Relationship between Motor Coordination, Cognitive Abilities, and Academic Achievement in Japanese Children with Neurodevelopmental Disorders

Cognitive function in SMA patients with 2 or 3 SMN2 copies treated with SMN-modifying or gene addition therapy during the first year of life

BACKGROUND

Spinal muscular atrophy (SMA) is a neuromuscular disease, causing progressive muscle weakness due to loss of lower motoneurons. Since 2017, three therapies, two modifying gene transcription and one adding the defective gene, have been approved with comparable efficacy on motor outcome. Data on cognitive outcomes of treated SMA type 1 patients is limited. The aim of this study was to evaluate cognitive function in symptomatic and presymptomatic SMA type 1 patients with two or three SMN2 copies who received SMN-modifying or gene-addition therapy in the first year of life.

METHODS

Cognitive testing was performed in 20 patients, including 19 symptomatic SMA type 1 patients with up to three SMN2 copies and 1 pre-symptomatically treated patient. Children were tested using Bayley Scales of Infant Development (BSID-III) at the age of 2 or 3 years or the Wechsler Preschool and Primary Scale of Intelligence (WPSII-IV) at the of age of 5 years.

RESULTS

11/20 patients showed subnormal cognitive development. Boys had significantly lower cognitive scores. Patients requiring assisted ventilation or feeding support were more likely to have cognitive deficits. Achieving more motor milestones was associated with a better cognitive outcome.

CONCLUSION

Treated patients with SMA type 1 have heterogeneous cognitive function with 55 % of patients showing deficits. Risk factors for cognitive impairment in our cohort were male gender and need for assisted ventilation or feeding support. Therefore, cognitive assessment should be included in the standard of care to allow early identification of deficits and potential therapeutic interventions.

Unimodal versus bimodal auditory stimulation in inner ear malformations: Cognitive, language, and motor performance

Purpose

New perspectives on rehabilitation options for inner ear malformations have still been studied in the literature. This study investigated the cognitive, language, and motor skills of auditory brainstem implant (ABI) users in unimodal and bimodal groups.

Methods

The motor competency of the participants was assessed with Bruininks-Oseretsky Motor Proficiency Test-2 Short Form (BOT2 SF). Language performance was evaluated by the test of Early Language Development-3 and Speech Intelligibility Rating. Word identification, sentence recognition tests, and Categories of Auditory Performance were used to assess auditory perception skills. To examine the cognitive performance, Cancellation Test and Gesell Copy Form were administered. All the tests were conducted in a quiet environment without any distractions.

Results

The participants were divided into two groups: (1) 17 children in the unimodal group and (2) 11 children in the bimodal (who used a cochlear implant on one side and ABI on the other side) group. There were significant correlations between the chronological age of participants and BOT2 SF total score, cancellation tests, auditory perception tests, and language performance. Similarly, there were significant correlations between the duration of ABI use and auditory perception tests, language performance, cancellation test, and some BOT2 SF subtests (r = -0.47 to -0.60, p < .001). There was no significant difference between the unimodal and bimodal groups in any task (p > .05). However, there were moderate-to-strong correlations among the auditory perception tests, cancellation test, language test, and BOT2 SF total score and subtests (r = 0.40 to 0.55, p < .05).

Conclusion

Although there were no significant differences between bimodal and unimodal groups, a holistic approach, which indicates that hearing and balance issues can have broader impacts on a person's physical, emotional, social, and psychological aspects, should be used in the assessment process.

Level of Evidence

Level 4.

Similar Cognitive Skill Impairment in Children with Upper Limb Motor Disorders Due to Arthrogryposis Multiplex Congenita and Obstetrical Brachial Plexus Palsy

Arthrogryposis multiplex congenita (AMC) and obstetrical brachial plexus palsy (OBPP) are motor disorders with similar symptoms (contractures and the disturbance of upper limb function). Both conditions present as flaccid paresis but differ from each other in the pathogenesis: AMC is a congenital condition, while OBPP results from trauma during childbirth. Despite this difference, these diseases are identical in terms of their manifestations and treatment programmes. We compared the cognitive skills of children with AMC and OBPP diagnoses with those of healthy children; we also compared the motor skills of impaired children with those of healthy ones. The patients in both groups significantly differed from the healthy children with regard to psychological parameters, such as 'visual memory capacity' and 'thinking'. Moreover, the two groups with children with AMC and OBPP significantly differed from each other in motor skill parameters, such as 'delayed motor development', 'general motor development', and the 'level of paresis'. Upper limb motor function in the OBPP children was less impaired compared to that of the AMC children. However, we did not find any significant differences in cognitive deficits between the AMC children and the OBPP children. This may indicate that motor impairment is more significant than the underlying cause for the development of cognitive impairment; however, the factors causing this phenomenon require further study (e.g., social environment, treatment, and rehabilitation programme).

