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The United Kingdom and Ireland have a well-established research base in motor competence (MC) research, ranging from reporting and monitoring levels of MC, developing assessment tools for MC, providing innovative curriculum and intervention design to support learning and development, as well as providing advocacy for particular groups, such as those with motor impairments. This expert statement, on behalf of the International Motor Development Research Consortium, draws together what is currently known about levels of MC in the United Kingdom and Ireland as well as current approaches to intervention in both countries. Subsequently presented are recommendations for researchers and practitioners to advance the field of MC for the benefit of children and youth in the United Kingdom, Ireland, and worldwide.

Handwriting difficulties are frequently mentioned in descriptions of developmental coordination disorder (DCD). Recent studies have shown that children with DCD pause more and produce less text than typically developing (TD) peers. This temporal dysfluency indicates a lack of automaticity in handwriting production. One possible contributing factor is the accuracy and consistency of letter formation. The aim of this study was to gain a better understanding of handwriting dysfluency by examining the accuracy and consistency of letter production both within and across different writing tasks. A total of 28 children aged 8 to 15 years with DCD participated in the study with 28 TD age- and gender-matched control participants. They completed the alphabet writing and copy fast tasks from "The Detailed Assessment of Speed of Handwriting" on a digitizing writing tablet. The accuracy and consistency of letter production were examined. The DCD group had a higher percentage of errors within their letterforms than did the TD peers. Letter production was also less consistent between tasks. Children with DCD appear to have difficulties with the "allograph" (motor program) aspect of handwriting and may require explicit teaching of letter formation.

Movement, which draws on motor skills and executive functions for managing them, plays an important role in literacy learning (e.g., movement of mouth during oral reading and movement of hand and fingers during writing); but relatively little research has focused on movement skills in students with specific learning disabilities as the current study did. Parents completed normed "Movement Assessment Battery for Children Checklist, 2nd edition" (ABC-2), ratings and their children in grades 4 to 9 (M = 11 years, 11 months; 94 boys, 61 girls) completed diagnostic assessment used to assign them to diagnostic groups: control typical language learning (N = 42), dysgraphia (impaired handwriting) (N = 29), dyslexia (impaired word decoding/reading and spelling) (N = 65), or oral and written language learning disability (OWL LD) (impaired syntax in oral and written language) (N = 19). The research aims were to (a) correlate the "Movement ABC-2" parent ratings for Scale A Static/Predictable Environment (15 items) and Scale B Dynamic/ Unpredictable Environment (15 items) with reading and writing achievement in total sample varying within and across different skills; and (b) compare each specific learning disability group with the control group on "Movement ABC-2" parent ratings for Scale A, Scale B, and Scale C Movement-Related (Non-Motor Executive Functions, or Self-Efficacy, or Affect) (13 items). At least one "Movement ABC-2" parent rating was correlated with each assessed literacy achievement skill. Each of three specific learning disability groups differed from the control group on two Scale A (static/predictable environment) items (fastens buttons and forms letters with pencil or pen) and on three Scale C items (distractibility, overactive, and underestimates own ability); but only OWL LD differed from control on Scale B (dynamic/unpredictable environment) items. Applications of findings to assessment and instruction for students ascertained for and diagnosed with persisting specific learning disabilities in literacy learning, and future research directions are discussed.

