Psychosocial implications of poor motor coordination in children and adolescents

Human Movement Science 20 (2001) 73±94

www.elsevier.com/locate/humov

Psychosocial implications of poor motor coordination in children and adolescents Rosemary A. Skinner, Jan P. Piek

*

School of Psychology, Curtin University of Technology, GPO Box U1987, Perth 6845, WA, Australia

Abstract Utilising Harter's theory of competence motivation (Harter, S. The determinants and mediational role of global self-worth in children. In: N. Eisenberg, Contemporary topics in developmental psychology, Wiley, New York, 1987, pp. 219±242.), the current study examined perceived competence and social support, and their in¯uence on self-worth and anxiety in children and adolescents with and without developmental coordination disorder (DCD). A group of children aged 8±10 years, and a group of adolescents aged 12±14 years, with signi®cant movement problems were compared with matched control groups on measures of perceived competence, perceived social support, self-worth and anxiety. Those with DCD were found to perceive themselves as less competent in several domains, and having less social support than control participants. Overall, DCD groups had lower self-worth and higher levels of anxiety than the control groups. Adolescents also perceived themselves as less competent with poorer social support and lower self-worth than younger children. In addition, anxiety was signi®cantly higher for the adolescent group compared to their younger counterparts. Ó 2001 Elsevier Science B.V. All rights reserved. PsycINFO classi®cation: 2330; 2840; 3250 Keywords: Developmental coordination disorder; Self-perceptions; Anxiety; Self-worth; Social support; Adolescents

*

Corresponding author. Tel.: +618-9266-7990; fax: +618-9266-2464. E-mail address: [email protected] (J.P. Piek).

0167-9457/01/$ - see front matter Ó 2001 Elsevier Science B.V. All rights reserved. PII: S 0 1 6 7 - 9 4 5 7 ( 0 1 ) 0 0 0 2 9 - X

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1. Introduction Increasingly, the importance of motor competence on the psychosocial lives of children has been recognised in the literature. Research has linked poor coordination to attention disorders (Gillberg & Gillberg, 1983; Gillberg, Gillberg, & Groth, 1989; Piek, Pitcher, & Hay, 1999), low self-esteem and poor self-concept (Henderson, May, & Umney, 1989; Losse et al., 1991; Maeland, 1992; Piek, Dworcan, Barrett, & Coleman, 2000; Schoemaker & Kalverboer, 1994), and emotional disorders (Cratty, 1994; O'Dwyer, 1987; Schoemaker & Kalverboer, 1994). Children with poor motor coordination have also been found to underachieve educationally (Fox, 1997; Gillberg, Gillberg, & Rasmussen, 1983; O'Dwyer, 1987) and to experience diculties with peer relations (Bou€ard, Watkinson, Thompson, Causgrove Dunn, & Romanow, 1996; Gubbay, 1975; Schoemaker & Kalverboer, 1994). The above research indicates poor motor coordination has far-reaching implications for social and emotional functioning. Harter (1987) provides a useful framework for investigating the psychosocial repercussions of DCD. According to Harter, a major goal of achievement behaviour is the feeling of competence. Competence refers to one's level of mastery, which may range from poor to adequate to superior. Children's perceived competence a€ects their continued interest in an activity and in further mastery attempts. When applied to physical activity, Harter's (1987) theory of competence motivation means that if individuals perceive themselves as physically competent, they will continue to participate in physical activities. If, however, they perceive themselves as physically incompetent, they will limit participation and suspend mastery attempts. In terms of Harter's competence motivation theory, children with poor coordination are likely to experience low perceptions of competence in the physical domain as a consequence of repeated failure at movement skills. If these children avoid motor activities, for fear of failure and peer criticism, then opportunities to practise skills and participate socially will be limited. It is predicted that this would have broad implications on the development of the poorly coordinated child's self-perceptions extending beyond the athletic domain (White, 1959). There is some indication that this is indeed the case for children with DCD. Using Harter's self-perception pro®le (Harter, 1985a), children with DCD have been found to have a lower perception of their athletic competence than their peers (Cantell, Smyth, & Ahonen, 1994; Losse et al.,