Neurodevelopment at 6 years of age in children with atopic dermatitis

BACKGROUND

Few studies have reported an association between atopic dermatitis and cognitive impairment in children. Therefore, we evaluated the association between atopic dermatitis (AD) and neurodevelopmental dysfunction in children.

METHODS

We analyzed 2,395,966 children born between 2008 and 2012 in Korea. All data were acquired from the databases of the Korean National Health Insurance System. AD was defined as five or more diagnoses before age 24 months. The outcome was suspected neurodevelopmental dysfunction in the gross motor skill, fine motor skill, cognition, language, sociality, and self-care domains of the Korean Developmental Screening Test for Infants and Children at age 6 years. The positive control outcome was defined as attention deficit hyperactive disorder (ADHD). The associations were assessed using ordinal logistic regression, adjusting for asthma and allergic rhinitis.

RESULTS

Among the eligible children, 89,452 and 30,557 were allocated to the control and AD groups, respectively. In the weighted data, the AD group showed a higher risk of suspected neurodevelopmental dysfunction in the total score (weighted adjusted odds ratio [95% CI] 1.10 [1.05-1.16]), gross motor skills (1.14 [1.04-1.25]), and fine motor skills (1.15 [1.06-1.25]) than the control group. The AD with steroids or hospitalization groups showed an increased risk of suspected neurodevelopmental dysfunction. In addition, the AD group showed a significant association with mental retardation, psychological development disorder, and behavioral and emotional disorders as well as ADHD.

CONCLUSIONS

AD before age 2 years may be associated with an increased risk of neurodevelopmental dysfunction including gross and fine motor skills in the young childhood period.

Findings of a Multidisciplinary Assessment of Children Referred for Possible Neurodevelopmental Disorders: Insights from a Retrospective Chart Review Study

Children with ASD have a wide spectrum of functional deficits in multiple neurodevelopmental domains. A multidisciplinary team assessment (MDT) is required to assess those deficits to help construct a multimodal intervention plan. This is a retrospective chart review of the assessment for children who were referred for an assessment of potential neurodevelopmental disorders. We reviewed 221 participants' charts from January 2019 to January 2020. The mean age of the children was 7.95 ± 3.69, while the mean age of the fathers and mothers was 37.31 ± 8.57 and 31.95 ± 6.93, respectively. Consanguinity was as high as 37.9% for the referred children with developmental delay who were first-degree related, and 13.2% of the parents were second-degree relatives. Approximately 26.6% of children had a family history of mental illness in first-degree relatives. ASD was the most commonly reported diagnosis post-assessment, and ADHD was the most common reported comorbidity at 64.3% and 88.5%, respectively. The MDT findings showed that 58% of children required moderate or higher assistance with toileting, 79.2% were unable to answer yes/no questions, and 86.8% were unable to understand "wh" questions. Only 26% of the nonverbal children had average IQ testing results, and 31% of verbal children did. In conclusion, the mean age of the children when assessed was above that recommended for early screening and intervention. An increased paternal and maternal age was noticeable. Consanguinity and a family history of mental disorders in first-degree relatives were high, attesting to a possible genetic risk.

Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders

We provide evidence to support the contention that many aspects of Autistic Spectrum Disorder (ASD) are related to interregional brain functional disconnectivity associated with maturational delays in the development of brain networks. We think a delay in brain maturation in some networks may result in an increase in cortical maturation and development in other networks, leading to a developmental asynchrony and an unevenness of functional skills and symptoms. The paper supports the close relationship between retained primitive reflexes and cognitive and motor function in general and in ASD in particular provided to indicate that the inhibition of RPRs can effect positive change in ASD.

