Umschriebene motorische Entwicklungsstörungen (UEMF)
Weisen betroffene Kinder spezifische Intelligenzprofile auf?
Abstract
Zusammenfassung. Die umschriebene Entwicklungsstörung der motorischen Funktionen (UEMF) zählt zu den häufigsten Entwicklungsabweichungen des Kindesalters. Charakteristisch sind Defizite der Fein- und Grobmotorik, denen ursächlich keine sensorischen, neurologischen oder kognitiven Einschränkungen zugrunde liegen. Verschiedene Studien belegen, dass Kinder mit einer UEMF auch kognitive Defizite in der visuellen Wahrnehmung, in ihren Aufmerksamkeits- und Arbeitsgedächtnisleistungen aufweisen. Das Ziel ist es daher, den Einfluss dieser kognitiven Teilleistungsdefizite auf die Intelligenzleistungen von Kindern mit UEMF zu untersuchen und zu überprüfen, ob Kinder mit UEMF ein spezifisches Intelligenzprofil aufweisen. Die Datenbanken Web of Science und PubMed wurden entsprechend nach deutsch- und englischsprachigen Beiträgen für den Zeitraum 2007 bis 2017 durchsucht. Lediglich fünf Studien erfüllten die Auswahlkriterien. Die Ergebnisse deuten darauf hin, dass Kinder mit einer UEMF geringere Testleistungen im Gesamt-IQ aufweisen. Auf Skalenebene konnten insbesondere geringere Testleistungen in der Handlungsskala der WPPSI-III bzw. dem Wahrnehmungsgebundenen Logischen Denken der WISC-IV sowie in der Verarbeitungsgeschwindigkeit nachgewiesen werden. Die sprachlichen Leistungen der Kinder mit UEMF scheinen zumindest ab dem Grundschulalter unbeeinträchtigt. Testverfahren, die auf den Wechsler-Skalen basieren, stellen ein ökonomisches Instrument dar, um kognitive Leistungsdefizite orientierend im Zusammenhang mit einer UEMF abzubilden.
Abstract. Developmental coordination disorders (DCD) are among the most common disorders in childhood. They are characterized by deficits in fine and gross motor skills without any sensory, neurological, or cognitive causation. Different studies confirm that children with DCD also have cognitive deficits in visual perception, attention, and working memory. These cognitive deficits often have a negative impact on later performance at school. The guidelines of the European Childhood Academy (EACD) and Criterion D of the classification systems DSM-5 and ICD-10 underline the importance of measuring the intelligence quotient (IQ) in order to detect comorbid cognitive deficits in DCD precociously and to eliminate a general intelligence deficit (IQ<70) as a cause of the movement difficulties. The objective of this review was to investigate the influence of these cognitive deficits on intellectual abilities and whether or not children suffering from DCD have specific performance profiles in intelligence tests. Furthermore, DCD is frequently accompanied by comorbid disorders such as ADHD, developmental language disorders, and dyslexia. Therefore, it is also of interest to know if children with combined disorders show special intelligence profiles. The Web of Science and PubMed databases were searched for German and English language articles from 2007 through 2017 inclusive. The systematic literature search was based on the keywords developmental coordination disorders or DCD and cognition or academic or intellectual or intelligence or WISC-IV or WPPSI-III. Only five studies fulfilled the selection criteria; another four studies not meeting all the conditions were reported additionally. The results of this review indicate that children with DCD score below average in general IQ and performance IQ (WPPSI-III) as well as perception reasoning (WISC-IV). Contrary to expectations, the DCD group also presented weaknesses in verbal comprehension in preschool age (WPPSI-III). In contrast to these results, no group differences were found in verbal comprehension in school age (WISC-IV). Both in preschool and in school age, children with DCD had lower IQ scores in the processing speed index of WPPSI-III and WISC-IV. It is unclear whether only motor demands in manual dexterity are responsible for the worse results in the processing speed index or whether children suffering from DCD have a general problem with processing speed performances. The confounding results in this area may highlight the need for further exploration of these phenomena. The control group had better results in working memory (WISC-IV) than the clinical group. In comparison with children showing isolated DCD, children with a combined diagnosis of DCD and ADHD and/or dyslexia show no performance differences in the WISC-IV or the WPPSI-III. Within-group analyses depict a heterogeneous cognitive profile in the DCD group. Children with DCD cannot be differentiated from their peers solely on a cognitive profile Therefore, in clinical practice the Wechsler Scales are an orienting instrument for detecting cognitive deficits in DCD.
