Parameterization of movement execution in children with developmental coordination disorder

Which outcomes are key to the pre-intervention assessment profile of a child with developmental coordination disorder? A systematic review and meta-analysis

BACKGROUND

Purpose of this study was to determine what key aspects of function should be incorporated to make up a pre-intervention assessment profile of a child with Developmental Coordination Disorder (DCD); more specifically, what aspects of functioning are implicated in DCD and what is their relative impact?

METHODS

A systematic review and meta-analysis were conducted, for which Pubmed, Web of Science, Scopus and Proquest were searched (last update: April 2023, PROSPERO: CRD42023461619). Case-control studies were included to determine point estimates for performances on field-based tests in different domains of functioning. Risk of bias was assessed, and level of evidence estimated. Random-effect meta-analyses were performed to calculate the pooled standardized mean differences for domains of functioning and subgrouping was done for clinically relevant subdomains. Heterogeneity was determined with I2.

RESULTS

121 papers were included for analyses. Data of 5 923 children with DCD were included (59.8% boys) and 23 619 Typically Developing (TD) children (45.8% boys). The mean (SD) age of the DCD group was 10.3y (1.2) and 9.3y (1.3) for the TD children. Moderate evidence was found for motor performance, executive functions, sensory processing and perceptions, cognitive functions and sports and leisure activities to be affected in children with DCD.

CONCLUSION

Differences between the two groups varied per domain of functioning. This emphasizes the diversity present within children with DCD and provides a rationale for explaining the heterogeneity in this patient group. Yet, results highlight the potential involvement of all these domains and call for clinicians to be alert not only to examine motor skill difficulties but also other aspects of function. Results indicate the need to develop an individualized pre-intervention multi-dimensional assessment profile for each child with DCD. It also supports the important role that clinicians play in an interdisciplinary team to tackle the difficulties encountered by children with DCD.

Motor deficits in autism differ from that of developmental coordination disorder

LAY ABSTRACT

A vast majority of individuals with autism spectrum disorder experience impairments in motor skills. Those are often labelled as additional developmental coordination disorder despite the lack of studies comparing both disorders. Consequently, motor skills rehabilitation programmes in autism are often not specific but rather consist in standard programmes for developmental coordination disorder. Here, we compared motor performance in three groups of children: a control group, an autism spectrum disorder group and a developmental coordination disorder group. Despite similar level of motor skills evaluated by the standard movement assessment battery for children, in a Reach-to-Displace Task, children with autism spectrum disorder and developmental coordination disorder showed specific motor control deficits. Children with autism spectrum disorder failed to anticipate the object properties, but could correct their movement as well as typically developing children. In contrast, children with developmental coordination disorder were atypically slow, but showed a spared anticipation. Our study has important clinical implications as motor skills rehabilitations are crucial to both populations. Specifically, our findings suggest that individuals with autism spectrum disorder would benefit from therapies aiming at improving their anticipation, maybe through the support of their preserved representations and use of sensory information. Conversely, individuals with developmental coordination disorder would benefit from a focus on the use of sensory information in a timely fashion.

Qualitative and Quantitative Assessment of Overarm Throwing in Children With and Without Developmental Coordination Disorder

Background: Children with developmental coordination disorder (DCD) frequently have difficulties performing gross motor skills such as the overarm throw. Our study examines the differences in both qualitative and quantitative characteristics of overarm throwing for accuracy between typically developing (TD) and children with DCD. Methods: A total of 74 children (36 females/38 males) aged between 7 and 11 years, participated in this study. The authors used the Movement Assessment Battery for Children—second edition to assess motor impairment. In total, 37 (50%) met the criteria for DCD. Each participant completed 10 overarm throws for accuracy at a target. The authors assessed movement quality using the component approach (Roberton & Halverson, 1984) and quantity using target accuracy. Results: The analyses revealed significantly lower throwing accuracy in DCD versus TD children. Children with DCD also demonstrated fewer component combinations and lower developmental levels than their TD peers. Finally, product scores tracked with process scores. Discussion: Both qualitative and quantitative measures clearly showed that children with DCD are at a disadvantage in controlling a ball during overarm throwing. They used stability profiles that limited coordination variability. TD participants performed more combinations of higher developmental levels to achieve more accurate throws, suggesting they controlled variability to optimize the accuracy of their throws.

Gaze behaviour during walking in young adults with developmental coordination disorder

BACKGROUND

Individuals with Developmental Coordination Disorder (DCD) experience difficulty with motor coordination and this affects their daily functioning. Research indicated inferior visuospatial processing and oculomotor control in DCD. As visual information is essential for locomotor control, more insight in the gaze behaviour of this population during walking is required and crucial for gaze training interventions as a possible means to improve daily functioning of children and adults with DCD.