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75

1991; Piek et al., 2000; Rose, Larkin, & Berger, 1997; Schoemaker & Kalverboer, 1994). Some studies have revealed that children with poor motor skills perceive themselves to be less competent than control children on the domain of scholastic competence in addition to athletic competence (Cantell et al., 1994; Piek & Edwards, 1997; Rose et al., 1997). Children and adolescents with DCD have also been reported to have poorer perceptions of their physical appearance than their coordinated counterparts (Losse et al., 1991; Rose et al., 1997). Social acceptance has also been found by some to be lower in children with poor motor coordination (Rose et al., 1997; Schoemaker & Kalverboer, 1994). Schoemaker and Kalverboer (1994) found that children with poor coordination tend to withdraw from social situations in order to prevent failure. This, in combination with negative reactions from peers, was concluded to contribute to lower perceived competence toward social relationships in poorly coordinated children. Others however, have not found a signi®cant difference in perceived social acceptance in poorly coordinated children when compared to their peers (Cantell et al., 1994; Losse et al., 1991; Maeland, 1992; Piek et al., 2000). Harter (1987) suggested that not only is one's perceived achievements important in determining one's regard for self, but the importance one places on them is also a signi®cant determinant of self-worth. Hence a person's selfworth would depend upon the extent to which a person thought he/she was competent in areas which he/she considered important, measured by the competence/importance discrepancy score on Harter's self-perception pro®le. Using path analysis to examine the relationship between global self-worth and domain speci®c evaluations for elementary school children, Harter (1987) found the perceived competence/importance discrepancy to be a strong predictor of self-worth. However Marsh (1986) suggested that using an importance discrepancy score is less than ideal by arguing that a set of speci®c self-concept domains has much more explanatory power than the discrepancy score. Harter (1987) also found that acceptance from others was important in determining a child's self-worth. This construct of perceived social support was based on the work of Cooley (cited in Harter, 1987), who postulated that origins of self are primarily social in nature, and our sense of self lies in our perceptions of what others think of us. Social support was operationalised by Harter as the degree to which children felt signi®cant others acknowledged their worth. In order to tap perceived support Harter developed social support scales for children and adolescents, with the most recent version

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involving the measurement of approval, emotional and instrumental support (Harter & Robinson, 1988). According to Harter (1987), both perceived social support and perceived competence are equally important in determining self-worth, with the contribution of each construct being relatively independent of each other. Therefore, in order to understand the development of self-worth, it is important to consider social support as well as perceived competencies (Harter, 1987). Whilst several studies cite poor social status and poor peer integration in children with DCD (e.g., Losse et al., 1991; Schoemaker & Kalverboer, 1994), perceptions of social support in these children have received little attention to date. This may partially explain why studies that have investigated global self-worth in children with DCD have produced equivocal ®ndings. Most researchers have failed to ®nd a signi®cant di€erence in global self-worth between children with poor motor skills and those who are coordinated (Cantell et al., 1994; Maeland, 1992; Piek et al., 2000; van Rossum & Vermeer, 1994). In line with Harter's (1987) research it is possible that if children with poor motor coordination have good levels of perceived social support, this may bu€er the e€ect of low perceived competence on self-worth. This appeared to be the case in the study by Piek et al. (2000), where children with DCD had lowered self-perceptions in the domain of athletic competence, but there were no di€erences between the DCD and Control groups for perceived social support or global self-worth. Considering the importance social support may have on a child's self-worth, it is important to assess children with DCD on this construct in addition to perceived competence. In a study of middle school children, Harter found those who like themselves as people were found to be the happiest, while those who had a less positive view of themselves reported more feelings of sadness and depression. Whilst Harter has explored the link between self-worth and depression, others have utilised Harter's model explore anxiety within the sports arena. For example research indicates that those children anxious about sports performance experience lower self-esteem than the less anxious children (Brustad, 1988; Passer, 1983). For the child with poor motor coordination, negative appraisal from signi®cant others and social comparison with teammates can all add to the milieu of poor self-concept, inaptness and fear of future participation manifesting in symptoms of anxiety. Few studies have investigated anxiety in children with DCD. Schoemaker and Kalverboer (1994) examined the social and a€ective concomitants of poor motor coordination in children aged 6 to 9 years. A signi®cant

