Understanding participation and quality of life of university students with probable DCD using structural equation modeling

Backgrounds Individuals with developmental coordination disorder (DCD) attending higher-education institutions face challenges in their everyday life. Nevertheless, research regarding participation and quality of life (QoL) in this population is limited. Aim To explore determinants of participation and QoL in university students with probable DCD (pDCD) through structural equation modelling (SEM). Methods A cross-sectional comparative and correlational design. A random sample of 297 undergraduate university students was divided into three groups based on cutoff scores of the Adolescents & Adults Coordination Questionnaire: pDCD; n = 40, borderline pDCD (BpDCD) n = 45 and typically developing (TD) n = 212. Measures included self-report questionnaires relating to pDCD, attention deficit and hyperactivity disorder (ADHD) symptoms, executive functions (EF), including metacognition and behavioral regulation, as well as participation and QoL. Results Students with pDCD reported reduced participation and QoL and impairment in EF and ADHD compared to TD students. SEM results showed that pDCD had a direct significant effect on EF, ADHD symptoms and participation and an indirect effect on QoL, mediated most strongly by participation. ADHD and behavioral regulation had a direct effect on QoL, whereas the relationship between metacognition and QoL was mediated by participation. Conclusions and relevance Through a SEM model, this study demonstrated that pDCD in university students is associated with reduced participation and QoL, and emphasized the role of EF, ADHD and participation in explaining QoL. These findings offer important insights for the assessment and intervention of higher-education students with pDCD.