The ability to finely control our movement is key to achieving many of the educational milestones and life-skills we develop throughout our lives. Despite the centrality of coordination to early development, there is a vast gap in our understanding of the underlying biology. Like most complex traits, both genetics and environment influence motor coordination, however, the specific genes, early environmental risk factors and molecular pathways are unknown. Previous studies have shown that about 5% of school-age children experience unexplained difficulties with motor coordination. These children are said to have Developmental Coordination Disorder (DCD). For children with DCD, these motor coordination difficulties significantly impact their everyday life and learning. DCD is associated with poorer academic achievement, reduced quality of life, it can constrain career opportunities and increase the risk of mental health issues in adulthood. Despite the high prevalence of coordination difficulties, many children remain undiagnosed by healthcare professionals. Compounding under-diagnosis in the clinic, research into the etiology of DCD is severely underrepresented in the literature. Here we present the first genome-wide association study to examine the genetic basis of early motor coordination in the context of motor difficulties. Using data from the Avon Longitudinal Study of Parents and Children we generate a derived measure of motor coordination from four components of the Movement Assessment Battery for Children, providing an overall measure of coordination across the full range of ability. We perform the first genome-wide association analysis focused on motor coordination (N = 4542). No single nucleotide polymorphisms (SNPs) met the threshold for genomewide significance, however, 59 SNPs showed suggestive associations. Three regions contained multiple suggestively associated SNPs, within five preliminary candidate genes: IQSEC1, LRCC1, SYNJ2B2, ADAM20, and ADAM21. Association to the gene IQSEC1 suggests a potential link to axon guidance and dendritic projection processes as a potential underlying mechanism of motor coordination difficulties. This represents an interesting potential mechanism, and whilst further validation is essential, it generates a direct window into the biology of motor coordination difficulties. This research has identified potential biological drivers of DCD, a first step towards understanding this common, yet neglected neurodevelopmental disorder. [ABSTRACT FROM AUTHOR]

Students must be able to produce legible and fluent text when completing classwork and for exam purposes. Some students, however, present with handwriting difficulties in secondary school. When these are significant, intervention may be necessary or alternatives to handwriting may be offered (e.g. use of a word processor). Little is known about current practice of supporting secondary students with handwriting difficulties in England and how recommendations are made to transition to typing. Semi‐structured interviews were conducted with 13 practitioners with a responsibility for supporting students with handwriting difficulties. Two themes were identified. The first theme, 'doing the right thing', illustrated the tension between practitioners' commitment to supporting students with handwriting difficulties and their uncertainty around what is the 'right' approach. The second theme, 'influencing practice', described the contextual factors (student and family, school environment and national context) that impact on practitioners' practice and their decision to transition from handwriting to typing. Findings highlight the complexities of supporting this group of students and an urgent need for guidance at a national level to assist best practice. Implications for practice are discussed. Further research examining the effectiveness of handwriting interventions with secondary students and the optimum time to start typing is warranted. [ABSTRACT FROM AUTHOR]

Spelling is a prerequisite to expressing vocabulary in writing. Research has shown that children with dyslexia are hesitant spellers when composing. This study aimed to determine whether the hesitant spelling of children with dyslexia, evidenced by frequent pausing, affects vocabulary choices when writing. A total of 31 children with dyslexia, mean age 9 years, were compared to typically developing groups of children: the first matched by age, the second by spelling ability. Oral vocabulary was measured and children completed a written and verbal compositional task. Lexical diversity comparisons were made across written and verbal compositions to highlight the constraint of having to select and spell words. A digital writing tablet recorded the writing. Children with dyslexia and the spelling-ability group made a high proportion of spelling errors and within-word pauses, and had a lower lexical diversity within their written compositions compared to their verbal compositions. The age-matched peers demonstrated the opposite pattern. Spelling ability and pausing predicted 53% of the variance in written lexical diversity of children with dyslexia, demonstrating the link between spelling and vocabulary when writing. Oral language skills had no effect. Lexical diversity correlated with written and verbal text quality for all groups. Practical implications are discussed and related to writing models.

Current models of writing do not sufficiently address the complex relationship between the 2 transcription skills: spelling and handwriting. For children with dyslexia and beginning writers, it is conceivable that spelling ability will influence rate of handwriting production. Our aim in this study was to examine execution speed and temporal characteristics of handwriting when completing sentence-copying tasks that are free from composing demands and to determine the predictive value of spelling, pausing, and motor skill on handwriting production. Thirty-one children with dyslexia (M[subscript age] = 9 years 4 months) were compared with age-matched and spelling-ability matched children (M[subscript age] = 6 years 6 months). A digital writing tablet and Eye and Pen software were used to analyze handwriting. Children with dyslexia were able to execute handwriting at the same speed as the age-matched peers. However, they wrote less overall and paused more frequently while writing, especially within words. Combined spelling ability and within-word pausing accounted for over 76% of the variance in handwriting production of children with dyslexia, demonstrating that productivity relies on spelling capabilities. Motor skill did not significantly predict any additional variance in handwriting production. Reading ability predicted performance of the age-matched group, and pausing predicted performance for the spelling-ability group. The findings from the digital writing tablet highlight the interactive relationship between the transcription skills and how, if spelling is not fully automatized, it can constrain the rate of handwriting production. Practical implications are also addressed, emphasizing the need for more consideration to be given to what common handwriting tasks are assessing as a whole.

