The use of visually guided behaviour in children with Developmental Coordination Disorder (DCD) when crossing a virtual road

Auditory rhythm facilitates perception and action in children at risk for developmental coordination disorder

Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder featuring deficits in motor coordination and motor timing among children. Deficits in rhythmic tracking, including perceptually tracking and synchronizing action with auditory rhythms, have been studied in a wide range of motor disorders, providing a foundation for developing rehabilitation programs incorporating auditory rhythms. We tested whether DCD also features these auditory-motor deficits among 7-10 year-old children. In a speech recognition task with no overt motor component, modulating the speech rhythm interfered more with the performance of children at risk for DCD than typically developing (TD) children. A set of auditory-motor tapping tasks further showed that, although children at risk for DCD performed worse than TD children in general, the presence of an auditory rhythmic cue (isochronous metronome or music) facilitated the temporal consistency of tapping. Finally, accuracy in the recognition of rhythmically modulated speech and tapping consistency correlated with performance on the standardized motor assessment. Together, the results show auditory rhythmic regularity benefits auditory perception and auditory-motor coordination in children at risk for DCD. This provides a foundation for future clinical studies to develop evidence-based interventions involving auditory-motor rhythmic coordination for children with DCD.

The self-reported driving and pedestrian behaviour of adults with developmental coordination disorder

BACKGROUND

Developmental coordination disorder (DCD) affects movement coordination, but little is known about how the condition impacts the behaviours of car drivers and pedestrians.

AIMS

This study examined the self-reported driving and pedestrian behaviours of adults with Developmental Coordination Disorder (DCD).

METHODS AND PROCEDURES

One hundred and twenty-eight participants (62 adults with DCD vs. 66 TD adults) responded to an online survey asking them about their perceptions of confidence and self-reported driving and pedestrian behaviours in the real-world.

OUTCOMES AND RESULTS

Results suggested that adults with DCD felt less confident and reported more lapses in attention (e.g., forgetting where their car was parked) and errors (e.g., failing to check their mirrors prior to a manoeuvre) when driving compared to typically developed (TD) adults. Adults with DCD also reported feeling less confident and reported less adherence to road traffic laws (e.g., not waiting for a green crossing signal before crossing the road) when walking as pedestrians.

CONCLUSIONS AND IMPLICATIONS

These results offer some much-needed insight into the behaviours of those with DCD outside of the laboratory environment and underline the need for research investigating the driving and pedestrian behaviours of individuals with DCD in 'real-world' contexts.

Roadside experiences of parents of children with developmental coordination disorder and/or attention deficit hyperactivity disorder

Introduction

Pedestrians are a vulnerable group at the roadside and previous research has identified that children with DCD and ADHD are at a heightened risk of pedestrian injuries. Despite this, limited research has explored parental perspectives of the pedestrian risks faced by children with DCD and/or ADHD. Understanding parents' perspectives provides a unique insight into the challenges children face every day and the concerns that parents perceive regarding their children's safety as pedestrians. Therefore, the aim of this study was to explore parents' perspectives of the pedestrian risks faced by their children with DCD and/or ADHD.

Methods

Semi-structured interviews were conducted with 14 parents of primary school and early secondary school aged children with age range 7-17. The participants were divided into three groups based on their children's conditions: DCD group (10-17 years, n = 3), ADHD group (7-13 years, n = 5), and co-occurring group (7-16 years, n = 6). All parents confirmed an existing diagnosis and completed the SNAP-IV and DCDQ as screening tools. The interviews explored parents' perspectives regarding their children's pedestrian behaviors, parents' concerns and preventative measures taken to improve the pedestrian safety of their children with DCD and/or ADHD. Reflexive thematic analysis was undertaken to analyze the interviews, from which three themes were developed.

