Comorbid sleep and behavioral problems in preschool children with developmental coordination disorder

LIN Senran; LI Huizhen; HUANG Songsong; HUA Jing

doi:10.11852/zgetbjzz2025-0239

PDF(661 KB)

Chinese Journal of Child Health Care ›› 2025, Vol. 33 ›› Issue (5) : 472-477. DOI: 10.11852/zgetbjzz2025-0239

Original Articles

Comorbid sleep and behavioral problems in preschool children with developmental coordination disorder

LIN Senran^1,2, LI Huizhen¹, HUANG Songsong^1,3, HUA Jing¹

Author information +

History +

Abstract

Objectives To investigate the comorbid sleep and behavioral problems in preschool children with developmental coordination disorder (DCD), in order to provide evidence for early screening and intervention. Methods A cross-sectional study was conducted among 24 230 children aged 3 - 6 years in Shanghai Pudong New Area from June 24 to July 12, 2021.DCD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria combined with the Developmental Coordination Disorder Questionnaire (DCDQ)(DCDQ'07 andLittle DCDQ versions).The Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep problems, while the Conners Parent Symptom Questionnaire (PSQ) was utilized to evaluate hyperactivity symptoms. Results A total of 2 129 children (8.8%) were identified as suspected DCD.Compared to non-DCD children, those with suspected DCD exhibited significantly higher rates of overall sleep problems (84.2% vs. 70.0%, χ²=191.484, P<0.001) and hyperactivity symptoms (7.1% vs. 2.8%, χ²=113.54, P<0.001).Additionally, suspected DCD children scored higher across all CSHQ and PSQ subscales (P<0.001).Multivariate analysis confirmed that the association between DCD and these scores remained statistically significant (P<0.001) after adjusting for birth and family-related covariates. Conclusions Preschool children with DCD demonstrate more pronounced sleep and behavioral difficulties than their typically developed peers.However, the bidirectional mechanisms warrant further investigation.An early screening system incorporating multidimensional assessments should be established, along with individualized intervention strategies integrating motor rehabilitation and behavioral management.

Key words

developmental coordination disorder / comorbidity problems / sleep disturbances / behavioral problems / preschool children

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

LIN Senran, LI Huizhen, HUANG Songsong, HUA Jing. Comorbid sleep and behavioral problems in preschool children with developmental coordination disorder[J]. Chinese Journal of Child Health Care. 2025, 33(5): 472-477 https://doi.org/10.11852/zgetbjzz2025-0239

References

[1] American Psychiatric Association.Diagnostic and statistical manual of mental disorders, 5th ed[M].Arlington, MA: American Psychiatric Association, 2013.
[2] Blank R, Barnett AL, Cairney J, et al.International clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder[J].Dev Med Child Neurol, 2019, 61(3): 242-285.
[3] 刘明霞, 花静, 柯李, 等.中国儿童发育性协调障碍现况分析[J].中华儿科杂志, 2021, 59(11): 928-934.
Liu MX, Hua J, Ke L, et al.Analysis of developmental coordination disorder in Chinese children[J].Chin J Child Health Care, 2021, 59(11): 928-934.(in Chinese)
[4] 花静, 孟炜, 吴擢春, 等.苏州城区幼儿园学龄前儿童发育性运动协调障碍的环境影响因素研究[J].中华儿科杂志, 2014, 52(8): 590-595.
Hua J,Meng W,Wu ZC, et al.Environmental factors associated with developmental coordination disorder in preschool children in urban area of Suzhou city[J].Chin J Pediatr, 2014, 52(8): 590-595.(in Chinese)
[5] 金华.学龄前儿童发育性协调障碍的研究[D].苏州:苏州大学, 2015.
[6] Marija P, Navin R, Adelia K, 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, 153:105389.
[7] Rihtman T, Wilson BN, Parush S.Development of the Little Developmental Coordination Disorder Questionnaire for preschoolers and preliminary evidence of its psychometric properties in Israel[J].Res Dev Disabil, 2011, 32(4): 1378-1387.
[8] 耿姗姗, 戴霄天, 王天景, 等.中文版小龄发育性协调障碍问卷信效度初步研究[J].临床儿科杂志, 2020, 38(12): 921-924.
Geng SS, Dai XT, Wang TJ,et al.The preliminary study on the reliability and validity of the Chinese version of the little Developmental Coordination Disorder Questionnaire[J].J Clin Pediatr, 2020, 38(12): 921-924.(in Chinese)
[9] 王广海.我国学龄前儿童睡眠问题:特点、影响因素及行为干预[D].上海华东师范大学, 2015.
[10] 郭茹.长沙市3～5岁儿童行为问题调查及Conners常模的选择[D].长沙:中南大学, 2012.
[11] 苏林雁, 李雪荣, 黄春香, 等.Conners父母症状问卷的中国城市常模[J].中国临床心理学杂志, 2001, 8(4): 241-243,252.
Su LY,Li XR,Huang CX,et al.Norms of The Conners Parent Symptom Questionnaire in Chinese Urban Children[J].Chin J Clin Psychol, 2001, 8(04): 241-243,252.(in Chinese)
[12] Dewey D, Volkovinskaia A.Health-related quality of life and peer relationships in adolescents with developmental coordination disorder and attention-deficit-hyperactivity disorder[J].Dev Med Child Neurol, 2018, 60(7): 711-717.
[13] 丁利, 李海峰, 王慧等.浙江省学龄前发育性协调障碍筛查阳性儿童睡眠状况的调查分析[J].中华物理医学与康复杂志, 2024, 46(2): 160-164.
Ding L, Li HF, Wang H, et al.A study of the sleep status of preschool children with a coordination development disorder[J].Chin J Phys Med Rehabil, 2024, 46(2): 160-164.(in Chinese)
[14] Barnett AL, Wiggs L.Sleep behaviour in children with developmental co-ordination disorder[J].Child Care Health & Development, 2012, 38(3): 403-411.
[15] 刘美燕, 郭倩雯, 吴丹, 等.学龄前儿童运动与睡眠质量的关联研究[J].中国儿童保健杂志, 2020, 28(10): 1097-1100,1117.
Liu MY, Guo QW, Wu D, et al.Study on the association between exercise and sleep uality in preschool children[J].Chin J Child Health Care, 2020, 28(10): 1097-1100,1117.(in Chinese)
[16] 王晓芬, 王林容.3～6岁儿童睡眠、身体活动、久坐行为与发育性协调障碍的关联研究[J].体育科技文献通报, 2024, 32(12): 272-276.
Wang XF, Wang LR.Correlation between sleep,physical activity,sedentary behavior and developmental coordination disorder in children aged 3-6 years[J].Bulletin of Sport Science & Technology, 2024, 32(12): 272-276.(in Chinese)
[17] Esposito M, Precenzano F, Bitetti I, et al.Sleep macrostructure and NREM sleep instability analysis in pediatric developmental coordination disorder[J].Int J Environ Res Public Health, 2019, 16(19): 3716.
[18] De Groot ER, Dudink J, Austin T.Sleep as a driver of pre- and postnatal brain development[J].Pediatr Res, 2024, 96(6): 1503-1509.
[19] Crane L, Sumner E, Hill E L.Emotional and behavioural problems in children with developmental coordination Disorder: Exploring parent and teacher reports[J].Res Dev Disabil, 2017, 70:67-74.
[20] Dahan A, Reiner M.Evidence for deficient motor planning in ADHD[J].Sci Rep, 2017, 7(1): 9631.
[21] Shaw P, Eckstrand K, Sharp W, et al.Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation[J].Proc Natl Acad Sci U S A, 2007, 104(49): 19649-19654.