Learning from falling

Natural-ish behavior: The interplay of culture and context in shaping motor behavior in infancy

What is natural behavior and how does it differ from laboratory-based behavior? The "natural" in natural behavior implies the everyday, complex, ever-changing, yet predictable environment in which children grow up. "Behavior" is motor action and is foundational to psychology, as it includes all things to function in everyday environments. Is behavior demonstrated in the laboratory un-natural? Suppose behavior emerges spontaneously, in a context that is most common to the animal but an observer is there to document it using particular research tools. Is that behavior natural or natural-ish? Methods can powerfully affect conclusions about infant experiences and learning. In the lab, tasks are typically narrowly constrained where infants and children have little opportunity to display the variety of behaviors in their repertoire. Data from naturalistic observations may paint a very different picture of learning and development from those based on structured tasks, exposing striking variability in the environment and behavior and new relations between the organism and its environment. Using motor development as a model system, in this chapter we compare frameworks, methods, and findings originating in the lab and in the field, applied and adapted in different settings. Specifically, we recount our journey of pursuing the study of cultural influences on motor development in Tajikistan, and the challenges, surprises, and lessons learned.

Can I Squeeze Through? Effects of Self-Avatars and Calibration in a Person-Plus-Virtual-Object System on Perceived Lateral Passability in VR

With the popularity of Virtual Reality (VR) on the rise, creators from a variety of fields are building increasingly complex experiences that allow users to express themselves more naturally. Self-avatars and object interaction in virtual worlds are at the heart of these experiences. However, these give rise to several perception based challenges that have been the focus of research in recent years. One area that garners most interest is understanding the effects of self-avatars and object interaction on action capabilities or affordances in VR. Affordances have been shown to be influenced by the anthropometric and anthropomorphic properties of the self-avatar embodied. However, self-avatars cannot fully represent real world interaction and fail to provide information about the dynamic properties of surfaces in the environment. For example, pressing against a board to feel its rigidity. This lack of accurate dynamic information can be further amplified when interacting with virtual handheld objects as the weight and inertial feedback associated with them is often mismatched. To investigate this phenomenon, we looked at how the absence of dynamic surface properties affect lateral passability judgments when carrying virtual handheld objects in the presence or absence of gender matched body-scaled self-avatars. Results suggest that participants can calibrate to the missing dynamic information in the presence of self-avatars to make lateral passability judgments, but rely on their internal body schema of a compressed physical body depth in the absence of self-avatars.

Correlation between performance and quantity/variability of leg exploration in a contingency learning task during infancy

Quantity and quality of motor exploration are proposed to be fundamental for infant motor development. However, it is still not clear what types of motor exploration contribute to learning. To determine whether changes in quantity of leg movement and/or variability of leg acceleration are related to performance in a contingency learning task, twenty 6-8-month-old infants with typical development participated in a contingency learning task. During this task, a robot provided reinforcement when the infant's right leg peak acceleration was above an individualized threshold. The correlation coefficient between the infant's performance and the change in quantity of right leg movement, linear variability, and nonlinear variability of right leg movement acceleration from baseline were calculated. Simple linear regression and multiple linear regression were calculated to explain the contribution of each variable to the performance individually and collectively. We found significant correlation between the performance and the change in quantity of right leg movement (r = 0.86, p < 0.001), linear variability (r = 0.71, p < 0.001), and nonlinear variability (r = 0.62, p = 0.004) of right leg movement acceleration, respectively. However, multiple linear regression showed that only quantity and linear variability of leg movements were significant predicting factors for the performance ratio (p < 0.001, adjusted R² = 0.94). These results indicated that the quantity of exploration and variable exploratory strategies could be critical for the motor learning process during infancy.

Motor control: In constant pursuit of optimality

Humans learn through exploration. A new study suggests that this may be how we learn to save energy when we walk.

The impact of errors in infant development: Falling like a baby

What is the role of errors in infants' acquisition of basic skills such as walking, skills that require immense amounts of practice to become flexible and generative? Do infants change their behaviors based on negative feedback from errors, as suggested by "reinforcement learning" in artificial intelligence, or do errors go largely unmarked so that learning relies on positive feedback? We used falling as a model system to examine the impact of errors in infant development. We examined fall severity based on parent reports of prior falls and videos of 563 falls incurred by 138 13- to 19-month-old infants during free play in a laboratory playroom. Parent reports of notable falls were limited to 33% of infants and medical attention was limited to 2% of infants. Video-recorded falls were typically low-impact events. After falling during free play in the laboratory, infants rarely fussed (4% of falls), caregivers rarely showed concern (8% of falls), and infants were back at play within seconds. Impact forces were mitigated by infants' effective reactive behaviors, quick arrest of the fall before torso or head impact, and small body size. Moreover, falling did not alter infants' subsequent behavior. Infants were not deterred from locomotion or from interacting with the objects and elevations implicated in their falls. We propose that a system that discounts the impact of errors in early stages of development encourages infants to practice basic skills such as walking to the point of mastery.