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di€erence was found on state and trait anxiety between the children with poor motor coordination and the control children, with the poorly coordinated children being more anxious. The children were presented with the state-trait anxiety inventory (Spielberger, 1973) prior to motor assessment resulting in a rise in worrying thoughts and emotionality reactions for 33% of the poorly coordinated children. Twenty-two percent of children with poor motor coordination also reported more trait anxiety, a more stable form of anxiety. The authors' inspection of the individual questions revealed that the poorly coordinated children endorsed questions dealing with feelings of shyness, unhappiness and brooding about what other people think of them more frequently than the control children. Based on Harter's (1987) model of self-worth, the current study investigated the existence of secondary self-concept and anxiety problems in children with DCD in the middle primary school and in those who have made the transition to high school. Participants with and without DCD were compared on the constructs of perceived competence, perceived social support, global self-worth and anxiety in order to provide further knowledge of the psychosocial diculties faced by those with DCD. Whilst a number of recent studies have explored the social and emotional impact of DCD on children, fewer studies have investigated the impact of DCD on adolescents. Those that have been conducted on adolescents have been longitudinal in nature where children have been identi®ed in early to mid-childhood. These studies have found that adolescents with DCD experience persistent diculties in motor skills in addition to behavioural, emotional and social diculties (Gillberg et al., 1983; Losse et al., 1991; Roussounis, Gaussen, & Stratton, 1987). A cross-sectional design was utilised rather than longitudinal, as a previous diagnosis of DCD may confound the age e€ects. Given the cumulative e€ect of failed mastery attempts and increasing accuracy of self-judgments as children get older, it is expected that the psychosocial outcome for adolescents with DCD will be poorer than for the younger group of children. 2. Method 2.1. Participants The 218 participants in the study were selected from seven primary schools and eight high schools in the Perth metropolitan area. The

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Table 1 Means and standard deviations for the DCD and control groups on estimated Verbal IQ Age levels 8±10 years

M S.D.

12±14 years

DCD n ˆ 58

Control n ˆ 58

DCD n ˆ 51

Control n ˆ 51

102 13.50

104 16.05

97 9.27

97 9.70

sample comprised two age groups: 58 children with DCD and 58 control children aged 8±10 years; and 51 adolescents with DCD and 51 control adolescents aged 12±14 years. The classi®cation of the participants at both ages was based on performance on the movement assessment battery for children (M-ABC) test (Henderson & Sugden, 1992) and the Wechsler intelligence scale for children (WISC-III; Wechsler, 1992). The DCD group consisted of those participants who scored below the 15th percentile on the total score of the M-ABC test. The cuto€ point for the DCD group was selected in line with the recommendations of Henderson and Sugden (1992). Total impairment scores below the 5th percentile are indicative of a de®nite movement problem. Scores between the 5th and 15th percentile suggest borderline motor coordination problems. The control group consisted of those participants whose scores were above the 50th percentile on the total score of the M-ABC test. Participants were excluded from the study if their estimated Verbal IQ was below 80 (Wechsler, 1981). Table 1 gives the mean estimated Verbal IQ for each of the four groups. There were no signi®cant group di€erences, t…100† ˆ 0:002; P > 0:05, and no signi®cant age di€erences, t…100† ˆ 0:02; P > 0:05. Participants were matched on age (to within six months) and gender. The younger groups had 40 girls and 18 boys in each, whereas the adolescent groups had 29 girls and 22 boys in each. The gender distribution in favour of girls, particularly in the younger group was unexpected as other studies report DCD is more frequently diagnosed in boys than in girls (Henderson & Hall, 1982). However in the current study more girls returned the consent form than boys. Hence the population pool from which the sample was selected was biased in favour of girls initially.

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2.2. Measures 2.2.1. M-ABC test (Henderson & Sugden, 1992) Level of motor functioning was measured using the M-ABC test. This is relatively easy to administer and includes eight items measuring manual dexterity, ball skills and static and dynamic balance. Each task is given a score from 0 to 5 with the scores being summed to produce a total impairment score. Higher scores indicate increasing level of motor impairment. The M-ABC test has been validated against other instruments designed to measure similar constructs (Barnett & Henderson, 1992; Laszlo & Bairstow, 1985; Riggen, Ulrich, & Ozmun, 1990). Test-retest reliability of the M-ABC test is reported as 0.75 and the inter-tester reliability is 0.70. 2.2.2. Wechsler intelligence scale for children (WISC-III; Wechsler, 1992) A short form of the WISC-III was used to determine the estimated Verbal IQ. The Similarities and Vocabulary tests from the Verbal section were chosen on the basis of their high reliability coecients (Sattler, 1988). Other studies with children diagnosed with DCD have also used these subtests to determine the estimates of Verbal IQ (Henderson & Hall, 1982; Lord & Hulme, 1987; Piek & Coleman-Carman, 1995). 2.2.3. State-trait anxiety inventory for children/adults (STAI; Spielberger, 1983) The STAI was used to determine the level of state and trait anxiety in the younger and older children. The STAI comprises separate self-report scales for measuring state and trait anxiety. The S-Anxiety scale consists of 20 statements that evaluate how the respondent is feeling ``right now, at this moment''. The T-Anxiety scale consists of twenty statements that assess how people generally feel. The STAI has been used extensively in research and clinical practice to assess worry, apprehension, and tension. The reliability and validity of the scale are adequate (Spielberger, 1973). 2.2.4. Self-perception pro®le (Harter, 1985a; Harter, 1985b) The self-perception pro®le was designed to assess self-perceptions and global self-worth. The measure has versions appropriate for both children

