Children with Developmental Coordination Disorder are deficient in a visuo-manual tracking task requiring predictive control

The effect of different depth planes during a manual tracking task in three-dimensional virtual reality space

Unlike ballistic arm movements such as reaching, the contribution of depth information to the performance of manual tracking movements is unclear. Thus, to understand how the brain handles information, we investigated how a required movement along the depth axis would affect behavioral tracking performance, postulating that it would be affected by the amount of depth movement. We designed a visually guided planar tracking task that requires movement on three planes with different depths: a fronto-parallel plane called ROT (0), a sagittal plane called ROT (90), and a plane rotated by 45° with respect to the sagittal plane called ROT (45). Fifteen participants performed a circular manual tracking task under binocular and monocular visions in a three-dimensional (3D) virtual reality space. As a result, under binocular vision, ROT (90), which required the largest depth movement among the tasks, showed the greatest error in 3D. Similarly, the errors (deviation from the target path) on the depth axis revealed significant differences among the tasks. Under monocular vision, significant differences in errors were observed only on the lateral axis. Moreover, we observed that the errors in the lateral and depth axes were proportional to the required movement on these axes under binocular vision and confirmed that the required depth movement under binocular vision determined depth error independent of the other axes. This finding implies that the brain may independently process binocular vision information on each axis. Meanwhile, the required depth movement under monocular vision was independent of performance along the depth axis, indicating an intractable behavior. Our findings highlight the importance of handling depth movement, especially when a virtual reality situation, involving tracking tasks, is generated.

Motor Skills and Visual Deficits in Developmental Coordination Disorder: A Narrative Review

BACKGROUND

Developmental coordination disorder (DCD) is a developmental disorder in which numerous comorbidities seem to coexist, such as motor and visual impairment and some executive functions; Methods: A narrative review on motor and visual deficits in children with DCD was carried out; Results and Discussion: Fine and gross motor skills are affected in children with DCD. In addition, they seem to be related to visual deficits, such as difficulty in visual perception, sensory processing and visual memory. Limitations have also been found in accommodation. Interventions in children with DCD should be aimed at improving both aspects, since vision affects motor skills and vice versa; Conclusions: In children with DCD, who present a marked deficit in global shape processing, it causes an association between deficiencies in visual perception and motor skills.

Walking adaptability improves after treadmill training in children with Developmental Coordination Disorder: A proof-of-concept study

BACKGROUND

Children with Developmental Coordination Disorder (DCD) have motor coordination deficits leading to difficulties in sports and play that require adaptations of the walking pattern. Children with DCD indeed demonstrate poorer walking adaptability (WA) compared to typically developing children, but it remains elusive whether WA can be improved by training.

RESEARCH QUESTION

Does augmented-reality treadmill training lead to improvements in WA in children with DCD?

METHODS

Seventeen children with DCD were included in this proof-of-concept intervention study. They received a six-session training on the C-mill, a treadmill on which gait adjustments can be evoked by projected visual context. The effect of the training was evaluated before (M1), directly after training (M2) and after 6 months follow-up (M3) using the WAL-K (single and double run) and WA-tasks on the C-mill (as a single and with concurrent visuo-motor and cognitive task). In addition, parents completed a questionnaire on their perception of the training. Linear Mixed Model analyses were performed to assess the differences in WAL-K scores and success rates on the WA-tasks between M1-M2 and M1-M3.

RESULTS

Children significantly improved on the WAL-K double run and on all three WA-tasks between M1-M2 and M1-M3. Children did not improve on the WAL-K single run. Parents found the training useful and fun for their child and indicated that their child fell less frequently.

SIGNIFICANCE

The results show that C-mill training had positive and task-specific effects on WA in children with DCD, which effects generalized to an overground task and were retained at 6 months follow-up. This may help children with DCD to better participate in daily activities. Future research should include a control group to examine the effectiveness of the training program compared to receiving no training and may also examine the effect of the training on participation in daily life.

Effects of virtual reality training intervention on predictive motor control of children with DCD - A randomized controlled trial

It has been hypothesised that deficits in the functions of predictive motor control and internal modeling may contribute to motor control issues of children with Developmental Coordination Disorder (DCD). Virtual reality (VR) technologies have great potential to provide opportunity for Motor observation and motor imagery (MI) which could enhance learning and development of motor skills in children with DCD. Thus, the present study aimed to investigate the benefits of a VR training intervention to improve predictive motor control functions of children with DCD. Forty female children with DCD (aged 7-10) were randomly assigned to VR and control groups. In this study, an experimental pre-post and follow-up design was used, and Predictive motor control functions were measured before and after the VR intervention and two-months later. Predictive motor control was evaluated using MI (by hand rotation task), action planning (by sword placement task), and rapid and online control (by rotational tracking task) tests. VR intervention consisted of a selection of Xbox 360 Kinect games that were performed for sixteen 30-min sessions over 8 weeks. Compared to the control group, the VR group improved significantly on measures of MI, motor planning, and rapid and online control scores from pre- to post-test and retained their performance to follow-up. Overall, it seems that virtual reality training program may be used as an appropriate intervention approach for developing the ability of MI and predictive motor control functions in DCD children.