Exploring to learn and learning to explore

In respect to ecological psychology processes of attunement and calibration, this critical review focusses on how exploratory behaviors may contribute to skilled perception and action, with particular attention to sport. Based on the theoretical insights of Gibson (The senses considered as perceptual systems, Houghton Mifflin, Boston, 1966) and Reed (Encountering the world: Toward an ecological psychology, Oxford University Press, New York, 1996), exploratory and performatory actions have been differentiated in numerous experiments to study the perception of opportunities of action. The distinction between exploratory and performatory actions has informed the study of infant behavior in developmental psychology. In the current article, we highlight limitations with this distinction in the study of sports performers. We propose that a dynamic view of exploratory behavior would reveal how individuals develop exploratory activity that generates information about the fit between environmental properties and action capabilities. In this aim, practitioners should: (1) give learners the opportunity to safely develop exploratory behaviors even when they act outside their action boundary; and (2) guide learners to search for more reliable information to develop exploratory behaviors that would enhance the transfer of skills to various performance contexts.

Learning and transfer of perceptual-motor skill: Relationship with gaze and behavioral exploration

Visual and haptic exploration were shown to be central modes of exploration in the development of locomotion. However, it is unclear how learning affects these modes of exploration in locomotor task such as climbing. The first aim of this study was to investigate the modifications of learners' exploratory activity during the acquisition of a perceptual-motor skill. The second aim was to determine to what extent the acquired perceptual-motor skill and the learners' exploratory activity were transferred to environments presenting novel properties. Seven participants attended 10 learning sessions on wall climbing. The effects of practice were assessed during pretest, posttest, and retention tests, each composed of four climbing routes: the route climbed during the learning sessions and three transfer routes. The transfer routes were designed by manipulating either the distance between handholds, the orientation of the handholds or the handholds shape. The results showed that the number of exploratory hand movements and fixations decreased with practice on the learning route. A visual entropy measure suggested that the gaze path in this route became more goal-directed on posttest, but some search was necessary on the retention test. The number of exploratory movements also decreased on the three transfer routes following practice, whereas the number of fixations was higher than on the learning route, suggesting that, with learning, participants relied more on exploration from a distance to adapt to the new properties of the transfer routes. Analyses of the individual performances and behaviors showed differences in the development of skilled exploratory activity.

In-Home Mobility Training With a Portable Body Weight Support System of an Infant With Down Syndrome

PURPOSE

To report on the feasibility of an open-area, portable body weight support system (PBWSS) for in-home use and overground mobility training in an infant with Down syndrome.

SUMMARY OF KEY POINTS

The family used the PBWSS on average 4 days/week and for a mean duration of 27.9 minutes/day. Within sessions, the infant's mobility in the open area was greater with PBWSS assistance. The infant's mobility increased whereas variable trends were noted in the infant's motor, language, and cognitive development.

CONCLUSIONS

The long-term and frequent use of the PBWSS by this family provided opportunities to practice on emerging motor skills and exploratory actions that may have had a positive effect on her mobility and overall development.

RECOMMENDATION FOR CLINICAL PRACTICE

High-dose, body weight-supported training on emerging motor skills is feasible in the infants' natural environments. Future studies using a large sample will quantify the effects.

The retention of fall-resisting behavior derived from treadmill slip-perturbation training in community-dwelling older adults

The purpose of this study was to determine whether and to what extent the immediate generalization of treadmill slip-perturbation training could be retained over 6 months to resist overground slip-induced falls. Four protocols (Tc: treadmill control; Tt: treadmill slip-perturbation training; Oc: overground control; Ot: overground slip-perturbation training) from two randomized controlled trials were compared in which two training protocols were executed with single-session repeated slip-perturbation training on the treadmill or overground context, while two control protocols were executed without repeated training. A total of 152 community-dwelling older adults (≥ 65 years) who were trained by one of the four protocols and tested by an overground slip in the initial session attended a retest session 6 months later. Falls were detected by a load cell. Data collected from motion analysis system and force plates were used to calculate stability. Tt group had no significant change in fall incidence from initial post-training test to retest. Tt group had significantly lower fall incidence (p < 0.05) and higher reactive stability (p < 0.05) than Tc group in retest. Tt group had significantly higher fall incidence (p < 0.05) and lower reactive stability (p < 0.01) than Ot group. The generalization of a single session of treadmill slip-perturbation training to overground slip resulted in inferior outcomes compared with overground slip-perturbation training (absolute retention), although the training generalization could be retained over 6 months (relative retention). Thus, treadmill slip-perturbation training could be more convenient to use if future dose-response studies indicate better or equal efficacy to overground slip-perturbation training.