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and for adolescents and is designed to measure self-evaluation across domains of scholastic competence, social acceptance, athletic competence, physical appearance and behavioural conduct. For adolescents three additional subscales are included: job competence, romantic appeal, and close friendship. Both versions also include a subscale designed to evaluate global self-worth that assesses self-esteem independent from the competence domains. A structured alternative format is used. The participant is ®rst asked to identify which child/teenager is most like him or her, and they are then asked whether this is only sort of true or really true for him/her. The overlap between content across the two versions of the self-perception pro®le allows for a switch of versions at the appropriate age level and allows for comparison of the subscale scores across the two versions (Byrne, 1996; Harter, 1985b). Overall internal consistency reliability ranges from 0.74 to 0.92. 2.2.5. Social support scale for older children and adolescents (Harter & Robinson, 1988) This version of Harter's social support scale crosses source of support and type of support. There are four sources of support ± parents, teachers, classmates and close friends and three types of support, approval, emotional and instrumental support. For all sources of support, each type is represented. Items are scored on a four-point scale where the presence of support ± really true is 4, presence of support ± sort of true is 3, absence ± sort of true is 2, and absence ± really true is 1. The instrument contains the same question format devised for the self-perception pro®le. Internal consistency ranges from 0.72 to 0.88. The measure is suitable for children aged 8±18 years of age. 2.3. Procedure The research was carried out according to the ethical guidelines laid down by the National Health and Medical Research Council of Australia. Before commencing the study, consent was obtained from parents, principals and teachers. Participants were tested over two sessions at the child's school. For the ®rst session each child was individually assessed on the STAI, which was administered immediately prior to administration of the M-ABC test. This is in line with the procedure used by Schoemaker and Kalverboer (1994). Each

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child was informed that once he/she had completed the STAI he/she would be participating in some physical activities such as throwing and catching a ball and balancing. The participants were then administered the M-ABC test, followed by the WISC-III. Session one took approximately ®fty minutes altogether. In the second testing session, participants completed the self-perception pro®le and the social support scale, which took approximately forty minutes and was administered in small groups of three to four participants. For children younger than nine years of age the items were read out loud.

2.4. Data analysis Multivariate analyses of covariance were used to compare the DCD and control groups on the dependent variables, with Verbal IQ as a covariate. MANOVA is popularly recommended for use with dependent variables that are correlated to reduce Type I error. The familywise error rate was set at a ˆ 0:05. Power was set at b ˆ 0:2 allowing a 20% chance of a type II error. Power analysis and e€ect size were determined and used to interpret the results. MANCOVA was employed to examine both Group (control and DCD) and Age (children and adolescents) di€erences for all variables except selfperception. This was analysed separately for each age level as the number of items and the number of domains included in the measure di€ered between older and younger children. Also, while the layout and wording for the STAI di€ered between age groups, the number of items was the same, constructs being tapped by each item were the same and the method of scoring was the same. Hence age groups were combined for analysis on this dependent variable. ANOVA was used to examine global self-worth between groups and ages. Multiple linear regression was used to determine which domains of selfperception and which sources of social support were predictors of selfworth. As in a previous study (Piek et al., 2000), the two groups, control and DCD, were examined in separate analyses. The two age groups were also examined separately due to the additional domains of selfworth for the adolescent groups, resulting in a total of four regression analyses.

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Table 2 Means and standard deviations for the DCD and control groups on the M-ABC test Age levels 8±10 years

M S.D.

12±14 years

DCD n ˆ 58

Control n ˆ 58

DCD n ˆ 51

Control n ˆ 51

14.58 3.29

2.06 1.38

16.06 3.87

2.47 1.31

3. Results 3.1. Performance on the M-ABC test Table 2 displays the mean score and standard deviation for the M-ABC test for each group. There was no signi®cant di€erence across age for the M-ABC test, F …1; 216† ˆ 0:96; P ˆ 0:32. Of those identi®ed with DCD, 34 children (59%) and 41 adolescents (80%) scored below the 5th percentile on the M-ABC test, and 24 children and 10 adolescents scored between the 6th and 15th percentile. 3.2. Performance on the self-perception pro®le 3.2.1. 8±10 year old children Table 3 displays the mean score on the self-perception pro®le. Inspection of these means suggests that children in the DCD group perceived themselves as less competent overall compared to their peers. A two-group MANCOVA con®rms this, T 2 …6; 107† ˆ 4:6; P < 0:001. Inspection of the univariate F values found that scholastic competence, athletic competence, physical appearance, and self-worth were signi®cantly lower for children with DCD than for those in the control group. Table 4 gives the F values, e€ect size and statistical power for each of the univariate analyses. 3.2.2. 12±14 year old children Table 3 displays the mean score on the self-perception pro®le for both the DCD and control groups aged 12±14 years. A linear combination of scholastic competence, social acceptance, athletic competence, physical appear-

