維基百科

發展協調障礙

發展協調障礙（developmental coordination disorder，DCD）[1][2][3][4][5][6][7]也稱為發展性協調障礙[8]、發育性運動協調障礙[9]、動作協調障礙[10]或動作障礙[11][12][13][14]是一種神經發展障礙。其特徵是大腦訊息無法準確傳遞到身體，導致肢體協調受損。動作技能的缺失隨着兒童的實際年齡干預日常生活活動[15]。發展協調障礙只在沒有其他神經損傷（例如大腦麻痺[16][11]、多發性硬化症或帕金森氏症）之下方可診斷。

Developmental coordination disorder
又稱Developmental motor coordination disorder, developmental dyspraxia
類型活動障礙[*]、特殊性發育障礙、疾病
分類和外部資源
醫學專科Psychiatry, neurology
ICD-116A04
ICD-9-CM315.4
DiseasesDB31600
MedlinePlus001533
[編輯此條目的維基數據]
維基百科中的醫學內容僅供參考，並不能視作專業意見。如需獲取醫療幫助或意見，請諮詢專業人士。詳見醫學聲明。

根據加拿大CanChild的說法，這種疾病影響5%到6%的學齡兒童[17]。不過這種疾病確實會發展到成年，成為終身的健康狀況。

徵象和症狀

由於無法治癒，發展協調障礙影響各種發育，將會持續到成年[14]。通常發展出各種應對策略，應對策略能夠透過職業治療、物理治療、語言治療、心理治療及心理動作治療加強。

肢體受損之外，發展協調障礙影響記憶（尤其工作記憶）[18]。患者難以記得指令、限期及管理時間，並且傾向忘記物品以及難以執行需要記得多個步驟的任務（例如煮食）。縱使人們普遍在某程度上也碰到上述難題，上述難題卻更大程度上影響患者的生活[19]。很多患者雖然短期記憶差勁，長期記憶卻出色[19]。患者受惠於有序環境，因為重複例行程序減低時間管理的難度，患者也能夠將步驟置於長期記憶當中。

患者有時難以調整來自身體的感官資訊。因此，這些患者也許容易遭受感官過度負荷和恐慌發作[19]。

有些患者遭遇肢體動作的中度至極端困難。由於正確執行肢體動作消耗大幅能量，導致發展協調障礙患者普遍疲憊。肌肉張力減退及肌肉張力低同樣損害一些發展協調障礙患者的平衡力[2]

一般運動控制

全身動作和動作協調問題指主要發展目標（包括步行、跑步、攀爬和跳躍）受影響。遭受的困難因人而異，可能包括以下行為：

  • 節拍不當[20]
  • 平衡力差[20][21]（有時甚至中幅度步行摔倒，常見自己絆倒自己）
  • 難以合併一連串受控動作
  • 難以記得下一個動作
  • 難以意識空間[21][22]或肌肉運動知覺。
  • 難以拾起及握住簡單物品如鉛筆，因為肌肉張力或肌肉運動知覺差勁
  • 笨拙到碰跌物品令自己受傷及不小心撞到人
  • 左右不分
  • 常見交叉用手、轉換慣用手、雙撇子
  • 難以咀嚼食物

精細動作控制

精細動作問題導致難以執行多方面的任務，例如使用刀叉、扣鈕、綁鞋帶、煮食、刷牙、弄頭髮、剃鬚[2][23]、化妝、保養、打開瓶罐及包裝、鎖門及開鎖、做家務。

精細動作協調問題也會導致書寫困難[2]，或許出自聯想或聯想動作困難[20][24]。行為可能包括：

  • 學習基本動作[25]
  • 建立想要的書寫速度[23]
  • 正確握筆[23]
  • 難以閱讀的筆跡，以可能漏字或錯誤排列文字
  • 排列字位——例如拉丁字母以及數字

發展性言語失用症

發展性言語失用症（DVD）是一種聯想障礙性失用症，導致言語障礙。英國支持這個術語，但發展性言語失用症有時被稱為構音運用障礙（articulatory dyspraxia），在美國通常稱為兒童期言語失用症（childhood apraxia of speech, CAS）[26][27][28]。

主要行為包括：

  • 難以控制言語器官
  • 難以發音
  • 難以發出一連串的聲音
    • 單字音節，以及
    • 以單字組成句子
  • 難以控制呼吸、抑制流涎和唱歌時發聲（有歌詞）。
  • 語言發展緩慢