Results

The first theme related to the challenges experienced by children at the roadside; parents emphasized the significance of structured and controlled pedestrian crossing sites, underlining their preference for designated crossings as safer options due to their heightened perceptions of risk associated with other road-crossing locations. The second theme: parental concerns and influences on children's road safety referred to their children's performance and safety at the roadside, leading to increased monitoring and a more protective approach to road crossing. The third theme: road safety education related to various strategies parents implemented to mitigate risks, while balancing independence and prioritizing their safety.

Discussion

While there were commonalities in the challenges faced by children with DCD and/or ADHD at the roadside, there were also notable differences. Parents of children with DCD discussed challenges with spatial awareness and motor skills, whereas parents of children with ADHD discussed challenges with impulsivity and inattention. Parents of children with co-occurring DCD and ADHD described a complex interplay of these challenges. It is evident from the interviews that children with DCD and/or ADHD require a distinct approach to develop their pedestrian skills effectively and parents reported specific strategies they used to address the risks associated with their children's roadside behavior. Promoting pedestrian safety for children with DCD and/or ADHD necessitates collaboration among parents, schools and local authorities to implement comprehensive measures ensuring their safety. These findings contribute to understanding parental experiences and needs, providing valuable guidance for targeted interventions and policies to enhance the road safety of children with DCD and/or ADHD.

Moving With Confidence: How Does Anxiety Impede Performance in Individuals With Developmental Coordination Disorder (DCD)?

Purpose of Review

It is well-established that anxiety levels are higher among people with developmental coordination disorder (DCD) compared to their peers. However, it is unclear whether this anxiety influences movement and behaviour. The purpose of this paper is to review studies demonstrating the influence of anxiety on movement and/or behaviour in non-DCD and DCD populations.

Recent Findings

When considering non-DCD literature, many studies have illustrated the influence of anxiety on movement. Only two papers were found which explicitly aimed to consider the influence of anxiety on movement in a DCD population. These findings are described and explored against a backdrop of the wider research field.

Summary

This paper has highlighted the potential role of anxiety in constraining movement patterns in DCD. While a great deal more evidence is needed before definitive conclusions, there is emerging evidence that motor behaviour may be related to task-specific anxiety in children with DCD.

Young Adults With Developmental Coordination Disorder Adopt a Different Visual Strategy During a Hazard Perception Test for Cyclists

Cycling in traffic requires a combination of motor and perceptual skills while interacting with a dynamic and fast-changing environment. The inferior perceptual-motor skills in individuals with developmental coordination disorder (DCD) may put them at a higher risk for accidents. A key skill to navigate in traffic is to quickly detect hazardous situations. This perceptual-cognitive skill was investigated in young adults with DCD using simulated traffic situations in a hazard perception test in cycling. Nine individuals with DCD (age: 23.0 ± 3.8) and nine typically developing (TD) individuals (age: 24.6 ± 3.5) participated in the study and completed the test while their gaze was tracked using a remote eye tracking device. A questionnaire was used to determine cycling experience and the perception of cycling and anticipation skill in traffic. Despite a longer period to master the motor skill of cycling, individuals with DCD reported to be able to safely cycle in traffic around the same age as TD young adults. In the hazard perception test, individuals with DCD fixated the hazards later, less frequently and for a shorter duration than the TD participants, however, the participants with DCD did not wait longer to react to the hazard than the TD participants. Interestingly, individuals with DCD rated the traffic situations in the test as significantly more dangerous than the TD participants. In conclusion, the differences exposed in the hazard perception test may imply an increased risk of accidents in individuals with DCD. In further research and practice it is recommended that both the motor and the perceptual aspects of cycling are addressed.

Comparison of the Effect of Traffic Park-Based and School-Based Educational Interventions on Safe Road Crossing in Yazd Elementary School Students

INTRODUCTION

Traffic accidents are one of the most important health problems that cause many deaths every year. Scientific-practical interventions are needed to prevent traffic accidents. This study aimed to compare the effectiveness of traffic-based and school-based interventions on the safe road crossing in Yazd elementary school students.

