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Iuzzini-Seigel J. Procedural Learning, Grammar, and Motor Skills in Children With Childhood Apraxia of Speech, Speech Sound Disorder, and Typically Developing Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1081-1103. [PMID: 33784194 DOI: 10.1044/2020_jslhr-20-00581] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose This case-control study sought to determine if (a) children with childhood apraxia of speech (CAS), other speech sound disorders (SSDs), and typical development would perform differently on a procedural learning assessment and (b) whether grammatical ability would impact group differences. Method Communication, motor, and procedural learning abilities were assessed in 48 children with CAS (n = 13), SSD (n = 20), and typical development (n = 15), between 43 and 97 months of age (M = 66 months, SD = 12 months). Results On average, children with CAS demonstrated grammatical and motor impairments and required an increased number of exposures to the visuospatial sequence to demonstrate procedural learning, compared to peers with SSD or typical development. A subset of children from each group demonstrated an unanticipated procedural learning pattern wherein they evidenced an uptick in reaction time during the second sequenced block. Children with CAS with this pattern still evidenced procedural learning gains by the fifth sequenced block. In contrast, children with SSD and typical development with this pattern showed poor procedural learning outcomes and were characterized by lower scores on language and motor assessments as well. Conclusions This research provides partial support for the procedural learning deficit hypothesis in children with CAS and for a subset of children with SSD as well. Future research should examine the role of a serial reaction time task in identifying children at risk of multisystem communication and motor deficits. Supplemental Material https://doi.org/10.23641/asha.14173532.
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Affiliation(s)
- Jenya Iuzzini-Seigel
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee, WI
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Cheng M, Anderson M, Levac DE. Performance Variability During Motor Learning of a New Balance Task in a Non-immersive Virtual Environment in Children With Hemiplegic Cerebral Palsy and Typically Developing Peers. Front Neurol 2021; 12:623200. [PMID: 33790848 PMCID: PMC8005528 DOI: 10.3389/fneur.2021.623200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Motor impairments contribute to performance variability in children with cerebral palsy (CP) during motor skill learning. Non-immersive virtual environments (VEs) are popular interventions to promote motor learning in children with hemiplegic CP. Greater understanding of performance variability as compared to typically developing (TD) peers during motor learning in VEs may inform clinical decisions about practice dose and challenge progression. Purpose: (1) To quantify within-child (i.e., across different timepoints) and between-child (i.e., between children at the same timepoint) variability in motor skill acquisition, retention and transfer in a non-immersive VE in children with CP as compared to TD children; and (2) To explore the relationship between the amount of within-child variability during skill acquisition and learning outcomes. Methods: Secondary data analysis of 2 studies in which 13 children with hemiplegic CP and 67 TD children aged 7-14 years undertook repeated trials of a novel standing postural control task in acquisition, retention and transfer sessions. Changes in performance across trials and sessions in children with CP as compared to TD children and between younger (7-10 years) and older (11-14 years) children were assessed using mixed effects models. Raw scores were converted to z-scores to meet model distributional assumptions. Performance variability was quantified as the standard deviation of z-scores. Results: TD children outperformed children with CP and older children outperformed younger children at each session. Older children with CP had the least between-child variability in acquisition and the most in retention, while older TD children demonstrated the opposite pattern. Younger children with CP had consistently high between-child variability, with no difference between sessions. Within-child variability was highest in younger children, regardless of group. Within-child variability was more pronounced in TD children as compared to children with CP. The relationship between the amount of within-child variability in performance and performance outcome at acquisition, retention and transfer sessions was task-specific, with a positive correlation for 1 study and a negative correlation in the other. Conclusions: Findings, though preliminary and limited by small sample size, can inform subsequent research to explore VE-specific causes of performance variability, including differing movement execution requirements and individual characteristics such as motivation, attention and visuospatial abilities.
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Affiliation(s)
- Minxin Cheng
- Rehabilitation Games and Virtual Reality Laboratory, Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, United States
| | - Michael Anderson
- Department of Biology, Macalester College, St. Paul, MN, United States
| | - Danielle E Levac
- Rehabilitation Games and Virtual Reality Laboratory, Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA, United States
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Carneiro MIS, Russo C, Masson R, Rossi Sebastiano D, Baranello G, Turati C, Bolognini N. Motor learning in unilateral cerebral palsy and the influence of corticospinal tract reorganization. Eur J Paediatr Neurol 2020; 27:49-59. [PMID: 32417186 DOI: 10.1016/j.ejpn.2020.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 04/06/2020] [Accepted: 04/25/2020] [Indexed: 11/28/2022]
Abstract
Cerebral Palsy (CP) is a complex neurological disorder, characterized by congenital motor disability associated with behaviour, perception and cognition disorders. The sensorimotor impairments represent the main hallmark of the disease, significantly impacting the quality of life. So far, few studies have investigated motor learning abilities in CP and their association with the plastic reorganization of the motor system remains largely unknown. The present proof-of-principle study explored explicit motor sequence learning in children with unilateral CP and different patterns of motor system reorganization (bilateral, ipsilateral, contralateral). Children with unilateral CP, and a group of age-matched typically developing (TD) children, underwent a sequential finger tapping task, performed with the affected hand by children with CP and with the non-dominant hand by TD children. The pattern of corticospinal tract projections in hemiparetic patients was assessed by single-pulse Transcranial Magnetic Stimulation (TMS). Results showed the presence of finger dexterity impairments in children with unilateral CP presenting with a bilateral or an ipsilateral control of the affected (trained) hand, as compared to TD children. Conversely, motor sequence learning was impaired in unilateral CP with ipsilateral or contralateral corticospinal reorganization, but not in the case of a bilateral control of the paretic hand. These preliminary findings, although referred to small clinical samples, suggest that unilateral control of the paretic upper-limb, from the ipsilateral or the contralateral motor cortex, may not be sufficient to develop typical motor learning with the affected hand, which seems to require a bilateral representation in the motor cortex. This evidence has potential implications for fine motor skills rehabilitation in CP.