相關失調及二次後果

發展協調障礙患者也許有以下共病：

不過，發展協調障礙患者不太可能同時具備上述所有條件，其遭受困難的程度因人而異。一個患者的主要弱項可能是另一個患者的強項或天賦。例如有些患者有讀寫障礙，或計算障礙，其他患者卻或許有出色的閱讀、拼寫或數學能力。ADHD和發展協調障礙的共病率特別高，大約50%（一半發展協調障礙患者有ADHD，一半ADHD患者有發展協調障礙）[43][44][45]。

感官處理障礙

感官處理障礙（SPD）是對於生理刺激的過度敏感或過度不敏感（例如觸覺、視覺、聽覺及嗅覺）[46]。可能外現為無能力忍受某種質地（例如砂紙）或布料（例如羊毛）、口腔無法忍受口感過於豐富的食物（普遍被認為挑食）、被觸碰（觸覺過度敏感的個案）、或由於陽光使其不適而需要定期在戶外使用太陽眼鏡（視覺過度敏感的個案）。厭惡響亮音樂及本身響亮的環境（如舞廳及酒吧）是聽覺過敏的典型表現，只有在異常溫暖或寒冷環境之下才感到舒適是溫度過敏的典型表現。對刺激過於不敏感也許會造成困難，因為個人缺乏足夠的感官資訊去理解身體在空間的哪個位置，令其更難以完成任務[47]。對痛楚過於不敏感或許不意識自己受傷。

發展性言語障礙

發展性言語障礙（DLD），前稱特殊語言障礙（specific language disorder, SLI）、接受性-表達性混合語言障礙或言語障礙。研究發現擁有正常語言技巧的發展協調障礙學生仍然經歷學習障礙。即是說，發展協調障礙學生遭遇的學習障礙取決於其工作記憶能力。任何語言強項不足以完全支持其學習[41]。

發展協調障礙學生的視覺空間記憶遭受最大障礙。患有發展協調障礙的學生相對可能在視覺空間記憶得到差勁的分數，比沒有此障礙的同儕高出7倍[48]。視覺空間記憶受損是一種工作記憶受損，導致患有發展協調障礙的學生同時出現學習障礙[49]。

心理和社交後果

心理層面：發展協調障礙兒童也許遭受社交上比同儕較低的自我效能，以及認為自己的能力比同儕低。有些兒童展現更高程度的攻擊性及活躍度[50]。

社交層面：兒童也許更容易遭受社會排擠及欺凌，或許令其更孤獨[50]。

診斷

評估發展協調障礙通常需要潛在患者的童年發展歷史[12]，患者的童年發展歷史需要詳細說明重要的兒童發展階段（如爬行和步行）在甚麼歲數發生[5][11][29]。

為了診斷兒童是否患上發展協調障礙，美國精神醫學學會列出四種包括性的主要診斷準則[29]。

準則如下：

  1. 動作協調大幅降少，智力正常
  2. 動作協調或動作規劃的困難干預兒童日常生活
  3. 動作協調困難不是出自其他醫療狀況
  4. 即使有共病（如智力障礙或其他發展障礙），動作協調仍有不成比例的影響[12]

能夠應用於發展協調障礙的篩查包括：

  • Movement Assessment Battery for Children (Movement-ABC – Movement-ABC 2)[51][52][53][54][55]
  • Peabody Developmental Motor Scales- Second Edition (PDMS-2)[51]
  • Bruininks-Oseretsky Test of Motor Proficiency (BOTMP-BOT-2)[51][56][57][58]
  • Motoriktest für vier- bis sechsjährige Kinder (MOT 4–6)[51][59]
  • Körperkoordinationtest für Kinder (KTK)[51]
  • Test of Gross Motor Development, Second Edition (TGMD-2)[51]
  • Maastrichtse Motoriek Test (MMT)[51]
  • Wechsler Adult Intelligence Scale (WAIS-IV) 
  • Wechsler Individual Achievement Test (WAIT-II) 
  • Test Of Word Reading Efficiency Second Edition (TOWRE-2) 
  • Developmental Coordination Disorder Questionnaire (DCD-Q).[60] 此問卷已譯成多種語文，例如法文人士可用加拿大法文版[61]或歐陸法文版[62]。
  • Children's Self-Perceptions of Adequacy in, and Predilection for Physical Activity (CSAPPA)[63]