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Table 3 Self-perception means for children and adolescents with and without DCD Subscales

Age levels 8±10 years

Scholastic M S:D: Social acceptance M S:D: Athletic M S:D: Physical appearance M S:D: Behavioural conduct M S:D: Global self-worth M S:D: Job competence M S:D: Romantic appeal M S:D: Close friendships M S:D:

12±14 years

DCD n ˆ 58

Control n ˆ 58

DCD n ˆ 51

Control n ˆ 51

2.73 0.54

3.07 0.62

2.74 0.58

2.93 0.56

2.80 0.66

3.03 0.70

3.12 0.48

3.32 0.49

2.67 0.69

3.21 0.58

2.56 0.83

3.17 0.74

2.94 0.59

3.22 0.59

2.30 0.69

2.74 0.67

3.16 0.65

3.18 0.56

2.69 0.56

2.89 0.64

3.08 0.65

3.41 0.52

2.80 0.57

3.20 0.46

NA NA

NA NA

2.90 0.59

3.03 0.57

NA NA

NA NA

2.56 0.58

2.56 0.59

NA NA

NA NA

3.20 0.72

3.40 0.74

ance, job competence, romantic appeal, behavioural conduct, close friendships and self-worth signi®cantly separated the DCD group from the control group, T 2 …9; 91† ˆ 3:07; P < 0:01. Univariate F values revealed that on the domains of social acceptance, athletic competence, physical appearance, and self-worth adolescents with DCD had signi®cantly lower perceived competence than for those in the control group. 3.2.3. Global self-worth A 2 …Group†  2 …Age† ANCOVA was used to investigate age and group di€erences for Global Self-Worth. There was a signi®cant group e€ect,

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Table 4 Univariate results for perceived competence and global self-worth subscales for children and adolescents Subscales Scholastic Social acceptance Athletic Physical appearance Behavioural conduct Global selfworth Job competence Romantic appeal Close friendships

8±10 years

12±14 years F …1; 99†

Eta2

Power

0.86 0.40

3.18 4.17

0.031 0.040

0.42 0.52

0.151 0.055

0.99 0.71

14.92 10.70

0.131 0.098

0.96 0.90

0.04

0

0.05

2.55

0.025

0.35

8.81

0.069

0.82

12.86

0.115

0.94

NA

0.80

0.008

0.14

NA

0

0

0.05

NA

1.06

0.011

0.17

F …1; 113† 9.49 2.98

20.03 6.51

Eta2

Power

0.077 0.026

 P < 0:05.  P < 0:01:  P < 0:001.

F …1; 213† ˆ 5:64; P < 0:05, and a signi®cant age e€ect, F …1; 213† ˆ 6:37; P < 0:05, but no signi®cant interaction e€ect, F …1; 213† ˆ 3:51; P > 0:05. Those in the DCD group reported signi®cantly lower global self-worth than the control group. In addition adolescents reported signi®cantly lower global self-worth than the younger children. 3.3. Performance on the social support scale Table 5 displays the mean scores on the social support scale for the DCD and control groups at both age levels. The data were analysed using a 2 …group†  2 …age† MANCOVA. The main e€ect for group was signi®cant, T 2 …3; 211† ˆ 4:9; P < 0:01, indicating that those in the DCD groups had signi®cantly lower perception of social support than the control groups. A signi®cant main e€ect was found for age, T 2 …3; 11† ˆ 6:9; P < 0:001. Overall those in the older age groups perceived themselves as having signi®cantly less social support than the younger children. No signi®cant interaction was found between age and group. To establish where the signi®cant di€erences occurred, the univariate F values were consulted for both group and age di€erences. Table 6 displays the

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Table 5 Social support means for children and adolescents with and without DCD Subscales

Age levels 8±10 years

Approval M S:D: Emotional M S:D: Instrumental M S:D:

12±14 years

DCD n ˆ 58

Control n ˆ 58

DCD n ˆ 51

Control n ˆ 51

3.25 0.49

3.45 0.49

3.13 0.39

3.32 0.45

3.18 0.45

3.49 0.49

3.07 0.42

3.20 0.45

3.35 0.43

3.61 0.38

3.17 0.41

3.31 0.39

Table 6 Univariate results for perceived social support subscales Subscales

Coordination F …3; 211†

Approval Emotional Instrumental **



9.4 12.52 13.09

Age 2

Eta

Power

F …3; 211†

Eta2

Power

0.042 0.056 0.058

0.86 0.94 0.95

2.12 9.59 15.67

0.010 0.043 0.069

0.30 0.86 0.97

P < 0:01: P < 0:001:

