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Brazilian research on the development of coordination development: a review in the light of bioecological theory

Abstract

Introduction

Children with Developmental Coordination Disorder (DCD) present motor disorders that compromise their engagement in occupations.

Objective

Adopting the Bioecological Theory of Human Development (BTHD) as a basis for examining the productions of DCD, this study aimed to identify and discuss the elements of the Process-Person-Context-Time model (PPCT) in the national scientific production about children with DCD.

Method

The first phase of the study consisted of an integrative review of the national scientific literature on DCD in journals indexed in Virtual Health Library and SciELO, based on health descriptors. The second phase consisted of collating the elements of the PPCT model in the selected literature.

Results

The sample, composed of 19 studies, showed a predominance of quantitative methodology and cross-sectional studies. Elements of the core Person were present in all searches. Motor performance was the central condition for the identification of DCD and correlation with other clinical, health and social variables. In the proximal processes, the family and school microsystem prevailed. In the core Time, the importance of diagnosis and early intervention, and specificities of normative life events of the child were highlighted. The review revealed the intense use of the Movement Assessment Battery for Children (MABC) as an instrument of identification and the importance of broader measures for the development of children with DCD.

Conclusion

The analysis of research in the light of the bioecological theory made us think about important aspects of child development and there is a gap in the literature in relation to studies on DCD that contemplate the macrosystem with emphasis in the national health and education policies.

Keywords:
Motor Skills Disorders; Human Development; Child

Resumo

Introdução

Crianças com Transtorno do Desenvolvimento da Coordenação (TDC) apresentam desordens motoras que comprometem seu engajamento em ocupações.

Objetivo

Adotando-se a Teoria Bioecológica do Desenvolvimento Humano (TBDH) como base para o exame das produções sobre o TDC, este estudo objetivou identificar e discutir os elementos do modelo Processo-Pessoa-Contexto-Tempo (PPCT) na produção científica nacional sobre crianças com TDC.

Método

A primeira fase do estudo consistiu na revisão integrativa da literatura científica nacional sobre o TDC em periódicos indexados na Biblioteca Virtual em Saúde e SciELO, a partir de descritores em saúde. A segunda fase consistiu no cotejamento dos elementos do modelo PPCT na literatura selecionada.

Resultados

A amostra, composta por 19 estudos, apresentou predomínio da metodologia quantitativa e estudos transversais. Os elementos do núcleo Pessoa estiveram presentes em todas as pesquisas. O desempenho motor foi a condição central para a identificação do TDC e correlação com outras variáveis clínicas, de saúde e sociais. Nos processos proximais prevaleceram o microssistema familiar e escolar. No núcleo Tempo destacou-se a importância do diagnóstico e intervenção precoce e especificidades dos eventos de vida normativos da criança. A revisão revelou o intenso uso do Movement Assessment Battery for Children (MABC) como instrumento de identificação e a importância de medidas mais amplas do desenvolvimento da criança com TDC.

Conclusão

A análise das pesquisas à luz da teoria bioecológica traz à reflexão importantes aspectos do desenvolvimento da criança e mostra-se uma lacuna na literatura em relação aos estudos sobre TDC que contemplem o macrossistema com ênfase nas políticas nacionais de saúde e educação.

Palavras-chave:
Transtorno do Desenvolvimento da Coordenação; Desenvolvimento Humano; Criança

1 Introduction

Changes in motor skills of children without specific neurological injuries, “apparently normal”, have been called, since the 1980s, Developmental Coordination Disorder (CDC) by the American Psychiatric Association (DSM-III) and Specific Motor Development Disability by the World Health Organization (WHO) in the International Classification of Diseases (ICD-10). This fact represented the recognition that these children had problems in motor development that affected their overall development (Dantas & Manoel, 2009Dantas, L. E. B. P. T., & Manoel, E. J. (2009). Crianças com dificuldades motoras: questões para a conceituação do transtorno do desenvolvimento da coordenação. Movimento, 15(3), 293-313. http://dx.doi.org/10.22456/1982-8918.3908.
http://dx.doi.org/10.22456/1982-8918.390...
).

According to the recent recommendations of the European Academy for Childhood Disability (Blank et al., 2019Blank, R., Barnett, A. L., Cairney, J., Green, D., Kirby, A., Polatajko, H., Rosenblum, S., Smits-Engelsman, B., Sugden, D., Wilson, P., & Vinçon, S. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention and psychosocial aspects of developmental coordination disorder (long version). Developmental Medicine and Child Neurology, 61(3), 1-44. PMid:30671947. http://dx.doi.org/10.1111/dmcn.14132.
http://dx.doi.org/10.1111/dmcn.14132...
), closely related to those established by the DSM-V (American Psychiatric Association, 2013American Psychiatric Association – APA. (2013). Diagnostic and statistical manual of mental disorders. Washington: APA.), for the diagnosis of DCD the following criteria must be met:

  1. I

    the acquisition and performance of coordinated motor skills are substantially lower than expected for chronological age and enough opportunities for age-appropriate skills acquisition; together there may be clumsiness, falls, bumping into things, balance deficit, difficulties on writing, jumping, cutting, coloring, catching and/or kicking the ball;

  2. II

    the impairment in motor skills described in criterion I significantly and persistently interferes with the child's daily activities, such as self-care and mobility, and academic/school productivity, pre-vocational and vocational activities, leisure, games and jokes;

  3. III

    such impairments in motor skills are not better explained by other medical, neurodevelopmental, psychological, social or cultural conditions;

  4. IV

    the onset of symptoms occurs in childhood, although not identified before adolescence or adulthood.

In addition, poor motor behavior can lead to poor postural control and difficulties in motor learning (new skills, motion planning, automation), strategic planning, timing and motion sequencing, and processing visuospatial information (Vaivre-Douret, 2014Vaivre-Douret, L. (2014). Developmental coordination disorders: state of art. Neurophysiologie Clinique, 44(1), 13-23. PMid:24502901. http://dx.doi.org/10.1016/j.neucli.2013.10.133.
http://dx.doi.org/10.1016/j.neucli.2013....
).

Vaivre-Douret et al. (2016)Vaivre-Douret, L., Lalanne, C., & Golse, B. (2016). Developmental coordination disorder, an umbrella term for motor impairments in children: nature and co-morbid disorders. Frontiers in Psychology, 7(502), 1-13. PMid:27148114. http://dx.doi.org/10.3389/fpsyg.2016.00502.
http://dx.doi.org/10.3389/fpsyg.2016.005...
present three subtypes for DCD; Ideomotor is the rarest and characterized by special difficulty in digital perception, gesture imitation and digital praxis; Visuospatial/Constructional presents dysfunctions in visuomotor integration and tasks involving visuospatial integration; and Mixed type, which presents specific difficulties in motor coordination and poor manual dexterity.

DCD is present in different cultures, races and socioeconomic conditions and considered idiopathic, so far. It is very often in comorbidity with other neurodevelopmental disorders including Attention Deficit Hyperactivity Disorder (ADHD), language disorders, learning disorders, autistic spectrum disorders, dyslexia or other writing disorders. It has a commonly reported prevalence of 5 to 6% in schoolchildren, however, between 2 and 20% in more recent research, and is more common in boys (Blank et al., 2019Blank, R., Barnett, A. L., Cairney, J., Green, D., Kirby, A., Polatajko, H., Rosenblum, S., Smits-Engelsman, B., Sugden, D., Wilson, P., & Vinçon, S. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention and psychosocial aspects of developmental coordination disorder (long version). Developmental Medicine and Child Neurology, 61(3), 1-44. PMid:30671947. http://dx.doi.org/10.1111/dmcn.14132.
http://dx.doi.org/10.1111/dmcn.14132...
).

Motor difficulties tend to affect negatively socio-emotional aspects of children with DCD, with secondary damage on self-esteem, self-concept, feeling of competence, anxiety levels, participation in physical and sports activities, and physical conditioning (Ferreira et al., 2015Ferreira, L. F., Cabral, G. C. F., Santos, J. O. L., Souza, C. J. F., & Freudenheim, A. M. (2015). Transtorno do desenvolvimento da coordenação: discussões iniciais sobre programas de intervenção. Revista Acta Brasileira de Movimento Humano, 5(1), 42-65.). It also impairs sense of self-efficacy in tasks and facing barriers to physical activity (Batey et al., 2014Batey, C. A., Missiuna, C. A., Timmons, B. W., Hay, J. A., Faught, B. E., & Cairney, J. (2014). Efficacy toward physical activity and physical activity behavior of children with and without developmental coordination disorder. Human Movement Science, 36, 258-271. PMid:24345354. http://dx.doi.org/10.1016/j.humov.2013.10.003.
http://dx.doi.org/10.1016/j.humov.2013.1...
), perceived efficacy in school activities/productivity, leisure and self-care (Engel-Yeger & Hanna Kasis, 2010Engel-Yeger, B., & Hanna Kasis, A. (2010). The relationship between developmental coordination disorders, child’s perceived self efficacy and preference to participate in daily activities. Child: Care, Health and Development, 36(5), 670-677. PMid:20412146. http://dx.doi.org/10.1111/j.1365-2214.2010.01073.x.
http://dx.doi.org/10.1111/j.1365-2214.20...
). Tal-Saban et al. (2014)Tal-Saban, M., Ornoy, A., & Parush, S. (2014). Young adults with developmental coordination disorder: a longitudinal study. The American Journal of Occupational Therapy, 68(3), 307-316. PMid:24797194. http://dx.doi.org/10.5014/ajot.2014.009563.
http://dx.doi.org/10.5014/ajot.2014.0095...
identified that these primary and secondary impairments of DCD affect participation in daily activities, quality of life and adult satisfaction.

The ecological theory of human development, conceived by Urie Bronfrenbrenner in the 1970s, explain the relevance of ecological contexts in the process of human development (Bronfenbrenner, 1996Bronfenbrenner, U. (1996). A ecologia do desenvolvimento humano: experimentos naturais e planejados. Porto Alegre: Artmed.). After reformulation by the author himself, the Bioecological Theory of Human Development (BTHD) now includes biological, process and time factors as equally determinant to human development and interdependent not only in context but also among them. Based on this reformulation, the author systematizes the theory into four cores, namely process, person, context and time (PPCT), understanding that human development would be a process of reciprocal interaction between the person and their context through time (Bronfenbrenner, 2011Bronfenbrenner, U. (2011). Bioecologia do desenvolvimento humano: tornando os seres humanos mais humanos. Porto Alegre: Artmed.).