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Affiliation(s)
- Maíra I S Carneiro
- University of Milano-Bicocca, Department of Psychology & NeuroMI - Milan Center for Neuroscience, Milan, Italy.
| | - Cristina Russo
- University of Milano-Bicocca, Department of Psychology & NeuroMI - Milan Center for Neuroscience, Milan, Italy
| | - Riccardo Masson
- Fondazione IRCCS Istituto Neurologico C. Besta, Developmental Neurology Unit, Milan, Italy
| | | | - Giovanni Baranello
- Fondazione IRCCS Istituto Neurologico C. Besta, Developmental Neurology Unit, Milan, Italy
| | - Chiara Turati
- University of Milano-Bicocca, Department of Psychology & NeuroMI - Milan Center for Neuroscience, Milan, Italy
| | - Nadia Bolognini
- University of Milano-Bicocca, Department of Psychology & NeuroMI - Milan Center for Neuroscience, Milan, Italy; IRCCS Istituto Auxologico, Laboratory of Neuropsychology, Milan, Italy.
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van Abswoude F, Buszard T, van der Kamp J, Steenbergen B. The role of working memory capacity in implicit and explicit sequence learning of children: Differentiating movement speed and accuracy. Hum Mov Sci 2020; 69:102556. [DOI: 10.1016/j.humov.2019.102556] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 10/09/2019] [Accepted: 11/13/2019] [Indexed: 11/28/2022]
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Cherriere C, Robert M, Fung K, Tremblay Racine F, Tallet J, Lemay M. Is there evidence of benefits associated with dancing in children and adults with cerebral palsy? A scoping review. Disabil Rehabil 2019; 42:3395-3402. [PMID: 30973761 DOI: 10.1080/09638288.2019.1590866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Purpose: Cerebral palsy is a neurological disorder not only affecting motor functions but also cognitive and psychosocial dimension. Multispecialty therapies are needed to address these dimensions. Dance practice provides multidimensional benefits for people with various neurological disorders and may present a real potential for people with cerebral palsy. A scoping review is conducted to evaluate the impact of dance in children and adults with cerebral palsy, based on the Human Development Model-Disability Creation Process 2 and its three key concepts: personal factors, environmental factors and life habits.Materials and methods: Studies were selected based on a systematic search of published literature in the following databases PubMed, Medline, EBM Reviews, EMBASE and CINAHL. Studies addressing any concepts on the impact of dance training on motor, cognitive and psychosocial dimensions in people with cerebral palsy were included.Results: Seven studies representing 45 children and 12 adults with cerebral palsy were selected. They had heterogeneous populations, protocols and outcomes measures, but overall covered the three main concepts of the model. Dance may have both motor and social benefits although the evidence remains weak.Conclusions: Dance appears to be a promising activity for people with cerebral palsy. Recommendations are proposed for future studies.Implications for rehabilitationCerebral palsy affects motor and cognitive functions and has social repercussions.Dance can be a promising activity for people with a cerebral palsy.Dance may have both motor and social benefits although the evidence remains weak.