It is commonly assumed that children with dyslexia are slower at handwriting than other children. However, evidence of slow handwriting in children with dyslexia is very mixed. Thirty-one children with dyslexia, aged 9 years, were compared to both age-matched children and younger spelling-ability matched children. Participants completed an alphabet-writing task and a composition task on the surface of a digital writing tablet. Children with dyslexia wrote the same amount of letters per minute in the alphabet task but wrote fewer words per minute when composing their texts than children of the same age. Crucially, no differences were found between children with dyslexia and their same age peers for speed of handwriting execution, measured by the tablet, when writing the alphabet or composing their texts. However, children with dyslexia were found to pause within their compositions as often as the spelling ability matched group. Thus handwriting execution is not impaired in children with dyslexia. The slow writing that is typical of children with dyslexia is due to pausing more often when composing and is related to spelling ability. This may reflect processing problems in response to high cognitive load through having to contend with spelling and composing concurrently.

When picking up an object, adults show a longer deceleration phase when the onward action has a greater precision requirement. Tailoring action in this way is thought to need forward modelling in order to predict the consequences of movement. Some evidence suggests that young children also tailor reaching in this way; however, how this skill develops in children with Developmental Coordination Disorder (DCD) is unknown. The current study compared the kinematics of reaching to an object when the onward intention was: to place the object on a target (either with high or low precision requirements), to throw the object or to lift the object vertically. Movements of both adults (N = 18) and children (N = 24) with DCD and their age-matched controls were recorded. The typically developing adults discriminated across all action types, the adults with DCD and the typically developing children only across the actions to place and throw and the children with DCD only between the actions to lift and throw. The results demonstrate developmental progression towards fine tuning the planning of reaching in relation to onward intentions. Both adults and children with DCD are able to plan movement using inverse models but this skill is not yet fully developed in early adulthood. (Contains 2 tables and 3 figures.)

A description of Developmental Coordination Disorder (DCD) is included in the "Diagnostic Manual of the American Psychiatric Association" fourth edition ("DSM-IV-TR"). The major feature of this condition is impairment in motor skill, which has a negative impact on the performance of everyday life tasks. The present review outlines major issues concerning the assessment of motor performance in DCD. First, the psychometric principles of reliability and validity are considered, together with a discussion of test norms. This is followed by a review of 5 major purposes of assessment: screening and identification, measurement of motor performance, making a diagnosis, understanding the nature and mechanisms of the condition, and planning for intervention. In each case, the relevant assessment tools are identified and their application discussed. The article concludes with recommendations for future work, which include the need to refine the DCD diagnostic criteria in order to offer a more principled approach to the selection of assessment techniques. (Contains 2 tables.)

Individuals with developmental coordination disorder (DCD) experience motor skill and executive function (EF) difficulties that challenge their daily activities. This systematic review aims to provide an in-depth analysis of the relationships between motor skills and EFs in studies among individuals with DCD. We conducted a systematic search of eight electronic databases for articles (published 1994–2021) reporting on quantitative studies that estimated relationships between motor skills and EFs when assessing children, adolescents and adults with DCD. Motor skills and EFs were assessed via reliable and validated assessment tools. Two reviewers independently screened the articles. We evaluated the quality of the selected articles according to EPHPP guidelines and the methodological quality of the assessments from these studies using the COSMIN checklist and reported results following the PRISMA-P checklist. This systematic review was registered in PROSPERO (CRD42019124578). A total of 30,808 articles were screened. Eleven articles met the inclusion criteria and were reviewed. Findings from nine studies demonstrated weak to strong correlations between aspects of motor skills and EFs. Limited evidence supports the relationships between motor skills and EFs among individuals with DCD. Occupational therapists should consider the possibility of this relationship and give more consideration to these components when planning intervention for individuals with DCD. [ABSTRACT FROM AUTHOR]