目前沒有單一評估測試[51]。

最低限度的動作評估是介入發展障礙的起點。對比正常兒童的發展速度或許有助尋找患童明顯遭受困難的方面。

不過，《英國特殊教育雜誌》的研究顯示，仍然嚴重缺乏有關識別及應對各種困難的知識（包括發展協調障礙、閱讀障礙、DAMP）[29]。及早留意及評估能夠更快介入。如果老師或全科醫生只是粗略診斷，很可能會錯過有需要的患者。

「如果老師知識有限，就無法識別或幫助學習障礙的兒童。相似地，醫生難以偵測及轉介學習障礙兒童到適當的地方。」[64]

分類

發展協調障礙在《精神疾病診斷與統計手冊第五版》 (DSM-5) 歸類為動作障礙，位於神經發育障礙類別[65][66]。

控制

發展協調障礙無法治癒，只能透過治療控制。物理治療或職業治療能夠幫助患者。

有些患者利用替代方法幫助自己，例如打字取代寫字，或利用日記及日曆保持條理[67]。Cochrane在2017年審核對發展協調障礙的任務導向介入，得到不一致的結果，呼籲隨機化對照組及進一步研究[68]。

流行病學

發展協調障礙是終生神經系統狀況，男性和女性同樣普遍。不過目前的診斷準則有利男性，導致超過80%男性在16歲前確診，相對22%女性。發展協調障礙的實際比例是未知，由於缺乏具體實驗室測試而難以偵測。因此，只要診斷出其中一種狀況就會排除其他可能的原因或疾病。大約5%-6%兒童及成人受此影響[2][4][5][69]。

歷史

Collier首先形容發展協調障礙為「先天性發育不良」。1972年，A. Jean Ayres形容發展協調障礙為感官統合障礙[70][71]。1975年，醫學博士Sasson Gubbay稱之為「笨拙兒童症」[12][31][72]。發展協調障礙也曾被稱為「最低度腦部失能」，後兩者已不再使用。

其他名稱包括發展性失用症[12]、注意力和運動感知障礙（DAMP）[12][31]、動作障礙[11]、發育性運動障礙[12]、動作學習障礙[12][31]感知動作失能[12][31][71]和感官動作失能[12]。

世界衛生組織目前將發展協調障礙列作「動作功能的具體發展障礙（"Specific Developmental Disorder of Motor Function"）」[11]

流行文化

Ryan Sinclair是BBC科幻電視節目《神秘博士》中博士的人類伴侶，患有這種失調。該角色於2018年首次亮相。[73]

著名案例

公開表明確診發展協調障礙的人包括《哈利波特》演員丹尼爾拉德克利夫[74]、攝影師大衛貝利[75]、模特卡拉迪瓦伊[76]、歌手弗洛倫斯韋爾奇[77]、英國政治家艾瑪勒威爾巴克[78][79]、欖球聯盟球員Ellis Genge[80]、演員Will Poulter[81]、歌手Mel B[82]、演員Olive Gray[83]、作家Holly Smale[84]、遊戲評論家John "TotalBiscuit" Bain[85]和音樂家托亞·威爾考克斯[86]。