Developing a conceptual model of pediatric inpatient safety accidents: A mixed methods approach

Given that injuries to children during periods of hospitalization can lead to more serious health conditions in vulnerable children, preventing pediatric inpatient injuries should be a priority for the pediatric health care profession. This study was conducted to develop a conceptual model of factors affecting pediatric inpatient safety, including all injuries, not just fall injuries, in pediatric units. An explorative sequential mixed methods design was used. Qualitative interviews were conducted with 13 nurses working in pediatrics units and 17 parents of hospitalized children, and then 200 nurses in pediatrics units and parents of hospitalized children completed a self-report questionnaire. Based on the integration of both qualitative and quantitative data using building and weaving narrative integration, the Pediatric Inpatient Safety Accidents (PISA) model was proposed. The PISA model contains two main domains, the immediate and mediating domain and encompasses the six factors explain of the elements affecting the occurrence and prevention of pediatric inpatient safety accidents. The PISA model can serve as a model to understand child accidents in hospitals as well as to plan customized nursing interventions to prevent child accidents.

Fear in infancy: Lessons from snakes, spiders, heights, and strangers

This review challenges the traditional interpretation of infants' and young children's responses to three types of potentially "fear-inducing" stimuli-snakes and spiders, heights, and strangers. The traditional account is that these stimuli are the objects of infants' earliest developing fears. We present evidence against the traditional account, and provide an alternative explanation of infants' behaviors toward each stimulus. Specifically, we propose that behaviors typically interpreted as "fearful" really reflect an array of stimulus-specific responses that are highly dependent on context, learning, and the perceptual features of the stimuli. We speculate about why researchers so commonly misinterpret these behaviors, and conclude with future directions for studying the development of fear in infants and young children. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Development of affordance perception and recalibration in children and adults

Changes in the body over developmental time (e.g., physical growth) as well as over shorter timescales (e.g., wearing a backpack, carrying a large object) alter possibilities for motor action. How well can children recalibrate their perception of action possibilities to account for sudden changes to body size? The current study compared younger children (4-7 years), older children (8-11 years), and adults as they decided whether they could squeeze through doorways of varying widths. To test for age-related changes in recalibration to modified abilities versus perception of unmodified abilities, half of the participants wore a backpack while making judgments and squeezing through doorways and half did not. Results indicated that judgment accuracy improved with age but that participants had more difficulty when recalibrating to modified abilities. Bias in decision making also changed with age; whereas younger children made riskier decisions by attempting to fit through impossibly small doorways, older children were more cautious. Some particularly cautious participants never generated practice feedback by attempting (and failing) to fit through smaller doorways, which prevented them from recalibrating. Taken together with previous literature, the results of the current study suggest that the development of perception for unmodified versus modified ability proceeds at different rates and depends on the particular motor task.

Motor Development: Embodied, Embedded, Enculturated, and Enabling

Motor development and psychological development are fundamentally related, but researchers typically consider them separately. In this review, we present four key features of infant motor development and show that motor skill acquisition both requires and reflects basic psychological functions. ( a) Motor development is embodied: Opportunities for action depend on the current status of the body. ( b) Motor development is embedded: Variations in the environment create and constrain possibilities for action. ( c) Motor development is enculturated: Social and cultural influences shape motor behaviors. ( d) Motor development is enabling: New motor skills create new opportunities for exploration and learning that instigate cascades of development across diverse psychological domains. For each of these key features, we show that changes in infants' bodies, environments, and experiences entail behavioral flexibility and are thus essential to psychology. Moreover, we suggest that motor development is an ideal model system for the study of psychological development.

