Hot executive function in children with Developmental Coordination Disorder: Evidence for heightened sensitivity to immediate reward

Far Transfer Effects of Trainings on Executive Functions in Neurodevelopmental Disorders: A Systematic Review and Metanalysis

Executive Functions are a set of interrelated, top-down processes essential for adaptive goal-directed behaviour, frequently impaired across different neurodevelopmental disorders with variable degrees of severity. Many executive-function-training studies in children with neurodevelopmental disorders have focused on near effects, investigating post-treatment improvements on directly trained processes, while enhancements of skills not directly trained, defined as far effects, are less considered, albeit these could be extremely relevant for reducing the negative impact of a disorder's core symptomatology. This systematic review and metanalysis aims to investigate the far effect outcomes after EF training in children with different types of neurodevelopmental disorders. 17 studies met the inclusion criteria for the systematic review, while 15 studies were selected in the metanalysis. An overall statistically significant effect size was found in the majority of far effect outcome measures considered in the studies. In particular, trainings on executive functions determine significant far effects on daily life functioning (0.46, 95% CI: [0.05-0.87]) and clinical symptoms (0.33, 95% CI: [0.15-0.51]). Despite a high variability of the results, intensity, frequency and the laboratory/life contexts dimension seem to be the most influential variables in determining far effects. This systematic review and metanalysis highlights the need to measure far effects of executive function training in neurodevelopmental disorders, selecting treatments not only on directly targeted processes, but also according to far impacts on the functional weakness of the disorder.

Associations between Gross and Fine Motor Skills, Physical Activity, Executive Function, and Academic Achievement: Longitudinal Findings from the UK Millennium Cohort Study

Accumulating evidence from behavioral studies and neuroscience suggests that motor and cognitive development are intrinsically intertwined. To explore the underlying mechanisms of this motor-cognition link, our study examined the longitudinal relationship of early motor skills and physical activity with later cognitive skills. The sample was 3188 children from the United Kingdom Millennium Cohort Study, followed at 9 months and 5, 7, and 11 years. Early motor skills were examined at 9 months. Children's daily physical activity level was measured using accelerometers at 7 years and a questionnaire was conducted at 11 years. Cognitive skills, including executive function and academic achievement, were measured at age 11. The results suggest that gross motor skills were positively associated with spatial working memory, whereas fine motor skills were predictive of good English and science outcomes. Moderate-to-vigorous activity was found to be negatively associated with English performance, although self-reported activity frequency was positively linked to math. Our results highlight the significant role of both gross and fine motor skills in cognitive development. This study also elucidates the limitations of using activity intensity to assess the impact of motor activity on children's cognitive development, suggesting that attention to the effects of specific types of physical activity would better elucidate the motor/cognition link.

Developmental coordination disorder

Developmental coordination disorder (DCD) is a neurodevelopmental disorder that affects children's ability to execute coordinated motor actions, resulting in slow, clumsy, or inaccurate motor performances and learning difficulties (of new motor tasks or to adapt previously learned gestures to a modified or additional constraint). In the course of development, children with DCD exhibit a diversity of motor signs, including fine and gross motor problems with impaired postural control and balance, and sensorimotor coordination or motor learning difficulties. The prevalence ranges between 1.8% and 8%, depending on the diagnostic criteria used, based on the cutoff of motor scores from standardized scales. Four main hypotheses have been postulated to explain DCD in terms of deficits in visuospatial functions, procedural learning, internal modeling, or executive functions. Neuroimaging studies are scarce but have highlighted several brain regions, including the parietal, frontal, and cerebellar cortices. Meta-analyses have supported task-oriented approaches as effective therapies to improve motor performance in children with DCD.

Success in Adults With Probable Developmental Coordination Disorder Using Structural Equation Modeling

OBJECTIVE. The aim of this study was to conduct a broad in-depth examination of the relationship between developmental coordination disorder (DCD) and use of executive strategies, daily life activities, emotional state, and internal factors attributed to success.

METHOD. We used a large randomized cohort of young adults. Structural equation modeling was performed to test both the direct effects and the mediated effects of the independent variable (probable DCD) on dependent variables (executive functions, academic and nonacademic activities, emotional state, and attribution to success).

RESULTS. Probable DCD had a direct and significant effect on all variables. Motor coordination impairments directly affected daily function in nonacademic and academic abilities and resulted in decreased use of executive strategies. Likewise, all the indirect effects hypothesized in the model were found to be significant.

CONCLUSION. The model revealed the direct and indirect influences of probable DCD on a range of functions, with far-reaching clinical implications.

Cognitive and neuroimaging findings in developmental coordination disorder: new insights from a systematic review of recent research

AIM

To better understand the neural and performance factors that may underlie developmental coordination disorder (DCD), and implications for a multi-component account.

METHOD

A systematic review of the experimental literature published between June 2011 and September 2016 was conducted using a modified PICOS (population, intervention, comparison, outcomes, and study type) framework. A total of 106 studies were included.