***

univariate results. Inspection of the univariate F values revealed signi®cant di€erences between the Control and DCD groups on approval, emotional and instrumental support. Those in the DCD group reported less social support on these domains. Signi®cant age di€erences were apparent on two of the dependent variables: emotional and instrumental support. Those in the older age group reported less social support than the younger children on these domains. 3.4. State and trait anxiety Table 7 displays the mean score for anxiety for children with DCD and the control children at both age levels. MANCOVA revealed a signi®cant main e€ect for group, T 2 …2; 212† ˆ 9:25; P < 0:001 indicating that those in the DCD group were signi®cantly more anxious than the control group. The

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Table 7 State and trait anxiety means and standard deviations for children and adolescents with and without DCD Subscales

Age levels 8±10 years

State M S:D: Trait M S:D:

12±14 years

DCD n ˆ 58

Control n ˆ 58

DCD n ˆ 51

Control n ˆ 51

28.79 4.14

26.55 3.72

34.53 7.10

31.11 6.24

33.86 6.64

31.60 5.48

38.68 7.40

34.29 6.86

main e€ect for age was signi®cant T 2 …2; 212† ˆ 20:84; P < 0:01, indicating that older children were signi®cantly more anxious than their younger counterparts. The interaction between group and age was not signi®cant. The univariate F values revealed that children in the DCD group reported signi®cantly higher levels of both state, F …2; 212† ˆ 13:17; P < 0:001, and trait, F …2; 212† ˆ 13:60; P < 0:001, anxiety compared to those in the control group. Univariate F values for age level revealed that those in the older age bracket had signi®cantly higher levels of both state, F …2; 212† ˆ 40:46; P < 0:001, and trait, F …2; 212† ˆ 14:98; P < 0:001, anxiety than the younger children. Inspection of the e€ect sizes indicated the relationship between coordination and anxiety, and age and anxiety were small. 3.5. Multiple regression 3.5.1. 8±10 year old children For 8±10 year old children in the control group, eight independent variables (®ve domains of self-perception and three sources of support) accounted for 70% …R2 ˆ 0:70† of the variance in global self-worth. This was statistically signi®cant, F …8; 48† ˆ 13:66; P < 0:05. Only two of the eight variables were statistically signi®cant predictors of self-worth, namely physical appearance, t…48† ˆ 4:70; P < 0:05, and athletic competence, t…48† ˆ 2:98; P < 0:05. The standardised coecient …b† for physical appearance was 0.46 …standard error ˆ 0:087†, and for athletic competence 0.36 …standard error ˆ 0:109†. For 8±10 year old children in the DCD group, eight independent variables (®ve domains of self-perception and three sources of support) accounted for 51% …R2 ˆ 0:51† of the variance in global self-worth. This was statistically

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signi®cant, F …8; 49† ˆ 6:29; P < 0:05. However, there were no independent variables that separately signi®cantly predicted self-worth. 3.5.2. 12±14 year old children For the adolescent control group, 11 independent variables (eight domains of self-perception and three sources of support) accounted for 54% …R2 ˆ 0:54† of the variance in global self-worth. This was statistically significant, F …11; 39† ˆ 4:12; P < 0:05. Three variables were statistically signi®cant predictors of self-worth. For physical appearance, t…39† ˆ 3:26; P < 0:05, the standardised coecient …b† was 0.56 with a standard error of 0.117; for close friendship, t…39† ˆ 2:98; P < 0:05, the standardised coecient …b† was 0.44 with a standard error of 0.092 and for instrumental support, t…39† ˆ 2:06; P < 0:05, the standardised coecient …b† was 0.45 with a standard error of 0.26. For 12±14 year olds in the DCD group, 11 independent variables accounted for 63% …R2 ˆ 0:63† of the variance in global self-worth. This was statistically signi®cant, F …11; 39† ˆ 5:98; P < 0:05. In this case, there were four variables that were signi®cant predictors of self-worth, namely physical appearance, t…39† ˆ 5:56; P < 0:05 …b ˆ 0:76; standard error ˆ 0:112†, scholastic competence, t…39† ˆ 2:33; P < 0:05 …b ˆ 0:28; standard error ˆ 0:118†, romantic appeal, t…39† ˆ 2:30; P < 0:05 …b ˆ 0:32; standard error ˆ 0:136†, and instrumental support, t…39† ˆ 2:68; P < 0:05 …b ˆ 0:43; standard error ˆ 0:218†.