That theory has been used in several national studies (Dessen & Polonia, 2007Dessen, M. A., & Polonia, A. C. (2007). A família e a escola como contextos de desenvolvimento humano. Paidéia, 17(36), 21-32. http://dx.doi.org/10.1590/S0103-863X2007000100003.
http://dx.doi.org/10.1590/S0103-863X2007...
; Alves & Emmel, 2008Alves, H. C., & Emmel, M. L. G. (2008). Abordagem bioecológica e narrativas orais: um estudo com crianças vitimizadas. Paidéia, 18(39), 85-100. http://dx.doi.org/10.1590/S0103-863X2008000100009.
http://dx.doi.org/10.1590/S0103-863X2008...
; Rolfsen & Martinez, 2008Rolfsen, A. B., & Martinez, C. M. S. (2008). Programa de intervenção para pais de crianças com dificuldades de aprendizagem: um estudo preliminar. Paidéia, 18(39), 175-188. http://dx.doi.org/10.1590/S0103-863X2008000100016.
http://dx.doi.org/10.1590/S0103-863X2008...
; Portes et al., 2013Portes, J. R. M., Vieira, M. L., Crepaldi, M. A., More, C. L. O. O., & Motta, C. C. L. (2013). A criança com síndrome de Down: na perspectiva da Teoria Bioecológica do Desenvolvimento Humano, com destaque aos fatores de risco e de proteção. Boletim Academia Paulista de Psicologia, 33(85), 446-464.) about childhood problems in both health and education. The study by Custódio et al. (2014)Custódio, Z. O., Crepaldi, M., & Linhares, M. M. (2014). Redes sociais de apoio no contexto da prematuridade: perspectiva do modelo bioecológico do desenvolvimento humano. Estudos de Psicologia, 31(2), 247-255. http://dx.doi.org/10.1590/0103-166X2014000200010.
http://dx.doi.org/10.1590/0103-166X20140...
reported a critical review of the literature about social support networks in the context of preterm infants’ development. It pointed out that the network approach in the context of prematurity, under the conception of BTHD, allowed us to glimpse the complexity of the various systems involved in this scenario, as well as the interrelationship between them.

With regard to schoolchildren, the studies of Nobre et al. (2014Nobre, F. S. S., Coutinho, M. T. C., & Valentini, N. C. (2014). A ecologia do desenvolvimento motor de escolares litorâneos do Nordeste do Brasil. Journal of Human Growth and Development, 24(3), 263-273. http://dx.doi.org/10.7322/jhdg.88910.
http://dx.doi.org/10.7322/jhdg.88910...
, 2016)Nobre, G. C., Bandeira, P. F. R., & Valentini, N. C. (2016). The relationship between general perceived motor competence, perceived competence relative to motor skill and actual motor competence in children. Journal of Physical Education , 27(e2744), 1-12. http://dx.doi.org/10.4025/jphyseduc.v27i1.2744.
http://dx.doi.org/10.4025/jphyseduc.v27i...
and Costa et al. (2014)Costa, C. L. A., Nobre, G. C., Nobre, F. S. S., & Valentini, N. C. (2014). Efeito de um programa de intervenção motora sobre o desenvolvimento motor de crianças em situação de risco social na região do Cariri – CE. Revista da Educação Física, 25(3), 353-364. http://dx.doi.org/10.4025/reveducfis.v25i3.21968.
http://dx.doi.org/10.4025/reveducfis.v25...
reveal the contributions of BTHD to both critical analysis and the systematization of public actions related to factors that affect the motor development of socioeconomically disadvantaged Brazilian children. However, among national studies, there is no analysis of the problem of DCD in the light of TBDH.

In the international context, although there is evidence about the biological factors (pre, peri and postnatal) associated with the development of DCD (Hua et al., 2014Hua, J., Jin, H., Gu, G., Liu, M., Zhang, L., & Wu, Z. (2014). The influence of chinese one-child family status on developmental coordination disorder status. Research in Developmental Disabilities, 35(1), 3089-3095. PMid:25137180. http://dx.doi.org/10.1016/j.ridd.2014.07.044.
http://dx.doi.org/10.1016/j.ridd.2014.07...
), there are few studies exploring the reciprocal relationship with sociocultural aspects or using Bronfenbrenner's approach to this kind of investigation.

The fact that there is no construction of knowledge about the nature of children with DCD interaction in their environmental context is a major gap, given the interactional reciprocal nature of development (McQuillan, 2015McQuillan, V. (2015). Stability and change over time in children with movement difficulties. Hillary Place Papers, 1-14.).

Sugden (2014)Sugden, D. (2014). Multi-level and ecological models of developmental coordination disorder. Current Developmental Disorders Reports, 1(2), 102-108. http://dx.doi.org/10.1007/s40474-014-0015-5.
http://dx.doi.org/10.1007/s40474-014-001...
points out that BTHD provides a solid theoretical framework for understanding the developmental process of children with DCD, considering that this development occurs as a function of the child's resources and the various environmental influences that occur over time. These influences range from broad social conditions to those present when engaged directly in physical activity. In this sense, this study aimed to identify and discuss the elements of PPCT cores in the national scientific production related to children with DCD. By dimensioning these elements in each study, we expect to discuss the developmental conditions of the Brazilian child with DCD in face of the importance of interactions reciprocity and environmental influences.

2 Method

This research consisted of an integrative review of the national scientific literature on studies on DCD, whose data were analyzed based on the perspective of BTHD elements. The integrative review consists of a method that reviews and systematizes literature data in order to gather and relate empirical and theoretical findings that provide a comprehensive understanding of certain thematic(s) and proposes new research questions (Cecílio & Oliveira, 2017Cecílio, H. P. M., & Oliveira, D. C. (2017). Modelos de revisão integrativa: discussão na pesquisa em enfermagem. In Anais do 6o Congreso Ibero-Americano Investigacion Qualitativa (pp. 764-772). Salamanca: CIAIQ.).

Following the steps of an integrative review proposed by Mendes et al. (2008)Mendes, K. D. S., Silveira, R. C. C. P., & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto Enfermagem, 17(4), 758-764. http://dx.doi.org/10.1590/S0104-07072008000400018.
http://dx.doi.org/10.1590/S0104-07072008...
, the guiding question of this integrative literature review is as follows: what do national research on children with DCD reveal when analyzed in the light of BTHD elements?

As inclusion criteria of the studies in this review, we selected articles available in full, which should: 1) constitute research on the topic of DCD; 2) not constitute a theoretical or documentary research; and 3) be national studies.

Data collection occurred in journals indexed in Virtual Health Library (Bireme) databases and in Scielo database. The following search descriptors were selected in English and Portuguese using the Health Science Descriptors (DeCS) and Medical Subjects Headings (Mesh): motor skills, motor skills disorders, child, Brazil, transtorno das habilidades motoras, transtorno do desenvolvimento da coordenação, criança e Brasil, in a combined way. No time limit has been set for the search period, which occurred until March 2018.

The articles were analyzed using the quantitative and qualitative approach (Turato, 2005Turato, E. R. (2005). Métodos qualitativos e quantitativos na área da saúde: definições, diferenças e seus objetos de pesquisa. Revista de Saúde Pública, 39(3), 507-514. PMid:15997330. http://dx.doi.org/10.1590/S0034-89102005000300025.
http://dx.doi.org/10.1590/S0034-89102005...
). The characterization of the studies regarding quantitative data was tabulated by the following information: author, year, objective, characterization of participants, research location, assessment instruments and outcomes. The information from each article in the light of the four cores of PPCT model of BTHD went through a categorization process, using the characterization of the cores and indicators described in Table 1, which classify the presence of each component according to Bronfenbrenner (2011)Bronfenbrenner, U. (2011). Bioecologia do desenvolvimento humano: tornando os seres humanos mais humanos. Porto Alegre: Artmed., Prati et al. (2008)Prati, L. E., Couto, M. C. P. P., Moura, A., Poletto, M., & Koller, S. H. (2008). Revisando a inserção ecológica: uma proposta de sistematização. Psicologia: Reflexão e Crítica, 21(1), 160-169. http://dx.doi.org/10.1590/S0102-79722008000100020.
http://dx.doi.org/10.1590/S0102-79722008...
and Narvaz & Koller (2004)Narvaz, M. G., & Koller, S. H. (2004). O modelo bioecológico do desenvolvimento humano. In S. H. Koller. Ecologia do desenvolvimento humano (pp. 51-65). São Paulo: Casa do Psicólogo.. Three of the authors independently performed reading of each study and categorization in each core, verifying the agreement between the items.

Table 1
Characterization of cores according to the concept and indicators used in the categorization of studies.

Based on the search criteria, 268 articles were found. After reading titles and abstracts, we excluded duplicate articles and those that did not mention DCD. Thus, the sample consisted of 30 articles read in full. After the complete reading, the selection was refined according to the objectives of this research and we excluded other studies that did not mention or were not directly related to children with DCD or that conceptually discussed DCD. The final sample for descriptive analysis consisted of 19 articles.

Figure 1 shows the diagram with the search and selection procedures of the articles for analysis.

Figure 1
Articles Search and Selection Flow Diagram (Moher et al., 2009Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLoS Medicine, 6(6), e1000097. PMid:19621072. http://dx.doi.org/10.1371/journal.pmed.1000097.
http://dx.doi.org/10.1371/journal.pmed.1...
).

3 Results

3.1 Characterization of the articles sample

Table 2 shows the characteristics of the 19 studies according to authors, year, objective, participants, research region and instruments or measures used. The articles of this review were published between 2009 and 2017.

Table 2
Studies characterization.

Regarding the objectives of the studies, eleven of them correlated motor performance with other motor, physical, cognitive health, school performance aspects and the presence of risk factors such as prematurity and related to social context. Five studies sought to establish the prevalence of DCD in Brazilian children and three aimed, respectively, to analyze mothers’ perceptions of their children's difficulties, teachers’ identification of DCD and to test the effectiveness of CO-OP in improving motor performance and perceived efficacy of children with DCD.

