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Gauduel T, Blondet C, Gonzalez-Monge S, Bonaiuto J, Gomez A. Alteration of body representation in typical and atypical motor development. Dev Sci 2024; 27:e13455. [PMID: 37926863 DOI: 10.1111/desc.13455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023]
Abstract
Developmental coordination disorder (DCD) impacts the quality of life and ability to perform coordinated actions in 5% of school-aged children. The quality of body representations of individuals with DCD has been questioned, but never assessed. We hypothesize that children with DCD have imprecise body representations in the sensory and motor domains. Twenty neurotypical children, seventeen children with DCD (8-12 years old) and twenty neurotypical adults (25-45 years old) performed both sensory and motor body representation tasks: a limb identification and a limb movement task. We observed lower accuracy in the sensory task but not in the motor task. In both tasks, we observe a larger amplitude of errors, or synkinesis, in children with DCD than in neurotypical children. In neurotypical children, accuracy was lower than in neurotypical adults in the motor and sensory task, and the amplitude of sensory errors and synkinesis was higher than in neurotypical adults. Using a linear regression model, we showed that sensory accuracy is a good predictor of synkinesis production, and that synkinesis production is a good predictor of sensory accuracy, as can be expected by the perception-action loop. Results support the hypothesis of an imprecision of body representation in DCD. We suggest that this imprecision arises from noise in the body representation used at the level of internal models of action. Future studies may assess whether slower plasticity of body representations, initial imprecision, or both may account for this observation. At the clinical level, prevention strategies targeting body representation in early childhood are strategically important to limit such impairments. RESEARCH HIGHLIGHTS: Body representation is impaired in children with DCD and has a significant cost in terms of the accuracy of sensory identification of body parts and associated movements. Inaccuracies in the body representation measured in perception and in action (error amplitude and synkinesis) are related in both NT children and adults. In typical development, we provide evidence of a strong link between body schema and body image.
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Affiliation(s)
- Thomas Gauduel
- Lyon Neuroscience Research Center (CRNL), INSERM U1028-CNRS UMR 5292, University of Lyon, Bron, France
| | - Camille Blondet
- Lyon Neuroscience Research Center (CRNL), INSERM U1028-CNRS UMR 5292, University of Lyon, Bron, France
| | - Sibylle Gonzalez-Monge
- Lyon Neuroscience Research Center (CRNL), INSERM U1028-CNRS UMR 5292, University of Lyon, Bron, France
| | - James Bonaiuto
- CNRS UMR 5229, Institut des Sciences Cognitives Marc Jeannerod, Lyon, France
| | - Alice Gomez
- Lyon Neuroscience Research Center (CRNL), INSERM U1028-CNRS UMR 5292, University of Lyon, Bron, France
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Gras D, Ploix Maes E, Doulazmi M, Huron C, Galléa C, Boespflug Tanguy O, Germanaud D, Roze E. Developmental coordination disorder subtypes in children: An unsupervised clustering. Dev Med Child Neurol 2023; 65:1332-1342. [PMID: 36883642 DOI: 10.1111/dmcn.15563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 03/09/2023]
Abstract
AIM To identify subtypes of developmental coordination disorder (DCD) in children. METHOD Children with DCD diagnosed through comprehensive evaluation at Robert-Debré Children's University Hospital (Paris, France) were consecutively enrolled from February 2017 to March 2020. We performed an unsupervised hierarchical clustering based on principal component analysis using a large set of variables encompassing cognitive, motor, and visuospatial scores (Wechsler Intelligence Scale for Children, Fifth Edition; Developmental Neuropsychological Assessment, Second Edition; Movement Assessment Battery for Children, Second Edition). RESULTS One hundred and sixty-four children with DCD were enrolled (median age 10 years 3 months; male:female ratio 5.56:1). We identified distinct subgroups with mixed visuospatial and gestural disorders, or with pure gestural disorders that predominantly impaired either speed or precision. Associated neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder, did not influence the results of the clustering. Importantly, we identified a subgroup of children with marked visuospatial impairment with the lowest scores in almost all of the evaluated domains, and the poorest school performance. INTERPRETATION The classification of DCD into distinct subgroups could be indicative of prognosis and provide critical information to guide patient management, taking into account the child's neuropsychological profile. Beyond this clinical interest, our findings also provide a relevant framework with homogeneous subgroups of patients for research on the pathogenesis of DCD. WHAT THIS PAPER ADDS Unsupervised hierarchical clustering identified four subgroups of children with developmental coordination disorder. Two subgroups had combined visuospatial/gestural difficulties, and two had pure gestural disorders. Severe visuospatial impairment was associated with poor performance in most domains including school. Difficulties in the gestural-only clusters were predominantly either gestural precision or speed.
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Affiliation(s)
- Domitille Gras
- Sorbonne University, INSERM, CNRS, Paris Brain Institute, Paris, France
- CEA Paris-Saclay, Frederic Joliot Institute, Neurospin, UNIACT, Gif-sur-Yvette, France
| | | | - Mohamed Doulazmi
- Adaptation Biologique et Vieillissement, Institut de Biologie Paris Seine, Sorbonne University, Paris, France
| | - Caroline Huron
- Université Paris Cité, Inserm, System Engineering and Evolution Dynamics, Paris, France
- Learning Planet Institute, Paris, France
| | - Cécile Galléa
- Sorbonne University, INSERM, CNRS, Paris Brain Institute, Paris, France
| | - Odile Boespflug Tanguy
- CRMR Leukofrance Service de Neuropédiatrie, Hôpital Robert Debré AP-HP, Paris, France
- UMR1141 Neurodiderot Université de Paris, Paris, France
| | - David Germanaud
- CEA Paris-Saclay, Frederic Joliot Institute, Neurospin, UNIACT, Gif-sur-Yvette, France
- Université Paris Cité, Inserm, NeuroDiderot, InDEV, Paris, France
- Department of Genetics, Centre of Excellence InovAND, Robert-Debré Hospital, HP, Paris, France
| | - Emmanuel Roze
- Sorbonne University, INSERM, CNRS, Paris Brain Institute, Paris, France
- APHP, Salpêtrière Hospital, DMU Neurosciences, Paris, France
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Irie K, Mukaiyama K, Yamashita R, Zeidan H, Bandara A, Nagai-Tanima M, Aoyama T. Investigating Subtypes of Motor Skills and Activities of Daily Living among Young Children with Motor Delay. Occup Ther Int 2023; 2023:4031372. [PMID: 37360553 PMCID: PMC10287527 DOI: 10.1155/2023/4031372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/15/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
The purpose of this study was to classify preschool children into subtypes based on motor skills and to characterize the activities of daily living for each subtype. The subjects were 45 preschool children whose scores on the Movement Assessment Battery for Children-Second Edition (MABC-2) and the Functional Independence Measure for Children (WeeFIM) were measured. The fine score and gross score were calculated from the MABC-2, and a cluster analysis was performed. The difference between the fine score and the gross score was evaluated for each subtype, and multiple comparisons among subtypes were performed for the fine, gross, and WeeFIM scores. Subtype analysis showed that the fine score was significantly lower than the gross score for subtype I (p < 0.001), and the gross score was significantly lower than the fine score for subtype III (p = 0.018). Subtype II had a significantly lower score than subtype I and subtype III (p < 0.001). Children with subtype II had more difficulty dressing movements and less communication skills than subtype III (p < 0.05). Classification into three subtypes according to motor ability and some of the characteristics of ADLs were identified.