AIM

This study explored differences and similarities in gaze behaviour during walking between typically developing young adults and those with DCD.

METHODS AND PROCEDURES

Ten young adults with DCD (age: 22.13 ± 0.64) and ten typically developing individuals (age: 22.00 ± 1.05) completed a walking task in which they had to place their feet on irregularly placed targets wearing eye tracking glasses.

OUTCOMES AND RESULTS

Individuals with DCD walked slower and demonstrated a different gaze strategy compared to their neurotypical peers as they fixated almost each and every target sequentially. Typically developing individuals, on the other hand, directed gaze further along the path and often fixated areas around the targets.

CONCLUSIONS AND IMPLICATIONS

Despite adequate walking performance in daily situations in young adults with DCD, fundamental control deficits persist into adulthood. WHAT THIS PAPER ADDS?: This paper is the first to demonstrate differences in gaze behaviour between young adults with DCD and typically developing individuals in a task that resembles a task of daily living, as previous research focused on laboratory tasks. This is a valuable finding as DCD has a clear impact on the daily life. Furthermore, this study demonstrated that the fundamental control deficits of DCD persist into adulthood despite frequent performance and practice of these daily tasks. Lastly, these findings might contribute to the therapeutic potential of gaze training interventions to improve the daily functioning of children and adults with DCD.

The differentiated effect of the task complexity on retention and transfer of stroke survivors

The aim of this study was to investigate the effects of task complexity on the motor learning of by stroke survivors. Participants (N = 24) performed 150 trials of a simple or complex balance task during three acquisition days. Level of complexity was determined by the number of sequential movements. Outcomes were recorded on pretest, posttest, retention and transfer test. Data were analyzed by considering measures of performance score and movement time. Results showed that only the low complexity group improved the performance from the pretest to posttest and maintained it in the retention test. Performance worsened in both groups from retention to transfer test. The main conclusions were: (i) complex task did not allow learning; (ii) stroke survivors were able to learn a simple task in terms of retention, but not of transfer.

The Prevalence of Left-Handedness Is Higher Among Individuals With Developmental Coordination Disorder Than in the General Population

Many medical, psychiatric and neurological conditions have been characterized by a high prevalence of left-handedness or mixed-handedness. Several studies have indicated an elevated frequency of left-handedness in children with Developmental Coordination Disorder (DCD). However, there have been few studies explicitly exploring this relationship. The assumption is that the prevalence of left-handedness in individuals with DCD is higher compared with the prevalence in the general population and resembles the prevalence described in children with other developmental disorders. Computerized searches were conducted in PubMed, PsycInfo and CINAHL databases. Thirty-eight studies were identified and included in the present review, containing handedness distributions across 1071 persons with DCD and 1,045 controls. The distribution of DCD participants across handedness-categories was proved to be significantly different from that of the control group, with 14.7 and 8.1% left-handers, respectively. The prevalence of left-handedness within the DCD-group is lower than that reported for ASD, and larger than in dyslexia. The elevated levels of left-handedness within the different developmental disorders supports the notion of an association between the different diagnoses. However, the present results are not sufficient to conclude anything about a common cause or underlying factor via the male hormone testosterone. The present results could act as a starting point for testing the hypothesis of such a common factor, as one of the requirements is an elevated prevalence of left-handedness, and without such considerable doubt would be cast upon the hypothesis.

Effects of practice on visual finger-force control in children at risk of developmental coordination disorder

BACKGROUND

The production of finger force control is essential for a large number of daily activities. There is evidence that deficits in the mechanisms of accuracy and control of finger force tasks are associated with children's motor difficulties.

OBJECTIVE

To compare the effect of practice of an isometric finger force/torque task between children with significant movement difficulty and those with no difficulty movement.

METHODS

Twenty-four children aged between 9 and 10 years (12 at risk of developmental coordination disorder and 12 with no movement difficulty - typically developing children) were asked to produce finger force/torque control in a continuous and constant 25% of maximum voluntary torque with visual feedback during 15s. Practice was given during five consecutive days with 15 trials per day. After the practice with visual feedback, children were asked to perform five trials without visual feedback. In these trials, feedback was removed 5s after the start of the trial.

RESULTS

Typically developing children were consistently more accurate in maintaining finger force/torque control than those children at risk of developmental coordination disorder. Children from both groups improved the performance in the task according to practice sessions. Also, children at risk of developmental coordination disorder poorly performed the task without visual feedback as they did when visual feedback was available.

