This study looks at whether therapeutic climbing - indoor climbing activities guided by therapists - can help children with Developmental Coordination Disorder (DCD).

DCD is a condition where children have difficulty with motor skills and participation in everyday activities, and sometimes confidence in physical activities.

The climbing program is based on a problem-solving approach called CO-OP (Cognitive Orientation to daily Occupational Performance), in which children learn strategies to achieve goals.

Background: Therapeutic climbing, based on the Cognitive Orientation to daily Occupational Performance (CO-OP) approach, may improve goal performance and satisfaction in children with Developmental Coordination Disorder (DCD), as well as their motivation and self-efficacy toward physical activity.

Objective: This study aims to examine the effectiveness of a CO-OP-based group therapeutic climbing intervention for children with DCD.

Methods: A randomized crossover trial will be conducted with children with DCD. The intervention will consist of a 10-week group-based therapeutic climbing program delivered in an indoor climbing setting. Primary outcomes will include performance and satisfaction related to individualized goals. Secondary outcomes will assess motor skills, self-efficacy, executive functions, motivation toward physical activity, and transfer of learning. Effects of the intervention will be assessed using linear mixed effects models.

Results: It is hypothesized that participants will demonstrate improvements in both primary and secondary outcomes following the intervention.

Conclusions: This study will contribute to the evidence base regarding therapeutic climbing and CO-OP-based interventions for children with DCD, informing future rehabilitation practices.

Inclusion Criteria:

• Diagnosis of DCD by a physician*.
• Ability to follow instructions, communicate verbally, interact with adults and peers, and use cognitive strategies.
• Ability to attend all assessment and intervention sessions in Sherbrooke.
• Ability to understand and speak French.
• Provision of child assent and parental consent. * If the target sample size (n = 16) is not reached, children with suspected DCD based on the Developmental Coordination Disorder Questionnaire (DCDQ) (25,26) will also be considered. Eligibility will then require: (1) a score below the 15th percentile on the total motor composite or below the 5th percentile in a domain of the Bruininks-Oseretsky Test of Motor Proficiency (BOT) (27,28), and (2) the identification of occupational challenges using the Canadian Occupational Performance Measure (COPM) (29,30) during the initial assessment.

Exclusion Criteria:

• Diagnosis of severe behavioral disorders, autism spectrum disorder, intellectual disability, cerebral palsy, muscular dystrophy, and/or severe functional limitations.
• Prior proficiency in climbing or absence of climbing-related goals.