參見

參考

  1. ^ An International Consensus on Children with Developmental Coordination Disorder. Canadian Journal of Occupational Therapy. 1995, 62 (1): 3–6. doi:10.1177/000841749506200101. 
  2. ^ 2.0 2.1 2.2 2.3 2.4 2.5 Developmental coordination disorder. Physical Therapy. August 2003, 83 (8): 722–31 [2022-05-02]. PMID 12882613. doi:10.1093/ptj/83.8.722. （原始內容存檔於2016-07-13）. 
  3. ^ Consensus Statements. CanChild. [2022-05-02]. （原始內容存檔於2015-07-22）. 
  4. ^ 4.0 4.1 European Academy for Childhood Disability (EACD): recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version). Developmental Medicine and Child Neurology. January 2012, 54 (1): 54–93. PMID 22171930. doi:10.1111/j.1469-8749.2011.04171.x. 
  5. ^ 5.0 5.1 5.2 Developmental coordination disorder: a review and update. European Journal of Paediatric Neurology. November 2012, 16 (6): 573–81. PMID 22705270. doi:10.1016/j.ejpn.2012.05.005. 
  6. ^ 發展協調障礙 物理治療運動指南 (PDF). web.archive.org. 屯門醫院物理治療部. [2022-05-02]. 原始內容存檔於2022-05-02. 
  7. ^ 陳玉蘭. 何為發展協調障礙. web.archive.org. 臺北榮民總醫院 復健部 兒童發展評估中心. 2021-11-14 [2022-05-02]. 原始內容存檔於2021-11-14. 
  8. ^ 發展性協調障礙. web.archive.org. 協康會. 2022-05-02 [2022-05-02]. 原始內容存檔於2022-05-02. 
  9. ^ 世界衛生組織．ICD-11精神、行为与神经发育障碍临床描述与诊断指南 [M]．王振，黃晶晶, 主譯．北京：人民衛生出版社, 2023. 978-7-117-34848-5.
  10. ^ World Health Organization. ICD-11 – Mortality and Morbidity Statistics: 6A04 Developmental motor coordination disorder. icd.who.int. 2018 [25 February 2019]. （原始內容存檔於2018-08-01）. 
  11. ^ 11.0 11.1 11.2 11.3 11.4 Toward an understanding of developmental coordination disorder: terminological and diagnostic issues. Neural Plasticity. 2003, 10 (1–2): 1–13. PMC 2565424  . PMID 14640303. doi:10.1155/NP.2003.1. 
  12. ^ 12.00 12.01 12.02 12.03 12.04 12.05 12.06 12.07 12.08 12.09 Dyspraxia or developmental coordination disorder? Unravelling the enigma. Archives of Disease in Childhood. June 2007, 92 (6): 534–9. PMC 2066137  . PMID 17515623. doi:10.1136/adc.2005.088054. 
  13. ^ Terminology used in research reports of developmental coordination disorder. Developmental Medicine and Child Neurology. November 2006, 48 (11): 937–41. PMID 17044965. doi:10.1017/S0012162206002040. 
  14. ^ 14.0 14.1 The development and standardization of the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC). Research in Developmental Disabilities. 2010, 31 (1): 131–9. PMID 19819107. doi:10.1016/j.ridd.2009.08.010. 
  15. ^ Kotsopoulos, S. https://archive.org/details/diagnosticstatis0005unse/page/257 |chapterurl=缺少標題 (幫助). Neurodevelopmental Disorders. Journal of Psychiatry and Neuroscience. DSM Library 26 (American Psychiatric Association). 2013-05-22: 257. ISBN 978-0890425558. PMC 1408294  . doi:10.1176/appi.books.9780890425596.dsm01. 
  16. ^ Developmental Coordination Disorder and cerebral palsy: categories or a continuum?. Human Movement Science. October 2010, 29 (5): 787–98. PMID 20594606. doi:10.1016/j.humov.2010.04.006. 
  17. ^ Developmental Coordination Disorder. CanChild (2016-02). [2022-05-02]. （原始內容存檔於2015-07-22）. 
  18. ^ Working memory in children with developmental disorders (PDF). Journal of Learning Disabilities. 2009, 42 (4): 372–82 [2022-05-02]. PMID 19380495. doi:10.1177/0022219409335214. （原始內容 (PDF)存檔於2021-11-23）. 
  19. ^ 19.0 19.1 19.2 Biggs, Victoria. 3 A Survival Guide to School. London; Philadelphia: Jessica Kingsley Publishers. 2005. ISBN 978-1-84310-347-9. OCLC 57316751. 
  20. ^ 20.0 20.1 20.2 Parental questions about developmental coordination disorder: A synopsis of current evidence. Paediatrics & Child Health. October 2006, 11 (8): 507–12. PMC 2528644  . PMID 19030319. doi:10.1093/pch/11.8.507. 