The Relationship between Motor Coordination Ability, Cognitive Ability, and Academic Achievement in Japanese Children with Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder

Motor coordination abilities are related to cognitive abilities and academic achievement in children with neurodevelopmental disorders. However, the similarities and differences of these relationships in children with autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (AD/HD) have not been explored. The purpose of this study was to investigate the relationship between motor coordination abilities, cognitive abilities, and academic achievement in Japanese children with ASD and AD/HD. Participants included 20 children with ASD, 20 children with AD/HD, and 20 typically developing children, matched for age and gender. Their motor coordination abilities were assessed with the Movement Assessment Battery for Children-2 (MABC-2). Furthermore, cognitive ability and academic achievement were assessed with the Kauffman Assessment Battery for Children-II (K-ABCII). Results demonstrated that the MABC-2 Total score significantly correlated with the K-ABCII Simultaneous processing, Planning, Total cognitive ability, Writing and Arithmetic scores in children with ASD. However, in children with AD/HD, there was no significant correlation between MABC-2 and K-ABCII subscale scores. The results of this study indicated that the relationship between motor coordination ability, cognitive ability, and academic achievement differs between ASD and AD/HD. This difference might indicate the non-similarity of neurological characteristics and encourage consideration for an approach that accommodates the features of neurodevelopmental disorders in children.

Teacher-Rated Executive Functions, Gender and Relative Age: Independent and Interactive Effects on Observed Fundamental Motor Skills in Kindergarteners

Fundamental motor skills (FMS) of children can be affected by different variables, such as executive functions (EF), gender and relative age. However, the effects of these variables on FMS have been scarce studied, especially in early childhood, and show inconsistent results. To clarify these relationships, this study was carried out. Its aim was to analyze whether EF, gender and relative age influenced FMS in 43 Spanish kindergarteners. A multimethod and mixed methods approach was used. Kindergarteners' teachers completed the Childhood Executive Functioning Inventory to know the children level of EF (working memory and inhibition control). Kindergarteners' parents complimented ad hoc questionnaire reporting the children gender and birth data (to know their relative age). A Nomothetic/Punctual/Multidimensional observational design was used to observe children FMS in their habitual motor sessions at school. Two-way ANOVAs were performed to know the independent and interactive effects of working memory level (lower/higher), inhibition control level (lower/higher), gender (boys/girls) and relative age (according to the birth semester in the year) on FMS. Results showed these variables have independent and interactive effects on some FMS, but not on others. FMS influenced by these variables vary depending what independent variable(s) is/are considered. Therefore, it can be concluded that the influences of teacher-rated EF, gender and relative age on observed FMS in kindergarteners are complex and specific. Results obtained must be taken into to design and implement instructional and intervention strategies, as well as educational and sport policy changes, especially in early childhood, when FMS are more malleable.

Is there a relation between visual motor integration and academic achievement in school-aged children with and without ADHD?

Visual-motor integration, motor coordination, and visual perception are associated with academic achievement in early school-aged children; however, our understanding of these associations in older school-aged children and children with neurodevelopmental disorders is limited. A well-characterized, clinically evaluated sample of 39 children with and without ADHD ages 8-13 (M = 10.07, SD = 1.56; 14 girls; 67.5% White/non-Hispanic) were administered standardized academic and visual-motor integration tests. Results: Backward entry regression analyses that initially included age, sex, socioeconomic status, ADHD symptoms, comorbidities, and IQ revealed that better visual perception uniquely predicted better-developed reading (β = .38) and math skills (β = .21; both p < .03), whereas better motor coordination was associated with better reading (β = .25), writing (β = .50), and math skills (β = .21 all p < .05). The integration of visual perception and motor coordination processes was uniquely associated only with math skills (β = .28; p = .007). Children with ADHD exhibited significantly lower visual-motor integration (d = 1.16) and potentially motor coordination (d = 0.51), but did not differ from Non-ADHD children in terms of visual perception (d = 0.03). These findings extend prior evidence from younger, neurotypical samples, and indicate that underdeveloped visual-motor integration and/or its subcomponents (visual perception and motor coordination) reflect unique risk factors for academic underachievement in school-aged children's math, reading, and written language skills.

Parent-Reported Motivators and Barriers to Participation in a Community-Based Intervention Designed for Children With Motor Skill Difficulties: A Qualitative Program Evaluation

INTRODUCTION

Parents play a critical role in their child's participation in community-based intervention programs. Yet, their perspectives remain largely overlooked in the literature. This qualitative program evaluation used social cognitive theory to understand parents' motivators and barriers to participation in a community-based intervention program designed for children with motor skill difficulties.

METHOD

Parents (n = 15) of children with motor skill difficulties enrolled in a community-based intervention program participated in semistructured interviews.

