Psychometric properties of a Chinese version of the Developmental Coordination Disorder Questionnaire in community-based children
Introduction
Coordinated movement is fundamental to the development and learning of children. Children diagnosed with a Developmental Coordination Disorder (DCD) have motor-based restrictions that affect their academic, recreational and home life (Cantell et al., 1994, Smits-Engelsman et al., 2003). Studies have also shown that DCD is a life-long disability, and social, emotional and academic problems associated with coordination difficulties may persist through adolescence and adulthood (Cantell et al., 1994, Geuze and Börger, 1993, Losse et al., 1991).
The estimated prevalence of DCD is as 4–10% (American Psychological Association, 1994, Henderson and Sugden, 1992, Wright and Sugden, 1996). In Taiwan, the prevalence of DCD for children ranged from 3.5% to 17.9%, depending on the study sample (Lin and Wu, 2002, Wu, 2002). The long-term primary and associated problems faced by children who have motor coordination problems demonstrate the need for early identification and intervention. Given that the diagnosis of DCD is made only if the impairment in motor coordination significantly interferes with the routines of daily life or with academic achievement (American Psychological Association, 2000), teacher and parent questionnaires which identify functional limitations across a variety of tasks and settings provide an economic and effective first step for assessing children (Green et al., 2005). The results of the questionnaires can then be confirmed by motor tests (Schoemaker, Smits-Engelsman, & Jongmans, 2003).
A number of questionnaires have been developed for the evaluation of children's motor coordination difficulties in the Western countries. One promising parent report instrument, developed in Canada, is the Developmental Coordination Disorder Questionnaire (DCDQ) (Wilson, Dewey, & Campbell, 1998). The DCDQ is a 17-item questionnaire, designed to be a quick and easy-to-use screening tool for children aged 8–14.5 years. Parents rate their children's performance on ball, balance, and handwriting skills across home, school and play environments. The DCDQ was selected for use in Taiwan because it has demonstrated good reliability and validity in Canada (Wilson, Kaplan, Crawford, Campbell, & Dewey, 2000), the UK (Green et al., 2005) and the Netherlands (Schoemaker et al., 2006) not only in the age range for which the questionnaire was developed originally (8–14.5 years) but also in a younger age range (4–8 years) (Schoemaker et al., 2006). It has also demonstrated good sensitivity (Green et al., 2005, Schoemaker et al., 2006). The DCDQ is an efficient screening tool that provides reliable and valid information on children's current skills and deficits in natural environments.
Having a standardized parent questionnaire in Chinese to easily identify children at-risk for movement problems would benefit children, parents and teachers in all Chinese-speaking societies. The aims of this study therefore were: (1) to describe the process of cross-cultural adaptation of the DCDQ; (2) to evaluate the applicability of this parent report to a Chinese population aged from 6 years to 9 years, and (3) to investigate the reliability, validity, sensitivity and specificity of the test for use with children in Taiwan. To address these aims, the study was undertaken in two phases: I. Translation and adaptation Process, and II. Evaluation of the Chinese version of the DCDQ.
Section snippets
Measures
The Developmental Coordination Disorder Questionnaire was developed for children between 8 and 14.5 years (Wilson et al., 2000). There were 17 statements rated by parents on their child's motor performance on functional home and school tasks, using a 5 point Likert scale, with anchor ratings of “extremely like my child” to “not at all like my child”. Ten of the statements described well coordinated motor performance, and seven were worded in the reverse to describe poor coordination. The total
The Developmental Coordination Disorder Questionnaire–Chinese version (DCDQ-C)
As described previously, the DCDQ-C is a 17-item parent questionnaire of the translated DCDQ.
The Movement Assessment Battery for Children (MABC)
The MABC assesses motor functioning across fine and gross motor tasks for children aged 4–12 years (Henderson & Sugden, 1992). Test–retest reliability is 0.92–0.98 (Croce, Horvat, & McCarthy, 2001). The MABC has acceptable concurrent validity, with correlation coefficients with other tests of motor skills (BOTMP, r = 0.53) and visual-motor skills (Developmental Test of Visual Motor Integration, r = 0.48) (
Internal consistency
The analysis of internal consistency was performed initially on the questionnaire with 17 items as designed using the entire sample (n = 1082). Cronbach's α was calculated, and showed an α coefficient for the whole questionnaire of 0.84, which is above the acceptable level of 0.70 (Cronbach, 1951), indicating a high internal consistency.
Next, a corrected item–total correlation was computed to examine the relationship between each item and the whole questionnaire. Table 2 shows the corrected
Discussion
This study describes the cross-cultural adaptation of a parent questionnaire for identifying children with DCD in the Chinese-speaking populations. The translation and adaptation were made with care and diligence. Through a series of rigorous procedures, a questionnaire adapted for the Chinese language demonstrated strong equivalence to the original DCDQ and the revised 2007 version, with cultural appropriateness for use with Taiwanese children.
This study also showed that the psychometric
Conclusion
The DCDQ was successfully adapted to Chinese for use in Taiwan. This is the first standardized parent questionnaire developed for screening children's movement problem in Chinese-speaking societies. This test demonstrated a high degree of reliability when applied to a community-based population of children. The first-order factor structure of the DCDQ-C was similar to that in Canada and the Netherlands indicating the robustness of the construct of the scale, and the similarity in types of motor
Acknowledgements
We gratefully acknowledge Professors Anne Henderson and Sharon Cermak for their valuable comments on the manuscript. Drs. Yung-Wen Hsu and Chin-Kai Lin are acknowledged for their assistance in translation. We also thank the parents and their children who participated in our study. This study was supported through funding from the Department of Health, Executive Yuan, Taiwan, ROC (DOH92-TD-1035, DOH93-TD-M-113-038, and DOH94-TD-M-113-007 to MHT).
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2019, Research in Developmental DisabilitiesCitation Excerpt :Estimates have reported a wide range of prevalence among different countries. For instance, high-risk DCD was observed in 1.4% of children in Singapore (Wright & Sugden, 1996), 1.8% of children in England (Lingam et al., 2009), 3% of children in Columbia (Pineda, Lopera, Palacio, Ramirez, & Henao, 2003), 3.5% of children in Taiwan (Tseng et al., 2010), 6% of children in South Africa (De Milander et al., 2016), 7.3% of children in Sweden (Gillberg, Carlström, Rasmussen, & Waldenström, 1983), 8% of children in Canada (Tsiotra et al., 2006), 9.9% of children in Spain (Amador-Ruiz et al., 2018), 17.8% of children in Brazil (Valentini et al., 2015), and 19% of children in Greece (Tsiotra et al., 2006). Also probable DCD was found in 4% of children in Singapore (Wright & Sugden, 1996), 4.9% of children in England (Lingam et al., 2009), 12% of children in South Africa (De Milander et al., 2016), 12.2% of children in Spain (Delgado-Lobete et al., 2019), 17.9% of children in Taiwan (Tseng et al., 2010), and 32.8% of children in Brazil (Valentini et al., 2015).