  21. ^ 21.0 21.1 Postural control in children with developmental coordination disorder. Neural Plasticity. 2005, 12 (2–3): 183–96; discussion 263–72. PMC 2565450  . PMID 16097486. doi:10.1155/NP.2005.183. 
  22. ^ Information processing deficits associated with developmental coordination disorder: a meta-analysis of research findings. Journal of Child Psychology and Psychiatry, and Allied Disciplines. September 1998, 39 (6): 829–40. PMID 9758192. doi:10.1111/1469-7610.00384. 
  23. ^ 23.0 23.1 23.2 Developmental coordination disorder (dyspraxia): an overview of the state of the art. Seminars in Pediatric Neurology. December 2005, 12 (4): 250–8. PMID 16780296. doi:10.1016/j.spen.2005.12.007. 
  24. ^ Handwriting measures as reflectors of executive functions among adults with Developmental Coordination Disorders (DCD). Frontiers in Psychology. 2013, 4: 357. PMC 3693067  . PMID 23805113. doi:10.3389/fpsyg.2013.00357. 
  25. ^ Central representations of human limb movement as revealed by studies of drawing and handwriting. Trends in Neurosciences. August 1989, 12 (8): 287–91. PMID 2475946. doi:10.1016/0166-2236(89)90008-8. 
  26. ^ FOXP2 and the neuroanatomy of speech and language (PDF). Nature Reviews. Neuroscience. February 2005, 6 (2): 131–8 [2022-05-02]. PMID 15685218. doi:10.1038/nrn1605. （原始內容 (PDF)存檔於2020-03-09）. 
  27. ^ The distinct and overlapping phenotypic spectra of FOXP1 and FOXP2 in cognitive disorders. Human Genetics. November 2012, 131 (11): 1687–98. PMC 3470686  . PMID 22736078. doi:10.1007/s00439-012-1193-z. 
  28. ^ Evo-devo, deep homology and FoxP2: implications for the evolution of speech and language. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. July 2011, 366 (1574): 2124–40. PMC 3130369  . PMID 21690130. doi:10.1098/rstb.2011.0001. 
  29. ^ 29.0 29.1 29.2 29.3 Children with developmental coordination disorders. Journal of the Royal Society of Medicine. April 2007, 100 (4): 182–6. PMC 1847727  . PMID 17404341. doi:10.1177/014107680710011414. 
  30. ^ [Motor problems in children with ADHD receive too little attention in clinical practice]. Nederlands Tijdschrift voor Geneeskunde. 2011, 155 (50): A3559. PMID 22186361 （荷蘭語）. 
  31. ^ 31.0 31.1 31.2 31.3 31.4 31.5 Why bother about clumsiness? The implications of having developmental coordination disorder (DCD). Neural Plasticity. 2003, 10 (1–2): 59–68. PMC 2565425  . PMID 14640308. doi:10.1155/NP.2003.59. 
  32. ^ Lucas, Barbara R; Doney, Robyn; Latimer, Jane; Watkins, Rochelle E; Tsang, Tracey W; Hawkes, Genevieve; Fitzpatrick, James P; Oscar, June; Carter, Maureen. Impairment of motor skills in children with fetal alcohol spectrum disorders in remote Australia: The Lililwan Project. Drug and Alcohol Review (Australasian Professional Society on Alcohol and other Drugs). 2016, 35 (6): 719–727 [10 December 2021]. PMID 26879822. doi:10.1111/dar.12375. （原始內容存檔於2021-12-10）. 
  33. ^ Dyspraxia in autism: association with motor, social, and communicative deficits. Developmental Medicine and Child Neurology. October 2007, 49 (10): 734–9. PMID 17880641. doi:10.1111/j.1469-8749.2007.00734.x. 
  34. ^ The neurology of autism spectrum disorders. Current Opinion in Neurology. April 2011, 24 (2): 132–9. PMC 3160764  . PMID 21293268. doi:10.1097/WCO.0b013e3283446450. 
  35. ^ Meta review of systematic and meta analytic reviews on movement differences, effect of movement based interventions, and the underlying neural mechanisms in autism spectrum disorder. Frontiers in Integrative Neuroscience. 2013, 7: 16. PMC 3607787  . PMID 23532374. doi:10.3389/fnint.2013.00016. 