Introduction: While most children have developed effective handwriting by secondary school age, some have handwriting difficulties that hamper academic progress. Occupational therapists play a role in assessment and planning support, which may include introducing typing as an alternative. However, there is limited understanding regarding how decisions are made about recommending typing. This study explored the support provided to adolescents with handwriting difficulties by occupational therapists, and the contextual factors that influence their decision-making. Method: Semi-structured interviews were conducted with 13 occupational therapists and analysed using thematic analysis. Findings: Although there was shared practice underpinned by occupational therapy philosophy, there was also divergent practice due to different approaches. Roles and responsibilities, resources, and evidence and experience influenced occupational therapists' practice. Understanding the adolescent's motivation, the effect of handwriting difficulties on well-being and the need for a functional method to record schoolwork, was central to occupational therapists' decision-making to recommend typing. Conclusion: Strategies are needed to address the knowledge-practice gap, including evidence-based guidelines. Closer collaboration between occupational therapists and school staff could increase understanding of roles and highlight the unique occupational therapy contribution. Further research examining whether, when and how to introduce typing as an alternative to handwriting would support best practice. [ABSTRACT FROM AUTHOR]

The article offers information related to the United Kingdom standardisation of intelligence and development scales (IDS-2) to test psychomotor performance on the basis of intelligence, executive functions, psychomotor skills, social emotional skills, scholastic skills, and motivation and attitude. Topics discussed include fundamental aspect of general development, facilitating and interacting with cognitive, social and emotional development and visual motor control.

Background: In school, children are required to perform a range of handwriting tasks. The writing needs to be legible to the child and other readers. The aim of this study was to examine handwriting legibility across different writing tasks and to explore which components might predict overall handwriting legibility. Methods: This was a secondary analysis of data from 148 school-aged children across writing scripts obtained from the Detailed Assessment of Speed of Handwriting: copying-best, copying-quickly and free-writing. Results: Results showed that letter formation was the major predictor of the total HLS score, and significant differences in handwriting legibility were found across the three tasks. Conclusions: The HLS is a practical tool that can benefit occupational therapists who work in schools by assessing handwriting legibility across different handwriting tasks. [ABSTRACT FROM AUTHOR]

Background: Successful self-feeding reflects the readiness of early motor development and environmental impacts, and the onset of self-feeding as a developmental milestone might be a predictor of subsequent motor development in children. In this study, we explored the association between the onset of self-feeding and childhood risk of Developmental Coordination Disorder in children from one-child and two-child families. Methods: We conducted a data-linkage prospective cohort study from 38 kindergartens in 6 cities in China. A total of 11,727 preschoolers aged 3–6 years old were included in the final analysis and were assessed with the Movement Assessment Battery for Children-second edition (MABC-2) Test. The information on early self-feeding onset was obtained from parents. The mixed and multi-level logistic models utilizing a random intercept were used to investigate the associations between the onset time of self-feeding and subsequent motor performance. Results: The results showed that, compared with those beginning self-feeding at or younger than 12 months of age, children starting self-feeding at 13–24, 25–36, and later than 36 months, showed a decrease in their total MABC-2 scores of 2.181, 3.026, and 3.874, respectively; and had an increased risk of suspected DCD by 36.0, 101.6, 102.6%, respectively; they also had 30.2, 46.6, 71.2% increased prevalence of at risk of suspected DCD, when adjusting for both child and family characteristics (each p < 0.05). Significant associations were observed in fine motor, gross motor, and balance subtests (each p < 0.05) in groups with a delayed onset of self-feeding. However, the strength of the associations was mitigated in the fine motor and balance subtests in children with a sibling. Conclusion: The delayed onset time of self-feeding acts as an early behavioral marker for later childhood motor impairment. Moreover, children with a sibling may benefit from additional interaction and their motor developmental pattern may be affected by the presence of a sibling. [ABSTRACT FROM AUTHOR]