Effectiveness of adults' spontaneous exploration while perceiving affordances for squeezing through doorways

When motor abilities change, people need to generate information to recalibrate their perception through active exploration. Most prior research has focused on observers' ability to update perception by executing experimenter-specified exploratory behaviors, however, the question of how observers spontaneously choose how to explore has been overlooked. We asked how effectively adults decide to explore when adapting to changes in their ability to squeeze through doorways. Results revealed that participants made efficient decisions about when to explore by approaching and practicing-they most often explored doorways that were near the limit of their abilities, and participants explored less often as their perceptual calibration improved. However, participants made sub-optimal decisions about how to explore, which resulted in a failure to fully recalibrate. We discuss the implications of these findings for understanding the processes of perceptual-motor recalibration that underlie real-world behavior.

iMOVE: Intensive Mobility training with Variability and Error compared to conventional rehabilitation for young children with cerebral palsy: the protocol for a single blind randomized controlled trial

BACKGROUND

Cerebral palsy (CP) is the most common cause of physical disability in children. The best opportunity to maximize lifelong independence is early in motor development when there is the most potential for neuroplastic change, but how best to optimize motor ability during this narrow window remains unknown. We have systematically developed and pilot-tested a novel intervention that incorporates overlapping principles of neurorehabilitation and infant motor learning in a context that promotes upright mobility skill and postural control development. The treatment, called iMOVE therapy, was designed to allow young children with CP to self-initiate motor learning experiences similar to their typically developing peers. This manuscript describes the protocol for a subsequent clinical trial to test the efficacy of iMOVE therapy compared to conventional therapy on gross motor development and other secondary outcomes in young children with CP.

METHODS

The study is a single-blind randomized controlled trial. Forty-two participants with CP or suspected CP between the ages of 1-3 years will be randomized to receive either the iMOVE or conventional therapy group. Distinguishing characteristics of each group are detailed. Repeated measures of gross motor function will be collected throughout the 12-24 week intervention phase and at three follow-up points over one year post therapy. Secondary outcomes include measures of postural control, physical activity, participation and caregiver satisfaction.

DISCUSSION

This clinical trial will add to a small, but growing, body of literature on early interventions to optimize the development of motor control in young children with CP. The information learned will inform clinical practice of early treatment strategies and may contribute to improving the trajectory of motor development and reducing lifelong physical disability in individuals with CP.

TRIAL REGISTRATION

ClinicalTrials.gov identifier NCT02340026 . Registered January 16, 2015.

The recovery response to a novel unannounced laboratory-induced slip: The "first trial effect" in older adults

BACKGROUND

After a single slip, older adults rapidly make adaptive changes to avoid or eliminate further backward loss of balance or a fall. This rapid adaptation has been termed the "single trial effect". The purpose of this study was to explore the relationship between the motor errors subjects experienced upon a novel slip and the selection and execution of corrective response by which they modified their ongoing gait pattern and turned it into a protective step.

METHODS

A forward slip was induced in the laboratory among 145 community-living older (≥65year old) adults who were protected by an overhead full body harness system. An eight-camera motion analysis system recorded subjects' kinematics, which was used to compute their instability (motor error), recovery step placement (response selection), and stability gain (motor correction).

FINDINGS

A linear relationship was found between the stability errors at recovery foot liftoff and the distance between the recovery foot and slipping foot at the time of its touchdown, reflecting an appropriate selection of response that was proportionate to the motor error. A linear relationship was also found between this step modification and resulting stability gain, indicating that greater step modification resulted in greater stability gain. This learning behavior was surprisingly consistent regardless whether the outcome was a recovery or a fall.

INTERPRETATIONS

These results suggest that fallers and non-fallers all have an intact motor learning foundation that has enabled them to rapidly improve their stability in subsequent exposures.

Retention of the "first-trial effect" in gait-slip among community-living older adults

"First-trial effect" characterizes the rapid adaptive behavior that changes the performance outcome (from fall to non-fall) after merely a single exposure to postural disturbance. The purpose of this study was to investigate how long the first-trial effect could last. Seventy-five (≥ 65 years) community-dwelling older adults, who were protected by an overhead full body harness system, were retested for a single slip 6-12 months after their initial exposure to a single gait-slip. Subjects' body kinematics that was used to compute their proactive (feedforward) and reactive (feedback) control of stability was recorded by an eight-camera motion analysis system. We found the laboratory falls of subjects on their retest slip were significantly lower than that on the novel initial slip, and the reactive stability of these subjects was also significantly improved. However, the proactive stability of subjects remains unchanged between their initial slip and retest slip. The fall rates and stability control had no difference among the 6-, 9-, and 12-month retest groups, which indicated a maximum retention on 12 months after a single slip in the laboratory. These results highlighted the importance of the "first-trial effect" and suggested that perturbation training is effective for fall prevention, with lower trial doses for a long period (up to 1 year). Therefore, single slip training might benefit those older adults who could not tolerate larger doses in reality.