  36. ^ Mathematical problems in children with developmental coordination disorder. Research in Developmental Disabilities. 2012, 33 (4): 1128–35. PMID 22502838. doi:10.1016/j.ridd.2012.02.007. 
  37. ^ SOS: a screening instrument to identify children with handwriting impairments. Physical & Occupational Therapy in Pediatrics. August 2012, 32 (3): 306–19 [2022-05-02]. PMID 22515913. doi:10.3109/01942638.2012.678971. （原始內容存檔於2022-05-02）. 
  38. ^ Pickering, Susan J.; Gathercole. https://web.archive.org/web/20200801035725/https://books.google.com/books?id=IoXidOBdNpMC&pg=PA29 |archive-url=缺少標題 (幫助). Packiam Alloway, Susan E. (編). Working Memory and Neurodevelopmental Disorders. Psychology Press. 2012 [2022-05-02]. ISBN 978-1-135-42134-2. （原始內容存檔於2020-08-01）. 
  39. ^ Michele Poletti. Disturbo di Sviluppo della Coordinazione Motoria e Sindrome Non Verbale: esistono aree di sovrapposizione clinica?. Psicologia Clinica Dello Sviluppo. 2011, (3): 525–550. doi:10.1449/35886. 
  40. ^ Sensory integration and activities of daily living in children with developmental coordination disorder. Italian Journal of Pediatrics. April 2012, 38 (1): 14. PMC 3395584  . PMID 22546072. doi:10.1186/1824-7288-38-14. 
  41. ^ 41.0 41.1 Working memory and learning in children with developmental coordination disorder and specific language impairment. Journal of Learning Disabilities. 2008, 41 (3): 251–62. Bibcode:10.1.1.541.7017 請檢查|bibcode=值 (幫助). PMID 18434291. doi:10.1177/0022219408315815. 
  42. ^ Perceptual skills of children with developmental coordination disorder (PDF). Human Movement Science. March 2001, 20 (1–2): 111–33 [2013-12-29]. PMID 11471393. doi:10.1016/s0167-9457(01)00031-8. （原始內容 (PDF)存檔於2013-12-30）. 
  43. ^ Barkley, Russell A. Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. New York: Guilford Press. 1990. ISBN 978-0-89862-443-4. OCLC 21335369. 
  44. ^ Attention deficit hyperactivity disorder and developmental coordination disorder: Two separate disorders or do they share a common etiology. Behavioural Brain Research. 2015-07-10, 292: 484–492. PMID 26168770. doi:10.1016/j.bbr.2015.07.009. 
  45. ^ Tourette syndrome and other neurodevelopmental disorders: a comprehensive review. Child and Adolescent Psychiatry and Mental Health. 2017-12-04, 11: 59. PMC 5715991  . PMID 29225671. doi:10.1186/s13034-017-0196-x. 
  46. ^ Concept evolution in sensory integration: a proposed nosology for diagnosis (PDF). The American Journal of Occupational Therapy. 2007, 61 (2): 135–40. PMID 17436834. doi:10.5014/ajot.61.2.135. （原始內容 (PDF)存檔於2012-10-24）. 
  47. ^ Fitts, Diana. Explaining Motor Dyspraxia in Children and Ways to Address It. The Sensory Toolbox. 2019-03-25 [2019-11-02]. （原始內容存檔於2021-01-15） （美國英語）. 
  48. ^ Working memory, reading, and mathematical skills in children with developmental coordination disorder (PDF). Journal of Experimental Child Psychology. January 2007, 96 (1): 20–36 [2022-05-02]. PMID 17010988. doi:10.1016/j.jecp.2006.07.002. （原始內容 (PDF)存檔於2021-07-14）. 
  49. ^ A Comparison of Working Memory Profiles and Learning in Children with Developmental Coordination Disorder and Moderate Learning Difficulties. Applied Cognitive Psychology. 2007, 21 (4): 473–487. doi:10.1002/acp.1284. 
  50. ^ 50.0 50.1 Quality of life domains affected in children with developmental coordination disorder: a systematic review. Child: Care, Health and Development. 2012-04-20, 39 (4): 562–580. PMID 22515477. doi:10.1111/j.1365-2214.2012.01379.x. 
  51. ^ 51.0 51.1 51.2 51.3 51.4 51.5 51.6 51.7 Movement skill assessment of typically developing preschool children: a review of seven movement skill assessment tools. Journal of Sports Science & Medicine. June 2009, 8 (2): 154–68. PMC 3761481  . PMID 24149522. 