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Affiliation(s)
- Keisuke Irie
- Department of Occupational Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kohei Mukaiyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Reika Yamashita
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Anuradhi Bandara
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Momoko Nagai-Tanima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Lust JM, Steenbergen B, Diepstraten J(AEM, Wilson P, Schoemaker MM, Poelma MJ. The subtypes of developmental coordination disorder. Dev Med Child Neurol 2022; 64:1366-1374. [PMID: 35578393 PMCID: PMC9790450 DOI: 10.1111/dmcn.15260] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/25/2022] [Accepted: 04/04/2022] [Indexed: 12/30/2022]
Abstract
AIM To identify subtypes in a large group of children clinically diagnosed with developmental coordination disorder (DCD) based on their pattern of motor, cognitive, and visual-motor abilities. METHOD Standardized scores for verbal IQ, total IQ, Movement Assessment Battery for Children, Second Edition (MABC-2) balance, MABC-2 manual dexterity, MABC-2 ball skills, and Beery-Buktenica Developmental Tests of Visual-Motor Integration (Beery-VMI), Motor Coordination (Beery-MC), and Visual Perception (Beery-VP) were used. The NbClust complete procedure was used to best partition the data on 98 children (84 males, 14 females, mean [SD] age: 8 years [2 years 1 month]) into clusters. Deviation contrasts, multivariate analysis of variance, and post hoc comparisons were used to characterize the clusters. RESULTS Four clusters were revealed: two clusters with a broad motor skill problem, one with relatively preserved visual-motor integration and Beery-MC skills, and a second with abnormal ball skills, balance, and Beery-MC skills. A third cluster with more specific gross-motor problems, and a fourth with relatively preserved ball skills but low Beery-MC and performance IQ, were identified. Balance scores were 'at risk' or 'abnormal' in all four clusters. INTERPRETATION DCD is a heterogeneous condition. However, subtypes can be discriminated on the basis of more severe difficulties in fine-motor performance, gross-motor performance, or both. There was evidence for generalized motor impairments in around half of all children. Importantly, at least borderline level reduced balance was evident in each subtype. WHAT THIS PAPER ADDS Four subtypes were identified in a large clinical group of children with developmental coordination disorder (DCD). Subtypes were based on motor, cognitive, and visual-motor abilities. There was evidence of generalized motor impairments in around 50% of children with DCD. A generalized balance problem is present across all subtypes of DCD.
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Affiliation(s)
- Jessica M. Lust
- Behavioural Science Institute, Faculty of Social SciencesRadboud UniversityNijmegenthe Netherlands
| | - Bert Steenbergen
- Behavioural Science Institute, Faculty of Social SciencesRadboud UniversityNijmegenthe Netherlands,Development and Disability Program, Healthy Brain and Mind Research CentreAustralian Catholic UniversityMelbourneVictoriaAustralia
| | | | - Peter H. Wilson
- Development and Disability Program, Healthy Brain and Mind Research CentreAustralian Catholic UniversityMelbourneVictoriaAustralia
| | - Marina M. Schoemaker
- University of Groningen, University Medical Center Groningen, Center for Human Movement SciencesGroningenthe Netherlands
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Van Dyck D, Baijot S, Aeby A, De Tiège X, Deconinck N. Cognitive, perceptual, and motor profiles of school-aged children with developmental coordination disorder. Front Psychol 2022; 13:860766. [PMID: 35992485 PMCID: PMC9381813 DOI: 10.3389/fpsyg.2022.860766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/24/2022] [Indexed: 12/05/2022] Open
Abstract
Developmental coordination disorder (DCD) is a heterogeneous condition. Besides motor impairments, children with DCD often exhibit poor visual perceptual skills and executive functions. This study aimed to characterize the motor, perceptual, and cognitive profiles of children with DCD at the group level and in terms of subtypes. A total of 50 children with DCD and 31 typically developing (TD) peers (7–11 years old) underwent a comprehensive neuropsychological (15 tests) and motor (three subscales of the Movement Assessment Battery for Children-2) assessment. The percentage of children with DCD showing impairments in each measurement was first described. Hierarchical agglomerative and K-means iterative partitioning clustering analyses were then performed to distinguish the subtypes present among the complete sample of children (DCD and TD) in a data-driven way. Moderate to large percentages of children with DCD showed impaired executive functions (92%) and praxis (meaningless gestures and postures, 68%), as well as attentional (52%), visual perceptual (46%), and visuomotor (36%) skills. Clustering analyses identified five subtypes, four of them mainly consisting of children with DCD and one of TD children. These subtypes were characterized by: (i) generalized impairments (8 children with DCD), (ii) impaired manual dexterity, poor balance (static/dynamic), planning, and alertness (15 DCD and 1 TD child), (iii) impaired manual dexterity, cognitive inhibition, and poor visual perception (11 children with DCD), (iv) impaired manual dexterity and cognitive inhibition (15 DCD and 5 TD children), and (v) no impairment (25 TD and 1 child with DCD). Besides subtle differences, the motor and praxis measures did not enable to discriminate between the four subtypes of children with DCD. The subtypes were, however, characterized by distinct perceptual or cognitive impairments. These results highlight the importance of assessing exhaustively the perceptual and cognitive skills of children with DCD.
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Affiliation(s)
- Dorine Van Dyck
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
- *Correspondence: Dorine Van Dyck,
| | - Simon Baijot
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
- Neuropsychology and Functional Neuroimaging Research Group at Center for Research in Cognition and Neurosciences, ULB Neurosciences Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Alec Aeby
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
- Neuropsychology and Functional Neuroimaging Research Group at Center for Research in Cognition and Neurosciences, ULB Neurosciences Institute, Université libre de Bruxelles, Brussels, Belgium
- Department of Pediatric Neurology, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université libre de Bruxelles, Brussels, Belgium
| | - Xavier De Tiège
- Laboratoire de Neuroanatomie et Neuroimagerie Translationnelles, ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
- Department of Translational Neuroimaging, CUB Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université libre de Bruxelles, Brussels, Belgium
| | - Nicolas Deconinck
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université libre de Bruxelles, Brussels, Belgium
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Biotteau M, Albaret JM, Chaix Y. Developmental coordination disorder. HANDBOOK OF CLINICAL NEUROLOGY 2020; 174:3-20. [PMID: 32977886 DOI: 10.1016/b978-0-444-64148-9.00001-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
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.
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Affiliation(s)
- Maëlle Biotteau
- Toulouse NeuroImaging Center, University of Toulouse, INSERM, Université Paul Sabatier, Toulouse, France; Pediatric Neurology Unit, Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France.
| | - Jean-Michel Albaret
- Psychomotricity Training Institute, University of Toulouse, Université Paul Sabatier, Toulouse, France
| | - Yves Chaix
- Toulouse NeuroImaging Center, University of Toulouse, INSERM, Université Paul Sabatier, Toulouse, France; Pediatric Neurology Unit, Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
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Kilroy E, Cermak SA, Aziz-Zadeh L. A Review of Functional and Structural Neurobiology of the Action Observation Network in Autism Spectrum Disorder and Developmental Coordination Disorder. Brain Sci 2019; 9:E75. [PMID: 30925819 PMCID: PMC6523237 DOI: 10.3390/brainsci9040075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/20/2019] [Accepted: 03/22/2019] [Indexed: 12/20/2022] Open
Abstract
Recent research has reported motor impairment similarities between children with developmental coordination disorder (DCD) and a subgroup of individuals with autism spectrum disorder (ASD). However, there is a debate as to whether DCD is a co-occurring diagnosis in individuals with ASD and motor impairments (ASDd), or if motor impairments in ASD are distinct from DCD. However, the etiology of motor impairments is not well understood in either disorder. Clarifying comorbidities in ASD is important to determine different etiopathological phenotyping clusters in ASD and to understand the variety of genetic and environmental factors that contribute to the disorder. Furthermore, this distinction has important therapeutic relevance. Here we explore the current neuroimaging findings in ASD and DCD and discusses possible neural mechanisms that underlie similarities and differences between the disorders.
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Affiliation(s)
- Emily Kilroy
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University Southern California, Los Angeles, CA 90089, USA.
- Brain and Creativity Institute, University Southern California, Los Angeles, CA 90089, USA.
| | - Sharon A Cermak
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University Southern California, Los Angeles, CA 90089, USA.
| | - Lisa Aziz-Zadeh
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University Southern California, Los Angeles, CA 90089, USA.
- Brain and Creativity Institute, University Southern California, Los Angeles, CA 90089, USA.