The development of motor behavior

This article reviews research on the development of motor behavior from a developmental systems perspective. We focus on infancy when basic action systems are acquired. Posture provides a stable base for locomotion, manual actions, and facial actions. Experience facilitates improvements in motor behavior and infants accumulate immense amounts of experience with all of their basic action systems. At every point in development, perception guides motor behavior by providing feedback about the results of just prior movements and information about what to do next. Reciprocally, the development of motor behavior provides fodder for perception. More generally, motor development brings about new opportunities for acquiring knowledge about the world, and burgeoning motor skills can instigate cascades of developmental changes in perceptual, cognitive, and social domains. WIREs Cogn Sci 2017, 8:e1430. doi: 10.1002/wcs.1430 For further resources related to this article, please visit the WIREs website.

Keeping still doesn't "make sense": examining a role for movement variability by stabilizing the arm during a postural control task

Small-amplitude, higher frequency oscillations of the body or limb are typically observed when humans attempt to maintain the position of a body or limb in space. Recent investigations have suggested that these involuntary movements of the body during stance could be used as an exploratory means of acquiring sensory information. In the present study, we wanted to determine whether a similar phenomenon would be observed in an upper limb postural task that does not involve whole body postural control. Participants were placed in a supine position with the arm pointing vertically and were asked to maintain the position of the limb in space with and without visual feedback. The wrist was attached to an apparatus that allowed the experimenter to stabilize or "lock" movements of the arm without the participants' awareness. When participants were "locked," the forces recorded predicted greater accelerations than those observed when the arm was freely moving with and without visual feedback. From unlocked to locked, angular accelerations increased in the eyes-closed condition and when participants were provided visual feedback of arm angular displacements. Irrespective of their origin, small displacements of the limb may be used as an exploratory means of acquiring sensory information from the surrounding environment.NEW & NOTEWORTHY The role of movement variability during a static limb position task is currently unknown. We tested whether variability remains in the absence of sensory-based error with an apparatus that stabilized the limb without the participant's knowledge during a static postural task. Increased forces observed during arm stabilization predicted movements greater than those observed when not externally stabilized. These results suggest movement variability during static postures could facilitate the gathering of sensory information from the surrounding environment.

Decisions at the Brink: Locomotor Experience Affects Infants' Use of Social Information on an Adjustable Drop-off

How do infants decide what to do at the brink of a precipice? Infants could use two sources of information to guide their actions: perceptual information generated by their own exploratory activity and social information offered by their caregivers. The current study investigated the role of locomotor experience in using social information-both encouragement and discouragement-for descending drop-offs. Mothers of 30 infants (experienced 12-month-old crawlers, novice 12-month-old walkers, and experienced 18-month-old walkers) encouraged and discouraged descent on a gradation of drop-offs (safe "steps" and risky "cliffs"). Novice walkers descended more frequently than experienced crawlers and walkers and fell while attempting to walk over impossibly high cliffs. All infants showed evidence of integrating perceptual and social information, but locomotor experience affected infants' use of social messages, especially on risky drop-offs. Experienced crawlers and walkers selectively deferred to social information when perceptual information is ambiguous. In contrast, novice walkers took mothers' advice inconsistently and only at extreme drop-offs.

The organization of exploratory behaviors in infant locomotor planning

How do infants plan and guide locomotion under challenging conditions? This experiment investigated the real-time process of visual and haptic exploration in 14-month-old infants as they decided whether and how to walk over challenging terrain - a series of bridges varying in width. Infants' direction of gaze was recorded with a head-mounted eye tracker and their haptic exploration and locomotor actions were captured on video. Infants' exploration was an organized, efficient sequence of visual, haptic, and locomotor behaviors. They used visual exploration from a distance as an initial assessment on nearly every bridge. Visual information subsequently prompted gait modifications while approaching narrow bridges and haptic exploration at the edge of the bridge. Results confirm predictions about the sequential, ramping-up process of exploration and the distinct roles of vision and touch. Exploration, however, was not a guarantee of adaptive decisions. With walking experience, exploratory behaviors became increasingly efficient and infants were better able to interpret the resulting perceptual information in terms of whether it was safe to walk.

