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Aim The aim of this study was to analyse the impact of Developmental Coordination Disorder (DCD) on the lives of young people and identify factors that promote resilience to mental health difficulties within this population. Methods The study used a mixed methods approach. Results from the analysis of data from a longitudinal population-based birth cohort, the Avon longitudinal Study of Parents and Children {n=6,902) were synthesised with qualitative data from a purposive sample of 11 young people with clinically diagnosed DCD aged 11 to 16 years. Findings from the qualitative study highlighted areas that were important in the lives of the young people interviewed. These areas, such as the importance of friendship groups, bullying and a positive sense of self, were added to the final analytical model as explanatory mediators in the relationship between DCD and mental health difficulties. Findings In total, 123 young people (1.8% of the eligible cohort aged seven years), met all four diagnostic criteria for DCD using strict (5th centile) cut-offs (severe DCD). In addition, 346 young people met wider inclusion criteria (15th centile of a motor test and activity of daily living scales) and were defined as having moderate or severe DCD. These young people with moderate or severe DCD had increased odds of difficulties in attention, short-term memory, social communication, non-verbal skills, reading and spelling. They also had increased odds of self-reported depression, odds ratio: 2.08 (95% confidence interval (Cl) 1.36 to 3.19) and parent reported mental health difficulties, odds ratio: 4.23 (95% Cl 3.10 to 5.77) at age nine to ten years. The young people interviewed did not see themselves as disabled. Factors that increased a positive sense of self were inclusion in friendship groups, information that helped them understand their difficulties and being understood by parents and teachers. These findings were mirrored in the quantitative analysis which showed that the odds of mental health difficulties reduced after accounting for social communication difficulties, bullying, lower verbal intelligence and self-esteem. Conclusions Developmental Coordination Disorder is a common developmental disorder in childhood. The difficulties seen in these young people are complex and assessment needs to be multidisciplinary and consider neurological causes of poor motor coordination, the presence of coexisting developmental difficulties and associated mental health difficulties. Due to the high prevalence of the condition, ongoing one-to-one therapeutic interventions are not feasible. School based interventions, using therapists as trainers, working within a socio-medical model of disability, could work to promote resilience within the individual and improve the acceptance of differences in abilities within the school.

Background: Community-centred approaches are increasingly popular in public health practice. The use of volunteers as part of such approaches is common, as it recognises people as assets within communities; assets that can help improve community public health and wellbeing outcomes and aid community development. Case study: Given the widely accepted importance of early years in providing children with the best possible start in life, and in recognition of the need for a shift to bottom-up approaches, a community volunteer programme was designed and implemented in a deprived ward of Stockton-on-Tees in the North East of England. Using this programme as a case study, this PhD thesis aimed to explore what volunteering is and how it works in a community-centred volunteer programme, through examining professionals', volunteers' and parents' accounts. Methods: Qualitative intrinsic case study methodology was used. Rich qualitative data were collected through forty-four interviews, five focus groups, observations and documents. Findings: This study contributes to current understandings around community, professionalism and volunteering within community-centred approaches. A profound lack of a shared understanding of the term 'community' amongst different stakeholders was identified. It was also found that volunteering presents development opportunities for disadvantaged community members and particularly asylum seekers. Their strong reciprocal feelings and their willingness to volunteer as well as the plethora of human, social, cultural and political capital they can offer presents opportunities to widen the volunteer workforce. The findings also emphasised the detrimental effect tensions between professionals and volunteers can have on a community-centred approach. Conclusions: This PhD has implications for theory and research. Equally, it has implications for public health practice through the development of a model which can be used as a tool to design community-centred approaches. This model, informed by literature, previous research and the findings from this thesis, can be valuable for commissioners, practitioners, professionals, volunteers and the wider community.