  52. ^ A two-step procedure for the identification of children with developmental co-ordination disorder in Singapore. Developmental Medicine and Child Neurology. December 1996, 38 (12): 1099–105. PMID 8973295. doi:10.1111/j.1469-8749.1996.tb15073.x. 
  53. ^ Can the movement assessment battery for children-test be the "gold standard" for the motor assessment of children with Developmental Coordination Disorder?. Research in Developmental Disabilities. 2011, 32 (1): 1–10. PMID 20940096. doi:10.1016/j.ridd.2010.09.006. 
  54. ^ Reliability and validity of age band 1 of the Movement Assessment Battery for Children--second edition. Research in Developmental Disabilities. 2011, 32 (3): 1046–51. PMID 21333488. doi:10.1016/j.ridd.2011.01.035. 
  55. ^ Validity and reliability of the Movement Assessment Battery for Children-2 Checklist for children with and without motor impairments. Developmental Medicine and Child Neurology. April 2012, 54 (4): 368–75. PMID 22320829. doi:10.1111/j.1469-8749.2012.04226.x. 
  56. ^ Use of the Bruininks-Oseretsky Test of Motor Proficiency for identifying children with motor impairment. Developmental Medicine and Child Neurology. November 2007, 49 (11): 846–8. PMID 17979863. doi:10.1111/j.1469-8749.2007.00846.x. 
  57. ^ Motor assessment of preschool aged children: A preliminary investigation of the validity of the Bruininks-Oseretsky test of motor proficiency - short form. Human Movement Science. August 2009, 28 (4): 543–50 [2022-05-02]. PMID 19443065. doi:10.1016/j.humov.2009.03.002. （原始內容存檔於2022-05-02）. 
  58. ^ The Bruininks-Oseretsky Test of Motor Proficiency-Short Form is reliable in children living in remote Australian Aboriginal communities. BMC Pediatrics. September 2013, 13: 135. PMC 3844452  . PMID 24010634. doi:10.1186/1471-2431-13-135. 
  59. ^ The Motor-Proficiency-Test for children between 4 and 6 years of age (MOT 4-6): an investigation of its suitability in Greece. Research in Developmental Disabilities. 2012, 33 (5): 1626–32. PMID 22543059. doi:10.1016/j.ridd.2012.04.002. 
  60. ^ Evaluation of the Developmental Coordination Disorder Questionnaire as a screening instrument. Developmental Medicine and Child Neurology. August 2006, 48 (8): 668–73. PMID 16836779. doi:10.1017/S001216220600140X. 
  61. ^ French Canadian cross-cultural adaptation of the Developmental Coordination Disorder Questionnaire '07: DCDQ-FC. Canadian Journal of Occupational Therapy. December 2011, 78 (5): 318–27. PMID 22338299. doi:10.2182/cjot.2011.78.5.7. 
  62. ^ Lin, Chung-Ying (編). Psychometric assessment of the French European Developmental Coordination Disorder Questionnaire (DCDQ-FE). PLOS ONE. 2019-05-23, 14 (5): e0217280. Bibcode:2019PLoSO..1417280R. PMC 6532915  . PMID 31120966. doi:10.1371/journal.pone.0217280. 
  63. ^ Evaluation of a screening instrument for developmental coordination disorder. The Journal of Adolescent Health. April 2004, 34 (4): 308–13. PMID 15041000. doi:10.1016/j.jadohealth.2003.07.004. 
  64. ^ Kirby, Amanda; Davies, Rhys; Bryant, Amy. Do teachers know more about specific learning difficulties than general practitioners?. British Journal of Special Education. 2005, 32 (3): 122–126. ISSN 0952-3383. doi:10.1111/j.0952-3383.2005.00384.x. 
  65. ^ American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: American Psychiatric Publishing. 2013: 74–77. ISBN 978-0-89042-559-6. doi:10.1176/appi.books.9780890425596. 
  66. ^ Diagnosis and management of developmental coordination disorder. CMAJ. June 2015, 187 (9): 659–665. PMC 4467929  . PMID 26009588. doi:10.1503/cmaj.140994. 
  67. ^ Dyspraxia (developmental co-ordination disorder) in adults. 2017-10-18 [2022-05-02]. （原始內容存檔於2022-07-06）. 
