A continuum of balance performance between children with developmental coordination disorder, spastic cerebral palsy, and typical development.

This was a case-control study, not a treatment trial, so it cannot show that balance therapy improves outcomes. The developmental coordination disorder and cerebral palsy groups were not age-matched with typical development; age ranges were balanced and age was adjusted for, but there was only one 10-year-old child with cerebral palsy. Some children with developmental coordination disorder were not formally diagnosed: 27 had a formal diagnosis, and 12 met criteria but were suspected or detected during screening. Two children had incomplete Kids-BESTest results: one 5-year-old with cerebral palsy could not perform domain 4 tasks, and one 5-year-old with developmental coordination disorder could not reliably perform domain 5; those scores were excluded from their total scores. The cerebral palsy group included different brain lesions and unilateral or bilateral types, and no child with GMFCS level III was included, so results may not apply to more severe cerebral palsy. Vestibular and proprioceptive function were not systematically assessed, so some balance difficulties could relate to unmeasured sensory problems. The 15th percentile cutoffs came from this study's typical-development sample and were exploratory, so they are not established diagnostic thresholds. The Kids-BESTest structure has been questioned in adults, and structural validity in children needs further research.

The authors declared no conflict of interest with any financial organization. The study was funded by Research Foundation-Flanders grants 43498 (1117621N), 2020 and 928636 (11M2622N), 2021.

Do not conclude that a diagnosis of developmental coordination disorder or cerebral palsy tells you which balance systems are impaired. The study found large differences within and between these groups, so an individual child may score near typical peers in one balance domain and below expected in another.