The ability to finely control our movement is key to achieving many of the educational milestones and life-skills we develop throughout our lives. Despite the centrality of coordination to early development, there is a vast gap in our understanding of the underlying biology. Like most complex traits, both genetics and environment influence motor coordination, however, the specific genes, early environmental risk factors and molecular pathways are unknown. Previous studies have shown that about 5% of school-age children experience unexplained difficulties with motor coordination. These children are said to have Developmental Coordination Disorder (DCD). For children with DCD, these motor coordination difficulties significantly impact their everyday life and learning. DCD is associated with poorer academic achievement, reduced quality of life, it can constrain career opportunities and increase the risk of mental health issues in adulthood. Despite the high prevalence of coordination difficulties, many children remain undiagnosed by healthcare professionals. Compounding under-diagnosis in the clinic, research into the etiology of DCD is severely underrepresented in the literature. Here we present the first genome-wide association study to examine the genetic basis of early motor coordination in the context of motor difficulties. Using data from the Avon Longitudinal Study of Parents and Children we generate a derived measure of motor coordination from four components of the Movement Assessment Battery for Children, providing an overall measure of coordination across the full range of ability. We perform the first genome-wide association analysis focused on motor coordination (N = 4542). No single nucleotide polymorphisms (SNPs) met the threshold for genome-wide significance, however, 59 SNPs showed suggestive associations. Three regions contained multiple suggestively associated SNPs, within five preliminary candidate genes: IQSEC1 , LRCC1 , SYNJ2B2 , ADAM20 , and ADAM21. Association to the gene IQSEC1 suggests a potential link to axon guidance and dendritic projection processes as a potential underlying mechanism of motor coordination difficulties. This represents an interesting potential mechanism, and whilst further validation is essential, it generates a direct window into the biology of motor coordination difficulties. This research has identified potential biological drivers of DCD, a first step towards understanding this common, yet neglected neurodevelopmental disorder. [ABSTRACT FROM AUTHOR]

Lifecourse epidemiology suggests that preconception is a valuable opportunity for health promotion with young women. Yet young women are less likely than older women to be research participants, limiting evidence about their needs and risks. Marketing data indicate that young adults are not engaged with one advertising strategy because they transition through three life stages: (i) limited independence and focus on own interests, (ii) increased independence and time with peers and (iii) establishing a home and family. The aim of this study was to explore whether these marketing lifestage categories could inform the tailoring of strategies to recruit young women. Three focus groups per lifestage category were conducted (49 women aged 16–34 years). Lifestage category (i) was represented by further education students, category (ii) by women in workplaces and (iii) by mothers. Questions explored participants' lifestyles, identity, reasons for participation in the current study and beliefs about researchers. Three major themes were identified through framework analysis: profiling how young women spend their time; facilitators of participating in research and barriers to participating. Students and women in work valued monetary remuneration whereas mothers preferred social opportunities. Participants' perceived identity influenced whether they felt useful to research. All groups expressed anxiety about participation. Altruism was limited to helping people known to participants. Therefore, the marketing categories did not map exactly to differences in young women's motivations to participate but have highlighted how one recruitment strategy may not engage all. Mass media communication could, instead, increase familiarity and reduce anxiety about participation. [ABSTRACT FROM AUTHOR]

The note- and test-taking skills of typically functioning undergraduates are significantly and positively related to handwriting speed, listening comprehension, background knowledge and sustained attention. This study attempted to replicate these findings with two groups of high school students—those with and without the diagnosis of a learning disability (LD). Students without LD scored significantly higher than those with LD on handwriting speed, listening comprehension, background knowledge, sustained attention, quality of notes, and test performance. Results of regression analyses indicated that note-taking (f 2 = 1.94) and test-taking (f 2 = 2.69) were associated with listening comprehension and background knowledge predominately. If these results are replicated, they suggest that the variables related to note-taking in typically functioning undergraduates are similar to high school students with and without LD. Limitations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