CONCLUSION

The present study give support to the idea that movement difficulty is associated with finger force/torque control and children at risk of developmental coordination disorder can improve finger force/torque control with practice when visual feedback is available.

Neural changes associated to procedural learning and automatization process in Developmental Coordination Disorder and/or Developmental Dyslexia

OBJECTIVE

Recent theories hypothesize that procedural learning may support the frequent overlap between neurodevelopmental disorders. The neural circuitry supporting procedural learning includes, among others, cortico-cerebellar and cortico-striatal loops. Alteration of these loops may account for the frequent comorbidity between Developmental Coordination Disorder (DCD) and Developmental Dyslexia (DD). The aim of our study was to investigate cerebral changes due to the learning and automatization of a sequence learning task in children with DD, or DCD, or both disorders.

METHOD

fMRI on 48 children (aged 8-12) with DD, DCD or DD + DCD was used to explore their brain activity during procedural tasks, performed either after two weeks of training or in the early stage of learning.

RESULTS

Firstly, our results indicate that all children were able to perform the task with the same level of automaticity, but recruit different brain processes to achieve the same performance. Secondly, our fMRI results do not appear to confirm Nicolson and Fawcett's model. The neural correlates recruited for procedural learning by the DD and the comorbid groups are very close, while the DCD group presents distinct characteristics. This provide a promising direction on the neural mechanisms associated with procedural learning in neurodevelopmental disorders and for understanding comorbidity.

Motor Learning: An Analysis of 100 Trials of a Ski Slalom Game in Children with and without Developmental Coordination Disorder

Objective

Although Developmental Coordination Disorder (DCD) is often characterized as a skill acquisition deficit disorder, few studies have addressed the process of motor learning. This study examined learning of a novel motor task; the Wii Fit ski slalom game. The main objectives were to determine: 1) whether learning occurs over 100 trial runs of the game, 2) if the learning curve is different between children with and without DCD, 3) if learning is different in an easier or harder version of the task, 4) if learning transfers to other balance tasks.

Method

17 children with DCD (6–10 years) and a matched control group of 17 typically developing (TD) children engaged in 20 minutes of gaming, twice a week for five weeks. Each training session comprised of alternating trial runs, with five runs at an easy level and five runs at a difficult level. Wii scores, which combine speed and accuracy per run, were recorded. Standardized balance tasks were used to measure transfer.

Results

Significant differences in initial performance were found between groups on the Wii score and balance tasks. Both groups improved their Wii score over the five weeks. Improvement in the easy and in the hard task did not differ between groups. Retention in the time between training sessions was not different between TD and DCD groups either. The DCD group improved significantly on all balance tasks.

Conclusions

The findings in this study give a fairly coherent picture of the learning process over a medium time scale (5 weeks) in children novice to active computer games; they learn, retain and there is evidence of transfer to other balance tasks. The rate of motor learning is similar for those with and without DCD. Our results raise a number of questions about motor learning that need to be addressed in future research.

Kinesthetic deficit in children with developmental coordination disorder

The aim of this study was to measure and compare kinesthetic sensitivity in children with developmental coordination disorder (DCD) and typically developing (TD) children between 6 and 11 years old. 30 children with DCD aged 6 to 11 years (5 in each age group) and 30 TD children participated in the study. Participants placed their forearms on a passive motion apparatus which extended the elbow joint at constant velocities between 0.15 and 1.35°s(-1). Participants were required to concentrate on detection of passive arm motion and press a trigger held in their left hand once they sensed it. The detection time was measured for each trial. The DCD group was significantly less sensitive in detection of passive motion than TD children. Further analysis of individual age groups revealed that kinesthetic sensitivity was worse in DCD than TD children for age groups beyond six years of age. Our findings suggested that individual with DCD lag behind their TD counterparts in kinesthetic sensitivity. Between the ages of 7 and 11 years the difference between groups is quantifiable and significant with 11 year old children with DCD performing similar to 7 year old TD children.