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8
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Infant motor skill predicts later expressive language and autism spectrum disorder diagnosis. Infant Behav Dev 2019; 54:37-47. [DOI: 10.1016/j.infbeh.2018.11.003] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 11/18/2018] [Accepted: 11/18/2018] [Indexed: 11/18/2022]
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Paquet A, Olliac B, Golse B, Vaivre-Douret L. Nature of motor impairments in autism spectrum disorder: A comparison with developmental coordination disorder. J Clin Exp Neuropsychol 2018; 41:1-14. [DOI: 10.1080/13803395.2018.1483486] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Aude Paquet
- Faculty of Medicine, University of Paris Descartes, Sorbonne Paris Cité, Paris, France
- CESP/Inserm U1018, University Paris-Sud and University Paris Descartes, Paris, France
- Department of Child and Adolescent Psychiatry, Esquirol Hospital, Limoges, France
- Research Unit and Neurostimulation, Esquirol Hospital, Limoges, France
| | - Bertrand Olliac
- Department of Child and Adolescent Psychiatry, Esquirol Hospital, Limoges, France
- Inserm U1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France
| | - Bernard Golse
- Faculty of Medicine, University of Paris Descartes, Sorbonne Paris Cité, Paris, France
- Department of Child Psychiatry, Necker-Enfants Malades University Hospital, Paris, France
| | - Laurence Vaivre-Douret
- Faculty of Medicine, University of Paris Descartes, Sorbonne Paris Cité, Paris, France
- CESP/Inserm U1018, University Paris-Sud and University Paris Descartes, Paris, France
- Department of Child Psychiatry, Necker-Enfants Malades University Hospital, Paris, France
- Department of Paediatrics, Child Development, Cochin-Port Royal University Hospitals of Paris Center, Paris, France
- Endocrinology Laboratory, Imagine Institute, Necker-Enfants Malades University Hospital, Paris, France
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10
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Subtyping children with developmental coordination disorder based on physical fitness outcomes. Hum Mov Sci 2018; 60:87-97. [PMID: 29852337 DOI: 10.1016/j.humov.2018.05.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/16/2018] [Accepted: 05/22/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE Children with Developmental Coordination Disorder (DCD) are known to have poor physical fitness. However, differentiating homogenous subgroups of DCD using fitness performance has not yet been established. Therefore the purpose of this study was to identify subtypes in children with and without DCD using measures of physical fitness. METHOD Children (aged 6-10 years, n = 217) constituted the sample for this study. They were assessed on 1) aerobic fitness (20m Shuttle Run test), 2) anaerobic fitness (Muscle Power Sprint Test), 3) isometric muscle strength (handheld dynamometry) 4) functional upper and lower body strength (Functional Strength Measurement) and 5) motor coordination [Movement Assessment Battery for Children-2nd edition (MABC-2) test]. The Ward method was used to identify the various clusters. RESULTS Five subtypes emerged in the entire sample. In the typically developing (TD) children mainly 2 subtypes (number 5 and 2) were found containing 89% of the TD children (n = 55), with the largest group demonstrating above average performance on all measures (cluster 5). Children in subtype 2 had just above average motor coordination and good aerobic fitness but lower muscle strength. Subtypes 1, 3 and 4 were clearly "DCD" clusters, however they showed difference in fitness performance. Subtype 1 contained children with DCD who showed poor performance on all fitness outcomes (n = 45). Children with DCD in subtype 3 had poor aerobic but average strength and anaerobic fitness (n = 48). Subtype 4 contained children with DCD (n = 45) who had good muscle strength and anaerobic fitness. Of these, 36% were at risk of DCD while 24% had definite motor coordination problems. CONCLUSION Our findings indicate that children with and without DCD demonstrate heterogeneous physical fitness profiles. The majority of the children (66%) with DCD belonged to subtypes with lower fitness performance. Further studies are needed to confirm these findings in other samples of DCD children.
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Hands B, McIntyre F, Parker H. The General Motor Ability Hypothesis: An Old Idea Revisited. Percept Mot Skills 2018; 125:213-233. [DOI: 10.1177/0031512517751750] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While specific motor abilities have become a popular explanation for motor performance, the older, alternate notion of a general motor ability should be revisited. Current theories lack consensus, and most motor assessment tools continue to derive a single composite score to represent motor capacity. In addition, results from elegant statistical procedures such as higher order factor analyses, cluster analyses, and Item Response Theory support a more global motor ability. We propose a contemporary model of general motor ability as a unidimensional construct that is emergent and fluid over an individual’s lifespan, influenced by both biological and environmental factors. In this article, we address the implications of this model for theory, practice, assessment, and research. Based on our hypothesis and Item Response Theory, our Lifespan Motor Ability Scale can identify motor assessment tasks that are relevant and important across varied phases of lifespan development.
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Affiliation(s)
- Beth Hands
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Australia
| | - Fleur McIntyre
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, Australia
| | - Helen Parker
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Australia
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Liu T, Li F, Jiang Y, Zhang T, Wang F, Gong D, Li P, Ma T, Qiu K, Li H, Yao D, Xu P. Cortical Dynamic Causality Network for Auditory-Motor Tasks. IEEE Trans Neural Syst Rehabil Eng 2017; 25:1092-1099. [PMID: 28113671 DOI: 10.1109/tnsre.2016.2608359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Motor preparation and execution require the interactions of a large-scale brain network, while the study of the dynamic changes of their interactions could uncover the underlying neural mechanism of the corresponding information processing. This dynamic analysis requires high temporal resolution of the recorded signals. Electroencephalogram (EEG) with high temporal resolution has been widely used in related studies. However, studies based on scalp EEG always lead to distorted results, due to scalp volume conduction, compared with that of cortically recorded signals. In the current study, the dynamic networks of motor preparation and execution are investigated using Go/No-go tasks performed with the left/right hand. In the analysis, the EEG source localization and dynamic causal model are combined together to investigate the neural processes of motor preparation and execution. The results show that similar network patterns with nodes distributed in the bilateral occipital lobe, bilateral temporal lobe, bilateral dorsolateral prefrontal cortex, and contralateral supplementary motor area could be revealed for both the Go and No-go tasks. Statistical testing further indicates that stronger couplings with the supplementary motor area could be found in Go and right-hand response tasks compared with No-go and left-hand response tasks, respectively. The findings in the current study demonstrate that the information exchange within the motor related brain networks plays an important role for motor related functions, i.e., the different motor functions may have the different information exchange and processing network patterns.
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Chang SH, Yu NY. Evaluation and Classification of Types of Chinese Handwriting Deficits in Elementary Schoolchildren. Percept Mot Skills 2016; 101:631-47. [PMID: 16383102 DOI: 10.2466/pms.101.2.631-647] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The handwriting problems of elementary schoolchildren were investigated in this study. A questionnaire for evaluation of Chinese handwriting was developed and then administered to 165 children with handwriting deficits. Factor analysis indicated that the questionnaire has six major dimensions, including construction of characters, accuracy, developmental delay, pencil grip, gross movement, and emotional reaction. These six dimensions were utilized to search for subtypes of handwriting deficits. By further sampling, another 209 children were administered the handwriting evaluation questionnaire to classify their handwriting deficits. According to the severity of deficits on different dimensions of the questionnaire, K-means clustering was utilized to classify the children into four subtypes of mild, severe, motor-originated, and academic learning dysfunction subtypes. The classification by subtype might be helpful in planning interventions for children with handwriting deficits.
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Affiliation(s)
- Shao-Hsia Chang
- Department of Occupational Therapy, I-Shou University, Ta-Hsu Hsiang, Kaohsiung County, Taiwan, ROC
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14
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Chokron S, Dutton GN. Impact of Cerebral Visual Impairments on Motor Skills: Implications for Developmental Coordination Disorders. Front Psychol 2016; 7:1471. [PMID: 27757087 PMCID: PMC5048540 DOI: 10.3389/fpsyg.2016.01471] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 09/13/2016] [Indexed: 12/16/2022] Open
Abstract
Cerebral visual impairment (CVI) has become the primary cause of visual impairment and blindness in children in industrialized countries. Its prevalence has increased sharply, due to increased survival rates of children who sustain severe neurological conditions during the perinatal period. Improved diagnosis has probably contributed to this increase. As in adults, the nature and severity of CVI in children relate to the cause, location and extent of damage to the brain. In the present paper, we define CVI and how this impacts on visual function. We then define developmental coordination disorder (DCD) and discuss the link between CVI and DCD. The neuroanatomical correlates and aetiologies of DCD are also presented in relationship with CVI as well as the consequences of perinatal asphyxia (PA) and preterm birth on the occurrence and nature of DCD and CVI. This paper underlines why there are both clinical and theoretical reasons to disentangle CVI and DCD, and to categorize the features with more precision. In order to offer the most appropriate rehabilitation, we propose a systematic and rapid evaluation of visual function in at-risk children who have survived preterm birth or PA whether or not they have been diagnosed with cerebral palsy or DCD.