METHODS

This interventional study was conducted on 132 students (66 males and 66 females) in two groups of school-based and traffic park-based intervention. A questionnaire was used to determine the safe crossing behavior score. Then, an educational intervention was administered to both groups. Two months after the intervention, safe crossing behavior was evaluated in both groups. Finally, the data were analyzed using SPSS software version 22.

RESULTS

In both groups, the score of safe crossing behavior was significantly increased after the intervention. The school-based group had significantly better behaviors compared to the traffic park-based group (P=0.001). There was a significant difference in the mean score of behavior between males and females and the intervention had a greater effect on female students (P=0.017).

CONCLUSION

Educational interventions and especially school-based intervention can be effective in improving the students' safe crossing behaviors.

Driving Skills of Individuals With and Without Developmental Coordination Disorder (DCD/Dyspraxia)

Learning to drive is a significant event for the transition to adulthood and delay or avoidance may have social, practical, and psychological implications. For those with Developmental Coordination Disorder (DCD/Dyspraxia), driving presents a considerable challenge, and the literature shows that there are differences in driving ability between individuals with and without DCD. The aim of the current research is to further our understanding of the mechanisms underlying the driving experiences of individuals with DCD. Nineteen participants with DCD (10 drivers and 9 non-drivers) and 36 controls (17 drivers and 19 non-drivers) aged 18-57 years took part in this study. Participants completed standardized tests, questionnaires and a driving simulation task designed to measure speed, road positioning, and rate of change of steering in three conditions with increasing perceptual complexity. Results indicate that behaviors for all participants changed as the perceptual demands of the task increased. However, drivers with DCD were more affected than all other groups, driving more slowly, and driving further to the right. These findings illustrate how the impact of both internal and external constraints negatively affect the success of the driving task for individuals with DCD compared to their TD peers.

The nature of the risk faced by pedestrians with neurodevelopmental disorders: A systematic review

Pedestrians represent one of the most vulnerable road user groups worldwide. Children and adult pedestrians with neurodevelopmental disorders may be at greater risk due to deficits in a range of domains, such as attention, social communication, motor control and executive function. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychological Association, 2013), neurodevelopmental disorders include individuals with a diagnosis of Autism Spectrum Disorders, Attention Deficit Hyperactivity Disorder, Specific Learning Disorder, Motor Difficulties, Communication Disorders and Intellectual Disabilities. The purpose of this systematic review and meta-analysis was to explore existing literature relating to determine the nature of the risk faced by pedestrians with neurodevelopmental disorders. Relevant databases including Web of Science, PhysInfo and CINAHL were searched up to July 2019. All peer reviewed journals that presented data focusing on neurodevelopmental disorders and some aspect of road crossing or roadside behaviour that included a control or comparison group were included. A total of 149 abstracts were assessed and 17 met the inclusion criteria. The identified papers could be grouped into four areas: (1) rate of injury; (2) assessment of risk; (3) eye gaze and understanding of road layout and (4) gap choice. No papers exploring the risk factors at the roadside for individuals with Specific Learning Disorders or Communication Disorders were identified. Overall, the review provide evidence for an elevated risk of injury for individuals with ADHD at the roadside, potentially as a consequence of poor temporal gap choice, although there was evidence that this risk could be mediated by executive dysfunction rather than ADHD symptomology. Furthermore, poor temporal gap choice was found in children with DCD but it remains unclear as to whether this risk translates to the roadside. Finally, both children and adults with ASD and children with ID were found to demonstrate differences in behaviour / understanding at the roadside. In general, co-occurrence between neurodevelopmental disorders has been largely ignored in the current literature relating to pedestrian risk and future research could consider this along with executive functioning.