Intersegmental dynamics shape joint coordination during catching in typically developing children but not in children with developmental coordination disorder

Factors shaping joint coordination during multijoint movements were studied using a one-handed ball-catching task. Typically developing (TD) boys between 9 and 12 yr of age, at which catching becomes consistently successful, and boys with developmental coordination disorder (DCD) of the same age participated in the study. The arm was initially stretched down. Catching was performed by flexing the shoulder and elbow and extending the wrist in the parasagittal plane. Catching success rate was substantially lower in children with DCD. Amplitudes and directions of joint motions were similar in both groups. Group differences were found in shoulder and elbow coordination patterns. TD children performed the movement predominantly by actively accelerating into flexion, one joint at a time—first the elbow and then the shoulder—and allowing passive interaction torque (IT) to accelerate the other joint into extension. Children with DCD tended to accelerate both joints into flexion simultaneously, suppressing IT. The results suggest that the TD joint coordination was shaped by the tendency to minimize active control of IT despite the complexity of the emergent joint kinematics. The inefficient control of IT in children with DCD points to deficiency of the internal model of intersegmental dynamics. Together, the findings advocate that joint coordination throughout a multijoint movement is a by-product of the control strategy that benefits from movement dynamics by actively accelerating a single joint and using IT for rotation of the other joint. Reduction of control-dependent noise is discussed as a possible advantage of this control strategy.

Neural underpinnings of impaired predictive motor timing in children with Developmental Coordination Disorder

A dysfunction in predictive motor timing is put forward to underlie DCD-related motor problems. Predictive timing allows for the pre-selection of motor programmes (except 'program' in computers) in order to decrease processing load and facilitate reactions. Using functional magnetic resonance imaging (fMRI), this study investigated the neural correlates of motor timing in DCD (n=17) and typically developing children (n=17). The task involved motor responses to sequences of visual stimuli with predictive or unpredictive interstimulus intervals (ISIs). DCD children responded with a smaller reaction time (RT) advantage to predictive ISIs compared to typically developing children. Typically developing children exhibited higher activation in the right dorsolateral prefrontal cortex (DLPFC) and right inferior frontal gyrus (IFG) for responses at unpredictive as opposed to predictive ISIs, whereas activations in DCD children were non-differentiable. Moreover, DCD children showed less activation than typically developing children in the right DLPFC, the left posterior cerebellum (crus I) and the right temporo-parietal junction (TPJ) for this contrast. Notably, activation in the right temporo-parietal junction (TPJ) positively correlated with RT as an indicator of processing load in both groups. These data indicate that motor performance in DCD children requires extra processing demands due to impaired predictive encoding.

Timing abilities among children with developmental coordination disorders (DCD) in comparison to children with typical development

Timing ability is essential for common everyday performance. The aim of the study was to compare timing abilities and temporal aspects of handwriting performance and relationships between these two components among children with Developmental Coordination Disorders (DCD) and a control group. Forty two children, 21 diagnosed as DCD and 21 with typical development, aged 7-12, were matched for age, gender and school performed 14 tasks of the interactive metronome (IM) and three functional handwriting tasks on an electronic tablet that was part of a computerized system (ComPET--computerized penmanship evaluation tool). The IM supplies response time, while on-paper and in-air time per written stroke is received from the ComPET. Results indicated significant differences between the groups for both IM and handwriting tasks (ComPET). Linear regression indicated that the mean IM response time explained 37% of variance of the in-air time per stroke during a paragraph-copying task. Furthermore, based on one discriminate function including two measures reflected timing ability, 81% of all participants were correctly classified into groups. Study results strongly recommend consideration of the IM as an evaluation and intervention tool for children with DCD who are faced with timing deficits in their everyday functioning.

The ability to mentally represent action is associated with low motor ability in children: a preliminary investigation

BACKGROUND

Theory and anatomical research suggest that the ability to mentally represent intended actions affect level of execution. This study presents preliminary data examining the association between children's ability to mentally represent action and general motor ability.

METHODS

Children aged 7- to 10 years were assessed for motor imagery ability using a simulation of reach task and motor ability via the Movement ABC-2. Motor ability values, based on percentile rank, ranged from 2 to 91, with a mean of 36.

RESULTS

The overall correlation between mental representation and motor ability yielded a moderately positive relationship (r = .39). Interestingly, when looking at motor ability subcategories, only Balance was significant in the model, explaining 20% of the variance.

CONCLUSIONS

These results provide preliminary evidence that children's motor ability and the ability to mentally represent action are associated in a positive direction. Furthermore, given the results for Balance, we speculate that there are clinical implications regarding work with potentially at-risk children.