Functioning of peripheral Ia pathways in leg muscles of newly walking toddlers

Monosynaptic and polysynaptic spinal level reflexes in the leg muscles of infants show significant dispersion across muscles, high variability, and no change in response patterns over the first 10 months. Here we tested the hypothesized relation between early walking experience and the tuning of these responses in three primary gait muscles of participants in four subgroups: cruisers (n=7) and toddlers with one (n=5), two (n=5), or three (n=5) months of walking experience. Reflex responses in multiple Ia pathways - tendon reflex (T-reflex), vibration-induced inhibition of the T-reflex (VIM-T-reflex), and tonic vibration-induced reflex (VIR), were elicited by mechanical stimuli applied to the distal tendons of the quadriceps, gastrocnemius-soleus, and tibialis anterior of both legs. Walking skill was assessed via a GAITRite mat. Generally, walking experience seemed to be related to slowly emerging improvements and, depending on muscle tested and pathway, progress was quite varied. Amplitude and latency of reflex responses were more clearly impacted by age or leg length while the ratio or distribution pattern of reflex response among antagonist pairs of muscles was impacted by walking experience and skill. As walking experience increased, the ratio of reflex responses tended to increase for the stimulated and decrease for the antagonist reflex loops with distribution of the pattern shifting gradually toward a single type of reflex response in all tested muscles. The very slow tuning of these reflexes may underlie the many missteps and falls reported to occur during early walking and suggest that subsequent studies should continue to follow the developmental trajectory through the first year of walking experience.

Step by step: a microgenetic study of the development of strategy choice in infancy

To examine patterns of strategy choice and discovery during problem-solving of a novel locomotor task, 13.5- and 18-month-old infants were placed at the top of a staircase and encouraged to descend. Spontaneous stair descent strategy choices were documented step by step and trial by trial to provide a microgenetic account of problem-solving in action. Younger infants tended to begin each trial walking, were more likely to choose walking with each successive step, and were more likely to lose their balance and have to be rescued by an experimenter. Conversely, older infants tended to begin each trial scooting, were more likely to choose scooting with each successive step, and were more likely to use a handrail to augment balance on stairs. Documenting problem-solving microgenetically across age groups revealed striking similarities between younger infants' strategy development and older children's behaviour on more traditionally cognitive tasks, including using alternative strategies, mapping prior experiences with strategies to a novel task, and strengthening new strategies. As cognitive resources are taxed during a challenging task, resources available for weighing alternatives or inhibiting a well-used strategy are reduced. With increased motor experience, infants can more easily consider alternative strategies and maintain those solutions over the course of the trial.

Gut estimates: Pregnant women adapt to changing possibilities for squeezing through doorways

Possibilities for action depend on the fit between the body and the environment. Perceiving what actions are possible is challenging, because the body and the environment are always changing. How do people adapt to changes in body size and compression? In Experiment 1, we tested pregnant women monthly over the course of pregnancy to determine whether they adapted to changing possibilities for squeezing through doorways. As women gained belly girth and weight, previously passable doorways were no longer passable, but women's decisions to attempt passage tracked their changing abilities. Moreover, their accuracy was equivalent to that of nonpregnant adults. In Experiment 2, nonpregnant adults wore a "pregnancy pack" that instantly increased the size of their bellies, and they judged whether doorways were passable. Accuracy in the "pregnant" participants was only marginally worse than that of actual pregnant women, suggesting that participants adapted to the prosthesis during the test session. In Experiment 3, participants wore the pregnancy pack and gauged passability before and after attempting passage. The judgments were grossly inaccurate prior to receiving feedback. These findings indicate that experience facilitates perceptual-motor recalibration for certain types of actions.

Learning from laboratory-induced falling: long-term motor retention among older adults

Falls in older adults are a major health and societal problem. It is thus imperative to develop highly effective training paradigms to reduce the likelihood of falls. Perturbation training is one such emerging paradigm known to induce shorter term fall reduction in healthy young as well as older adults. Its longer term benefits are not fully understood, however. The purpose of this study was to determine whether and to what degree older adults could retain their fall-resisting skills acquired from a single perturbation training session. Seventy-three community-dwelling older adults (≥65 years) received identical single-session perturbation training consisting of 24 slips. This was delivered through unannounced unlocking (and mixed with relocking) of low-friction movable sections of the walkway. A single retest was subsequently scheduled based on a three-stage sequential, pre-post-retest design. Outcome measurements, taken upon the first (novel) and the 24th (final) slips of the initial session and the retest slip, included fall-or-no-fall and stability (quantified by the shortest distance from relative motion state of the center-of-mass and the base-of-support to the limits of stability) at instants prior to (proactive) and after (reactive) the onset of the slip. The training boosted subjects' resilience against laboratory-induced falls demonstrated by a significant reduction from 42.5 % falls on the first slip to 0 % on the 24th slip. Rate of falls which occurred during the laboratory retest remained low in 6-month (0 %), 9-month (8.7 %), and 12-month retest (11.5 %), with no significant difference between the three time intervals. Such reduction of laboratory-induced falls and its retention were attributable to the significant training-induced improvement in the proactive and reactive control of stability. This unique pre-post-retest design enabled us to provide scientific basis for the feasibility of a single session of perturbation training to "inoculate" older adults and to reduce their annual risk of falls in everyday living.