4. Discussion The current study provided a comprehensive examination of the psychosocial variables comparing children and adolescents with and without DCD. The ®ndings revealed that children and adolescents with DCD have lower self-perceptions and global self-worth than their coordinated peers. Those with DCD consistently viewed themselves as less competent than their peers over many domains, indicating that the group di€erence for perceived competence may not be speci®c to the athletic domain. That is, perceived competence may be a€ected on a number of domains for these children. In addition, those with DCD perceived themselves as having lower levels of social support and reported more symptoms of anxiety. Overall the pattern of results also indicated that higher levels of self-competence were related to higher levels of self-worth and lower levels of anxiety.

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As predicted, children and adolescents with DCD have lower self-perceptions in the domain of athletic competence than their peers. This ®nding supports other research which indicates that those with poor motor coordination have signi®cantly lower perceptions of athletic competence than control children (Cantell et al., 1994; Maeland, 1992; Piek et al., 2000; Rose et al., 1997; van Rossum & Vermeer, 1990). Younger children with DCD reported lower perceived competence on the scholastic domain compared to their peers. Whilst it is commonly reported in the literature that children with DCD exhibit poor school achievement (Geuze & B orger, 1993; Losse et al., 1991; Sovik & Maeland, 1986), few studies have investigated perceived competence for children with DCD in this domain. The link between DCD and perceptions of scholastic competence found in the current study is consistent with that of Rose et al. (1997). Whilst Cantell et al. (1994) found adolescents with DCD had signi®cantly lower perceptions of scholastic performance than their peers, this was not found for the adolescent group in the current study. However those with DCD in the Cantell study had signi®cantly lower IQ scores than the control group; in the current study there was no signi®cant group di€erence on the estimated Verbal IQ. The observed di€erence between the DCD group and control group for social acceptance in the adolescent group provides some support for the link between social status and movement ability (Losse et al., 1991). Those in the adolescent DCD group had signi®cantly lower perceptions of their social acceptance than their peers. This is consistent with the ®ndings of Losse et al. (1991), who found adolescents aged 15±17 years with poor motor coordination reported signi®cantly less social acceptance than the control group. The link between social acceptance and DCD was not supported in the younger age group, in contrast to past research which has reported poor perceptions of social acceptance for primary school children with DCD (Rose et al., 1997; Schoemaker & Kalverboer, 1994). The importance of social support and acceptance from peers and close friends changes from childhood to older adolescence. The transition to high school has been associated with increased importance of peer social support (Harter, 1987), with approval from classmates being central in determining popularity and general social acceptance. Harter (1987) found a high correlation between physical competence and social competence or popularity. For the adolescent with poor motor coordination peer approval may not be forthcoming, making the early years at high school more dicult for those with poor coordination (Evans & Roberts, 1987).

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At both age levels, the DCD groups reported signi®cantly lower perceptions of their physical appearance than the control groups, a ®nding consistent with Rose et al. (1997) in a sample of 8±12 year old children. In a follow-up study of adolescents with DCD aged 15±17 years, Losse et al. (1991) found that those with poor motor coordination reported signi®cantly less satisfaction with their physical appearance than the control group. Harter (1987) research implicated physical appearance as the most important domain in determining children's self-worth. This ®nding is largely supported in the current study with physical appearance being identi®ed as a signi®cant predictor of self-worth for both the control groups and the adolescent DCD group. Piek et al. (2000) also found that physical appearance was a signi®cant predictor of self-worth in both control children and children with DCD aged between 8 and 12 years. They also found that scholastic competence was a signi®cant predictor of self-worth for children with DCD but not control children. In the current study, both of these factors were found to signi®cantly predict self-worth in the adolescent group with DCD. Social acceptance was found by Harter to be the second largest contributor to self-worth. This was not supported in the current study, as this was not identi®ed as a signi®cant predictor of self-worth in any of the four groups of children. Interestingly, for the younger control group, athletic competence was found to be a determinant of self-worth. This link between lowered global self-worth and athletic competence supports theoretical proposals that athletic or physical competence is an important determinant of self-worth. Harter (1987) found that individuals who experience repeated failure develop perceptions of incompetence and feelings of being ine€ectual within their general environment, leading to low self-worth. The current study indicates that for children and adolescents with DCD, their self-perceptions are a€ected across a variety of domains, with DCD children having lower selfperceptions overall than the control group. The relationship of these domains to self-worth does not appear to be clear-cut in the current study indicating that the way in which dependent variables may interrelate to a€ect self-worth is complex. Indeed, no one variable was found to be a signi®cant predictor of self-worth for younger DCD children, yet as a whole they accounted for 51% of the variance in global self-worth. Furthermore, for adolescent groups, the perception of having close friends appeared to impact on the self-worth of the control group, whereas romantic appeal appeared to be an important factor for the DCD group.