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Affiliation(s)
- Sylvie Chokron
- Unité Fonctionnelle Vision and Cognition, Fondation Ophtalmologique RothschildParis, France; Laboratoire de Psychologie de la Perception, UMR 8242, Centre National de la Recherche Scientifique - Université Paris-DescartesParis, France
| | - Gordon N Dutton
- Department of Vision Science, Glasgow Caledonian University Glasgow, UK
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Michel E, Molitor S, Schneider W. Differential changes in the development of motor coordination and executive functions in children with motor coordination impairments. Child Neuropsychol 2016; 24:20-45. [DOI: 10.1080/09297049.2016.1223282] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Eva Michel
- Department of Psychology, University of Würzburg, Germany
| | - Sabine Molitor
- Department of Psychology, University of Würzburg, Germany
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Chang SH, Yu NY. Comparison of motor praxis and performance in children with varying levels of developmental coordination disorder. Hum Mov Sci 2016; 48:7-14. [DOI: 10.1016/j.humov.2016.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/02/2016] [Accepted: 04/05/2016] [Indexed: 11/28/2022]
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Farmer M, Echenne B, Bentourkia M. Study of clinical characteristics in young subjects with Developmental coordination disorder. Brain Dev 2016; 38:538-47. [PMID: 26763621 DOI: 10.1016/j.braindev.2015.12.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 12/18/2015] [Accepted: 12/21/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Developmental Coordination Disorder (DCD) is a chronic neurological disorder observed in children. DCD is characterized by slowness in activities and motor impairment that affects the children's daily living and academic achievements, and later their professional and social behavior. Our aim in this work was to report characteristics frequencies in a group of children with DCD and to propose a subtyping of DCD characteristics. METHODS Thirty three clinical DCD characteristics, the mostly reported in the literature, were assessed in 129 patients, boys and girls aged from 4years to 18years, and their subtyping was proposed. The statistical analyses were carried out with the Chi square, the t-test and the correlation for the statistical differences, and with the Ward clustering method for subtyping. RESULTS We found that there were 3.17 boys for one girl, all patients were characterized as slow, 47% were left-handers or ambidextrous, 36% and 26% had orofacial and verbal dyspraxia, respectively, 83% were found anxious, and 84% were described as being clumsy. CONCLUSIONS It appears from these results that a child with DCD expresses more than a single difficulty. Three subtypes emerged from the statistical analysis in this study: (1) clumsiness and other characteristics except language difficulties; (2) self-esteem and peer relation without clumsiness and language difficulties; (3) language difficulties and orofacial dyspraxia.
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Affiliation(s)
- Marie Farmer
- Department of Nuclear Medicine and Radiobiology, University of Sherbrooke, Sherbrooke, Canada; Department of Pediatrics, University of Sherbrooke, Sherbrooke, Canada
| | - Bernard Echenne
- Department of Nuclear Medicine and Radiobiology, University of Sherbrooke, Sherbrooke, Canada; Service de Neurologie Pédiatrique, Université de Montpellier I, Montpellier, France
| | - M'hamed Bentourkia
- Department of Nuclear Medicine and Radiobiology, University of Sherbrooke, Sherbrooke, Canada.
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Asonitou K, Koutsouki D. Cognitive process-based subtypes of developmental coordination disorder (DCD). Hum Mov Sci 2016; 47:121-134. [DOI: 10.1016/j.humov.2016.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/09/2015] [Accepted: 01/03/2016] [Indexed: 10/22/2022]
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Vaivre-Douret L, Lalanne C, Golse B. Developmental Coordination Disorder, An Umbrella Term for Motor Impairments in Children: Nature and Co-Morbid Disorders. Front Psychol 2016; 7:502. [PMID: 27148114 PMCID: PMC4832591 DOI: 10.3389/fpsyg.2016.00502] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 03/24/2016] [Indexed: 11/17/2022] Open
Abstract
Background: Developmental Coordination Disorder (DCD) defines a heterogeneous class of children exhibiting marked impairment in motor coordination as a general group of deficits in fine and gross motricity (subtype mixed group) common to all research studies, and with a variety of other motor disorders that have been little investigated. No consensus about symptoms and etiology has been established. Methods: Data from 58 children aged 6 to 13 years with DCD were collected on DSM-IV criteria, similar to DSM-5 criteria. They had no other medical condition and inclusion criteria were strict (born full-term, no medication, no occupational/physical therapy). Multivariate statistical methods were used to evidence relevant interactions between discriminant features in a general DCD subtype group and to highlight specific co-morbidities. The study examined age-calibrated standardized scores from completed assessments of psychological, neuropsychological, and neuropsychomotor functions, and more specifically the presence of minor neurological dysfunctions (MND) including neurological soft signs (NSS), without evidence of focal neurological brain involvement. These were not considered in most previous studies. Results: Findings show the salient DCD markers for the mixed subtype (imitation of gestures, digital perception, digital praxia, manual dexterity, upper, and lower limb coordination), vs. surprising co-morbidities, with 33% of MND with mild spasticity from phasic stretch reflex (PSR), not associated with the above impairments but rather with sitting tone (p = 0.004) and dysdiadochokinesia (p = 0.011). PSR was not specific to a DCD subtype but was related to increased impairment of coordination between upper and lower limbs and manual dexterity. Our results highlight the major contribution of an extensive neuro-developmental assessment (mental and physical). Discussion: The present study provides important new evidence in favor of a complete physical neuropsychomotor assessment, including neuromuscular tone examination, using appropriate standardized neurodevelopmental tools (common tasks across ages with age-related normative data) in order to distinguish motor impairments gathered under the umbrella term of developmental coordination disorders (subcortical vs. cortical). Mild spasticity in the gastrocnemius muscles, such as phasic stretch reflex (PSR), suggests disturbances of the motor pathway, increasing impairment of gross and fine motricity. These findings contribute to understanding the nature of motor disorders in DCD by taking account of possible co-morbidities (corticospinal tract disturbances) to improve diagnosis and adapt treatment programmes in clinical practice.
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Affiliation(s)
- Laurence Vaivre-Douret
- Faculty of Medicine, University of Paris Descartes, Sorbonne Paris CitéParis, France; Institut National de la Santé Et de la Recherche Médicale UMR 1018 and CESP, University of Paris Sud-Paris Saclay, UVSQ and Paris Descartes, Sorbonne Paris CitéParis, France; Department of Child Psychiatry, AP-HP Necker-Enfants Malades University HospitalParis, France; Department of Pediatrics, Child Development, Cochin-Port Royal University Hospitals of Paris Center, Assistance Publique-Hôpitaux de ParisParis, France; Necker-Enfants Malades Hospital, University Hospitalo-Institut ImagineParis, France
| | - Christophe Lalanne
- Patient-Centered Outcomes Research, EA 7334 (REMES), University of Paris Diderot, Sorbonne Paris Cité Paris, France
| | - Bernard Golse
- Faculty of Medicine, University of Paris Descartes, Sorbonne Paris CitéParis, France; Institut National de la Santé Et de la Recherche Médicale UMR 1018 and CESP, University of Paris Sud-Paris Saclay, UVSQ and Paris Descartes, Sorbonne Paris CitéParis, France; Department of Child Psychiatry, AP-HP Necker-Enfants Malades University HospitalParis, France
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Dewey D, Bernier FP. The Concept of Atypical Brain Development in Developmental Coordination Disorder (DCD)—a New Look. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0086-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Reynolds JE, Thornton AL, Elliott C, Williams J, Lay BS, Licari MK. A systematic review of mirror neuron system function in developmental coordination disorder: Imitation, motor imagery, and neuroimaging evidence. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:234-283. [PMID: 26458259 DOI: 10.1016/j.ridd.2015.09.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE The aim of this systematic review was to investigate the evidence of abnormal functioning of the mirror neuron system (MNS) in children and adults with developmental coordination disorder (DCD), through examination of imitation, motor imagery, and neuroimaging literature. METHODS The following databases were comprehensively searched for relevant articles: CINAHL Plus, Embase, MEDLINE, PsycINFO, Pubmed, and Web of Science. Full-text articles of all potentially relevant citations were obtained and assessed for eligibility by two authors. Outcome measures of interest at a motor behaviour level were any measures of imitation or motor imagery proficiency and, at a neurological level, were any measures of neural activity in MNS brain regions. Due to differences in outcome measures between studies and the variables reported, a narrative review was undertaken to synthesise findings from the studies. RESULTS Overall, 31 articles met the inclusion criteria. Children and adults with DCD display deficits imitating meaningful and novel gestures and demonstrate different response patterns to controls when undertaking complex motor imagery tasks. Children with DCD present reduced activation and connectivity of frontal, parietal, and temporal MNS regions. CONCLUSIONS Preliminary evidence indicates some deficit in the functioning of the MNS at a motor behaviour and neurological level. As no published neuroimaging studies have been designed specifically to explore MNS function, these results must be interpreted with caution. Further research to explore the MNS hypothesis in greater detail, particularly from a neuroimaging perspective, has the potential to provide information on the underlying mechanisms of DCD, inform future research into the aetiology of this disorder, and inform intervention approaches.