RESULTS

Behavioural data from 91 studies showed a broad cluster of deficits in the anticipatory control of movement, basic processes of motor learning, and cognitive control. Importantly, however, performance issues in DCD were often shown to be moderated by task type and difficulty. As well, we saw new evidence of compensatory processes and strategies in several studies. Neuroimaging data (15 studies, including electroencephalography) showed reduced cortical thickness in the right medial orbitofrontal cortex and altered brain activation patterns across functional networks involving prefrontal, parietal, and cerebellar regions in children with DCD than those in comparison groups. Data from diffusion-weighted magnetic resonance imaging suggested reduced white matter organization involving sensorimotor structures and altered structural connectivity across the whole brain network.

INTERPRETATION

Taken together, results support the hypothesis that children with DCD show differences in brain structure and function compared with typically developing children. Behaviourally, these differences may affect anticipatory planning and reduce automatization of movement skill, prompting greater reliance on slower feedback-based control and compensatory strategies. Implications for future research, theory development, and clinical practice are discussed.

Challenges of implementing a personalized mental task near-infrared spectroscopy brain-computer interface for a non-verbal young adult with motor impairments

PURPOSE

Near-infrared spectroscopy brain-computer interfaces (NIRS-BCIs) have been proposed as potential motor-free communication pathways. This paper documents the challenges of implementing an NIRS-BCI with a non-verbal, severely and congenitally impaired, but cognitively intact young adult.

METHODS

A 5-session personalized mental task NIRS-BCI training paradigm was invoked, whereby participant-specific mental tasks were selected either by the researcher or by the user, on the basis of prior performance or user preference.

RESULTS

Although the personalized mental task selection and training framework had been previously demonstrated with able-bodied participants, the participant was not able to exceed chance-level accuracies. Challenges to the acquisition of BCI control may have included disinclination to BCI training, structural or functional brain atypicalities, heightened emotional arousal and confounding haemodynamic patterns associated with novelty and reward processing.

CONCLUSIONS

Overall, we stress the necessity for further clinical NIRS-BCI research involving non-verbal individuals with severe motor impairments.

The relationship between motor performance and parent-rated executive functioning in 3- to 5-year-old children: What is the role of confounding variables?

It is generally agreed that motor performance and executive functioning (EF) are intertwined. As the literature on this issue concerning preschool children is scarce, we examined the relationship between motor performance and parent-rated EF in a sample of 3- to 5-year-old children with different levels of motor skill proficiency, while controlling for age, gender, socio-economic status (SES), and attention-deficit-hyperactivity disorder (ADHD) symptomatology. EF was reported by parents of 153 children (mean age 4years 1months, SD 8months; 75 male) by means of the Behaviour Rating Inventory of Executive Function-Preschool version (BRIEF-P). Parent-reported ADHD symptoms were assessed using the Hyperactivity-Inattention subscale of the Strengths and Difficulties Questionnaire3-4. In addition, the children performed the Movement Assessment Battery for Children-2 (MABC-2). Several weak to moderate relationships were found between the MABC-2 Total Score and the EF subscales. Once other variables such as age, gender, SES, and ADHD symptomatology were taken into account, the only BRIEF-P subscale that was associated with the MABC-2 Total Score was the Working Memory subscale. Compared to their typically developing peers, children who are at risk for motor coordination difficulties (⩽the 16th percentile on the MABC-2) performed poorly on the Working Memory subscale, which confirms the results of the regression analyses. The at risk group also performed significantly worse on the Planning/Organize subscale, however. This is one of the first studies investigating the relationship between motor performance and parent-rated EF in such a young age group. It shows that the relationship between motor performance and EF in young children is complex and may be influenced by the presence of confounding variables such as ADHD symptomatology.

Reprint of "Deficits of hot executive function in developmental coordination disorder: Sensitivity to positive social cues"

Recent research shows that children with motor coordination problems (or developmental coordination disorder--DCD) show deficits in not only cool executive function (EF), but also hot EF. We aimed to determine whether this deficit of hot EF is due to heightened sensitivity to rewarding stimuli, specifically, or to a general deficit of cognitive control, like inhibition. Using two versions of a go/no-go task, one with neutral facial expressions and the other with happy and fearful faces, we compared 12 children with DCD with 28 typically-developing children, aged 7-12 years. Like earlier studies, children responded faster to happy faces. Both groups showed comparable accuracy in response to go targets, and also had similar commission errors, except when the no-go stimulus was a happy face. Importantly, the DCD group made significantly more commission errors to happy faces failing to suppress their response on more than half of the no-go trials. These results suggest a heightened sensitivity to emotionally significant distractors in DCD; this type of impulsivity may undermine self-regulation in DCD, with possible implications for adaptive function and emotional well-being. We argue that the interaction of cognitive control and emotion processing networks may be disrupted in DCD or delayed in development.