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. 2017 Jul 31;2017(7):CD010914. doi: 10.1002/14651858.CD010914.pub2

Green 2008.

Methods Unblinded RCT with 4 groups.
Participants Number screened: 78.
Number included: 43.
Number followed up: 43.
Number of withdrawals: 0.
Diagnosis of DCD: DSM IV.
Presence and absence of comorbid conditions: children excluded if they had a severe learning difficulty or neuromotor or significant medical problem.
Regarding participants completing the study
Age: mean 97.7 months, range 62 to 128 months.
Sex: 37 boys and 6 girls.
Ethnicity: data collected but not analysed.*
Country: UK.
Setting: community adult education centre/leisure centre.
Sociodemographics: mean socioeconomic status ‐0.55, range from ‐5 to 7.
Inclusion criteria
  1. Diagnosis of DCD.

  2. Intact verbal cognitive capability.

  3. MABC test ≤ 15 percentile.


Exclusion criteria
  1. Severe learning difficulty.

  2. Neuromotor problem.

  3. Significant medical problem.

Interventions Comparison: CO‐OP intervention (group 1) vs inactive control (group 2) vs inactive control (group 3) vs inactive control (group 4).
Phases: each of the 4 groups received the intervention once during 1 of the 4 phases.
Intervention schedule: 1 hr/wk.
Duration of intervention: 20 wk.
Mode of delivery: face‐to‐face group sessions.
Intervention material: global strategy (GPDC) and strategies specific to the child and activity.
Intervention procedure: introduction of the global cognitive strategy, practise and implementation of domain‐specific strategies, consolidation strategies, and consolidation.
Intervention provider: senior therapist and a junior assistant therapist trained in the CO‐OP approach.
Place of intervention: local adult education centre.
Intervention compliance: all participants attended > 50%, a majority attended 16 sessions out of 20.
Outcomes Primary
  1. MABC test.

  2. Developmental Test of Visual‐Motor Integration.

  3. BOTMP subtests (undertaken but not reported


Secondary
  1. Clinical Observations of Motor and Postural Skills.

  2. Other assessments and questionnaires undertaken but not reported:

    1. Coordination Skills Questionnaire;

    2. DCDQ;

    3. Strengths and Difficulties Questionnaire;

    4. Profile of Neuropsychiatric Symptoms;

    5. Gesture Test.

    6. Undertook a measure reporting on goal attainment/COPM but this is not participation per se.*


Adverse effects or events: none recorded.*
Notes Study start date: not available.
Study completion date: not available.
Sample calculation: yes.
Ethics approval: yes.
Comments from study authors
Limitation:
    1. small number.


Key conclusions of study authors
Children with severe DCD were likely to have continuing difficulties despite progress following intervention.
Comment from review authors
Only the data from the first phase were used for meta‐analysis.
* Email correspondence with study authors: June 2015, January 2016 and February 2016. We contacted the first study author several times and obtained raw data for meta‐analysis and supplementary information.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Stratified randomisation into treatment groups of 6 children done according to age bands (6 to 8 years and 9 to 10.8 years) using the random sample selection function of the Statistical Package for Social Sciences (SPSS Inc., 1999).
Allocation concealment (selection bias) High risk High as the author knew the allocation.
Blinding of participants and personnel (performance bias) 
 All outcomes High risk High as the author stated single blinded.
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Testers, who recorded scores, were blinded to each child's intervention group status.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk All accounted for.
Selective reporting (reporting bias) Low risk No protocol obtained. All primary outcomes and 1 secondary outcome reported.
Other bias Low risk Funding: no information available.
Conflicts of interest: no information available.
Baseline imbalance.