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Affiliation(s)
- Jess E Reynolds
- School of Sport Science, Exercise & Health, The University of Western Australia, Australia.
| | - Ashleigh L Thornton
- School of Sport Science, Exercise & Health, The University of Western Australia, Australia
| | | | - Jacqueline Williams
- Institute of Sport, Exercise and Active Living, and School of Sport and Exercise Science, Victoria University, Melbourne, Australia
| | - Brendan S Lay
- School of Sport Science, Exercise & Health, The University of Western Australia, Australia
| | - Melissa K Licari
- School of Sport Science, Exercise & Health, The University of Western Australia, Australia
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Are Motor Timing Problems Subgroup Specific in Children with Developmental Coordination Disorder? ACTA ACUST UNITED AC 2015. [DOI: 10.1017/s0816512200027632] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTThis study investigated subgroup and task specificity of self-paced timing in children with developmental coordination disorder (DCD). Self-paced tempo (intertap interval) and timing stability (coefficient of variation) were measured in three repetitive tasks—hand tapping, foot tapping, and jumping in place—in 37 children aged 6 to 9 years classified into gross motor impaired (GM), fine and gross motor impaired (F&G), or coordinated control (CC) groups. Results showed that, although tempo did not vary between coordination groups, timing stability for the hand was significantly worse for the F&G motor impaired group (p < .05). Discriminant function analysis correctly classified 75% of CC, 67% of F&G, and 67% of GM children. Although timing inconsistency of hand tapping identified a coordination subgroup, these tasks provide only moderate prediction of group membership.
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Pieters S, Roeyers H, Rosseel Y, Van Waelvelde H, Desoete A. Identifying subtypes among children with developmental coordination disorder and mathematical learning disabilities, using model-based clustering. JOURNAL OF LEARNING DISABILITIES 2015; 48:83-95. [PMID: 23757349 DOI: 10.1177/0022219413491288] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A relationship between motor and mathematical skills has been shown by previous research. However, the question of whether subtypes can be differentiated within developmental coordination disorder (DCD) and/or mathematical learning disability (MLD) remains unresolved. In a sample of children with and without DCD and/or MLD, a data-driven model-based clustering was used to identify subgroups of individuals with relatively homogeneous profiles on measures associated with motor and mathematical skills. One subgroup of children with motor problems was found based on motor variables. Based on mathematical variables, two clinical clusters were found: a subtype with number fact retrieval problems and a subtype with procedural calculation problems. Clustering with motor and mathematical skills revealed two clinical clusters: a cluster with number fact retrieval as well as procedural calculation problems and below average motor and visual-motor integration skills. A second cluster of children had only procedural calculation and visual-motor problems. Our results raise questions about the usefulness of placing children who have below average mathematical skills into a single diagnostic category. Furthermore, we inform ongoing debates about the overlap between DCD and MLD, as below average motor skills were found in both MLD subgroups, although a different motor profile is linked to a different mathematical profile.
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Gidley Larson JC, Suchy Y. The contribution of verbalization to action. PSYCHOLOGICAL RESEARCH 2014; 79:590-608. [DOI: 10.1007/s00426-014-0586-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 06/04/2014] [Indexed: 11/28/2022]
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Vaivre-Douret L. Developmental coordination disorders: state of art. Neurophysiol Clin 2013; 44:13-23. [PMID: 24502901 DOI: 10.1016/j.neucli.2013.10.133] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 10/14/2013] [Indexed: 11/24/2022] Open
Abstract
In the literature, descriptions of children with motor coordination difficulties and clumsy movements have been discussed since the early 1900s. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), it is a marked impairment in the development of fine or global motor coordination, affecting 6% of school-age children. All these children are characterized for developmental coordination disorder (DCD) in motor learning and new motor skill acquisition, in contrast to adult apraxia which is a disorder in the execution of already learned movements. No consensus has been established about etiology of DCD. Intragroup approach through factor and cluster analysis highlights that motor impairment in DCD children varies both in severity and nature. Indeed, most studies have used screening measures of performance on some developmental milestones derived from global motor tests. A few studies have investigated different functions together with standardized assessments, such as neuromuscular tone and soft signs, qualitative and quantitative measures related to gross and fine motor coordination and the specific difficulties -academic, language, gnosic, visual motor/visual-perceptual, and attentional/executive- n order to allow a better identification of DCD subtypes with diagnostic criteria and to provide an understanding of the mechanisms and of the cerebral involvement.
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Costini O, Roy A, Faure S, Le Gall D. La dyspraxie développementale : actualités et enjeux. ACTA ACUST UNITED AC 2013. [DOI: 10.3917/rne.053.0200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Lalanne C, Falissard B, Golse B, Vaivre-Douret L. Refining developmental coordination disorder subtyping with multivariate statistical methods. BMC Med Res Methodol 2012; 12:107. [PMID: 22834855 PMCID: PMC3464628 DOI: 10.1186/1471-2288-12-107] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 06/24/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND With a large number of potentially relevant clinical indicators penalization and ensemble learning methods are thought to provide better predictive performance than usual linear predictors. However, little is known about how they perform in clinical studies where few cases are available. We used Random Forests and Partial Least Squares Discriminant Analysis to select the most salient impairments in Developmental Coordination Disorder (DCD) and assess patients similarity. METHODS We considered a wide-range testing battery for various neuropsychological and visuo-motor impairments which aimed at characterizing subtypes of DCD in a sample of 63 children. Classifiers were optimized on a training sample, and they were used subsequently to rank the 49 items according to a permuted measure of variable importance. In addition, subtyping consistency was assessed with cluster analysis on the training sample. Clustering fitness and predictive accuracy were evaluated on the validation sample. RESULTS Both classifiers yielded a relevant subset of items impairments that altogether accounted for a sharp discrimination between three DCD subtypes: ideomotor, visual-spatial and constructional, and mixt dyspraxia. The main impairments that were found to characterize the three subtypes were: digital perception, imitations of gestures, digital praxia, lego blocks, visual spatial structuration, visual motor integration, coordination between upper and lower limbs. Classification accuracy was above 90% for all classifiers, and clustering fitness was found to be satisfactory. CONCLUSIONS Random Forests and Partial Least Squares Discriminant Analysis are useful tools to extract salient features from a large pool of correlated binary predictors, but also provide a way to assess individuals proximities in a reduced factor space. Less than 15 neuro-visual, neuro-psychomotor and neuro-psychological tests might be required to provide a sensitive and specific diagnostic of DCD on this particular sample, and isolated markers might be used to refine our understanding of DCD in future studies.
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Affiliation(s)
- Christophe Lalanne
- AP-HP, Department of Clinical Research, Saint-Louis Hospital, Paris, France.
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Asonitou K, Koutsouki D, Kourtessis T, Charitou S. Motor and cognitive performance differences between children with and without developmental coordination disorder (DCD). RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:996-1005. [PMID: 22502823 DOI: 10.1016/j.ridd.2012.01.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 01/16/2012] [Accepted: 01/16/2012] [Indexed: 05/31/2023]
Abstract
The current study adopts the PASS theory of information processing to investigate the probable differences in specific motor and cognitive abilities between children with and without developmental coordination disorder (DCD). Participants were 108 5- and 6-year-old preschoolers (54 children with DCD and 54 children without DCD). The Movement Assessment Battery for Children assessed motor function. Running speed and agility were measured using the Bruininks-Oseretsky Test of Motor Proficiency. Finally, the Planning, Attention and Simultaneous Scales from the Das-Naglieri Cognitive Assessment System evaluated cognitive ability. Children with DCD differed significantly from those without DCD performing at a lower level on all motor and cognitive tasks. A correlation analysis revealed significant relationships between cognitive processes and motor skills. Simultaneous cognitive processing and manual dexterity were significantly correlated for both groups. Furthermore, a significant relationship was revealed between planning cognitive processing and balance for the non-DCD group. Thus, early assessment might identify specific cognitive-motor difficulties. Furthermore, early intervention might prevent some of the developmental comorbidities in the academic and everyday lives of children with movement difficulties.