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The ®ndings reported by Harter (1987) on the development of self-worth suggest social support is also an important factor in determining self-worth. In the current study, both DCD groups reported lower perceptions of social support than their coordinated counterparts. Whilst few studies have empirically measured social support in children with DCD, many studies make reference to poor social support for this group (e.g., Schoemaker & Kalverboer, 1994; Losse et al., 1991). For example, Losse et al. (1991) found school reports which indicated that adolescents with DCD had fewer friends, were more socially isolated and were at greater risk of bullying than their coordinated peers. When the contribution of approval, emotional and instrumental support to self-worth was investigated, these were not found to individually contribute to self-worth for the younger groups. However, for both control and DCD adolescent groups, instrumental support was found to be a signi®cant predictor of self-worth. In other words, adolescents' selfworth is a€ected by the degree to which they feel that signi®cant others help them out by doing things for them. This is the ®rst study to determine the e€ect of type of social support on self-worth in adolescents with DCD. The emotional impact of DCD has to date attracted limited research. Given the lowered self-worth found in DCD groups, Harter (1987) would predict that this would have an emotional impact on these individuals. In the present study, children and adolescents with DCD were found to signi®cantly di€er from control groups on both state and trait anxiety. Those in DCD groups reported higher levels of anxiety than their matched controls. Given the poorly coordinated child's history of failure in the movement domain, it is not surprising that these children may perceive expected performance on movement tasks as threatening because of lowered expectancy of success. Interestingly the anxiety experienced by those with DCD does not appear to be situation-speci®c with the anxiety generalising to other situations, as indicated by higher levels of trait anxiety for these groups. The ®ndings are consistent with those by Schoemaker and Kalverboer (1994) who found that young children with DCD reported signi®cantly more symptoms of state and trait anxiety than those in the control group. For all variables where the two age groups were compared, adolescents (from both control and DCD groups) reported more diculties than the younger groups. That is, adolescents reported signi®cantly lower social support, lower levels of self-worth and higher levels of anxiety than the younger children. It should be noted that the gender distribution between the adolescent and younger groups di€ered, with younger groups having more girls than boys. However, gender di€erences do not appear to explain the

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di€erences found between the two age groups as past research has found that girls have lower self-worth and experience more anxiety than boys (Ely & Stevenson, 1999; Rose et al., 1997). Rather, the above ®nding is consistent with previous research that indicates adolescents have poorer self-evaluations than younger children. Many researchers have reported age e€ects for self-concept (e.g., Hirsch & Rapkin, 1987; Marsh & Gouvernet, 1989; Marsh, Barnes, Cairns, & Thomas, 1984) with one's self-esteem and perceived competence declining in adolescence. The decline in self-evaluation found during adolescence may re¯ect a more realistic, objective view of the self that occurs as a result of cognitive maturation and additional life experience (Harter & Robinson, 1988; Marsh et al., 1984). In conclusion, the current study has indicated that poor motor skills may have adverse social and emotional implications for children and adolescents. The diculties experienced are not con®ned to the movement domain but may a€ect how children and adolescents view themselves physically, socially and scholastically. Children and adolescents with DCD are less happy with their lives, and place less value on themselves than their coordinated counterparts. Adolescents appear to be more disadvantaged socially and emotionally, perceiving less social support and experiencing more anxiety than younger children. Overall Harter's measures appeared to be appropriate measures for determining self-perceptions, self-worth and social support in the population sampled. However, whilst her measures have been well used, validity of the measures has not been adequately tested. Considering the importance coordination plays in psychosocial development, it is crucial for identi®cation and intervention to occur early for those with DCD. In addition it would appear that in order to improve the child's self-worth, attention needs to be paid not only to improving self-perceptions but bolstering social support from signi®cant others. Given di€erences in the interrelationships between variables for DCD and control groups in the current study, future research is needed to further investigate the interplay between variables and to examine the most salient contributors to self-worth and a€ect for those with and without DCD. Acknowledgements We would like to thank Megan Meadows, Marie Trifon and Robyn Willis for their assistance in the initial screening of participants. Also, thanks to

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Dr Nicholas Barrett for his statistical advice. We are sincerely grateful to the schools, parents and children who were willing to participate in this project.

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