Assessing postural control deficits with the Balance Evaluation Systems test for children, second edition in children with Developmental Coordination Disorder

Abstract

Background Postural control deficits are highly prevalent in children with Developmental Coordination Disorder (DCD). We developed an extended, age-specific version of the Balance Evaluation Systems test for children (Kids-BESTest-2; age 5-12) that allows for the identification of specific deficient postural control systems by assessing corresponding postural control test domains. Objective To assess the clinical value of the Kids-BESTest-2 in identifying postural control deficits in children with Developmental Coordination Disorder (DCD) by evaluating its construct and predictive validity. Methods We included 89 typically developing (TD) children and 66 children with DCD (age 5-12). Construct validity was established by: 1) exploring differences in Kids-BESTest-2 scores between the known groups (DCD/TD) using the Mann-Whitney U test, 2) determining internal relationships and relationships with child-specific factors with the Spearman rank correlations. Predictive validity was investigated with binary logistic regression analysis. Results TD children outperformed (p<0.001) their DCD peers on the Kids-BESTest-2. The Kids-BESTest-2 correlates moderately (rho=0.69-0.78, p<0.001) to strongly (rho=0.79-0.88, p<0.001) with domain scores. The Kids-BESTest-2 total score significantly correlates with the MABC-2 total score (rho= 0.62, p<0.001), the MABC-2 balance score (rho=0.64, p<0.001), and age (rho=0.40, p<0.001). Age and MABC-2 total and balance scores predict a Kids-BESTest-2 total score < 80%, with a 92.0% sensitivity, 92.9% specificity. Conclusions The Kids-BESTest-2 is a valid tool to identify and specify postural control deficits in children with DCD. Clinicians can decide to administer the Kids-BEST-test-2 by using age and MABC-2 total and balance scores to predict performance.