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Affiliation(s)
- Katerina Asonitou
- Laboratory of Adapted Physical Activity/Developmental and Physical Disabilities, Department of Physical Education and Sport Science, University of Athens, Greece.
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Vaivre-Douret L, Lalanne C, Cabrol D, Ingster-Moati I, Falissard B, Golse B. Identification de critères diagnostiques des sous-types de troubles de l’acquisition de la coordination (TAC) ou dyspraxie développementale. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.neurenf.2011.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Vaivre-Douret L, Lalanne C, Ingster-Moati I, Boddaert N, Cabrol D, Dufier JL, Golse B, Falissard B. Subtypes of developmental coordination disorder: research on their nature and etiology. Dev Neuropsychol 2011; 36:614-43. [PMID: 21667364 DOI: 10.1080/87565641.2011.560696] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Children with Developmental Coordination Disorder (DCD) are a group embracing clumsiness and developmental dyspraxia. Our study provides a better understanding of the nature of DCD and its etiology, and identifies subtypes of dyspraxia. Forty-three children with DCD (5-15 years) were enrolled on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV-TR]; American Psychiatric Association, 2000) criteria. Extensive standardized evaluations were conducted. We distinguished from two patterns of "pure" developmental dyspraxia: ideomotor and visual-spatial/visual-constructional, and mix dyspraxia with more co-morbidities. Our study provides a better understanding of the nature of DCD, and sheds light on its etiology and brain dysfunction, so as to identify subtypes of developmental DCD/dyspraxia with specific clinical criteria.
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Loh PR, Piek JP, Barrett NC. Comorbid ADHD and DCD: examining cognitive functions using the WISC-IV. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:1260-1269. [PMID: 21377321 DOI: 10.1016/j.ridd.2011.02.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 01/27/2011] [Accepted: 02/05/2011] [Indexed: 05/30/2023]
Abstract
This study explored the cognitive performance of children with Attention Deficit/Hyperactivity Disorder (ADHD) and/or Developmental Coordination Disorder (DCD) using the Wechsler Intelligence Scale for Children-IV. Participants were 62 children with ages between 9 years 8 months and 12 years 7 months. These children were placed into one of the four groups: Comparison (n=26), ADHD (n=14), DCD (n=11), and ADHD+DCD (n=11) groups. The ADHD symptoms were assessed using the Australian Disruptive Behaviours Scale, and motor ability was assessed using the McCarron Assessment of Neuromuscular Development (MAND). Significantly poorer perceptual reasoning ability was seen in DCD and ADHD+DCD groups but not in the ADHD group. The findings provide evidence that a deficit in visuo-spatial ability may underlie DCD but not ADHD. These findings revealed different cognitive profiles for ADHD and/or DCD, thus the current study does not lend support to the common aetiology hypothesis in understanding the basis of ADHD and DCD comorbidity.
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Affiliation(s)
- Pek Ru Loh
- School of Psychology and Speech Pathology, Curtin Health Innovation Research Institute, Curtin University, Western Australia, Australia.
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Asonitou K, Koutsouki D, Charitou S. Motor skills and cognitive abilities as a precursor of academic performance in children with and without DCD. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.sbspro.2010.07.350] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hetherington R, Dennis M. Motor function profile in children with early onset hydrocephalus. Dev Neuropsychol 2009. [DOI: 10.1080/87565649909540738] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Miyahara M, Leeder T, Francis G, Inghelbrecht A. Does an Instruction of a Verbal Labeling Strategy for Hand Movements Improve General Motor Coordination as Well as the Gestural Performance? Clin Case Stud 2008. [DOI: 10.1177/1534650107306876] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This multiple-case study investigated whether an instruction of a verbal labeling strategy could enhance developmental coordination disorder (DCD) as well as developmental dyspraxia (DD) on the basis of relative changes in the Movement Assessment Battery for Children (MABC) Performance Test scores and the Kaufmann Hand Movement Test (KHMT) scores. The authors used a case formulation approach and taught 4 children with DCD during an 8-week intervention period. During the last half of the intervention, the authors additionally instructed the verbal labeling strategy for hand movements. Visual inspection of plotted time-series data from the MABC and the KHMT showed discordant trend lines in 3 children and concordant lines in 1 child. The results indicated that the verbal labeling strategy could be useful for temporary improvement of DD but not for DCD and that DCD and DD might not be directly related.
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Green D, Chambers M, Sugden D. Does subtype of developmental coordination disorder count: Is there a differential effect on outcome following intervention? Hum Mov Sci 2008; 27:363-82. [DOI: 10.1016/j.humov.2008.02.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Campbell WN, Skarakis-Doyle E. School-aged children with SLI: the ICF as a framework for collaborative service delivery. JOURNAL OF COMMUNICATION DISORDERS 2007; 40:513-35. [PMID: 17343872 DOI: 10.1016/j.jcomdis.2007.01.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2006] [Revised: 11/14/2006] [Accepted: 01/24/2007] [Indexed: 05/14/2023]
Abstract
UNLABELLED Reports of associated disabilities among children with specific language impairment (SLI) and children with other developmental disabilities are widespread. Clinicians require a broader definition of SLI that recognizes associated disabilities because it is their goal to impact children's everyday functioning. In this paper, we explore SLI from a broader perspective in which consideration is given to features known to be common across different developmental disabilities. The World Health Organization's (2001) International Classification of Functioning, Disability and Health (ICF) is utilized as an organizational and conceptual framework for considering how knowledge of commonalities across developmental disabilities may be used to promote collaborative service delivery in an educational setting. This framework can potentially provide a coherent and comprehensive approach to treating SLI and its associated disabilities without overburdening clinical services. LEARNING OUTCOMES As a result of this activity, the reader will be able to: (1) describe the potential role of the ICF in facilitating collaborative service delivery in the school setting; (2) identify and describe the commonalities among SLI and its associated disabilities; and (3) describe how knowledge of commonalities may inform approaches to service delivery.
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Affiliation(s)
- Wenonah N Campbell
- Doctoral Program in Rehabilitation Sciences, Elborn College, The University of Western Ontario, London, Ont. N6G 1H1, Canada.
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Grove CR, Lazarus JAC. Impaired re-weighting of sensory feedback for maintenance of postural control in children with developmental coordination disorder. Hum Mov Sci 2007; 26:457-76. [PMID: 17467092 DOI: 10.1016/j.humov.2007.01.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2006] [Revised: 01/23/2007] [Accepted: 01/23/2007] [Indexed: 11/18/2022]
Abstract
To further the understanding of postural control impairments seen in children with developmental coordination disorder (DCD) and the effect of these impairments on motor performance in these children, 30 children with and without DCD (mean age=9 years, 7 months +/- 1 year, 10 months) were administered the Movement Assessment Battery for Children (M-ABC), Wechsler Abbreviated Scale of Intelligence and the Sensory Organization Test. Analyses of covariance revealed that children with DCD had greater difficulty maintaining postural control when visual and somatosensory feedback were compromised in sensory conflict environments (p=.031). Group differences in postural control were independent of age. Additionally, no correlation was seen between motor performance on the M-ABC and postural control measures for the Sensory Organization Test. Our results demonstrate that impaired ability to utilize vestibular feedback while re-weighting somatosensory and visual feedback for orientation may be responsible, in part, for the postural control impairments observed in some children with DCD.
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Affiliation(s)
- Colin R Grove
- University of Wisconsin Hospital and Clinics, 6630 University Avenue, Middleton, WI 53562, USA.