The sample size of children was between 3 and 1587, between 4 and 14 years old. The most frequent research region was the metropolitan area of ​​Belo Horizonte, following the southern, northern and other cities of southeastern Brazil. Noteworthy is the work of Valentini et al. (2015)Valentini, N. C., Clark, J. E., & Whitall, J. (2015). Developmental co-ordination disorder in socially disadvantaged Brazilian children. Child: Care, Health and Development, 41(6), 970-979. PMid:25424697. http://dx.doi.org/10.1111/cch.12219.
http://dx.doi.org/10.1111/cch.12219...
, which included children from 12 Brazilian cities.

Most studies (n=16) have a cross-sectional descriptive quantitative methodological design, one of them is quasi-experimental (Araújo et al., 2011Araújo, C. R. S., Magalhães, L. C., & Cardoso, A. A. (2011). Uso da cognitive orientation to daily occupational performance (co-op) com crianças com transtorno do desenvolvimento da coordenação. Revista de Terapia Ocupacional da Universidade de São Paulo, 22(3), 245-253. http://dx.doi.org/10.11606/issn.2238-6149.v22i3p245-253.
http://dx.doi.org/10.11606/issn.2238-614...
) and two are qualitative (Galvão et al., 2014Galvão, B. A. P., Bueno, K. M. P., Rezende, M. B., & Magalhães, L. C. (2014). Percepção materna do desempenho de crianças com transtorno do desenvolvimento da coordenação. Psicologia em Estudo, 19(3), 527-538. http://dx.doi.org/10.1590/1413-73722039315.
http://dx.doi.org/10.1590/1413-737220393...
; Magalhães et al., 2009bMagalhães, L. C., Rezende, M. B., Amparo, F., Ferreira, G. N., & Renger, C. (2009b). Problemas de coordenação motora em crianças de 4 a 8 anos: levantamento baseado no relato de professores. Revista de Terapia Ocupacional da Universidade de São Paulo, 20(1), 20-28. http://dx.doi.org/10.11606/issn.2238-6149.v20i1p20-28.
http://dx.doi.org/10.11606/issn.2238-614...
). The Movement Assessment Battery for Children (MABC) instrument, in its first and second editions (Henderson et al., 2007Henderson, S. E., Sugden, D. A., & Barnett, A. L. (2007). Movement assessment battery for children. London: The Psychological Corporation.), was the most used as a direct measure of motor performance and the score obtained by the child was the reference for analysis of its relationship with other variables in several of the studies analyzed.

3.2 Categorization of studies according to PPCT cores

Table 3 shows the categorization of the studies according to the presence of the core elements of the PPCT Model.

Table 3
Categorization of studies according to PPCT cores.

The studies reported a considerable set of elements of the core Person, in which motor performance is the central condition of studies on DCD, used to identify the disorder and correlate it with other variables of clinical history (gestational age and birth weight) and biological aspects of the child (gender, age, nutritional status, physical aptitude, digital torque control, cognitive performance).

The analysis in the light of BTHD identified how these characteristics of children with DCD influence their dispositions to support the proximal processes, especially in family and school microsystems, through differences between age groups, gender, its impact on academic or school performance, lifestyle and relationships with peers, family and teachers. In addition, some studies show characteristics of the demands that these motor difficulties bring to the family and school microsystem, based on the perception and reports of parents and teachers, analyzed through interviews and questionnaires. The influence of the exosystem and macro system on child development was also identified, considering relevant data on the association between motor difficulties and unfavorable socioeconomic status (economic level, mother's age at birth, maternal unemployment).

The core Time was identified, especially in relation to the importance of early diagnosis and intervention, locating normative life events related to DCD and the proposition of studies on DCD in the longitudinal perspective.

Due to the greater occurrence of quantitative approach studies that included instruments or measures, it was considered relevant to verify which elements of the PPCT cores such instruments make it possible to collect (Table 4).

Table 4
Categorization of instruments and measures in PPCT cores.

4 Discussion

The current study aimed to perform an integrative review of the national literature on DCD and to relate the contents of the studies with the elements of PPCT cores of the TBCTH. The studies revealed the presence of the four elements based on their objectives, method and outcomes. There is a predominance of the core Person in research, as they evaluate the individual repertoire of biological, cognitive, emotional and behavioral characteristics of children with DCD, which influence their development. Elements of the other cores (process, context and time) were identifiable, denoting the association between all of them.

Considering the prevalence of DCD, which ranged from 4.3% (Cardoso et al., 2014Cardoso, A. A., Magalhães, L. C., & Rezende, M. B. (2014). Motor skills in Brazilian children with developmental coordination disorder versus children with motor typical development. Occupational Therapy International, 21(4), 176-185. PMid:25327354. http://dx.doi.org/10.1002/oti.1376.
http://dx.doi.org/10.1002/oti.1376...
) to 19.9% ​​(Valentini et al., 2012Valentini, N. C., Coutinho, M. T. C., Pansera, S. M., Santos, V. A. P., Vieira, J. L. L., Ramalho, M. H., & Oliveira, M. A. (2012). Prevalência de déficits motores e desordem coordenativa desenvolvimental em crianças da região Sul do Brasil. Revista Paulista de Pediatria, 30(3), 377-384. http://dx.doi.org/10.1590/S0103-05822012000300011.
http://dx.doi.org/10.1590/S0103-05822012...
) for children with probable DCD and 5.9% (Capistrano et al., 2016Capistrano, R., Ferrari, E. P., Alexandre, J. M., Silva, R. C., Cardoso, F. L., & Beltrame, T. S. (2016). Relation between motor perfomance and physical fi tness level of schoolchildren. Journal of Human Growth and Development, 26(2), 174-180. http://dx.doi.org/10.7322/jhgd.119261.
http://dx.doi.org/10.7322/jhgd.119261...
) to 22.2% (Contreira et al., 2014Contreira, A. R., Capistrano, R., Oliveira, A. V. P., & Beltrame, T. S. (2014). Estilo de vida de escolares com e sem transtorno do desenvolvimento da coordenação. Fisioterapia e Pesquisa, 21(3), 223-228. http://dx.doi.org/10.590/1809-2950/48921032014.
http://dx.doi.org/10.590/1809-2950/48921...
) for risk of DCD, there is a need to know the risk factors that influence the development and manifestation of DCD and the characteristics of the Person regarding sensorimotor difficulties present in the development of skills. Equally important is the recognition of DCD influence in different ecological contexts present in the child’s daily life and the best therapeutic, family, educational and cultural practices about the problem.

The highest prevalence of DCD was found in premature infants, with rates of 39% (Moreira et al., 2014Moreira, R. S., Magalhães, L. C., Dourado, J. S., Lemos, S. M., & Alves, C. R. (2014). Factors influencing the motor development of prematurely born school-aged childrenn in Brazil. Research in Developmental Disabilities, 35(9), 1941-1951. PMid:24858787. http://dx.doi.org/10.1016/j.ridd.2014.04.023.
http://dx.doi.org/10.1016/j.ridd.2014.04...
) and 57% (Magalhães et al., 2009aMagalhães, L. C., Rezende, F. C. A., Magalhães, C. M., & Albuquerque, P. D. R. (2009a). Análise comparativa da coordenação motora de crianças nascidas a termo e pré-termo, aos 7 anos de idade. Revista Brasileira de Saúde Materno Infantil, 9(3), 293-300. http://dx.doi.org/10.1590/S1519-38292009000300008.
http://dx.doi.org/10.1590/S1519-38292009...
). The lower the birth weight and maternal age at delivery, the greater the chance of impairment in the result MABC-2 motor performance test (Moreira et al., 2014Moreira, R. S., Magalhães, L. C., Dourado, J. S., Lemos, S. M., & Alves, C. R. (2014). Factors influencing the motor development of prematurely born school-aged childrenn in Brazil. Research in Developmental Disabilities, 35(9), 1941-1951. PMid:24858787. http://dx.doi.org/10.1016/j.ridd.2014.04.023.
http://dx.doi.org/10.1016/j.ridd.2014.04...
).

The study by Rocha et al. (2016)Rocha, F. F., Santos, V. A. P., Contreira, A. R., Pizzo, G. C., Silva, P. N., Romero, P. V. S., & Vieira, J. L. L. (2016). Análise do desempenho motor e maturidade cognitiva de pré-escolares de Maringá (PR). Saúde e Pesquisa, 9(3), 507-515. http://dx.doi.org/10.17765/1983-1870.2016v9n3p507-515.
http://dx.doi.org/10.17765/1983-1870.201...
found a correlation impairment of cognitive development of children with DCD when compared to children with typical development (Rocha et al., 2016Rocha, F. F., Santos, V. A. P., Contreira, A. R., Pizzo, G. C., Silva, P. N., Romero, P. V. S., & Vieira, J. L. L. (2016). Análise do desempenho motor e maturidade cognitiva de pré-escolares de Maringá (PR). Saúde e Pesquisa, 9(3), 507-515. http://dx.doi.org/10.17765/1983-1870.2016v9n3p507-515.
http://dx.doi.org/10.17765/1983-1870.201...
). Although Silva et al. (2012)Silva, J., Beltrame, T. S., Oliveira, A. D. V. P., & Sperandio, F. F. (2012). Dificuldades motoras e de aprendizagem em crianças com baixo desempenho escolar. Journal of Human Growth and Development, 22(1), 1-9. http://dx.doi.org/10.7322/jhgd.20048.
http://dx.doi.org/10.7322/jhgd.20048...
found no significant relationship between learning disabilities and motor problems (with a sample size of only 19 children), there was significant comorbidity with ADHD (41.2% of children with DCD) in the study by Cardoso et al. (2014)Cardoso, A. A., Magalhães, L. C., & Rezende, M. B. (2014). Motor skills in Brazilian children with developmental coordination disorder versus children with motor typical development. Occupational Therapy International, 21(4), 176-185. PMid:25327354. http://dx.doi.org/10.1002/oti.1376.
http://dx.doi.org/10.1002/oti.1376...
.

