Biopsychosocial factors and participation in adults with developmental coordination disorder: A structural equation modelling analysis

Aim: To examine the effect of developmental coordination disorder (DCD) on biological (executive function deficit) and psychosocial (low self-esteem and social support) challenges, and the possible mediating effect of these biopsychosocial factors on the relationship between DCD and daily participation, including assistance in performance, performance level, pleasure in daily activities, and global occupational experience. Method: Fifty-five young adults with DCD (28 females; mean age [SD] = 27 years 7 months [3 years 7 months]) and 66 peers without DCD (34 females; mean age [SD] = 27 years 3 months [3 years 8 months]) were included in this structural equation modelling analysis study. Direct and indirect effects were tested using structural equation modelling. Results: DCD had a significantly negative direct effect on all biopsychosocial factors, the need of assistance in performance, and performance level. Self-esteem and social support mediated the effect of DCD on all participation dimensions, while executive function only mediated the effect on performance level and global occupational experience. Interpretation: Results suggest that participation adversities are not only the result of the motor deficits of individuals with DCD, but are also affected by their poor self-esteem, social support, and executive function. Hence, tailored interventions for this population, targeting daily participation, should consider the range of biopsychosocial risk factors affecting these individuals.