Reconsidering the Use of Cut-Off Scores: DCDQ - Brazil

Abstract

Introduction: The DCDQ is a parental report designed to assess daily living activities of children, and serves as a useful questionnaire to aid in the diagnostic criteria of Developmental Coordination Disorder (DCD). It is divided into three components: control during movement, fine motor/handwriting, and general coordination. The results categorize children in two groups: "Indication of DCD/suspect DCD", and "probably not DCD". Objective: The objective of this study was to determine appropriate cut-off scores for the Developmental Coordination Disorder Questionnaire -Brazil (DCDQ-BR) for use with Brazilian children employing a large sample. Methods: Seven hundred and seven children ages 6-10 were assessed with the DCDQ-BR and the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). Descriptive statistics was used to characterize the sample, and concurrent validity was assessed using Pearson's Correlation Coefficient. Predictive validity was determined through values of sensitivity (S) and specificity (E), while ROC curves were used to determine the optimal cut-off score for the DCDQ-BR. Results: Pearson's correlation coefficient analysis revealed a significant correlation between total scores of the DCDQ-BR and BOT-2 (r= 0.55 (p=0.00). Cut-off scores for the DCDQ-BR based on the BOT-2 17 th percentile (relating to below average descriptive category) were established as ≤40, ≤46 and ≤51 for ages 6-7 years and 11 months; 8-9 years and 11 months; and 10-10 years and 11 months, respectively. Conclusion: Based on the results of this study and previous literature suggesting the need for a reevaluation of cut-off scores for the Brazilian population with a larger sample, we recommend that the cut-off scores of the DCDQ-BR are adjusted to the values found with our sample. Level of evidence II; Diagnostic studies -Investigating a diagnostic test. RESUMOIntrodução: O DCDQ é um relatório para pais elaborado para avaliar as atividades diárias das crianças, além de servir como um questionário útil para auxiliar nos critérios diagnósticos de Transtorno do Desenvolvimento da Coordenação (TDC). O questionário é dividido em três componentes: controle durante o movimento, motricidade fina/escrita e coordenação geral. Os resultados classificam as crianças em dois grupos: "Indicação ou suspeita de TDC" e "provável não TDC". Objetivo: O objetivo do presente estudo consistia em determinar as pontuações de corte adequadas para o Questionário de Transtorno do Desenvolvimento da Coordenação -Brasil (DCDQ-BR) para uso com crianças brasileiras utilizando uma grande amostra. Métodos: Setecentas e sete crianças de seis a 10 anos foram avaliadas com o DCDQ-BR e o Teste de Proficiência Motora Bruininks-Oseretsky (BOT-2). Utilizaram-se estatísticas descritivas para caracterizar a amostra e a validade concorrente foi avaliada através do índice de Correlação de Pearson. A validade preditiva foi determinada através dos valores de sensibilidade (S), especificidade (E) e as curvas ROC foram realizadas para determinar o ponto de corte ótimo do DCDQ...

Identifying Children with Developmental Coordination Disorder via Parental Questionnaires. Spanish Reference Norms for the DCDDaily-Q-ES and Correlation with the DCDQ-ES

“…However, due to limitations in sample size, reference norms for Spanish children were not developed, and its concurrent validity with the Spanish version of the DCDQ (DCDQ-ES) has yet to be tested. Previous research shows that population-adjusted reference norms should always be operated when assessing motor performance [35][36][37]. To date, the original Dutch cutoffs are the only available criteria to identify children at risk of DCD when using the DCDDaily-Q, so it is unknown if these cutoffs are also suitable for children within different contexts or regions.…”

Psychometric Validation and Reference Norms for the European Spanish Developmental Coordination Disorder Questionnaire: DCDQ-ES

“…Country-adjusted cut-off points have also been developed for other Southern American and European versions of the DCDQ, and these are usually lower than the original ones [35,61]. The established cut-off points for Brazilian children are significantly lower than both the Canadian and the Spanish norms, indicating lower overall scores in the DCDQ for Brazilian children [61].…”

“…Country-adjusted cut-off points have also been developed for other Southern American and European versions of the DCDQ, and these are usually lower than the original ones [35,61]. The established cut-off points for Brazilian children are significantly lower than both the Canadian and the Spanish norms, indicating lower overall scores in the DCDQ for Brazilian children [61]. While Italian adjusted cut-off points are almost similar to the Spanish norms in younger children, they differ significantly in the 8-9 and 10-12-years-old groups [35], which in the Spanish situation may reflect an increasing improvement in motor performance with age [21].…”

Relationship between the Developmental Coordination Disorder Questionnaire 2007 and the Bruininks-Oseretsky Test of Motor Proficiency Second Edition in Korean Children

“…The DCDQ’07 assists in identifying children with DCD using a cutoff score established with Canadian and British children [ 23 ]. The cutoff score needs to be validated or adjusted when the DCDQ’07 is adapted to other cultures [ 30 , 31 ]. Lower cutoff scores have been proposed for Indian children [ 30 ] and Brazilian children aged over 8 years [ 31 ].…”