Literatur
2008). Working memory and learning in children with developmental coordination disorder and specific language impairment. Journal of Learning Disabilities, 41, 251 – 262.
(2007). A comparison of working memory skills and learning in children with developmental coordination disorder and moderate learning difficulties. Applied Cognitive Psychology, 21, 473 – 487.
(2008). Comparing language profiles: children with specific language impairment and developmental coordination disorder. International Journal of Language & Communication Disorders, 43, 165 – 180.
(2012). Motor and cognitive performance differences between children with and without developmental coordination disorder (DCD). Research in Developmental Disabilties, 33, 996 – 1005.
(2017). Neuropsychological status of French children with developmental dyslexia and/or developmental coordination disorder: Are both necessarily worse than one? Child Neuropsychology, 23, 422 – 441.
(2012). European Academy for Childhood Disability (EACD): Recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version). Developmental Medicine and Child Neurology, 54, 54 – 93.
(1994). Clumsiness in adolescence – Educational, motor, and social Outcomes of motor delay detected at 5-years. Adapted Physical Activity Quarterly, 11, 115 – 129.
(2003). Two distinct pathways for developmental coordination disorder: Persistence and resolution. Human Movement Science, 22, 413 – 431.
(2014). Developmental disorders: What can be learned from cognitive neuropsychology? Philosophical Transactions of the Royal Society B-Biological Sciences, 369, 1634.
(2014). Motor impairments screened by the Movement Assessment Battery for Children-2 are related to the visual-perceptual deficits in children with Developmental Coordination Disorder. Research in Developmental Disabilities, 35, 2172 – 2179.
(2011). Reading and writing performances of children 7 – 8 years of age with developmental coordination disorder in Taiwan. Research in Developmental Disabilities, 32, 2589 – 2594.
(2002). Developmental coordination disorder: Associated problems in attention, learning, and psychosocial adjustment. Human Movement Science, 21, 905 – 918.
(2007). Early identification: are speech/language-impaired toddlers at increased risk for Developmental Coordination Disorder? Child Care Health and Development, 33, 325 – 332.
(1993). Children who are clumsy: Five years later. Adapted Physical Activity Quarterly, 10, 10 – 21.
(1998). Hyperactivity, inattention and motor control problems: Prevalence, comorbidity and background factors. Folia Phoniatrica et Logopaedica, 50, 107 – 117.
(2015). Mathematical difficulties in developmental coordination disorder: Symbolic and nonsymbolic number processing. Research in Developmental Disabilities, 55, 43 – 44, 167 – 178.
(2007). Movement Assessment Battery for Children (M-ABC-2). London: Psychological Corporation.
(2015). Kognitive Leistungsprofile von Kindern mit motorischen Entwicklungsstörungen und ADHS im Vorschulalter. Praxis der Kinderpsychologie und Kinderpsychiatrie, 64, 117 – 134.
(1998). Attention deficits and clumsiness in Swedish 7-year-old children. Developmental Medicine and Child Neurology, 40, 796 – 804.
(1999). Developmental coordination disorder in Swedish 7-year-old children. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 820 – 828.
(2011). Kognitive Leistungsprofile motorisch und sprachentwicklungsverzögerter Vorschulkinder. Kindheit und Entwicklung, 20, 173 – 185.
(2009). Entwicklungsbedingte Koordinationsstörungen. Psychologische Rundschau, 60, 73 – 81.
(2010). Entwicklungsbedingte Koordinationsstörungen: Zum Zusammenhang von motorischen und kognitiven Defiziten. Klinische Pädiatrie, 222, 26 – 34.
(2015). Executive functioning, motor difficulties, and developmental coordination disorder. Developmental Neuropsychology, 40, 201 – 215.
