OBJECTIVEA population-based study on developmental coordination disorder (DCD) was conducted in Suzhou to explore the impacts of family and kindergarten environment on pre school children with DCD so as to provide a basis for etiological research and early intervention.

METHODStratified clustered sampling was used to select 160 classes from randomly selected 15 public nursery schools distributed throughout the five main districts in Suzhou city. A total of 4 001 children were included in the study. The family environment scale on motor development for urban preschool children (FESMDPU) which was established by our study group and early childhood environment rating scale-revised (ECERS-R) which has been applied well in China were used to assess the family and kindergarten's environment. The multilevel logistic regression was used to analyze the risk factors of DCD when kindergarten environment were considered as "context variables" and the family environment as "individual variables".

RESULTAccording to DSM-IV criteria, a total of 330 children were diagnosed as DCD. The prevalence of DCD was 8.3%. However, there were differences between the two groups in age, gender and Kaup index (all P < 0.05). The results of ECERS-R and FESMDPU showed that the scores of "class space and faculty" "class activity" "class interaction" "family material environment" "family rearing environment" in DCD group were 48.00, 51.00, 49.00, 39.00, and 30.00, respectively, which were higher than those of control group (45.00, 50.00, 47.00, 41.00, 31.00) with statistical significance (U = 455 446.000, 550 787.000, 508 109.000, 543 159.000, and 490 119.000, P < 0.05 for all comparisons) . The score of ECERS-R and FESMDPU were grouped into different levels using the method of K-MEANS. The school and family environment were compared after the clustering. The results showed that the distribution of the rates in different levels between the DCD and control group were different with statistical significance (χ(2) = 51.091, 9.295, 35.464, 15.174, 13.500, P < 0.05 for all comparisons) . There was no significant difference between DCD and non-DCD children in parents' schooling years and family per-capita income of every month (all P > 0.05). The results of the multilevel logistic regression model showed that when children's gender, age and Kaup index were controlled, "class space and faculty" "class activity" "class interaction" "family material environment" "family rearing environment" were included in the model (OR was 3.486, 1.840, 1.623, 1.531, and 1.379, respectively, P < 0.05 for all) .

CONCLUSIONThe prevalence of DCD in study area was higher than that reported by European and American countries. The family and kindergarten environment may affect the incidence of DCD in preschool children. Parents and preschool educational and child health care practitioners should conduct the early prevention and intervention on DCD based on the risk factors of environment in preschool children.