Children With Developmental Coordination Disorder Show Altered Visuomotor Control During Stair Negotiation Associated With Heightened State Anxiety

Safe stair negotiation is an everyday task that children with developmental coordination disorder (DCD) are commonly thought to struggle with. Yet, there is currently a paucity of research supporting these claims. We investigated the visuomotor control strategies underpinning stair negotiation in children with (N = 18, age = 10.50 ± 2.04 years) and without (N = 16, age = 10.94 ± 2.08 years) DCD by measuring kinematics, gaze behavior and state anxiety as they ascended and descended a staircase. A questionnaire was administered to determine parents' confidence in their child's ability to safely navigate stairs and their child's fall history (within the last year). Kinematics were measured using three-dimensional motion capture (Vicon), whilst gaze was measured using mobile eye-tracking equipment (Pupil labs). The parents of DCD children reported significantly lower confidence in their child's ability to maintain balance on the stairs and significantly more stair-related falls in the previous year compared to the parents of typically developing (TD) children. During both stair ascent and stair descent, the children with DCD took longer to ascend/descend the staircase and displayed greater handrail use, reflecting a more cautious stair negotiation strategy. No differences were observed between groups in their margin of stability, but the DCD children exhibited significantly greater variability in their foot-clearances over the step edge, which may increase the risk of a fall. For stair descent only, the DCD children reported significantly higher levels of state anxiety than the TD children and looked significantly further along the staircase during the initial entry phase, suggesting an anxiety-related response that may bias gaze toward the planning of future stepping actions over the accurate execution of an ongoing step. Taken together, our findings provide the first quantifiable evidence that (a) safe stair negotiation is a significant challenge for children with DCD, and that (b) this challenge is reflected by marked differences in their visuomotor control strategies and state anxiety levels. Whilst it is currently unclear whether these differences are contributing to the frequency of stair-related falls in children with DCD, our findings pave the way for future research to answer these important questions.

Children With Developmental Coordination Disorder Exhibit Greater Stepping Error Despite Similar Gaze Patterns and State Anxiety Levels to Their Typically Developing Peers

This study examined stepping accuracy, gaze behavior, and state-anxiety in children with (N = 21, age M = 10.81, SD = 1.89) and without (N = 18, age M = 11.39, SD = 2.06) developmental coordination disorder (DCD) during an adaptive locomotion task. Participants walked at a self-selected pace along a pathway, placing their foot into a raised rectangular floor-based target box followed by either no obstacles, one obstacle, or two obstacles. Stepping kinematics and accuracy were determined using three-dimensional motion capture, whilst gaze was determined using mobile eye-tracking equipment. The children with DCD displayed greater foot placement error and variability when placing their foot within the target box and were more likely to make contact with its edges than their typically developing (TD) peers. The DCD group also displayed greater variability in the length and width of their steps in the approach to the target box. No differences were observed between groups in any of the gaze variables measured, in mediolateral velocity of the center of mass during the swing phase into the target box, or in the levels of self-reported state-anxiety experienced prior to facing each task. We therefore provide the first quantifiable evidence that deficits to foot placement accuracy and precision may be partially responsible for the increased incidence of trips and falls in DCD, and that these deficits are likely to occur independently from gaze behavior and state-anxiety.

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.

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.

Associations between motor proficiency in children with history of maltreatment and living in social economically vulnerability

Maltreatment and living in poor socioeconomic conditions during childhood may implicate in deficits on motor proficiency, nevertheless, the literature on this issue is still scarce. The goal of the study was to investigate the possible associations among manual dexterity, aiming and catching tasks, and balance tasks for children who suffers maltreatment and lived in social vulnerability. Eighty-two (82) children (08-09 years old) participated in the study. Forty-one (41) belong to the (SEV-M Group) children living in social economic vulnerability and were previously maltreated (lived in foster homes as results of parental neglect and domestic violence), and 41 belong to the (SEV Group) children living in social economical vulnerability with no history of childhood maltreatment. Children were assessed using the Movement Assessment Battery for Children -2nd Edition. Structural Equation Modeling was used to analyze the data. The results suggest the existence of a variety of motor difficulties in the group of children who suffered from neglect and domestic violence. The statistics model showed a negative effect for children in at-risk environments (regression coefficient=-0.30) and only showed a significant effect (p=0.04) for balance abilities. Traumatic experiences may have a negative effect on children' balance proficiency.

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.