Sitting infants alter the magnitude and structure of postural sway when performing a manual goal-directed task

In typical daily life, adults routinely adapt posture so that balance can be maintained while other goal-directed activities are performed. Interestingly, newly standing infants also control posture based on the demands of a task. It is unknown if the ability to properly adapt postural movements as a goal-directed task is performed emerges soon after the acquisition of independent stance or if it is present at earlier key postural milestones, such as independent sitting. In this study, the postural sway patterns of independently sitting infants were compared while either holding or not holding a toy. Infants exhibited less postural sway when holding the toy. This reduction in sway allowed infants to look at and stabilize the toy in their hand. Thus, the ability to adjust postural movements while performing a concurrent goal-directed task emerges long before the acquisition of independent stance.

What Cruising Infants Understand about Support for Locomotion

"Cruising" infants can only walk using external support to augment their balance. We examined cruisers' understanding of support for upright locomotion under four conditions: cruising over a wooden handrail at chest height, a large gap in the handrail, a wobbly unstable handrail, and an ill positioned low handrail. Infants distinguished among the support properties of the handrails with differential attempts to cruise and handrail-specific forms of haptic exploration and gait modifications. They consistently attempted the wood handrail, rarely attempted the gap, and occasionally attempted the low and wobbly handrails. On the wood and gap handrails, attempt rates matched the probability of cruising successfully; but on the low and wobbly handrails, attempt rates under- and over-estimated the probability of success, respectively. Haptic exploration was most frequent and varied on the wobbly handrail, and gait modifications-including previously undocumented "knee cruising"-were most frequent and effective on the low handrail. Results are discussed in terms of developmental changes in the meaning of support.

Task-dependent postural control throughout the lifespan

Routine activities performed while standing and walking require the ability to appropriately and continuously modulate postural movements as a function of a concurrent task. Changes in task-dependent postural control contribute to the emergence, maturation, and decline of complex motor skills and stability throughout the lifespan.

Perceiving affordances for different motor skills

We examined several factors that affect people's ability to perceive possibilities for action. In Experiment 1, 24 participants crossed expanses of various sizes in three conditions: leaping, a familiar, launching action system; arm-swinging on monkey bars, an unpracticed skill that uses the arms rather than the legs; and crawling on hands and knees, a disused skill that involves all four limbs. Before and after performing each action, participants gave verbal judgments about the largest gap they could cross. Participants scaled initial judgments to their actual abilities in all three conditions. But they considerably underestimated their abilities for leaping, a launching action, and for arm-swinging when it was performed as a launching action; judgments about crawling, a non-launching action, and arm-swinging when it was performed as a non-launching action were more accurate. Thus, launching actions appear to produce a deficit in perceiving affordances that is not ameliorated by familiarity with the action. However, after performing the actions, participants partially corrected for the deficiency and more accurately judged their abilities for launching actions-suggesting that even brief action experience facilitates the perception of affordances. In Experiment 2, we confirmed that the deficit was due to the launching nature of the leaping and arm-swinging actions in Experiment 1. We asked an additional 12 participants to cross expanses using two non-launching actions using the legs (stepping across an expanse) and the arms (reaching across an expanse). Participants were highly accurate when judging affordances for these actions, supporting launching as the cause of the underestimation reported in Experiment 1.

An interdisciplinary momentary confluence of events model to explain, minimize, and prevent pediatric patient falls and fall-related injuries

PURPOSE

This article reviews theoretical, empirical, and clinical evidence to support the hypothesis that pediatric patient fall episodes are rarely predictable; rather, falls and fall-related injuries occur during the momentary convergence of child, parent, and caregiver human factors, and environmental, biomechanical, and system factors.

CONCLUSIONS

We propose an interdisciplinary pediatric fall and injury prevention model to guide future research toward interventions to prevent or minimize pediatric patient falls and injuries.

PRACTICE IMPLICATIONS

When falls and near miss falls occur, nurses' detailed descriptions of each model component are critical to discovery of more effective pediatric fall and injury prevention methods.

Colorful success: preschoolers' use of perceptual color cues to solve a spatial reasoning problem

Spatial reasoning, a crucial skill for everyday actions, develops gradually during the first several years of childhood. Previous studies have shown that perceptual information and problem solving strategies are critical for successful spatial reasoning in young children. Here, we sought to link these two factors by examining children's use of perceptual color cues and whether their use of such cues would lead to the acquisition of a general problem solving strategy. Forty-eight 3-year-olds were asked to predict the trajectory of a ball dropped into one of three intertwined tubes. Children who received additional perceptual cues in the form of distinctly colored tubes succeeded twice as often as those who did not receive the cues. A third group of children who received the additional cues on only the first half of the test trials succeeded while the cues were present but reverted to making errors once they were removed. These findings demonstrate that perceptual color cues provide preschoolers with answers to spatial reasoning problems but might not teach children a general strategy for solving the problem.