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Hövels-Gürich HH, Konrad K, Skorzenski D, Nacken C, Minkenberg R, Messmer BJ, Seghaye MC. Long-Term Neurodevelopmental Outcome and Exercise Capacity After Corrective Surgery for Tetralogy of Fallot or Ventricular Septal Defect in Infancy. Ann Thorac Surg 2006; 81:958-66. [PMID: 16488701 DOI: 10.1016/j.athoracsur.2005.09.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2005] [Revised: 09/02/2005] [Accepted: 09/06/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND The purpose of this prospective study was to assess whether neurodevelopmental status and exercise capacity of children 5 to 10 years after corrective surgery for tetralogy of Fallot or ventricular septal defect in infancy was different compared with normal children and influenced by the preoperative condition of hypoxemia or cardiac insufficiency. METHODS Forty unselected children, 20 with tetralogy of Fallot and hypoxemia and 20 with ventricular septal defect and cardiac insufficiency, operated on with combined deep hypothermic circulatory arrest and low flow cardiopulmonary bypass at a mean age of 0.7 +/- 0.3 years (mean +/- SD), underwent, at mean age 7.4 +/- 1.6 years, standardized evaluation of neurologic status, gross motor function, intelligence, academic achievement, language, and exercise capacity. Results were compared between the groups and related to preoperative, perioperative, and postoperative status and management. RESULTS Rate of mild neurologic dysfunction was increased compared with normal children, but not different between the groups. Exercise capacity and socioeconomic status were not different compared with normal children and between the groups. Compared with the normal population, motor function, formal intelligence, academic achievement, and expressive and receptive language were significantly reduced (p < 0.01 to p < 0.001) in the whole group and in the subgroups, except for normal intelligence in ventricular septal defect patients. Motor dysfunction was significantly higher in the Fallot group compared with the ventricular septal defect group (p < 0.01) and correlated with neurologic dysfunction, lower intelligence, and reduced expressive language (p < 0.05 each). Reduced New York Heart Association functional class was correlated with lower exercise capacity and longer duration of cardiopulmonary bypass (p < 0.05 each). Reduced socioeconomic status significantly influenced dysfunction in formal intelligence (p < 0.01) and academic achievement (p < 0.05). Preoperative risk factors such as prenatal hypoxia, perinatal asphyxia, and preterm birth, factors of perioperative management such as cardiac arrest, lowest nasopharyngeal temperature, and age at surgery, and postoperative risk factors as postoperative cardiocirculatory insufficiency and duration of mechanical ventilation were not different between the groups and had no influence on outcome. Degree of hypoxemia in Fallot patients and degree of cardiac insufficiency in ventricular septal defect patients did not influence the outcome within the subgroups. CONCLUSIONS Children with preoperative hypoxemia in infancy are at higher risk for motor dysfunction than children with cardiac insufficiency. Corrective surgery in infancy for tetralogy of Fallot or ventricular septal defect with combined circulatory arrest and low flow bypass is associated with reduced neurodevelopmental outcome, but not with reduced exercise capacity in childhood. In our experience, the general risk of long-term neurodevelopmental impairment is related to unfavorable effects of the global perioperative management. Socioeconomic status influences cognitive capabilities.
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CHANG SHAOHSIA. EVALUATION AND CLASSIFICATION OF TYPES OF CHINESE HANDWRITING DEFICITS IN ELEMENTARY SCHOOLCHILDREN. Percept Mot Skills 2005. [DOI: 10.2466/pms.101.6.631-647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
PURPOSE The purpose of this report is to present a descriptive profile of the postural responses and motor skill performance of four children with developmental coordination disorder (DCD). METHODS Four children with DCD, aged nine to 12 years participated. A profile of each child's case background, school performance, and motor skill performance was developed, in addition to the collection of data from three sessions of posturography trials on the computerized Sensory Organization Test (SOT). RESULTS All four children had a significant degree of impairment in balance responses and limitations in motor performance, with increased sway and frequency of falls in all sensory conditions on the SOT in comparison with peers. Mean equilibrium scores were between one and two standard deviations below peer averages, and sensory scores showed performance levels similar to those of younger age groups. There was a high level of variability associated with repeated SOTs. CONCLUSIONS The SOT data provide further insight into the underlying mechanisms that contribute to balance deficits experienced by children with DCD and suggest that assessment and therapeutic approaches take into account sensory deficits in postural control.
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Affiliation(s)
- Joanne M Inder
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Jongmans MJ, Smits-Engelsman BCM, Schoemaker MM. Consequences of comorbidity of developmental coordination disorders and learning disabilities for severity and pattern of perceptual-motor dysfunction. JOURNAL OF LEARNING DISABILITIES 2003; 36:528-37. [PMID: 15493435 DOI: 10.1177/00222194030360060401] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Children with developmental coordination disorder (DCD) have difficulty learning and performing age-appropriate perceptual-motor skills in the absence of diagnosable neurological disorders. Descriptive studies have shown that comorbidity of DCD exists with attention-deficit/hyperactivity disorder (ADHD) and learning disabilities (LD). This study examined the consequences of the comorbidity of DCD and LD for the severity and pattern of perceptual-motor dysfunction. Compared to children with DCD without LD, children with comorbid DCD and LD performed lower on a standardized assessment of perceptual-motor ability. Furthermore, it appeared that children with combined DCD and LD have particular difficulty performing manual dexterity and balance tasks but not ball-skill tasks. Implications for understanding the relationship between LD and perceptual-motor problems are discussed. We conclude that the comorbidity of DCD and LD not only affects the severity of perceptual-motor dysfunction but also is associated with a distinctive pattern of perceptual-motor dysfunction.
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Affiliation(s)
- Marian J Jongmans
- Faculty of Social Sciences, Department of General and Special Education, Utrecht University, The Netherlands.
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Abstract
The aim of this study was to extend the understanding of Developmental Coordination Disorder (DCD) into adulthood. We recruited 19 adults aged between 18 and 65 who had received diagnoses of DCD or dyspraxia or who self-reported as having motor impairments consistent with a history of DCD, together with age- and gender-matched controls. Participants were given tests of manual dexterity, handwriting, construction, obstacle avoidance, dynamic balance, static balance, dual task performance, ball skills, reaction time, movement time and sequencing. As a group, adults with DCD performed more poorly than controls across all tasks. Slowness and variability of movement was a pervasive feature of their performance and many individuals had considerable problems with sequencing and with dual task performance. A discriminant function analysis conducted using six performance measures correctly classified participants as car drivers or non-drivers. Adults do retain motor difficulties and these can exclude them from important activities of daily living.
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Affiliation(s)
- Margaret Cousins
- Department of Psychology, Lancaster University, LA1 4YF Lancaster, UK.
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Abstract
The interest in Developmental Coordination Disorder (DCD) has grown considerably over the last decade. Nevertheless, its etiology and prognosis are still poorly understood. The idea is growing that DCD may not be a uniform disorder. This review summarizes research on DCD, with a particular focus on subtype and comorbidity studies. The main message of the paper is that, in order to understand the etiology and prognosis of DCD, we need to have a better understanding of its nature. This requires an awareness of the existence of subtypes and comorbidities. Current theories on comorbidity phenomena are discussed in terms of their possible merit for the development of the field. Particular attention is given to the Automatization Deficit Hypothesis, a theory based on research on dyslexia.
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Affiliation(s)
- J Visser
- Department of Kinesiology, Pennsylvania State University, 267-J Recreation Building, University Park, PA 16802, USA.
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Dewey D, Kaplan BJ, Crawford SG, Wilson BN. Developmental coordination disorder: associated problems in attention, learning, and psychosocial adjustment. Hum Mov Sci 2002; 21:905-18. [PMID: 12620725 DOI: 10.1016/s0167-9457(02)00163-x] [Citation(s) in RCA: 260] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This study investigated the problems of attention, learning and psychosocial adjustment evidenced by children with developmental coordination disorder (DCD). Forty-five children identified with DCD, 51 children identified as being suspect for DCD and 78 comparison children without motor problems on standardized tests of motor function participated in this study. Results revealed that both children with DCD and children suspect for DCD obtained significantly poorer scores on measures of attention and learning (reading, writing and spelling) than comparison children. Children with DCD and those suspect for DCD were also found to evidence a relatively high level of social problems and display a relatively high level of somatic complaints based on parent report. These findings indicate that all children with movement problems are at risk for problems in attention, learning and psychosocial adjustment. Assessment of children with movement problems, regardless of the degree or severity of these problems should examine a wide range of functions in addition to motor functioning. Such an approach, would assist in determining the types of intervention that would provide the most benefit to these children.