Three studies on the prevalence of DCD in Brazilian children found manual dexterity as the most impaired motor dimension (Beltrame et al., 2017Beltrame, T. S., Capistrano, R., Alexandre, J. M., Lisboa, T., Andrade, R. D., & Felden, É. P. G. (2017). Prevalência do Transtorno do Desenvolvimento da Coordenação em uma amostra de crianças brasileiras. Cadernos de Terapia Ocupacional da UFSCar, 25(1), 105-113. https://doi.org/10.4322/0104-4931.ctoAO0777.
https://doi.org/10.4322/0104-4931.ctoAO0...
; Valentini et al., 2012Valentini, N. C., Coutinho, M. T. C., Pansera, S. M., Santos, V. A. P., Vieira, J. L. L., Ramalho, M. H., & Oliveira, M. A. (2012). Prevalência de déficits motores e desordem coordenativa desenvolvimental em crianças da região Sul do Brasil. Revista Paulista de Pediatria, 30(3), 377-384. http://dx.doi.org/10.1590/S0103-05822012000300011.
http://dx.doi.org/10.1590/S0103-05822012...
, 2015Valentini, N. C., Clark, J. E., & Whitall, J. (2015). Developmental co-ordination disorder in socially disadvantaged Brazilian children. Child: Care, Health and Development, 41(6), 970-979. PMid:25424697. http://dx.doi.org/10.1111/cch.12219.
http://dx.doi.org/10.1111/cch.12219...
). According to King et al. (2012)King, B. R., Clark, J. E., & Oliveira, M. A. (2012). Developmental delay of finger torque control in children with developmental coordination disorder. Developmental Medicine and Child Neurology, 54(10), 932-937. PMid:22803701. http://dx.doi.org/10.1111/j.1469-8749.2012.04375.x.
http://dx.doi.org/10.1111/j.1469-8749.20...
, children with DCD have less digital torque control, and delayed development of production and torque control. There is difficulty in the production of force, high variability and regularity in motor response, with difficulty in adapting to the demand for task modifications in fine motor skills (Oliveira et al., 2005Oliveira, M. A., Loss, J. F., & Petersen, R. D. S. (2005). Controle de força e torque isométrico em crianças com DCD. Revista Brasileira de Educação Física e Esporte, 19(2), 89-103.). The study by Valentini et al. (2015)Valentini, N. C., Clark, J. E., & Whitall, J. (2015). Developmental co-ordination disorder in socially disadvantaged Brazilian children. Child: Care, Health and Development, 41(6), 970-979. PMid:25424697. http://dx.doi.org/10.1111/cch.12219.
http://dx.doi.org/10.1111/cch.12219...
also found significant impairments in balance, and Valentini et al. (2012)Valentini, N. C., Coutinho, M. T. C., Pansera, S. M., Santos, V. A. P., Vieira, J. L. L., Ramalho, M. H., & Oliveira, M. A. (2012). Prevalência de déficits motores e desordem coordenativa desenvolvimental em crianças da região Sul do Brasil. Revista Paulista de Pediatria, 30(3), 377-384. http://dx.doi.org/10.1590/S0103-05822012000300011.
http://dx.doi.org/10.1590/S0103-05822012...
observed worse ability to throw/receive in girls.

In this way, it is identified the remarkable presence of the core Person when addressing the impairments in the performance of children with DCD. This impairment in the individual skills repertoire characterizes the child's biopsychological resources for their development. According to Bronfenbrenner (1999)Bronfenbrenner, U. (1999). Environments in developmental perspective: Theoretical and operational models. In B. L. Friedmann, & T. D. Wachs (Org.), Conceptualization and assessment of environment across the life span (pp. 3-30). Washington: American Psychologial Association. http://dx.doi.org/10.1037/10317-001.
http://dx.doi.org/10.1037/10317-001...
, the consequences of this limited repertoire are also built in relation to the environment, and can, in a reciprocal way, be a generator or disorganizer for development processes. Some examples of this relationship are shown in the following lines, such as the child with DCD engagement in physical activity, their weight gain, autonomy in family or school daily life, interaction with objects and symbols, and social peer comparison.

Although there is a discussion about greater weight gain in the presence of DCD (Goulardins et al., 2016Goulardins, J. B., Rigoli, D., Piek, J. P., Kane, R., Palácio, S. G., Casella, E. B., Nascimento, R. O., Hasue, R. H., & Oliveira, J. A. (2016). The relationship between motor skills, ADHD syntoms and childhood body weight. Research in Developmental Disabilities, 55(1), 279-286. PMid:27214681. http://dx.doi.org/10.1016/j.ridd.2016.05.005.
http://dx.doi.org/10.1016/j.ridd.2016.05...
), studies with Brazilian children have found a higher eutrophic index (Santos et al., 2015Santos, V. A. P., Contreira, A. R., Caruzzo, N. M., Passos, P. C. B., & Vieira, J. L. L. (2015). Desordem Coordenativa Desenvolvimental: uma análise do estado nutricional e nível sócioeconômico. Motricidade, 11(1), 78-86. http://dx.doi.org/10.6063/motricidade.3195.
http://dx.doi.org/10.6063/motricidade.31...
; Miranda et al., 2011Miranda, T. B., Beltrame, T. S., & Cardoso, F. L. (2011). Desempenho motor e estado nutricional de escolares com e sem transtorno do desenvolvimento da coordenação. Revista Brasileira de Cineantropometria & Desempenho Humano, 13(1), 59-66.), with levels of physical aptitude (Nascimento et al., 2013Nascimento, R. O., Ferreira, L. F., Goulardins, J. B., Freudenheim, A. M., Marques, J. C., Casella, E. B., & Oliveira, J. A. (2013). Health-related physical fitness children with severe and moderate developmental coordination disorder. Research in Developmental Disabilities, 34(11), 4222-4231. PMid:24077071. http://dx.doi.org/10.1016/j.ridd.2013.08.025.
http://dx.doi.org/10.1016/j.ridd.2013.08...
) similar to children without DCD. Nevertheless, Contreira et al. (2014)Contreira, A. R., Capistrano, R., Oliveira, A. V. P., & Beltrame, T. S. (2014). Estilo de vida de escolares com e sem transtorno do desenvolvimento da coordenação. Fisioterapia e Pesquisa, 21(3), 223-228. http://dx.doi.org/10.590/1809-2950/48921032014.
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, when using EVIA with children from 11 to 13 years old, observed a significant association between probable DCD and higher frequency of playing video games, to the detriment of more active physical activities.

When parents and teachers are asked about the main difficulties of children with DCD, they are perceived in different ecological contexts, whether in daily living activities, playing and school activities (Galvão et al., 2014Galvão, B. A. P., Bueno, K. M. P., Rezende, M. B., & Magalhães, L. C. (2014). Percepção materna do desempenho de crianças com transtorno do desenvolvimento da coordenação. Psicologia em Estudo, 19(3), 527-538. http://dx.doi.org/10.1590/1413-73722039315.
http://dx.doi.org/10.1590/1413-737220393...
), more specifically in the difficulties handling scissors and a frequent report of a “clumsy” child (Magalhães et al., 2009bMagalhães, L. C., Rezende, M. B., Amparo, F., Ferreira, G. N., & Renger, C. (2009b). Problemas de coordenação motora em crianças de 4 a 8 anos: levantamento baseado no relato de professores. Revista de Terapia Ocupacional da Universidade de São Paulo, 20(1), 20-28. http://dx.doi.org/10.11606/issn.2238-6149.v20i1p20-28.
http://dx.doi.org/10.11606/issn.2238-614...
).

In 14 of 19 studies, MABC was used to assess the child's motor performance and DCD screening. This is currently the reference tool for identifying DCD, both for its extensive presence in research on the subject and because the European Commission recommends its use (Blank et al., 2013Blank, R., Smits-Engelsman, B., Polatajko, H., Wilson, P., & European Academy for Childhood Disability (2013). 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(1), 54-93. PMid:22171930. http://dx.doi.org/10.1111/j.1469-8749.2011.04171.x.
http://dx.doi.org/10.1111/j.1469-8749.20...
). Already validated for the Brazilian population, MABC consists of a battery of motor tests (Valentini et al., 2014Valentini, N. C., Ramalho, H., & Oliveira, M. (2014). Movement assessment battery for children: translation, reliability, and validity for Brazilian children. Research in Developmental Disabilities, 35(3), 733-740. PMid:24290814. http://dx.doi.org/10.1016/j.ridd.2013.10.028.
http://dx.doi.org/10.1016/j.ridd.2013.10...
) and the motor difficulties check test (Ramalho et al., 2013Ramalho, M. H. S., Valentini, N. C., Muraro, C. F., Gadens, R., & Nobre, G. C. (2013). Validação para língua portuguesa: lista de Checagem da Movement Assessment Battery for Children. Motriz, 19(2), 423-431. http://dx.doi.org/10.1590/S1980-65742013000200019.
http://dx.doi.org/10.1590/S1980-65742013...
) answered by adults who deal with the child in their daily life. However, it is observed that MABC motor test battery is commonly used for screening DCD in isolation. According to the DCD diagnostic guidelines, it is important, in the diagnostic process, that motor difficulties have repercussions on autonomy in daily activities and school skills, which would also justify the use of instruments that identify this impact, such as MABC checking test and the Brazilian version of Developmental Coordination Disorder Questionaire (DCDQ) DCDQ-Brasil (Prado et al., 2009Prado, M. S. S., Magalhães, L. C., & Wilson, B. N. (2009). Cross-cultural adaptation of the Developmental Coordination Disorder Questionnaire for brazilian children. Brazilian Journal of Physical Therapy, 13(3), 236-243. http://dx.doi.org/10.1590/S1413-35552009005000024.
http://dx.doi.org/10.1590/S1413-35552009...
; Magalhães & Wilson, 2017Magalhães, L. C., & Wilson, B. N. (2017). Questionário de Transtorno do Desenvolvimento da Coordenação – DCDQ-Brasil. Belo Horizonte: UFMG. Recuperado em 11 de dezembro de 2018, de http://www.eeffto.ufmg.br/ideia/wp-content/uploads/2018/03/DCDQ-Brasil-AdminEscore-Feb-2018.pdf
http://www.eeffto.ufmg.br/ideia/wp-conte...
), for example.

