目的 了解3~6岁发育性协调障碍(DCD)儿童核心症状,并分析核心症状与其情绪行为问题的关联,为DCD儿童综合干预提供参考依据。方法 2023年10月—2024年12月,纳入南通市妇幼保健院儿童保健科就诊的126名明确诊断为DCD的3~6岁儿童为观察组,纳入同期健康体检的126名健康儿童为对照组,采用儿童成套运动评估工具(MABC-2)、儿童长处与困难问卷(SDQ)评估两组儿童运动协调能力和情绪行为问题,分析DCD儿童核心症状与其情绪行为问题的关系。结果 DCD组儿童MABC-2测试结果手灵巧度、目标抓握、动静态平衡、运动协调能力各维度得分依次为15.83±2.75、10.13±2.11、21.62±3.27、46.92±4.56,均低于对照组儿童各维度得分(25.68±4.24、20.10±3.08、28.37±4.60、74.38±6.72),差异有统计学意义(t=5.813、6.698、4.621、9.463,P<0.01);DCD组儿童SDQ情绪症状、多动注意不能、困难总分异常率分别为15.08%、33.33%、11.90%,高于对照组(6.35%、8.73%、4.76%),差异有统计学意义(χ2=5.019、22.961、4.208,P<0.05)。DCD儿童年龄、手灵巧度、目标抓握、动静态平衡、运动协调能力均与SDQ情绪症状、品行问题、多动注意不能、同伴交往问题得分和困难总分呈负相关(r＝-0.52~-0.10,P<0.05),与亲社会行为呈正相关(r＝0.18~0.33,P<0.05)。多元线性回归分析结果显示DCD儿童动静态平衡、运动协调能力与其情绪行为问题呈负相关(β=-0.47、-0.59,P<0.01)。结论 DCD儿童存在明显的精细动作、大运动和平衡能力缺陷,且情绪和行为问题发生率更高,尤其是多动和注意力问题。DCD儿童核心症状与其情绪行为问题相关,DCD核心症状越严重,其情绪和行为问题越明显,更易导致社会功能受损。建议相关部门和家长给予关注,增加对儿童DCD的了解和早期识别能力,做到早发现、早干预,以促进儿童全面健康成长。
Abstract
Objectives To investigate the core symptoms of children aged 3 - 6 years with developmental coordination disorder (DCD), and to analyze their association with emotional and behavioral problems, in order to provide evidence for comprehensive intervention strategies. Methods From October 2023 to December 2024, 126 children aged 3 - 6 years diagnosed with DCD were recruited from the Child Health Department of Nantong Maternal and Child Health Hospital, along with 126 age-matched healthy controls.Motor coordination was assessed using the Movement Assessment Battery for Children-Second Edition (MABC-2), and emotional/behavioral problems were evaluated using the Strengths and Difficulties Questionnaire (SDQ).The relationship between core DCD symptoms and emotional/behavioral outcomes was analyzed. Results The DCD group exhibited significantly lower MABC-2 scores in manual dexterity (15.83±2.75 vs.25.68±4.24), aiming/catching (10.13±2.11 vs.20.10±3.08), static/dynamic balance (21.62±3.27 vs. 28.37±4.60), and total motor coordination (46.92±4.56 vs. 74.38±6.72) compared to controls (t=5.813, 6.698, 4.621, 9.463, P<0.01).Abnormal SDQ rates in the DCD group were higher for emotional symptoms (15.08% vs. 6.35%), hyperactivity/inattention (33.33% vs. 8.73%), and total difficulties (11.90% vs. 4.76%) (χ2 =5.019, 22.961, 4.208, P<0.05).Negative correlations were observed between DCD core symptoms (age, manual dexterity, aiming/catching, balance, total motor coordination) and SDQ emotional/behavioral problems (r:-0.52 to -0.10,P<0.05), while positive correlations existed with prosocial behavior (r＝0.18-0.33,P<0.05).Multivariate regression confirmed that static/dynamic balance (β =-0.47) and total motor coordination (β =-0.59) independently predicted reduced emotional/behavioral difficulties (P<0.01). Conclusions DCD children demonstrate significant deficits in fine/gross motor and balance skills, alongside elevated emotional/behavioral problems—particularly hyperactivity/inattention.Core DCD symptoms correlate with worse psychosocial outcomes, suggesting that symptom severity exacerbates functional impairments.Increased awareness, early screening, and targeted interventions are urgently needed to mitigate long-term developmental risks.
关键词
发育性协调障碍 /
核心症状 /
情绪行为问题 /
学龄前儿童
Key words
developmental coordination disorder /
core symptoms /
emotional and behavioral problem /
preschool children
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参考文献
[1] Farhat F,Ammar A,Mezghani N,et al.The effect of task-oriented basketball training on motor skill-related fitness in children with developmental coordination disorder[J].Sports,2025,13(3):62-67.
