Background Although research has demonstrated associations between motor coordination difficulties and psychological problems in school-age children, including emotional and behavioral problems, longitudinal changes in these problems in children with motor coordination difficulties are not fully understood.
Aims The current study aimed to identify patterns in the trajectory of emotional and behavioral problems in school-age children with motor coordination difficulties, and to elucidate the effect of co-existing neurodevelopmental traits on the occurrence and course of these problems.
Methods and procedures Using the Developmental Coordination Disorder Questionnaire, 773 children were defined as cases with motor coordination difficulties and followed for 4 years, from 6 to 10 years of age. Emotional and behavioral problems were assessed using the Strengths and Difficulties Questionnaire completed by children’s parents or guardians.
Outcomes and results We identified four trajectory patterns of emotional and behavioral problems. Children with higher autism spectrum disorder and attention deficit hyperactivity disorder traits were more likely to be assigned to poor prognostic trajectory patterns.
Conclusions and implications Our findings emphasize the importance of assessing emotional and behavioral problems and co-existing neurodevelopmental traits in children with motor coordination difficulties in early elementary school.
Motor coordination difficulties (e.g., dropping or bumping into objects, slowness and inaccuracy in using tools such as scissors, and difficulties with handwriting or riding a bike) are frequently reported in community samples of children (Blank et al., 2019), and the severe form of these difficulties is classified as cardinal symptoms of developmental coordination disorder (DCD) (American Psychiatric Association, 2013). Increasing evidence suggests that many children with DCD continue to experience motor coordination difficulties throughout adolescence (Cantellet al., 1994; Geuze, 2003; Losse et al., 1991). Additionally, DCD frequently co-occurs with other neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) (American Psychiatric Association, 2013; Blank et al., 2019).
Motor coordination difficulties can also lead to non-motor coordination problems, including poor scholastic achievement, poor selfefficacy, and low life satisfaction (Blank et al., 2019; Cairney, 2015). A number of studies have suggested that children with DCD are at increased risk of psychological problems that negatively impact on long-term outcomes, such as symptoms of depression and anxiety in adolescence and adulthood (Hill & Brown, 2013; Sigurdsson et al., 2002; Zwickeret al., 2013). Furthermore, one line of research suggests that motor coordination difficulties in childhood could predict psychological problems in school-age children, even in children without a clinical diagnosis of DCD (Hill et al., 2016; Katagiri et al., 2021; Lingam et al., 2012; Piek et al., 2010). However, although several patterns in the trajectories of emotional and behavioral problems in a general population sample have been reported (Mulraney et al., 2020), studies have followed psychological problems in children with DCD or those with motor difficulties over time are limited, and no studies have examined the patterns of longitudinal changes of these problems in this population. Therefore, the occurrence and course of psychological problems in this population are not fully understood. Identifying the developmental trajectories of these problems may be helpful for detecting subgroups of children with motor coordination difficulties who could potentially benefit from early psychological interventions.
Using data from a prospective community-based school survey, we identified latent patterns for the trajectories of psychological challenges in children with motor coordination problems and confirmed the influence of ASD and ADHD traits on these trajectories. Our findings indicate the need for early intervention for emotional and behavioral problems in a subgroup of these children with elevated psychological problems in early elementary school, given the worsening trajectory pattern in this subgroup. Our findings also highlight the importance of assessing co-existing ASD and ADHD traits. Further investigations across a broader age range while considering the influence of other factors will be required to confirm the present results.