Evaluating the CSAPPA subscales as potential screening instruments for developmental coordination disorder.

Abstract

In this study, we assess the potential of three subscales of the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA), a measure of generalised self-efficacy, as possible screens for developmental coordination disorder (DCD). We used the Bruininks-Oseretsky Test of Motor Proficiency short form (BOTMP-SF) to identify probable cases of DCD. We administered the BOTMP-SF and the CSAPPA to 590 children in grades 4-8 from four schools in the Niagara region of Ontario, Canada. We used receiver operator characteristic (ROC) analysis to assess and compare the performance of the subscales and the full instrument. The area under the receiving operating characteristic curve (AUC), a measure of the overall performance of the test against a diagnostic standard, was good for the full CSAPPA (AUC = 0.81, 95% CI 0.75 to 0.87). The adequacy (AUC = 0.79, 95% CI 0.73 to 0.85) and predilection (AUC = 0.80, 95% CI 0.74 to 0.87) subscales had performance statistically equivalent to the full scale. Since the adequacy subscale is shorter and has good content validity with respect to DCD, we ran additional analyses on this measure. A cut-point of 24 on this subscale gives a sensitivity of 0.86 (95% CI 0.76 to 0.97) and a specificity of 0.47 (95% CI 0.43 to 0.51). The adequacy subscale of the CSAPPA appears to be equivalent to the full measure for the purposes of screening for DCD. Further research should explore the possibility of adding further criteria to improve the CSAPPA's modest specificity in this role.