(2011). Comorbid ADHD and DCD: Examining cognitive functions using the WISC-IV. Research in Developmental Disabilities, 32, 1260 – 1269.
(1991). Clumsiness in children – Do they grow out of It – A 10-year follow-up-study. Developmental Medicine and Child Neurology, 33, 55 – 68.
(1997). McCarron Assessment of Neuromuscular Development: Fine and gross motor abilities (rev. ed.). Dallas: Common Market Press.
(2011). Motorische Koordinationsdefizite im Kindesalter. Welche Bdeutung haben kognitive Basisfunktionen? Kindheit und Entwicklung, 20, 49 – 58.
(2006). Intelligenzdiagnostik. Kindheit und Entwicklung, 15, 71 – 75.
(2015). Movement Assessment Battery for Children-2 (M-ABC-2) (4., überarb. u. erw. Aufl.). Frankfurt: Pearson Assessment.
(Hrsg.). (2016). Sprachentwicklungsstörungen. Kindheit und Entwicklung, 25, 131 – 134.
(2018). Umschriebene Entwicklungsstörungen. Kindheit und Entwicklung, 27, 1 – 4.
(2013). Entwicklungstest 6 Monate – 6 Jahre Revision (ET 6 – 6-R). Frankfurt: Pearson Assessment.
(2011). Wechsler Intelligence Scale for Children-IV (WISC-IV) – Deutsche Version. Frankfurt: Pearson Assessment.
(Hrsg.). (2014). Wechsler Preschool and Primary Scale of Intelligence-III (WPPSI-III) – Deutsche Version (3., überarb. u. erw. Aufl.). Frankfurt: Pearson Assessment.
(Hrsg.). (2008). Entwicklungsdiagnostik mit dem ET 6 – 6 (3., veränd. Aufl.). Frankfurt: Pearson Assessment.
(2009). Neuropsychologische Diagnostik der ADHS. Kindheit und Entwicklung, 18, 83 – 94.
(2007). Working memory, processing speed, and set-shifting in children with developmental coordination disorder and attention-deficit-hyperactivity disorder. Developmental Medicine and Child Neurology, 49, 678 – 683.
(2014). The effect of motor load on planning and inhibition in developmental coordination disorder. Research in Developmental Disabilities, 35, 1579 – 1587.
(2015). Diagnostic criteria for DCD: Past and future. Human Movement Science, 42, 293 – 306.
(2004). Manuel de la Batterie d’Evaluation du Mouvement chez l’Enfant [Movement-ABC]. Paris: ECPA.
(2016). Examining the cognitive profile of children with Developmental Coordination Disorder. Research in Developmental Disabilities, 56, 10 – 17.
(2008). Role of visual-perceptual skills (non-motor) in children with developmental coordination disorder. Human Movement Science, 27, 649 – 664.
(2008). Relationship of visual perceptual deficit and motor impairment in children with developmental disabilities disorder. Perceptual and Motor Skills, 107, 457 – 472.
(2007). Cooccurrence of problems in activity level, attention, psychosocial adjustment, reading and writing in children with developmental coordination disorder. International Journal of Rehabilitation Research, 30, 327 – 332.
(1998). The relationship between physical growth, the level of activity and the development of motor skills in adolescence: Differences between children with DCD and controls. Human Movement Science, 17, 573 – 608.
(2002). Wechsler Preschool and Primary Scale of Intelligence-Third Edition. Technical and interpretative Manual. San Antonio: Psychological Corporation.
(2003). Wechsler Intelligence Scale for Children-Fourth Edition. Technical and interpretative manual. San Antonio: Psychological Corporation.
(2005). WISC-IV. Echelle d’intelligence de Wechsler pour enfants [Wechsler-Intelligenz-Skala für Kinder] (4e ed.). Paris: ECPA.
(1998). Information processing deficits associated with developmental coordination disorder: A meta-analysis of research findings. Journal of Child Psychology and Psychiatry, 39, 829 – 840.
(2013). Understanding performance deficits in developmental coordination disorder: a meta-analysis of recent research. Developmental Medicine and Child Neurology, 55, 217 – 228.
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