RESULTS

Thematic analysis revealed six motivators (child needs, satisfaction, perceived impact, affordability, design, and program culture) and three perceived barriers (parent knowledge, access, and accommodations).

DISCUSSION

Parents' motivators and barriers reflected a combination of personal and environmental factors consistent with social cognitive theory. This study revealed novel insight into program-related environmental motivators and barriers. Program leaders should consider ongoing evaluation and application of parental perspectives to optimize family participation and retention in community-based interventions.

Externalizing problems mediate the relationship between motor proficiency and internalizing problems in children: An extension of the Environmental Stress Hypothesis

The Environmental Stress Hypothesis (ESH) is a causal theoretical framework that provides a flexible context for understanding factors that mediate the relationship between low motor proficiency and internalizing problems in children. The purpose of the present study was to use the ESH framework to determine whether body mass index (BMI), physical activity levels, psychosocial health and physical health, self-efficacy, perceived social status, prosocial behavior and externalizing problems were potential mediators between motor proficiency and internalizing factors in a population of Brazilian children. 431 children aged 7- to 10 years (240 females, 191 males) participated in the study. The variables were measured with the Movement Assessment Battery for Children, 2^nd ed. (MABC-2), the Pediatric Quality of Life Inventory (PedsQL), the Strengths and Difficulties Questionnaire (SDQ), the MacArthur Subjective Social Status Scale (MacArthur SSS), the Self-efficacy Sense Assessment Roadmap (RASAE), and the Physical Activity Questionnaire (PAQ). The results indicated a direct relationship between motor proficiency and internalizing problems in a population of Brazilian children, with externalizing problems being the only variable mediating that relationship. To the best of our knowledge, this is the first time that externalizing problems were tested in the context of the ESH. Understanding and evaluating potential mediators in the relationship between motor proficiency and internalizing problems using the ESH framework is essential to promote prevention policies and interventions for school-age children.

Aberrant Auditory and Visual Memory Development of Children with Upper Limb Motor Disorders

The current study aimed to compare differences in the cognitive development of children with and without upper limb motor disorders. The study involved 89 children from 3 to 15 years old; 57 children with similar upper limb motor disorders and 32 healthy children. Our results showed that motor disorders could impair cognitive functions, especially memory. In particular, we found that children between 8 and 11 years old with upper limb disorders differed significantly from their healthy peers in both auditory and visual memory scales. These results can be explained by the fact that the development of cognitive functions depends on the normal development of motor skills, and the developmental delay of motor skills affects cognitive functions. Correlation analysis did not reveal any significant relationship between other cognitive functions (attention, thinking, intelligence) and motor function. Altogether, these findings point to the need to adapt general habilitation programs for children with motor disorders, considering the cognitive impairment during their development. The evaluation of children with motor impairment is often limited to their motor dysfunction, leaving their cognitive development neglected. The current study showed the importance of cognitive issues for these children. Moreover, early intervention, particularly focused on memory, can prevent some of the accompanying difficulties in learning and daily life functioning of children with movement disorders.

Temporal differences in eye-hand coordination between children and adults during manual action on objects

BACKGROUND/OBJECTIVE

Eye-hand coordination, which is essential for activities of daily living, develops with age. The objective of this study was to investigate the temporal patterns of visual fixation coupled with hands during manual action on objects in children and young adults.

METHODS

Twelve eight-year-old children and 12 young adults performed the Jebsen-Taylor Hand Function Test (JTT) wearing eye-tracking glasses. The interval from the eye arrival time to the hand arrival time on an object was measured as eye-hand arrival span. The interval between the eye departure time and the hand departure time from the object was measured as eye-hand departure span. Eye-hand arrival span, eye-hand departure span and the performance time to complete the JTT were compared between children and young adults. Correlation between eye-hand arrival span and eye-hand departure span was analysed to identify the mechanism of eye-hand coordination.

RESULTS

Compared with young adults, children showed longer performance time but shorter eye-hand arrival span and eye-hand departure span in the JTT. The difference in mean eye-hand arrival span of overall JTT between children and young adults was significant for both hands, whereas differences in the mean eye-hand departure span on the overall JTT and the total performance time were significant for the non-dominant hand. The eye-hand arrival span was positively correlated with the eye-hand departure span.

CONCLUSION

This study demonstrated temporal differences in eye-hand coordination between children and young adults. Temporal patterns of visual fixation coupled to object manipulation could be useful information about the sensorimotor system in the field of occupational therapy.