  68. ^ Miyahara, Motohide; Hillier, Susan L.; Pridham, Liz; Nakagawa, Shinichi. Task-oriented interventions for children with developmental co-ordination disorder. The Cochrane Database of Systematic Reviews. 31 July 2017, 7 (8): CD010914. ISSN 1469-493X. PMC 6483344  . PMID 28758189. doi:10.1002/14651858.CD010914.pub2. 
  69. ^ Educational outreach and collaborative care enhances physician's perceived knowledge about Developmental Coordination Disorder. BMC Health Services Research. January 2008, 8: 21. PMC 2254381  . PMID 18218082. doi:10.1186/1472-6963-8-21. 
  70. ^ Types of sensory integrative dysfunction among disabled learners. The American Journal of Occupational Therapy. 1972, 26 (1): 13–8. PMID 5008164. 
  71. ^ 71.0 71.1 Motor problems in children with developmental coordination disorder: review of the literature (PDF). The American Journal of Occupational Therapy. September 1995, 49 (8): 787–94. PMID 8526224. doi:10.5014/ajot.49.8.787. [失效連結]
  72. ^ The management of developmental apraxia. Developmental Medicine and Child Neurology. October 1978, 20 (5): 643–6. PMID 729912. doi:10.1111/j.1469-8749.1978.tb15283.x. 
  73. ^ Gerken, Tom. Doctor Who: How the dyspraxic assistant became my hero. BBC News (BBC). 2018-10-08 [16 October 2018]. （原始內容存檔於2019-04-06）. 
  74. ^ Irvine, Chris. Harry Potter's Daniel Radcliffe has dyspraxia. The Daily Telegraph (London). 2008-08-17 [2010-05-16]. （原始內容存檔於2008-08-21）. 
  75. ^ Walsh, John. David Bailey was a scowling, socially mobile rude boy. The Independent. 2 January 2016 [2022-05-02]. （原始內容存檔於2019-10-17）. 
  76. ^ Haskell, Rob. Cara Delevingne Opens Up About Her Childhood, Love Life, and Why Modeling Just Isn't Enough. Vogue. 19 June 2015 [14 September 2015]. （原始內容存檔於2016-11-24）. 
  77. ^ Hussey, Patrick. Interview: Florence & The Machine. Run Riot. 15 May 2008 [7 March 2010]. （原始內容存檔於2012-04-22）. 
  78. ^ Irvine, Chris. 'I'd love to wear eyeliner, but that requires a steady hand' Labour MP Emma Lewell-Buck struggled with clumsiness, until a diagnosis of dyspraxia helped her become a politician. The Daily Telegraph (London). 2013-09-28 [2013-09-28]. （原始內容存檔於2022-01-12）. 
  79. ^ Beater, Emily. Studying with dyspraxia: 'I never truly understood an academic text'. The Guardian. 5 March 2019 [2022-05-02]. （原始內容存檔於2022-05-02） –透過www.theguardian.com. 
  80. ^ Hennessy, Jason. Ellis Genge Was The Talk Of Television Last Night Following This Incredible Interview. 6 September 2018 [2022-05-02]. （原始內容存檔於2018-11-28）. 
  81. ^ The big picture: How Will Poulter shook off the tough tearaway tag to. The Independent. 2013-08-25 [2019-03-25]. （原始內容存檔於2019-03-25） （英語）. 
  82. ^ Mel B opens up about her ADHD, ADD and dyspraxia - but what are they?. uk.style.yahoo.com. [2021-04-11]. （原始內容存檔於2021-06-18） （英國英語）. 
  83. ^ Olive Gray | Dyspraxic Actor, Musician and Poet by The Dyspraxic Help 4U Podcast. Anchor. [2021-10-23]. （原始內容存檔於2022-04-15） （英語）. 
  84. ^ Smale, Holly [@HolSmale]. Just got my results through! I’m officially dyspraxic. Which comes as no surprise to anyone who has ever met me, but may stop me beating myself up for… beating myself up. ❤ (推文). June 29, 2021 [June 6, 2021] –透過Twitter （英語）. 
  85. ^ Bain, John. Sorry, diagnosed dyspraxic with a step-son who as you probably know has adhd and aspergers. This is a topic I care deeply about.. Twitter. [22 May 2020]. （原始內容存檔於2022-05-02）. 
  86. ^ Toyah Willcox Life Story | Punk Princess | Longevity & Success | Dyspraxic Star by The Dyspraxic Help 4U Podcast. Anchor. [2021-10-23]. （原始內容存檔於2021-10-26） （英語）. 
取自 "https://zh.wikipedia.org/w/index.php?title=發展協調障礙&oldid=84881531"