Vaivre-Douret (2014)Vaivre-Douret, L. (2014). Developmental coordination disorders: state of art. Neurophysiologie Clinique, 44(1), 13-23. PMid:24502901. http://dx.doi.org/10.1016/j.neucli.2013.10.133.
http://dx.doi.org/10.1016/j.neucli.2013....
calls the attention for the need to associate with motor performance tests the evaluation of aspects related to the child's neurological development (such as tone, visuomotor perception, praxis, laterality, digital perception, integration between rhythm and notion of the body in space), as well as neuropsychological tests, especially executive functions. This is important both for a differential diagnosis process and to elucidate better intervention strategies.

Considering all these aspects, the Cognitive Orientation to Daily Occupational Performance (CO-OP) seems to be a reference for DCD intervention, as it associates cognitive development or executive function strategies with task-oriented motor skills training (Zwicker et al., 2015Zwicker, J., Rehal, H., Sodhi, S., Karkling, M., Paul, A., Hilliard, M., & Jarus, T. (2015). Effectiveness of a summer camp intervention for children with developmental coordination disorder. Physical & Occupational Therapy in Pediatrics, 35(2), 163-177. PMid:25229503. http://dx.doi.org/10.3109/01942638.2014.957431.
http://dx.doi.org/10.3109/01942638.2014....
). As shown by Sangster Jokić & Whitebread (2016)Sangster Jokić, C. A., & Whitebread, D. (2016). Self-regulatory skill among children with and without developmental coordination disorder: an exploratory study. Physical & Occupational Therapy in Pediatrics, 36(4), 401-421. PMid:26939836. http://dx.doi.org/10.3109/01942638.2015.1135844.
http://dx.doi.org/10.3109/01942638.2015....
, self-regulatory skills in children with DCD are impaired in such a way that they are inefficient or require a lot of instructor or therapist mediation for the learning process of a motor skill. In the CO-OP strategy, the therapist mediates the process, with the child’s very active participation in choosing the goal, setting strategies to achieve it, and self-assessment (Zwicker et al., 2015Zwicker, J., Rehal, H., Sodhi, S., Karkling, M., Paul, A., Hilliard, M., & Jarus, T. (2015). Effectiveness of a summer camp intervention for children with developmental coordination disorder. Physical & Occupational Therapy in Pediatrics, 35(2), 163-177. PMid:25229503. http://dx.doi.org/10.3109/01942638.2014.957431.
http://dx.doi.org/10.3109/01942638.2014....
). The CO-OP was effective in reaching motor goals, transferring learning to extra goals and increasing satisfaction in a group of Brazilian children (Araújo et al., 2011Araújo, C. R. S., Magalhães, L. C., & Cardoso, A. A. (2011). Uso da cognitive orientation to daily occupational performance (co-op) com crianças com transtorno do desenvolvimento da coordenação. Revista de Terapia Ocupacional da Universidade de São Paulo, 22(3), 245-253. http://dx.doi.org/10.11606/issn.2238-6149.v22i3p245-253.
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, 2019Araújo, C. R. S., Cardoso, A. A., & Magalhães, L. C. (2019). Efficacy of the cognitive orientation to daily occupational performance with Brazilian children with developmental coordination disorder. Scandinavian Journal of Occupational Therapy, 26(1), 46-54. PMid:29260603. http://dx.doi.org/10.1080/11038128.2017.1417476.
http://dx.doi.org/10.1080/11038128.2017....
). Parental involvement in the therapeutic process contributed to the success of the intervention. This occurred through their participation in the intervention sessions, production of printed material with information on the overall CO-OP strategies to use for homework, and an extra session only with parents for guidance (Araújo et al., 2019Araújo, C. R. S., Cardoso, A. A., & Magalhães, L. C. (2019). Efficacy of the cognitive orientation to daily occupational performance with Brazilian children with developmental coordination disorder. Scandinavian Journal of Occupational Therapy, 26(1), 46-54. PMid:29260603. http://dx.doi.org/10.1080/11038128.2017.1417476.
http://dx.doi.org/10.1080/11038128.2017....
).

Relations with the core Context are shown in those studies that associate the child's biological conditions with those found in the micro, meso and exosystem. Moreira et al. (2014)Moreira, R. S., Magalhães, L. C., Dourado, J. S., Lemos, S. M., & Alves, C. R. (2014). Factors influencing the motor development of prematurely born school-aged childrenn in Brazil. Research in Developmental Disabilities, 35(9), 1941-1951. PMid:24858787. http://dx.doi.org/10.1016/j.ridd.2014.04.023.
http://dx.doi.org/10.1016/j.ridd.2014.04...
identified that, in relation to maternal age at delivery, for each additional year at mother's age, there is a 12% reduction in the chance of the child having an abnormal MABC-2 score. Children whose mother was employed at the time of the interview were four times less likely to have a poor MABC-2 score.

Studies identify the relationship between DCD and socioeconomic status (Della Barba et al., 2017Della Barba, P. C. S., Luiz, E. M., Pinheiro, R. C., & Lourenço, G. F. (2017). Prevalence of developmental coordination disorder signs in children 5 to 14 years in São Carlos. Motricidade, 13(3), 22-30. http://dx.doi.org/10.6063/motricidade.10058.
http://dx.doi.org/10.6063/motricidade.10...
; Santos et al., 2015Santos, V. A. P., Contreira, A. R., Caruzzo, N. M., Passos, P. C. B., & Vieira, J. L. L. (2015). Desordem Coordenativa Desenvolvimental: uma análise do estado nutricional e nível sócioeconômico. Motricidade, 11(1), 78-86. http://dx.doi.org/10.6063/motricidade.3195.
http://dx.doi.org/10.6063/motricidade.31...
). Children from private schools performed better on the motor test (Cardoso et al., 2014Cardoso, A. A., Magalhães, L. C., & Rezende, M. B. (2014). Motor skills in Brazilian children with developmental coordination disorder versus children with motor typical development. Occupational Therapy International, 21(4), 176-185. PMid:25327354. http://dx.doi.org/10.1002/oti.1376.
http://dx.doi.org/10.1002/oti.1376...
), as well as having fewer reports of motor coordination problems by teachers compared to those from public schools (Magalhães et al., 2009bMagalhães, L. C., Rezende, M. B., Amparo, F., Ferreira, G. N., & Renger, C. (2009b). Problemas de coordenação motora em crianças de 4 a 8 anos: levantamento baseado no relato de professores. Revista de Terapia Ocupacional da Universidade de São Paulo, 20(1), 20-28. http://dx.doi.org/10.11606/issn.2238-6149.v20i1p20-28.
http://dx.doi.org/10.11606/issn.2238-614...
). Valentini et al. (2015)Valentini, N. C., Clark, J. E., & Whitall, J. (2015). Developmental co-ordination disorder in socially disadvantaged Brazilian children. Child: Care, Health and Development, 41(6), 970-979. PMid:25424697. http://dx.doi.org/10.1111/cch.12219.
http://dx.doi.org/10.1111/cch.12219...
pointed out one of the highest rates (18% of children with probable DCD and more than 15% for DCD risk) when investigating the prevalence of DCD in socially disadvantaged children in Brazil, and the socioeconomic status is determinant in 21% in MABC percentile variation.

Considering the biological, cognitive and emotional impairments of children with DCD, it is important to look at the developmental opportunities given to them in a social structure and in the processes established in different contexts. Nobre et al. (2014)Nobre, F. S. S., Coutinho, M. T. C., & Valentini, N. C. (2014). A ecologia do desenvolvimento motor de escolares litorâneos do Nordeste do Brasil. Journal of Human Growth and Development, 24(3), 263-273. http://dx.doi.org/10.7322/jhdg.88910.
http://dx.doi.org/10.7322/jhdg.88910...
, in a study on the motor development ecology of extremely poor students in northeastern Brazil, identified delays in fundamental motor skills in 95% of the children evaluated. Regarding the structure in which these children lived, they pointed out the lack of physical space for the practice of guided motor activities, since the vast majority of schools do not have spaces for physical education classes and physical education professionals. The teachers reported the lack of material resources and didactic-pedagogical proposal to promote children’s motor proficiency, revealing lack of commitment from the local government. In the community, there was heterogeneity of opportunities, with more than one social support unit in some neighborhoods, with music, dance and school reinforcement, to the detriment of no unit in most of them. In the case of children with DCD, teachers reports show the lack of a structured policy for children care and monitoring, leaving only the school and the family to offer the conditions that they think are important for their development (Magalhães et al., 2009bMagalhães, L. C., Rezende, M. B., Amparo, F., Ferreira, G. N., & Renger, C. (2009b). Problemas de coordenação motora em crianças de 4 a 8 anos: levantamento baseado no relato de professores. Revista de Terapia Ocupacional da Universidade de São Paulo, 20(1), 20-28. http://dx.doi.org/10.11606/issn.2238-6149.v20i1p20-28.
http://dx.doi.org/10.11606/issn.2238-614...
).

On the other hand, mothers’ reports identify an over-protection and “doing for the child” behavior, much present in the home system, when faced with the difficulties of the child in their school activities and daily life (Galvão et al., 2014Galvão, B. A. P., Bueno, K. M. P., Rezende, M. B., & Magalhães, L. C. (2014). Percepção materna do desempenho de crianças com transtorno do desenvolvimento da coordenação. Psicologia em Estudo, 19(3), 527-538. http://dx.doi.org/10.1590/1413-73722039315.
http://dx.doi.org/10.1590/1413-737220393...
). The greatest concern of mothers is their children socialization, because of their difficulties in participating in motor games at school, clumsiness, slow behavior and stigmatization by peers. As Nobre et al. (2014Nobre, F. S. S., Coutinho, M. T. C., & Valentini, N. C. (2014). A ecologia do desenvolvimento motor de escolares litorâneos do Nordeste do Brasil. Journal of Human Growth and Development, 24(3), 263-273. http://dx.doi.org/10.7322/jhdg.88910.
http://dx.doi.org/10.7322/jhdg.88910...
, p. 271)

[…] it is explicit that the child’s MP [motor proficiency] guides their goals and dispositions and provokes the demand of their peers, affecting the way they deal with the developing child and with the goals, values ​​and expectations they have about it.

