| Task‐oriented interventions versus no intervention for children with developmental co‐ordination disorder (DCD) |
| Participant or population: children with DCD Settings: hospital settings; university‐based clinic, laboratory, or centre; community centres; home; and school Intervention: task‐oriented interventions Comparison: no intervention |
| MABC,Total Impairment Score, RCTs and quasi‐RCTs.
Scale from: 0 to 40. Follow‐up: range 6 weeks to 6 months. | The mean MABC, Total Impairment Score in the inactive control groups ranged from 5.5 to 27.0 | The mean MABC, Total Impairment Score in the intervention group was 3.63 lower (5.88 lower to 1.39 lower) | ‐ | 169
(6 RCTs) | ⊕⊝⊝⊝
Very low1 | Green 2008; Hillier 2010; Pless 2000b; Tsai 2009; Tsai 2012 Analysis conducted on the total impairment scores of the MABC; the higher the score, the more impaired. |
| MABC, Total Impairment Score, RCTs only.
Scale from: 0 to 40. Follow‐up: range 6 weeks to 20 weeks. | The mean MABC, Total Impairment Score in the inactive control groups ranged from 17.13 to 20.80 | The mean MABC, Total Impairment Score in the intervention group was 2.34 lower (7.50 lower to 2.83 higher) | ‐ | 51
(2 RCTs) | ⊕⊕⊝⊝
Low2 | Green 2008; Hillier 2010 Analysis conducted on the total impairment scores of the MABC; the higher the score, the more impaired. |
| Adverse events | 0 events reported in both the intervention and control group. | Not estimable | 340 (11 RCTs) | ‐ | ACTRN12614000106639; Fong 2016; Green 2008; Hillier 2010; Hung 2010; Miller 2001; Pless 2000b; Sugden 2003; Thornton 2016; Tsai 2009; Tsai 2012 |
| Changes in motor co‐ordination, as measured by standardised rating scales | 1 study used the DCDQ (Green 2008), and 2 studies used the MABC Checklist (Pless 2000b; Sugden 2003). Green 2008 reported no data on the questionnaire to be used for a randomised comparison. Pless 2000b found no significant intervention effect on the MABC Checklist, and Sugden 2003 used the MABC Checklist at pre‐intervention only, not at postintervention. | Not estimable | 111 (3 RCTs) | ⊕⊝⊝⊝
Very low3 | Important outcome to accumulate data for future evidence synthesis. |
| Measures of impairment (e.g. sensation, physical fitness) | See comment. | ‐ | ‐ | ‐ | Not reported. Important outcome to accumulate data for future evidence synthesis. |
| Measures of psychosocial factors | 3 studies used perceived competence scales (ACTRN12614000106639; Hillier 2010; Miller 2001). ACTRN12614000106639 used the PSPCSA and found a significant intervention effect on perceived physical competence, but no differential intervention effect between intervention setting and provider. Hillier 2010 also used the PSPCSA and found no evidence of an effect on perceived physical competence as a result of intervention. Miller 2001 used the Self Perception Profile for Children (Harter 1985) and found no significant intervention effect on the scale. It was impossible to estimate the anticipated absolute effects of the 3 studies for 2 reasons: 1. Hillier 2010 reported median and range, whereas ACTRN12614000106639 and Miller 2001 reported means and SDs; 2. Hillier 2010 and Miller 2001 used inactive controls, whereas ACTRN12614000106639 used active controls. | Not estimable | 126 (3 RCTs) | ⊕⊝⊝⊝
Very low3 | Important outcome to accumulate data for future evidence synthesis. |
| Measures of occupational and task performance | 2 studies used the COPM and reported improved performance and satisfaction as a result of intervention (Miller 2001; Thornton 2016). Miller 2001 reported that the differential intervention effect between the CO‐OP and the contemporary treatment approach (defined as a variety of approaches) was significant on the satisfaction subscale only, which had a considerable baseline difference between the 2 groups. Thornton 2016 reported the significant pre‐post improvement in the CO‐OP group only; the change in the control group is not reported. | Not estimable | 40 (2 RCT) | ⊕⊝⊝⊝
Very low3 | Important outcome to accumulate data for future evidence synthesis. |
| Measures of participation | 2 trials measured participation in physical activities by self‐made questionnaires only after the intervention (Hillier 2010; Pless 2000b). Hillier 2010 administered a participation questionnaire after the intervention and found no group difference between the intervention and the control group. Pless 2000b found no group difference in practising motor tasks at home. | Not estimable | 49 (2 RCTs) | ⊕⊝⊝⊝
Very low3 | Important outcome to accumulate data for future evidence synthesis. |
| * The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; CO‐OP: Cognitive Orientation to daily Occupational Performance (Missiuna 2001); COPM: Canadian Occupation Performance Measure (Law 1998); DCDQ: Developmental Coordination Disorder Questionnaire (Wilson 2009); MABC: Movement Assessment Battery for Children (Henderson 2007); PSPCSA: Pictorial Scale of Perceived Competence and Social Acceptance (Harter 1984); RCT: randomised controlled trial; SD: standard deviation. |
| GRADE Working Group grades of evidence
High quality: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate quality: We are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low quality: Our confidence in the effect estimate is limited. The true effect may be substantially different from the estimate of the effect.
Very low quality: We have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of effect. |