The Lived Experience of Crossing the Road When You Have Developmental Coordination Disorder (DCD): The Perspectives of Parents of Children With DCD and Adults With DCD

Pedestrians are one of the most vulnerable groups at the roadside, furthermore, previous research has demonstrated perceptual-motor limitations in individuals with DCD which may put these individuals at even more at risk in the context of road crossing. However, it is unclear whether this is the lived experience of these individuals at the roadside. Furthermore, difficulties with road crossing and safety have been found in other neurodevelopmental disorders but the impact this might have on an individual with co-occurring difficulties is unknown. Therefore, we utilized a questionnaire to survey the lived experience of adults with DCD and parents of children with DCD with the specific objectives of describing behaviors exhibited by adults and children with DCD (the latter reported by parents) at the roadside and to determine the how these individuals perceive road crossing actions. For each of these we compared different co-occurrence groups. We also had one final objective which was not focused on road crossing but more on the general perception of accidents and unrealistic optimism. Individuals with co-occurrences which have previously been linked to unsafe crossing behaviors (i.e., ADHD, ASD, and LD) reported a greater regularity of dangerous looking behavior (forgetting to look, running without looking) and visibility (crossing between cars, crossing when you can't see), these adults and the parents of these children were seemingly aware of the risky nature of these behaviors. When asked "why" crossing ability might be different, perceptual and motor difficulties alongside heightened awareness of risk and lowered awareness of risk were all cited by participants. Unrealistic optimism was not an explanation for the risky behavior in adults with DCD and in fact, these adults demonstrated a clear understanding of the likelihood of accidents. The findings of this study suggest that road crossing is perceived to be more challenging for both children and adults with DCD and this needs to be taken into account when considering remediation for this group.

Motor imagery and action observation for predictive control in developmental coordination disorder

In 2019, international clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of developmental coordination disorder (DCD) were published. Informing our understanding of mechanisms, recent systematic reviews have shown that children with DCD have difficulties with the predictive control of movements, including aspects of motor planning, which is expressed as the internal modeling deficit hypothesis. This motor control deficit is most evident when the spatial and temporal demands of a task increase. An increasing number of empirical studies suggest that motor planning problems can be remediated through training based on one or a combination of motor imagery and action observation. In this review, we show evidence of motor planning problems in children with DCD and show that task demands or complexity affects its appearance. Implications of these findings are treatments based on motor imagery and action observation to remediate motor planning issues. The article concludes with recommendations for future research.

Appropriateness of different pedagogical approaches to road safety education for children with Developmental Coordination Disorder (DCD)

BACKGROUND

In 2016, 29% of pedestrians killed or seriously injured on the roads in Great Britain were under 15 years of age. Children with Developmental Coordination Disorder (DCD), a chronic disorder affecting the acquisition and execution of motor skills, may be more vulnerable at the roadside than typically developing (TD) children. Current methods used to teach road safety are typically knowledge-based and do not necessarily improve behaviour in real traffic situations. Virtual reality road crossing tasks may be a viable alternative.

AIMS/METHODS

The present study aimed to test the road crossing accuracy of children with and without DCD in virtual reality tasks that varied the viewpoint to simulate the teaching methods currently used in road safety educational programmes. Twenty-one children with DCD and twenty-one age and gender matched TD peers were required to locate the safest road crossing sites in two conditions: allocentric (aerial viewpoint) and egocentric (first-person viewpoint).

PROCEDURES/OUTCOMES

All children completed both conditions and were required to navigate either themselves or an avatar across the road using the safest crossing route. The primary outcome was accuracy defined as the number of trials, out of 10, on which the child successfully identified and used the safest crossing route.

RESULTS/CONCLUSIONS

Children with DCD performed equally poorly in both conditions, while TD children were significantly more accurate in the egocentric condition. This difference cannot be explained by self-reported prior road crossing education, practice or confidence.

IMPLICATIONS

While TD children may benefit from the development of an egocentric virtual reality road crossing task, multimodal methods may be needed to effectively teach road safety to children with DCD.