The qualitative methodological approach, as used by Galvão et al. (2014)Galvão, B. A. P., Bueno, K. M. P., Rezende, M. B., & Magalhães, L. C. (2014). Percepção materna do desempenho de crianças com transtorno do desenvolvimento da coordenação. Psicologia em Estudo, 19(3), 527-538. http://dx.doi.org/10.1590/1413-73722039315.
http://dx.doi.org/10.1590/1413-737220393...
and Magalhães et al. (2009b)Magalhães, L. C., Rezende, M. B., Amparo, F., Ferreira, G. N., & Renger, C. (2009b). Problemas de coordenação motora em crianças de 4 a 8 anos: levantamento baseado no relato de professores. Revista de Terapia Ocupacional da Universidade de São Paulo, 20(1), 20-28. http://dx.doi.org/10.11606/issn.2238-6149.v20i1p20-28.
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, is able to abstract from the participants very relevant information for analysis under the PPCT model. The study by Nobre et al. (2014)Nobre, F. S. S., Coutinho, M. T. C., & Valentini, N. C. (2014). A ecologia do desenvolvimento motor de escolares litorâneos do Nordeste do Brasil. Journal of Human Growth and Development, 24(3), 263-273. http://dx.doi.org/10.7322/jhdg.88910.
http://dx.doi.org/10.7322/jhdg.88910...
specifically delineated under the bioecological model, also brings data richness acquired with the ethnographic method, inserting the researcher in the natural environment of phenomena. However, Prati et al. (2008)Prati, L. E., Couto, M. C. P. P., Moura, A., Poletto, M., & Koller, S. H. (2008). Revisando a inserção ecológica: uma proposta de sistematização. Psicologia: Reflexão e Crítica, 21(1), 160-169. http://dx.doi.org/10.1590/S0102-79722008000100020.
http://dx.doi.org/10.1590/S0102-79722008...
states that there is no rigid proposal of a research method in Bronfenbrenner's approach, being fundamental that the research model in this theory systematizes its design and analyzes the cores based on the model elements.

Considering that 16 studies from the sample of this review used the quantitative methodological approach, two instruments stand out in the possibility of broadening the perspective on child development through the PPCT model: RAF and EVIA. TheRecursos do Ambiente Familiar Inventory (RAF), used by Moreira et al. (2014)Moreira, R. S., Magalhães, L. C., Dourado, J. S., Lemos, S. M., & Alves, C. R. (2014). Factors influencing the motor development of prematurely born school-aged childrenn in Brazil. Research in Developmental Disabilities, 35(9), 1941-1951. PMid:24858787. http://dx.doi.org/10.1016/j.ridd.2014.04.023.
http://dx.doi.org/10.1016/j.ridd.2014.04...
, was created in the Brazilian context by researcher Edna Marturano (2006)Marturano, E. M. (2006). O inventário de recursos do ambiente familiar. Psicologia: Reflexão e Crítica, 19(3), 498-506. http://dx.doi.org/10.1590/S0102-79722006000300019.
http://dx.doi.org/10.1590/S0102-79722006...
, with an emphasis on resources that promote proximal processes, ie, parenting practices that promote family-school connection and activities that signal stability in family life. EVIA was also able to collect some data related to the proximal process between child and family in the home environment by identifying aspects of this relationship, such as frequency of going out and helping with housework, for example (Contreira et al., 2014Contreira, A. R., Capistrano, R., Oliveira, A. V. P., & Beltrame, T. S. (2014). Estilo de vida de escolares com e sem transtorno do desenvolvimento da coordenação. Fisioterapia e Pesquisa, 21(3), 223-228. http://dx.doi.org/10.590/1809-2950/48921032014.
http://dx.doi.org/10.590/1809-2950/48921...
). The use of this instrument identified that children with DCD play more video games than those without DCD, but no other significant differences were found between the lifestyle of parents and children with probable DCD and typical development (Contreira et al., 2014Contreira, A. R., Capistrano, R., Oliveira, A. V. P., & Beltrame, T. S. (2014). Estilo de vida de escolares com e sem transtorno do desenvolvimento da coordenação. Fisioterapia e Pesquisa, 21(3), 223-228. http://dx.doi.org/10.590/1809-2950/48921032014.
http://dx.doi.org/10.590/1809-2950/48921...
). The correlation between RAF score and an abnormal MABC-2 score was the strongest in the study by Moreira et al. (2014)Moreira, R. S., Magalhães, L. C., Dourado, J. S., Lemos, S. M., & Alves, C. R. (2014). Factors influencing the motor development of prematurely born school-aged childrenn in Brazil. Research in Developmental Disabilities, 35(9), 1941-1951. PMid:24858787. http://dx.doi.org/10.1016/j.ridd.2014.04.023.
http://dx.doi.org/10.1016/j.ridd.2014.04...
. For each 10-point increase in RAF score (environment with more development-friendly processes) there was a 36.5% observed reduction in the chance that the premature child would have an abnormal MABC-2 score, compatible with DCD, showing the importance of stimulating environment.

Both RAF and EVIA also allow the researcher a direct analysis of the core Time, as they characterize the child’s routine in relation to the time spent playing, in other leisure activities, indoors and outdoors, or in direct process of contact with parents, all very important aspects for child development (Marturano, 2006Marturano, E. M. (2006). O inventário de recursos do ambiente familiar. Psicologia: Reflexão e Crítica, 19(3), 498-506. http://dx.doi.org/10.1590/S0102-79722006000300019.
http://dx.doi.org/10.1590/S0102-79722006...
; Moreira et al., 2014Moreira, R. S., Magalhães, L. C., Dourado, J. S., Lemos, S. M., & Alves, C. R. (2014). Factors influencing the motor development of prematurely born school-aged childrenn in Brazil. Research in Developmental Disabilities, 35(9), 1941-1951. PMid:24858787. http://dx.doi.org/10.1016/j.ridd.2014.04.023.
http://dx.doi.org/10.1016/j.ridd.2014.04...
). It is understood that elements of the core Time were intrinsic in all these studies, as they evaluate the performance of children in preschool or school, an important moment of ecological transition for children (Bronfenbrenner, 2011Bronfenbrenner, U. (2011). Bioecologia do desenvolvimento humano: tornando os seres humanos mais humanos. Porto Alegre: Artmed.). The analysis of the study sample of this review shows how early detection and intervention of DCD, both in children and in the contexts in which they are inserted, can make a difference in their learning experience, performance and the demands that their difficulties place in the family and school context. Tal-Saban et al. (2014)Tal-Saban, M., Ornoy, A., & Parush, S. (2014). Young adults with developmental coordination disorder: a longitudinal study. The American Journal of Occupational Therapy, 68(3), 307-316. PMid:24797194. http://dx.doi.org/10.5014/ajot.2014.009563.
http://dx.doi.org/10.5014/ajot.2014.0095...
identified that, in adulthood, people with DCD continue to have lower levels of participation in daily activities, as well as life quality and satisfaction. Therefore, the dimension Time appears in studies generally pointing to preventive and other actions that can promote the improvement of life quality of these people in the medium and long term.

5 Final Considerations

In this review, there was a predominance of cross-sectional studies with quantitative methodology. The elements of the core Person were present in all analyzed articles, and motor performance was the central condition in the identification of DCD and correlation with other clinical, health and social variables. In the core Time, the importance of diagnosis, early intervention and specificities of the normative life events of the child were highlighted. There was an intense use of MABC as an identification instrument, as well as the importance of establishing broader measures for analyzing the development of children with DCD.

Based on these results, we identify the need for continuing investigations on the prevalence of DCD in Brazil. In addition, it was evident that instruments for DCD early detection and characterization of difficulties require improvement. There is also demand for the development of interventions that address the family, school contexts and foster strategies for the empowerment of these family members and professionals about DCD. Finally, there is the need for studies that address the dimension of the macro system, which dialogue with the development of health and education policies in Brazil, in order to consider the impacts of DCD on the developmental course of these children and the demands of different contexts.

This review limitation is the performing search only in certain databases by indexed journals, related only to searches in Brazilian context and without including theses and dissertations. However, it presents an original look at the research carried out with DCD, since it proposes to conduct a dialogue with the cores PPCT of the Bioecological Theory of Human Development.

  • How to cite: Oliveira, S. F., Martinez, C. M. S., Fernandes, A. D. S. A., & Figueiredo, M. O. (2020). Brazilian research on the development of coordination development: a review in the light of bioecological theory. Cadernos Brasileiros de Terapia Ocupacional. Ahead of Print. https://doi.org/10.4322/2526-8910.ctoAR1747