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Affiliation(s)
- Claire Cherriere
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montréal, Canada.,ToNIC Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Maxime Robert
- Department of Biobehavioral Sciences, Columbia University, New York, USA
| | - Karen Fung
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montréal, Canada.,Ecole de réadaptation, Université De Montréal, Montréal, Canada
| | - Fannie Tremblay Racine
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montréal, Canada
| | - Jessica Tallet
- ToNIC Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Martin Lemay
- Centre de Réadaptation Marie Enfant, Centre de Recherche du CHU Sainte Justine, Montréal, Canada.,Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montréal, Canada
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Chu VW, Park SW, Sanger TD, Sternad D. Children With Dystonia Can Learn a Novel Motor Skill: Strategies That are Tolerant to High Variability. IEEE Trans Neural Syst Rehabil Eng 2016; 24:847-858. [PMID: 26829795 DOI: 10.1109/tnsre.2016.2521404] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Children with dystonia are characterized by highly variable and seemingly uncontrolled movements. An important question for any rehabilitative effort is whether these children can learn and improve their performance. This study compared children with dystonia due to cerebral palsy, typically developing children, and healthy adults in their ability to acquire a novel sensorimotor skill. Using a virtual setup, subjects threw a virtual ball tethered to a post to hit a virtual target. Multiple combinations of release angle and velocity of the arm at ball release could achieve a target hit-the task was redundant and afforded solutions with different sensitivity to variability. Subjects performed 200 trials for two target locations that presented different types of redundancy. We hypothesized that children with dystonia develop strategies that are tolerant to their high variability. Estimating this variability highlighted the insufficiency of traditional outcome measures. Therefore, additional analyses of data distributions and of ball release timing were applied. Results showed that: 1) children with dystonia reduced their performance error despite their high variability; 2) this improvement was brought about by finding error-tolerant solutions; and 3) they generated arm trajectories that created time windows for ball release that were tolerant to timing variability. While reduced in magnitude, the performance improvements in children with dystonia paralleled those in healthy children and adults. These findings demonstrate that children with dystonia are able to adapt their behavior to their high variability, an important basis for any rehabilitative intervention.
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de Mello Monteiro CB, Massetti T, da Silva TD, van der Kamp J, de Abreu LC, Leone C, Savelsbergh GJP. Transfer of motor learning from virtual to natural environments in individuals with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2430-7. [PMID: 24981192 DOI: 10.1016/j.ridd.2014.06.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 06/05/2014] [Accepted: 06/06/2014] [Indexed: 05/14/2023]
Abstract
With the growing accessibility of computer-assisted technology, rehabilitation programs for individuals with cerebral palsy (CP) increasingly use virtual reality environments to enhance motor practice. Thus, it is important to examine whether performance improvements in the virtual environment generalize to the natural environment. To examine this issue, we had 64 individuals, 32 of which were individuals with CP and 32 typically developing individuals, practice two coincidence-timing tasks. In the more tangible button-press task, the individuals were required to 'intercept' a falling virtual object at the moment it reached the interception point by pressing a key. In the more abstract, less tangible task, they were instructed to 'intercept' the virtual object by making a hand movement in a virtual environment. The results showed that individuals with CP timed less accurate than typically developing individuals, especially for the more abstract task in the virtual environment. The individuals with CP did-as did their typically developing peers-improve coincidence timing with practice on both tasks. Importantly, however, these improvements were specific to the practice environment; there was no transfer of learning. It is concluded that the implementation of virtual environments for motor rehabilitation in individuals with CP should not be taken for granted but needs to be considered carefully.
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Affiliation(s)
| | - Thais Massetti
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | - Talita Dias da Silva
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, SP, Brazil
| | - John van der Kamp
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; Institute of Human Performance, University of Hong Kong, 111-113 Pokfulam Road, Pokfulam, Hong Kong
| | - Luiz Carlos de Abreu
- School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, CEP: 01255-000 São Paulo, SP, Brazil
| | - Claudio Leone
- School of Public Health, University of São Paulo, Av. Dr. Arnaldo, 715, CEP: 01255-000 São Paulo, SP, Brazil
| | - Geert J P Savelsbergh
- MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; Academy for Physical Education, University of Applied Sciences, Dr. Meurerlaan 8, 1067 SM Amsterdam, The Netherlands
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Gofer-Levi M, Silberg T, Brezner A, Vakil E. Cognitive procedural learning among children and adolescents with or without spastic cerebral palsy: the differential effect of age. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1952-1962. [PMID: 24858793 DOI: 10.1016/j.ridd.2014.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 04/02/2014] [Accepted: 04/09/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Children learn to engage their surroundings skillfully, adopting implicit knowledge of complex regularities and associations. Probabilistic classification learning (PCL) is a type of cognitive procedural learning in which different cues are probabilistically associated with specific outcomes. Little is known about the effects of developmental disorders on cognitive skill acquisition. METHODS Twenty-four children and adolescents with cerebral palsy (CP) were compared to 24 typically developing (TD) youth in their ability to learn probabilistic associations. Performance was examined in relation to general cognitive abilities, level of motor impairment and age. RESULTS Improvement in PCL was observed for all participants, with no relation to IQ. An age effect was found only among TD children. CONCLUSIONS Learning curves of children with CP on a cognitive procedural learning task differ from those of TD peers and do not appear to be age sensitive.
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Affiliation(s)
- M Gofer-Levi
- The Department of Psychology, Bar Ilan University, Ramat-Gan 52900, Israel.
| | - T Silberg
- The Department of Psychology, Bar Ilan University, Ramat-Gan 52900, Israel; The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel.
| | - A Brezner
- The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer 52621, Israel.
| | - E Vakil
- The Department of Psychology, Bar Ilan University, Ramat-Gan 52900, Israel.
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