This article reports the results from a study investigating the effects of a discipline-specific reading and writing intervention (I3C/PROVE IT!) with fourth and fifth graders. Participants included 237 students with writing difficulties (WD) from an initial pool of 608 upper elementary school students in a larger study. Teachers and students were randomly assigned to I3C/PROVE IT! or business-as-usual conditions and then provided instruction on reading historical documents and writing evidence-based arguments. Findings indicated that over a period of almost 3 months, the historical writing growth trajectories of students with WD in I3C/PROVE IT! classrooms were significantly greater than their peers in business-as-usual classrooms. Significant findings favoring I3C/PROVE IT! students also generalized to domain-general measures. This study provides evidence for the benefits of discipline-specific interventions in social studies for students with WD. Limitations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Previous work suggests that written text produced by university students with dyslexia is scored lower than that produced by their peers. The present study used a digital writing tablet to examine the writing process and the quality of text written by university students with dyslexia. Revision behavior during and after writing was also investigated. Thirty-two university students with dyslexia (mean age, 20 years), were compared with 32 typically developing (TD) students matched by age. Students composed a written text in response to an expository essay prompt. In line with previous research, students with dyslexia made a higher number of spelling errors and their essays were rated as poorer than TD students. However, students with dyslexia were comparable to their peers on measures of time spent writing, amount of text produced, and the temporal analyses (handwriting execution, pause times). Students with dyslexia made significantly more revisions to spelling during and after transcription than their peers, although other revision behavior was similar across groups. Explanations for the finding of poor writing quality are explored. Importantly, the findings suggest that continued support with spelling and writing is needed for university students with dyslexia. Instruction directed toward effective revision strategies may also prove useful. Limitations and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Developmental language disorder (DLD) and developmental dyslexia (DD) are two prevalent subtypes of Specific Learning Disabilities (SLDs; Diagnostic and Statistical Manual of Mental Disorders [5th ed.; DSM-5 ]). Yet, little information is available regarding the distinct challenges faced by adults with DLD and/or DD in college. The purpose of the present report is to characterize the relative strengths and challenges of college students with a history of DLD and/or DD, as this information is critical for providing appropriate institutional support. We examined the cognitive skill profiles of 352 college students (ages 18–35 years), using standardized and research-validated measures of reading, spoken language, nonverbal cognition, and self-reported childhood diagnostic history. We classified college students as having DLD (n = 50), and/or DD (n = 40), or as typically developed adults (n = 132) according to procedures described for adults with DLD and DD. A structural equation model determined the cognitive, language, and reading measures predicted by the classification group. Adults with DLD demonstrated poor verbal working memory and speeded sentence-level reading. Adults with DD primarily demonstrated deficits in phonology-based skills. These results indicate that adults with DLD and/or DD continue to face similar challenges as they did during childhood, and thus may benefit from differentially targeted accommodations in college. [ABSTRACT FROM AUTHOR]

Effectiveness of individual and group-based neuropsychological interventions on cognitive aspects of dyslexia in young adults was evaluated. Dyslexic adults were randomly assigned into individual intervention (n = 40), group intervention (n = 40), or wait-list control group (n = 40). The interventions focused on cognitive strategy learning, supporting self-esteem, and using psychoeducation. Cognitive performance and symptoms were assessed via psychometric testing and self-report questionnaires at baseline, after the intervention/wait-list control time at 5 months and at 10 months. And, 15 months post intervention long-term status was checked via mailed inquiry. Wait-list control group also received an intervention after the 5-month control period. No significant effects were found in primary self-report outcome measures. Both interventions had a positive effect on a measure of processing speed and attention and the effect remained after the 5-month follow-up period. In self-reported cognitive symptoms, a positive trend was evident in self-reported reading habits. Furthermore, minor self-evaluated benefits reaching up to 15 months post intervention were found. There were no significant differences between the results of individual and group intervention as both interventions improved cognitive performance. The results indicate that a structured neuropsychological intervention could be effective in ameliorating dyslexia-related cognitive symptoms in young adults. [ABSTRACT FROM AUTHOR]

Developmental dyslexia is defined as a specific reading disorder but is also thought to be underpinned by a deficit in motor skills that may well affect handwriting performance. However, the results of studies addressing this issue are not consistent. The present study was, therefore, designed to better understand the functioning of handwriting in children with dyslexia, by conducting an analysis of the legibility and fluency of handwritten letters, supplemented by an assessment of motor skills. The performances of 15 children with dyslexia (M age = 11.4 years) were compared with those of two groups of typically developing children, one matched for chronological age, the other for orthographic level (M age = 8.7 years) on two handwriting measures (production of the letters of the alphabet and the child's first name and surname). Results revealed a delay in motor skills, as well as in letter legibility, letter production duration, and the number of short pauses (i.e., lasting between 20 and 199 ms) made during letter production, in the children with dyslexia, with strong negative correlations between motor skills and the number of short pauses. Results are discussed in the context of handwriting control development in children, and perspectives are set out for practitioners. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the suitability of the Movement Assessment Battery for Children (M-ABC) for use in Greater China. Chinese children numbering 255 between the ages of 4 and 6 from Hong Kong and 544 from Taiwan were tested individually on the standardized test contained within the M-ABC. Data from these 799 children were compared to that presented in the test manual for the 493 children of the same age comprising the United States standardization sample. Both within-culture and cross-cultural differences were statistically significant when all items of the M-ABC were examined simultaneously, but effect sizes were too low to be considered meaningful. However, descriptive analysis of the cut-off scores used for impairment detection on the test suggested that adjustments to some items would be desirable for these particular Chinese populations. [ABSTRACT FROM AUTHOR]