Evidence review to investigate the support for subtypes of children with difficulty processing and integrating sensory information

We investigated the evidence for subtypes in children with difficulty processing and integrating sensory information. Fifty-seven articles were incorporated into a systematic literature review; only 4 articles provided direct evidence for subtypes. These studies did not provide a comprehensive assessment of all sensory functions and sensory-based motor functions (i.e., praxis) and included different diagnostic groups. Therefore, generalized conclusions about subtypes could not be drawn. The other 53 studies reviewed provided meaningful information about strengths and challenges that children with difficulty processing and integrating sensory information demonstrate, but these studies were limited in scope. A principal theme was the importance of conducting comprehensive assessments of sensory-based functions, including multiple measures of sensory integrative functions such as praxis, sensory modulation, and sensory discrimination in children and adolescents with various clinical disorders. In addition, more consistency in the use of specific assessment tools will allow for synthesis of data across studies.

Brain activation of children with developmental coordination disorder is different than peers

OBJECTIVES

Children with developmental coordination disorder (DCD) struggle to learn new motor skills, demonstrating more variable performance than typically developing (TD) children. The purpose of this study was to determine whether patterns of brain activity differed between children with and without DCD while performing a motor task.

METHODS

Using functional MRI, we measured brain activation patterns in 7 children with DCD and 7 age-matched peers (aged 8-12 years) during a fine-motor, trail-tracing task.

RESULTS

Despite similar levels of behavioral motor performance, different patterns of brain activity were noted between the 2 groups. The group with DCD showed significantly more activation than control subjects in left inferior parietal lobule, right middle frontal gyrus, right supramarginal gyrus, right lingual gyrus, right parahippocampal gyrus, right posterior cingulate gyrus, right precentral gyrus, right superior temporal gyrus, and right cerebellar lobule VI. These results suggest that the group with DCD relied on visuospatial processing to complete the task. The TD group demonstrated significantly more activation than the group with DCD in left precuneus, left superior frontal gyrus, right superior temporal gyrus/insula, left inferior frontal gyrus, and left postcentral gyrus; these regions have been associated with spatial processing, motor control and learning, and error processing.

CONCLUSIONS

Children with DCD activate different brain regions from typical children when performing the same trail-tracing task. Despite the small sample size, our results contribute to a growing body of literature suggesting that children with DCD exhibit differences in neural networks and patterns of brain activation relative to same-age peers.

Dual-task study of cognitive and postural interference: a preliminary investigation of the automatization deficit hypothesis of developmental co-ordination disorder

BACKGROUND

The purpose of this study was to investigate whether children with developmental co-ordination disorder and balance problem (DCD-BP) had greater problems than controls in performing a primary balance task while concurrently completing different cognitive tasks varying in oral or listening cognitive complexity, as well as to investigate the automatization deficit hypothesis of DCD-BP.

METHODS

Children with DCD-BP (n= 39), along with age-matched control counterparts (n= 39), were placed on automatic processing situation under dual-task conditions. All children were required to perform a primary task, five dual-task paradigms (oral counting task, auditory-verbal reaction task, auditory-choice reaction task, auditory-memory task and articulation alone) and an eyes-closed balancing task.

RESULTS

In the primary task condition, the differences were not statistically significant (P= 0.393) between children with and without DCD-BP. However, children with DCD-BP were significantly more impaired on three of five dual-task conditions (oral counting task: P= 0.003; auditory-verbal reaction task: P= 0.011; auditory-memory task: P= 0.041) compared with the single-task situation, with the exception of the auditory-choice reaction task (P= 0.471) and articulation alone (P= 0.067).

CONCLUSIONS

These results suggest that children with DCD-BP were more cognitively dependant and may have an automatization deficit.

Visual contribution to walking in children with Developmental Coordination Disorder

BACKGROUND

The motor co-ordination problems of children with Developmental Coordination Disorder (DCD) have been frequently associated with poor visuospatial processing. In order to extend these findings mainly based on fine motor experiments, the present study investigates the contribution of vision to the control of walking in children with DCD.

METHODS

Children with DCD (n = 12) walked at their preferred speed on a straight, firm and uncluttered walkway in a condition with normal lighting and in a dark condition. Spatiotemporal gait variables were assessed by means of a three-dimensional ProReflex camera system and compared with the gait pattern of matched, typically developing (TD) children (n = 12).

RESULTS

In normal lighting, the gait pattern of both groups was similar, with the exception of subtle differences in the temporal phasing, showing a slightly longer support phase in the children with DCD. In the dark, step frequency and step length were decreased in the children with DCD, resulting in a significantly slower walking velocity. In addition, the medio-lateral excursion of the centre of mass tended to increase in this group. In the TD children, adaptations to the spatiotemporal pattern remained absent.

CONCLUSIONS

These results suggest that children with DCD are more dependent on global visual flow information than TD children for the maintenance of balance and the control of velocity during walking. This increased dependency on visual control might be associated with a poorly developed internal sensorimotor model.