correlation was 0.51 and preliminary findings suggested satisfactory construct validity. The Area under the Curve was 0.918 [95% CI 0.84-1.00] indicating a diagnostic test with high accuracy. A cut-off score was established with a sensitivity and specificity of 86% [95% CI 78%-89%] and 81% [95 % CI 73%-89%] respectively. Test-retest reliability was good (ICC 0.96 [95% CI 0.92 to 0.98]. Conclusion: The psychometric properties of the FDQ-9 appear promising. Work is required to conduct further psychometric evaluations on new samples and apply the scale to clinical practice.