Aim: These international clinical practice recommendations (CPR) for developmental coordination disorder (DCD), initiated by the European Academy of Childhood Disability (EACD), aim to address key questions on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD relevant for clinical practice.Method: Key questions in five areas were considered through literature reviews and formal expert consensus. For recommendations based on evidence, literature searches on 'mechanisms', 'assessment', and 'intervention' were updated since the last recommendations in 2012. New searches were conducted for 'psychosocial issues' and 'adolescents/adults'. Evidence was rated according to the Oxford Centre for Evidence-Based Medicine (level of evidence [LOE] 1-4) and transferred into recommendations. For recommendations based on formal consensus, two meetings of an international, multidisciplinary expert panel were conducted with a further five Delphi rounds to develop good clinical practice (GCP) recommendations.Results: Thirty-five recommendations were made. Eight were based on the evidence from literature reviews (three on 'assessment', five on 'intervention'). Twenty-two were updated from the 2012 recommendations. New recommendations relate to diagnosis and assessment (two GCPs) and psychosocial issues (three GCPs). Additionally, one new recommendation (LOE) reflects active video games as adjuncts to more traditional activity-oriented and participation-oriented interventions, and two new recommendations (one GCP, one LOE) were made for adolescents and adults with DCD.Interpretation: The CPR-DCD is a comprehensive overview of DCD and current understanding based on research evidence and expert consensus. It reflects the state of the art for clinicians and scientists of varied disciplines. The international CPR-DCD may serve as a basis for national guidelines.What This Paper Adds: Updated international clinical practice guidelines on developmental coordination disorder (DCD). Refined and extended recommendations on clinical assessment and intervention for DCD. A critical synopsis of current research on mechanisms of DCD. A critical synopsis of psychosocial issues in DCD, with implications for clinical practice. The first international recommendations to consider adolescents and adults with DCD. [ABSTRACT FROM AUTHOR]

A phase 1 dose-escalation trial assessed the chemotherapeutic potential of ammoniumperfluorooctanoate (APFO). Forty-nine primarily solid-tumor cancer patients who failed standard therapy received weekly APFO doses (50-1200mg) for 6 weeks. Clinical chemistries and plasma PFOA (anionic APFO) were measured predose and weekly thereafter. Several clinical measures including total cholesterol, high-density lipoproteins (HDLs), thyroid stimulating hormone (TSH), and free thyroxine (fT4), relative to PFOA concentrations were examined by: Standard statistical analyses using generalized estimating equations (GEE) and a probabilistic analysis using probability distribution functions (pdf) at various PFOA concentrations; and a 2-compartment pharmacokinetic/pharmacodynamic (PK/PD) model to directly estimatemean changes. Based on the GEE, the average rates of change in total cholesterol and fT4 associated with increasing PFOA were approximately -1.2x10-3mmol/l/lMand 2.8x10-3pmol/l/lM, respectively. The PK/PDmodel predictedmore closely the trends observed in the data as well as the pdfs of biomarkers. A decline in total cholesterol was observed, with a clear transition in shape and range of the pdfs, manifested by the maximum value of the Kullback-Leibler (KL) divergence, that occurred at plasma PFOA between 420 and 565lM (175 000- 230 000 ng/ml). High-density lipoprotein was unchanged. An increase in fT4 was observed at a higher PFOA transition point, albeit TSH was unchanged. Our findings are consistent with some animalmodels and maymotivate re-examination of the epidemiologic studies to PFOA at levels several orders of magnitude lower than this study. These observational studies have reported contrary associations, but currently understood biology does not support the existence of such conflicting effects. [ABSTRACT FROM AUTHOR]