Referências

  • Alves, H. C., & Emmel, M. L. G. (2008). Abordagem bioecológica e narrativas orais: um estudo com crianças vitimizadas. Paidéia, 18(39), 85-100. http://dx.doi.org/10.1590/S0103-863X2008000100009
    » http://dx.doi.org/10.1590/S0103-863X2008000100009
  • American Psychiatric Association – APA. (2000). Diagnostic and statistical manual of mental disorders Washington: APA.
  • American Psychiatric Association – APA. (2013). Diagnostic and statistical manual of mental disorders Washington: APA.
  • Araújo, C. R. S., Cardoso, A. A., & Magalhães, L. C. (2019). Efficacy of the cognitive orientation to daily occupational performance with Brazilian children with developmental coordination disorder. Scandinavian Journal of Occupational Therapy, 26(1), 46-54. PMid:29260603. http://dx.doi.org/10.1080/11038128.2017.1417476
    » http://dx.doi.org/10.1080/11038128.2017.1417476
  • Araújo, C. R. S., Magalhães, L. C., & Cardoso, A. A. (2011). Uso da cognitive orientation to daily occupational performance (co-op) com crianças com transtorno do desenvolvimento da coordenação. Revista de Terapia Ocupacional da Universidade de São Paulo, 22(3), 245-253. http://dx.doi.org/10.11606/issn.2238-6149.v22i3p245-253
    » http://dx.doi.org/10.11606/issn.2238-6149.v22i3p245-253
  • Batey, C. A., Missiuna, C. A., Timmons, B. W., Hay, J. A., Faught, B. E., & Cairney, J. (2014). Efficacy toward physical activity and physical activity behavior of children with and without developmental coordination disorder. Human Movement Science, 36, 258-271. PMid:24345354. http://dx.doi.org/10.1016/j.humov.2013.10.003
    » http://dx.doi.org/10.1016/j.humov.2013.10.003
  • Beltrame, T. S., Capistrano, R., Alexandre, J. M., Lisboa, T., Andrade, R. D., & Felden, É. P. G. (2017). Prevalência do Transtorno do Desenvolvimento da Coordenação em uma amostra de crianças brasileiras. Cadernos de Terapia Ocupacional da UFSCar, 25(1), 105-113. https://doi.org/10.4322/0104-4931.ctoAO0777
    » https://doi.org/10.4322/0104-4931.ctoAO0777
  • Blank, R., Barnett, A. L., Cairney, J., Green, D., Kirby, A., Polatajko, H., Rosenblum, S., Smits-Engelsman, B., Sugden, D., Wilson, P., & Vinçon, S. (2019). International clinical practice recommendations on the definition, diagnosis, assessment, intervention and psychosocial aspects of developmental coordination disorder (long version). Developmental Medicine and Child Neurology, 61(3), 1-44. PMid:30671947. http://dx.doi.org/10.1111/dmcn.14132
    » http://dx.doi.org/10.1111/dmcn.14132
  • Blank, R., Smits-Engelsman, B., Polatajko, H., Wilson, P., & European Academy for Childhood Disability (2013). 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(1), 54-93. PMid:22171930. http://dx.doi.org/10.1111/j.1469-8749.2011.04171.x
    » http://dx.doi.org/10.1111/j.1469-8749.2011.04171.x
  • Bronfenbrenner, U. (1996). A ecologia do desenvolvimento humano: experimentos naturais e planejados Porto Alegre: Artmed.
  • Bronfenbrenner, U. (1999). Environments in developmental perspective: Theoretical and operational models. In B. L. Friedmann, & T. D. Wachs (Org.), Conceptualization and assessment of environment across the life span (pp. 3-30). Washington: American Psychologial Association. http://dx.doi.org/10.1037/10317-001
    » http://dx.doi.org/10.1037/10317-001
  • Bronfenbrenner, U. (2011). Bioecologia do desenvolvimento humano: tornando os seres humanos mais humanos Porto Alegre: Artmed.
  • Capistrano, R., Ferrari, E. P., Alexandre, J. M., Silva, R. C., Cardoso, F. L., & Beltrame, T. S. (2016). Relation between motor perfomance and physical fi tness level of schoolchildren. Journal of Human Growth and Development, 26(2), 174-180. http://dx.doi.org/10.7322/jhgd.119261
    » http://dx.doi.org/10.7322/jhgd.119261
  • Cardoso, A. A., Magalhães, L. C., & Rezende, M. B. (2014). Motor skills in Brazilian children with developmental coordination disorder versus children with motor typical development. Occupational Therapy International, 21(4), 176-185. PMid:25327354. http://dx.doi.org/10.1002/oti.1376
    » http://dx.doi.org/10.1002/oti.1376
  • Cecílio, H. P. M., & Oliveira, D. C. (2017). Modelos de revisão integrativa: discussão na pesquisa em enfermagem. In Anais do 6o Congreso Ibero-Americano Investigacion Qualitativa (pp. 764-772). Salamanca: CIAIQ.
  • Contreira, A. R., Capistrano, R., Oliveira, A. V. P., & Beltrame, T. S. (2014). Estilo de vida de escolares com e sem transtorno do desenvolvimento da coordenação. Fisioterapia e Pesquisa, 21(3), 223-228. http://dx.doi.org/10.590/1809-2950/48921032014
    » http://dx.doi.org/10.590/1809-2950/48921032014
  • Costa, C. L. A., Nobre, G. C., Nobre, F. S. S., & Valentini, N. C. (2014). Efeito de um programa de intervenção motora sobre o desenvolvimento motor de crianças em situação de risco social na região do Cariri – CE. Revista da Educação Física, 25(3), 353-364. http://dx.doi.org/10.4025/reveducfis.v25i3.21968
    » http://dx.doi.org/10.4025/reveducfis.v25i3.21968
  • Custódio, Z. O., Crepaldi, M., & Linhares, M. M. (2014). Redes sociais de apoio no contexto da prematuridade: perspectiva do modelo bioecológico do desenvolvimento humano. Estudos de Psicologia, 31(2), 247-255. http://dx.doi.org/10.1590/0103-166X2014000200010
    » http://dx.doi.org/10.1590/0103-166X2014000200010
  • Dantas, L. E. B. P. T., & Manoel, E. J. (2009). Crianças com dificuldades motoras: questões para a conceituação do transtorno do desenvolvimento da coordenação. Movimento, 15(3), 293-313. http://dx.doi.org/10.22456/1982-8918.3908
    » http://dx.doi.org/10.22456/1982-8918.3908
  • Della Barba, P. C. S., Luiz, E. M., Pinheiro, R. C., & Lourenço, G. F. (2017). Prevalence of developmental coordination disorder signs in children 5 to 14 years in São Carlos. Motricidade, 13(3), 22-30. http://dx.doi.org/10.6063/motricidade.10058
    » http://dx.doi.org/10.6063/motricidade.10058
  • Dessen, M. A., & Polonia, A. C. (2007). A família e a escola como contextos de desenvolvimento humano. Paidéia, 17(36), 21-32. http://dx.doi.org/10.1590/S0103-863X2007000100003
    » http://dx.doi.org/10.1590/S0103-863X2007000100003
  • Engel-Yeger, B., & Hanna Kasis, A. (2010). The relationship between developmental coordination disorders, child’s perceived self efficacy and preference to participate in daily activities. Child: Care, Health and Development, 36(5), 670-677. PMid:20412146. http://dx.doi.org/10.1111/j.1365-2214.2010.01073.x
    » http://dx.doi.org/10.1111/j.1365-2214.2010.01073.x
  • Ferreira, L. F., Cabral, G. C. F., Santos, J. O. L., Souza, C. J. F., & Freudenheim, A. M. (2015). Transtorno do desenvolvimento da coordenação: discussões iniciais sobre programas de intervenção. Revista Acta Brasileira de Movimento Humano, 5(1), 42-65.
  • Galvão, B. A. P., Bueno, K. M. P., Rezende, M. B., & Magalhães, L. C. (2014). Percepção materna do desempenho de crianças com transtorno do desenvolvimento da coordenação. Psicologia em Estudo, 19(3), 527-538. http://dx.doi.org/10.1590/1413-73722039315
    » http://dx.doi.org/10.1590/1413-73722039315
  • Goulardins, J. B., Rigoli, D., Piek, J. P., Kane, R., Palácio, S. G., Casella, E. B., Nascimento, R. O., Hasue, R. H., & Oliveira, J. A. (2016). The relationship between motor skills, ADHD syntoms and childhood body weight. Research in Developmental Disabilities, 55(1), 279-286. PMid:27214681. http://dx.doi.org/10.1016/j.ridd.2016.05.005
    » http://dx.doi.org/10.1016/j.ridd.2016.05.005
  • Henderson, S. E., Sugden, D. A., & Barnett, A. L. (2007). Movement assessment battery for children. London: The Psychological Corporation.
  • Hua, J., Jin, H., Gu, G., Liu, M., Zhang, L., & Wu, Z. (2014). The influence of chinese one-child family status on developmental coordination disorder status. Research in Developmental Disabilities, 35(1), 3089-3095. PMid:25137180. http://dx.doi.org/10.1016/j.ridd.2014.07.044
    » http://dx.doi.org/10.1016/j.ridd.2014.07.044
  • King, B. R., Clark, J. E., & Oliveira, M. A. (2012). Developmental delay of finger torque control in children with developmental coordination disorder. Developmental Medicine and Child Neurology, 54(10), 932-937. PMid:22803701. http://dx.doi.org/10.1111/j.1469-8749.2012.04375.x
    » http://dx.doi.org/10.1111/j.1469-8749.2012.04375.x
  • Magalhães, L. C., & Wilson, B. N. (2017). Questionário de Transtorno do Desenvolvimento da Coordenação – DCDQ-Brasil Belo Horizonte: UFMG. Recuperado em 11 de dezembro de 2018, de http://www.eeffto.ufmg.br/ideia/wp-content/uploads/2018/03/DCDQ-Brasil-AdminEscore-Feb-2018.pdf
    » http://www.eeffto.ufmg.br/ideia/wp-content/uploads/2018/03/DCDQ-Brasil-AdminEscore-Feb-2018.pdf
  • Magalhães, L. C., Rezende, F. C. A., Magalhães, C. M., & Albuquerque, P. D. R. (2009a). Análise comparativa da coordenação motora de crianças nascidas a termo e pré-termo, aos 7 anos de idade. Revista Brasileira de Saúde Materno Infantil, 9(3), 293-300. http://dx.doi.org/10.1590/S1519-38292009000300008
    » http://dx.doi.org/10.1590/S1519-38292009000300008
  • Magalhães, L. C., Rezende, M. B., Amparo, F., Ferreira, G. N., & Renger, C. (2009b). Problemas de coordenação motora em crianças de 4 a 8 anos: levantamento baseado no relato de professores. Revista de Terapia Ocupacional da Universidade de São Paulo, 20(1), 20-28. http://dx.doi.org/10.11606/issn.2238-6149.v20i1p20-28