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Affiliation(s)
- Deborah Dewey
- Department of Pediatrics, University of Calgary, Calgary, Alta T2T 5C7, Canada
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Hövels-Gürich HH, Seghaye MC, Schnitker R, Wiesner M, Huber W, Minkenberg R, Kotlarek F, Messmer BJ, Von Bernuth G. Long-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg 2002; 124:448-58. [PMID: 12202860 DOI: 10.1067/mtc.2002.122307] [Citation(s) in RCA: 138] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Neurodevelopmental status of children between 8 and 14 years of age after neonatal arterial switch operation for transposition of the great arteries has not previously been systematically evaluated. METHODS Within a longitudinal study, 60 unselected children operated on as neonates with combined deep hypothermic circulatory arrest and low-flow cardiopulmonary bypass were reevaluated at the age of 7.9 to 14.3 years (mean +/- SD 10.5 +/- 1.6 years). Clinical neurologic status and standardized tests to assess gross motor function, intelligence, acquired abilities, language, and speech were carried out, and the results were related to preoperative, perioperative, and postoperative status, to management, and to neurodevelopmental status at a mean age of 5.4 years. RESULTS Neurologic and speech impairments were evidently more frequent (27% and 40%, respectively) than in the general population. Intelligence and socioeconomic status were not different (P =.29 and P =.11), whereas motor function, acquired abilities, and language were reduced (P < or =.04 for each). Overall rate of developmental impairment in one or more domains was 55%, compared with 26% at age 5.4 years. Multivariable analysis showed that severe preoperative acidosis and hypoxia predicted reduced motor function (mean deficit 52.7 points, P <.001), whereas longer bypass duration predicted both neurologic (odds ratio per 10 minutes of bypass duration 1.8, P =.04) and speech (odds ratio per 10 minutes of bypass duration 1.9, P =.02) dysfunction, and perioperative and postoperative cardiocirculatory insufficiency predicted neurologic (odds ratio 6.5, P =.04) and motor (mean deficit 6.8 points, P =.03) dysfunction. CONCLUSIONS The neonatal arterial switch operation with combined circulatory arrest and low-flow bypass is associated increasingly with age, with reduced neurodevelopmental outcome but not with cognitive dysfunction. In our experience, the risk of long-term neurodevelopmental impairment after neonatal corrective cardiac surgery is related to deleterious effects of the global perioperative management and to special adverse effects of prolonged bypass duration. Severe preoperative acidosis and hypoxia and postoperative hemodynamic instability must be considered as important additional risk factors.
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Affiliation(s)
- Hedwig H Hövels-Gürich
- Departments of Pediatric Cardiology, Aachen University of Technology, and the Institute for Medical Research and Information Processing, Repges & Partner, Aachen, Germany.
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Kaplan BJ, Dewey DM, Crawford SG, Wilson BN. The term comorbidity is of questionable value in reference to developmental disorders: data and theory. JOURNAL OF LEARNING DISABILITIES 2001; 34:555-65. [PMID: 15503570 DOI: 10.1177/002221940103400608] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Over the last decade, there has been an enormous increase in the number of studies evaluating the overlap of developmental syndromes or disorders in both children and adults. This overlap of symptoms is often referred to as comorbidity, a term we criticize in this article because of its unsubstantiated presumption of independent etiologies. The premise of this article is that discrete categories do not exist in real life, and that it is misleading to refer to overlapping categories or symptoms as "comorbidities." We illustrate our point by presenting data from 179 school-age children evaluated with rigorous research criteria for seven disorders: reading disability (RD), attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD), oppositional defiant disorder (ODD), conduct disorder (CD), depression, and anxiety. Fully 50% of this sample met the criteria for at least two diagnoses. The children with ADHD were at higher risk of having at least a second disorder compared to the children with RD. Overall, the high rates of overlap of these behavioral, emotional, and educational deficits in this broadly ascertained sample support the idea that the concept of comorbidity is inadequate. We discuss the concept of atypical brain development as an explanatory idea to interpret the high rate of overlap of developmental disorders.
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Affiliation(s)
- B J Kaplan
- Department of Paediatrics, University of Calgary, Alberta, Canada
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Abstract
Studies using cluster analysis as a method to identify distinct subtypes of developmental coordination disorder (DCD) have been inconclusive leading some authors to conclude that the method of cluster analysis should be abandoned while others call for the validation of previously defined subtypes. The objective of the current study was to examine the use of cluster analysis as a method of searching for subtypes of DCD to gain a better understanding of how different samples and different measures influence the interpretation of results. The paper provides a detailed review of three commonly cited cluster analytical studies and then explores the possible reasons for the discrepant results by replicating the approach with a different clinical sample. The results highlight the impact of different measures on cluster structure and the importance of adoption of a common standard to facilitate interpretation across studies.
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Affiliation(s)
- J J Macnab
- Department of Biostatistics and Epidemiology, Biostatistical Support Unit, University of Western Ontario, London, Ont., Canada N6A 5C1.
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Gueze RH, Jongmans MJ, Schoemaker MM, Smits-Engelsman BC. Clinical and research diagnostic criteria for developmental coordination disorder: a review and discussion. Hum Mov Sci 2001; 20:7-47. [PMID: 11471398 DOI: 10.1016/s0167-9457(01)00027-6] [Citation(s) in RCA: 226] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this review was to investigate the selection criteria used in the past in studies of children with developmental motor problems (excluding those suffering from neurological dysfunctions such as cerebral palsy, muscular dystrophy, etc.). We therefore conducted an extensive analysis of 176 publications. First, an overview of the main characteristics of these studies (terminology, population, type and purpose) and the selection criteria that are reported in these publications are presented. Following this, the DSM-IV selection criteria for developmental coordination disorder (DCD) are contrasted with the selection criteria reported in 41 publications that have used this terminology to classify the children. The results of this comparison show that the inclusion criteria are largely followed, albeit with little consistency concerning selection instruments and quantitative cut-offs, while adherence to the exclusion criteria is not common practice. Strengths and weaknesses of the DSM-IV criteria, complementary to the previous discussion by Henderson and Barnett in the HMS special issue on DCD in 1998 on this same topic, are discussed. The results of the review also show that many studies have used additional selection criteria related to the specific research questions of the study concerned. In the broader context of clinical practice as well as basic research, the latter result suggests the usefulness of a distinction between Clinical Diagnostic Criteria and Research Diagnostic Criteria. This distinction helps to develop a unifying view on the use of diagnostic criteria for research and clinical practice. We conclude with a number of recommendations concerning the selection criteria for children with DCD.
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Affiliation(s)
- R H Gueze
- Developmental and Experimental Clinical Psychology, University of Groningen, Grote Kruisstraat 2-1, 9712 TS Groningen, The Netherlands.
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Bellinger DC, Wypij D, Kuban KC, Rappaport LA, Hickey PR, Wernovsky G, Jonas RA, Newburger JW. Developmental and neurological status of children at 4 years of age after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. Circulation 1999; 100:526-32. [PMID: 10430767 DOI: 10.1161/01.cir.100.5.526] [Citation(s) in RCA: 440] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is not known whether developmental and neurological outcomes in the preschool period differ depending on whether the predominant vital organ support strategy used in infant heart surgery was total circulatory arrest (CA) or low-flow cardiopulmonary bypass. METHODS AND RESULTS Infants with D-transposition of the great arteries who underwent an arterial-switch operation were randomly assigned to a support method consisting predominantly of CA or low-flow cardiopulmonary bypass. Developmental and neurological status were evaluated blindly at 4 years of age in 158 of 163 eligible children (97%). Neither IQ scores nor overall neurological status were significantly associated with either treatment group or duration of CA. The CA group scored lower on tests of motor function (gross motor, P=0.01; fine motor, P=0.03) and had more severe speech abnormalities (oromotor apraxia, P=0.007). Seizures in the perioperative period, detected either clinically or by continuous electroencephalographic monitoring, were associated with lower mean IQ scores (12.6 and 7.7 points, respectively) and increased risk of neurological abnormalities (odds ratios, 8.4 and 5.6, respectively). The performance of the full cohort was below expectations in several domains, including IQ, expressive language, visual-motor integration, motor function, and oromotor control. CONCLUSIONS Use of CA to support vital organs during open heart surgery in infancy is associated, at the age of 4 years, with worse motor coordination and planning but not with lower IQ or with worse overall neurological status.
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Affiliation(s)
- D C Bellinger
- Departments of Neurology, Medicine, Anesthesia, Cardiology and Cardiovascular Surgery, Children's Hospital, Boston, MA 02115, USA
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