[2] Nobre GC,Ramalho MHS,Ribas MS,et al.Motor, physical, and psychosocial parameters of children with and without developmental coordination disorder: A comparative and associative study[J].Int J Environ Res Public Health,2023,20(4):2801-2805.
[3] Zaguri-Vittenberg S,Weintraub N,Tal-Saban M."It feels as though I need to exert more effort than others": The experience of daily participation of young adults with developmental coordination disorder (DCD)-a qualitative study[J].Disabil Rehabil,2024,46(15):3332-3341.
[4] Chapman R,Botha M.Neurodivergence-informed therapy[J].Dev Med Child Neurol,2023,65(3):310-317.
[5] Pranjić M,Rahman N,Kamenetskiy A,et al.A systematic review of behavioral and neurobiological profiles associated with coexisting attention-deficit/hyperactivity disorder and developmental coordination disorder[J].Neurosci Biobehav Rev,2023,153(4):1053-1057.
[6] Klein ES, Licari M,Barbic S,et al.Diagnostic services for developmental coordination disorder: Gaps and opportunities identified by parents[J].Child Care Health Dev, 2024,50(1):1323-1328.
[7] van HJ.Exploring early risk factors and neural correlates of handwriting in developmental coordination disorder[J].Res Out, 2025, 6(1):475-479.
[8] Steenbergen B,Valtr L,Dunford C,et al.Awareness about developmental coordination disorder[J].Front Public Health,2024,12(6):1345-1349.
[9] Battle DE.Diagnostic and statistical manual of mental disorders (DSM-5)[J].Codas,2013,25(2):191-225.
[10] Hadwin KJ,Wood G,Payne S,et al.Strengths and weaknesses of the MABC-2 as a diagnostic tool for developmental coordination disorder: An online survey of occupational therapists and physiotherapists[J].PLoS One,2023,18(6):286-290.
[11] 杨玉凤.儿童发育行为心理评定量表[M].北京:人民卫生出版社,2020.
[12] 寇建华,杜亚松,夏黎明.儿童长处和困难问卷(父母版)上海常模的信度和效度[J].上海精神医学, 2005, (1): 25-28.
[12] Kou JH, Du YS, Xia LM.Reliability and validity of the Shanghai Norm of the Children's Strengths and Difficulties Questionnaire (Parent Version)[J].Shanghai Psychiatry,2005,(1):25-28.
[13] 杨高.儿童运动协调能力测评工具MABC中文版修订[D].重庆:西南大学,2023.
[14] Geng S,Wang W,Huang L,et al.Association between screen time and suspected developmental coordination disorder in preschoolers: A national population-based study in China[J].Front Public Health,2023,11(10):1152-1126.
[15] You H,Shi J,Huang F,et al.Advances in genetics and epigenetics of developmental coordination disorder in children[J].Brain Sci,2023,13(6):940-946.
[16] Ke L,Su X,Yang S,et al.New trends in developmental coordination disorder:Multivariate, multidimensional and multimodal[J].Front Psychiatry,2023,14(7):1116-1119.
[17] 刘振寰.发育性运动协调障碍儿童的早期筛查与干预[J].中国儿童保健杂志,2024,32(5):475-479.
Liu ZH.Early screening and intervention of children with developmental motor coordination disorders[J].Chin J Health Care, 2024, 32 (5): 475-479.(in Chinese)
[18] Meachon EJ, Melching H,Alpers GW.The overlooked disorder:(Un) Awareness of developmental coordination disorder across clinical professions[J].Adv Neurodev Disord,2024, 8(2): 253-261.
[19] Pimenta RA,Fuchs C,Fears NE,et al.Distinct mental health profiles in children with developmental coordination disorder: A latent class analysis and associations[J].Res Dev Disabil,2023,13(9):1043-1049.
[20] Gao J,Song W,Zhong Y,et al.Children with developmental coordination disorders: A review of approaches to assessment and intervention[J].Front neurol,2024,15(5):1359-1362.
[21] Bolk J,Källén K,Farooqi A,et al.Perinatal riskfactors for developmental coordination disorder in children born extremely preterm[J].Acta Paediatr,2023,112(4):675-685.
[22] Deshmukh AA,Sahu V,Deshpande MS.Prevalence of suspected developmental coordination disorder and its association with preterm and low birth weight in 5-10-year old children[J].Med J Armed Forces India,2024,80(2):153-160.
[23] Wilson P,Ruddock S,Rahimi-Golkhandan S,et al.Cognitive and motor function in developmental coordination disorder[J].Dev Med Child Neurol,2020,62(11):1317-1323.
[24] Krajenbrink H, Lust JM, Wilmut K, et al.Motor and cognitive dual-task performance under low and high task complexity in children with and without developmental coordination disorder[J].Res Dev Disabil,2023, 13(5):1044-1049.
[25] Fogel Y,Stuart N,Joyce T,et al.Relationships between motor skills and executive functions in developmental coordination disorder (DCD):A systematic review[J].Scand J Occup Ther,2023,30(3):344-356.
基金
南通市卫生健康委面上项目(MS2024100;MSZ2023058)
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