    » http://dx.doi.org/10.11606/issn.2238-6149.v20i1p20-28
  • Marturano, E. M. (2006). O inventário de recursos do ambiente familiar. Psicologia: Reflexão e Crítica, 19(3), 498-506. http://dx.doi.org/10.1590/S0102-79722006000300019
    » http://dx.doi.org/10.1590/S0102-79722006000300019
  • Mazer, E. P., & Barba, P. C. S. D. (2010). Identificação de sinais de transtornos do desenvolvimento da coordenação em crianças de três a seis anos e possibilidades de atuação da terapia ocupacional. Revista de Terapia Ocupacional da Universidade de São Paulo, 21(1), 74-82. http://dx.doi.org/10.11606/issn.2238-6149.v21i1p74-82
    » http://dx.doi.org/10.11606/issn.2238-6149.v21i1p74-82
  • McQuillan, V. (2015). Stability and change over time in children with movement difficulties. Hillary Place Papers, 1-14.
  • Mendes, K. D. S., Silveira, R. C. C. P., & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto Enfermagem, 17(4), 758-764. http://dx.doi.org/10.1590/S0104-07072008000400018
    » http://dx.doi.org/10.1590/S0104-07072008000400018
  • Miranda, T. B., Beltrame, T. S., & Cardoso, F. L. (2011). Desempenho motor e estado nutricional de escolares com e sem transtorno do desenvolvimento da coordenação. Revista Brasileira de Cineantropometria & Desempenho Humano, 13(1), 59-66.
  • Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLoS Medicine, 6(6), e1000097. PMid:19621072. http://dx.doi.org/10.1371/journal.pmed.1000097
    » http://dx.doi.org/10.1371/journal.pmed.1000097
  • Moreira, R. S., Magalhães, L. C., Dourado, J. S., Lemos, S. M., & Alves, C. R. (2014). Factors influencing the motor development of prematurely born school-aged childrenn in Brazil. Research in Developmental Disabilities, 35(9), 1941-1951. PMid:24858787. http://dx.doi.org/10.1016/j.ridd.2014.04.023
    » http://dx.doi.org/10.1016/j.ridd.2014.04.023
  • Narvaz, M. G., & Koller, S. H. (2004). O modelo bioecológico do desenvolvimento humano. In S. H. Koller. Ecologia do desenvolvimento humano (pp. 51-65). São Paulo: Casa do Psicólogo.
  • Nascimento, R. O., Ferreira, L. F., Goulardins, J. B., Freudenheim, A. M., Marques, J. C., Casella, E. B., & Oliveira, J. A. (2013). Health-related physical fitness children with severe and moderate developmental coordination disorder. Research in Developmental Disabilities, 34(11), 4222-4231. PMid:24077071. http://dx.doi.org/10.1016/j.ridd.2013.08.025
    » http://dx.doi.org/10.1016/j.ridd.2013.08.025
  • Nobre, F. S. S., Coutinho, M. T. C., & Valentini, N. C. (2014). A ecologia do desenvolvimento motor de escolares litorâneos do Nordeste do Brasil. Journal of Human Growth and Development, 24(3), 263-273. http://dx.doi.org/10.7322/jhdg.88910
    » http://dx.doi.org/10.7322/jhdg.88910
  • Nobre, G. C., Bandeira, P. F. R., & Valentini, N. C. (2016). The relationship between general perceived motor competence, perceived competence relative to motor skill and actual motor competence in children. Journal of Physical Education , 27(e2744), 1-12. http://dx.doi.org/10.4025/jphyseduc.v27i1.2744
    » http://dx.doi.org/10.4025/jphyseduc.v27i1.2744
  • Oliveira, M. A., Loss, J. F., & Petersen, R. D. S. (2005). Controle de força e torque isométrico em crianças com DCD. Revista Brasileira de Educação Física e Esporte, 19(2), 89-103.
  • Portes, J. R. M., Vieira, M. L., Crepaldi, M. A., More, C. L. O. O., & Motta, C. C. L. (2013). A criança com síndrome de Down: na perspectiva da Teoria Bioecológica do Desenvolvimento Humano, com destaque aos fatores de risco e de proteção. Boletim Academia Paulista de Psicologia, 33(85), 446-464.
  • Prado, M. S. S., Magalhães, L. C., & Wilson, B. N. (2009). Cross-cultural adaptation of the Developmental Coordination Disorder Questionnaire for brazilian children. Brazilian Journal of Physical Therapy, 13(3), 236-243. http://dx.doi.org/10.1590/S1413-35552009005000024
    » http://dx.doi.org/10.1590/S1413-35552009005000024
  • Prati, L. E., Couto, M. C. P. P., Moura, A., Poletto, M., & Koller, S. H. (2008). Revisando a inserção ecológica: uma proposta de sistematização. Psicologia: Reflexão e Crítica, 21(1), 160-169. http://dx.doi.org/10.1590/S0102-79722008000100020
    » http://dx.doi.org/10.1590/S0102-79722008000100020
  • Ramalho, M. H. S., Valentini, N. C., Muraro, C. F., Gadens, R., & Nobre, G. C. (2013). Validação para língua portuguesa: lista de Checagem da Movement Assessment Battery for Children. Motriz, 19(2), 423-431. http://dx.doi.org/10.1590/S1980-65742013000200019
    » http://dx.doi.org/10.1590/S1980-65742013000200019
  • Rocha, F. F., Santos, V. A. P., Contreira, A. R., Pizzo, G. C., Silva, P. N., Romero, P. V. S., & Vieira, J. L. L. (2016). Análise do desempenho motor e maturidade cognitiva de pré-escolares de Maringá (PR). Saúde e Pesquisa, 9(3), 507-515. http://dx.doi.org/10.17765/1983-1870.2016v9n3p507-515
    » http://dx.doi.org/10.17765/1983-1870.2016v9n3p507-515
  • Rolfsen, A. B., & Martinez, C. M. S. (2008). Programa de intervenção para pais de crianças com dificuldades de aprendizagem: um estudo preliminar. Paidéia, 18(39), 175-188. http://dx.doi.org/10.1590/S0103-863X2008000100016
    » http://dx.doi.org/10.1590/S0103-863X2008000100016
  • Sangster Jokić, C. A., & Whitebread, D. (2016). Self-regulatory skill among children with and without developmental coordination disorder: an exploratory study. Physical & Occupational Therapy in Pediatrics, 36(4), 401-421. PMid:26939836. http://dx.doi.org/10.3109/01942638.2015.1135844
    » http://dx.doi.org/10.3109/01942638.2015.1135844
  • Santos, V. A. P., Contreira, A. R., Caruzzo, N. M., Passos, P. C. B., & Vieira, J. L. L. (2015). Desordem Coordenativa Desenvolvimental: uma análise do estado nutricional e nível sócioeconômico. Motricidade, 11(1), 78-86. http://dx.doi.org/10.6063/motricidade.3195
    » http://dx.doi.org/10.6063/motricidade.3195
  • Silva, J., Beltrame, T. S., Oliveira, A. D. V. P., & Sperandio, F. F. (2012). Dificuldades motoras e de aprendizagem em crianças com baixo desempenho escolar. Journal of Human Growth and Development, 22(1), 1-9. http://dx.doi.org/10.7322/jhgd.20048
    » http://dx.doi.org/10.7322/jhgd.20048
  • Sugden, D. (2014). Multi-level and ecological models of developmental coordination disorder. Current Developmental Disorders Reports, 1(2), 102-108. http://dx.doi.org/10.1007/s40474-014-0015-5
    » http://dx.doi.org/10.1007/s40474-014-0015-5
  • Tal-Saban, M., Ornoy, A., & Parush, S. (2014). Young adults with developmental coordination disorder: a longitudinal study. The American Journal of Occupational Therapy, 68(3), 307-316. PMid:24797194. http://dx.doi.org/10.5014/ajot.2014.009563
    » http://dx.doi.org/10.5014/ajot.2014.009563
  • Turato, E. R. (2005). Métodos qualitativos e quantitativos na área da saúde: definições, diferenças e seus objetos de pesquisa. Revista de Saúde Pública, 39(3), 507-514. PMid:15997330. http://dx.doi.org/10.1590/S0034-89102005000300025
    » http://dx.doi.org/10.1590/S0034-89102005000300025
  • Vaivre-Douret, L. (2014). Developmental coordination disorders: state of art. Neurophysiologie Clinique, 44(1), 13-23. PMid:24502901. http://dx.doi.org/10.1016/j.neucli.2013.10.133
    » http://dx.doi.org/10.1016/j.neucli.2013.10.133
  • Vaivre-Douret, L., Lalanne, C., & Golse, B. (2016). Developmental coordination disorder, an umbrella term for motor impairments in children: nature and co-morbid disorders. Frontiers in Psychology, 7(502), 1-13. PMid:27148114. http://dx.doi.org/10.3389/fpsyg.2016.00502
    » http://dx.doi.org/10.3389/fpsyg.2016.00502
  • Valentini, N. C., Clark, J. E., & Whitall, J. (2015). Developmental co-ordination disorder in socially disadvantaged Brazilian children. Child: Care, Health and Development, 41(6), 970-979. PMid:25424697. http://dx.doi.org/10.1111/cch.12219
    » http://dx.doi.org/10.1111/cch.12219
  • Valentini, N. C., Coutinho, M. T. C., Pansera, S. M., Santos, V. A. P., Vieira, J. L. L., Ramalho, M. H., & Oliveira, M. A. (2012). Prevalência de déficits motores e desordem coordenativa desenvolvimental em crianças da região Sul do Brasil. Revista Paulista de Pediatria, 30(3), 377-384. http://dx.doi.org/10.1590/S0103-05822012000300011
    » http://dx.doi.org/10.1590/S0103-05822012000300011
  • Valentini, N. C., Ramalho, H., & Oliveira, M. (2014). Movement assessment battery for children: translation, reliability, and validity for Brazilian children. Research in Developmental Disabilities, 35(3), 733-740. PMid:24290814. http://dx.doi.org/10.1016/j.ridd.2013.10.028
    » http://dx.doi.org/10.1016/j.ridd.2013.10.028
  • Zwicker, J., Rehal, H., Sodhi, S., Karkling, M., Paul, A., Hilliard, M., & Jarus, T. (2015). Effectiveness of a summer camp intervention for children with developmental coordination disorder. Physical & Occupational Therapy in Pediatrics, 35(2), 163-177. PMid:25229503. http://dx.doi.org/10.3109/01942638.2014.957431
    » http://dx.doi.org/10.3109/01942638.2014.957431

Publication Dates

  • Publication in this collection
    17 Feb 2020
  • Date of issue
    Jan-Mar 2020

History

  • Received
    11 July 2018
  • Reviewed
    20 Mar 2019
  • Accepted
    12 June 2019
Universidade Federal de São Carlos, Departamento de Terapia Ocupacional Rodovia Washington Luis, Km 235, Caixa Postal 676, CEP: , 13565-905, São Carlos, SP - Brasil, Tel.: 55-16-3361-8749 - São Carlos - SP - Brazil
E-mail: cadto@ufscar.br