Learning to resist gait-slip falls: long-term retention in community-dwelling older adults

OBJECTIVES

To determine whether the fall-resisting skills acquired from a single perturbation training session can be retained for 6 months or enhanced by an intermediate ancillary session.

DESIGN

A randomized controlled trial.

SETTING

Biomechanics research laboratory.

PARTICIPANTS

Community-dwelling elderly (N=48; age, >65 y).

INTERVENTIONS

Initial perturbation training applied to all subjects using low-friction platforms to induce unannounced blocks of repeated right-side slips, interspersed with nonslips. The single-session group retested with only 1 slip 6 months later. The dual-session group received an additional slip at 3 months after the initial session, followed by a retest of slips at 6 months.

MAIN OUTCOME MEASURES

Slip outcome (incidence of falls and balance loss), dynamic stability (based on the center-of-mass position and velocity), and vertical limb support (based on hip height).

RESULTS

Subjects in both groups significantly reduced fall and balance loss incidence from first to last training slips, which resulted from improved stability and limb support control. Both groups demonstrated significant retention in all outcome measures at 6 months compared with the first novel slip, although performance decay was evident in comparison with the last training slip. The ancillary slip at 3 months led to significantly better control of stability and, hence, reduced balance loss outcome, in the dual-session group at 6 months than in the single-session group.

CONCLUSIONS

Motor memory could be retained for 6 months or longer after a single session of fall-resistance training, although a single "booster" slip could further impede its decay. Through the experience of slipping and falling, it may be possible to "inoculate" older adults against potentially life-threatening falls.

Feasibility and preliminary effectiveness of a novel mobility training intervention in infants and toddlers with cerebral palsy

OBJECTIVE

To design a novel mobility training intervention incorporating infant motor learning and neurorehabilitation principles and investigate its feasibility, tolerability and effect on motor development in toddlers with cerebral palsy (CP).

METHODS

A single-subject research design with repeated measures during 6-week baseline and intervention phases and after treatment withdrawal was used. Five participants attended therapy utilizing novel dynamic weight assistance technology, which allowed practice of motor skills beyond participants' current abilities.

RESULTS

Average attendance and engagement rates exceeded 90%. Gains in gross motor function were observed after treatment that exceeded the expected rate in four of the five participants. Rates of motor development during treatment were 10.8, 3.8, 7.0, 15.1, and 0.3 times greater than during baseline for the five participants, respectively.

CONCLUSIONS

This intervention was tolerated and demonstrated the potential to alter the trajectory of motor development in CP, providing proof of concept for further investigation.

Developmental continuity? Crawling, cruising, and walking

This research examined developmental continuity between "cruising" (moving sideways holding onto furniture for support) and walking. Because cruising and walking involve locomotion in an upright posture, researchers have assumed that cruising is functionally related to walking. Study 1 showed that most infants crawl and cruise concurrently prior to walking, amassing several weeks of experience with both skills. Study 2 showed that cruising infants perceive affordances for locomotion over an adjustable gap in a handrail used for manual support, but despite weeks of cruising experience, cruisers are largely oblivious to the dangers of gaps in the floor beneath their feet. Study 3 replicated the floor-gap findings for infants taking their first independent walking steps, and showed that new walkers also misperceive affordances for locomoting between gaps in a handrail. The findings suggest that weeks of cruising do not teach infants a basic fact about walking: the necessity of a floor to support their body. Moreover, this research demonstrated that developmental milestones that are temporally contiguous and structurally similar might have important functional discontinuities.

Infants' perception of affordances of slopes under high- and low-friction conditions

Three experiments investigated whether 14- and 15-month-old infants use information for both friction and slant for prospective control of locomotion down slopes. In Experiment 1, high- and low-friction conditions were interleaved on a range of shallow and steep slopes. In Experiment 2, friction conditions were blocked. In Experiment 3, the low-friction surface was visually distinct from the surrounding high-friction surface. In all three experiments, infants could walk down steeper slopes in the high-friction condition than they could in the low-friction condition. Infants detected affordances for walking down slopes in the high-friction condition, but in the low-friction condition, they attempted impossibly slippery slopes and fell repeatedly. In both friction conditions, when infants paused to explore slopes, they were less likely to attempt slopes beyond their ability. Exploration was elicited by visual information for slant (Experiments 1 and 2) or by a visually distinct surface that marked the change in friction (Experiment 3).

The complexity of childhood development: variability in perspective

The complexity of childhood development is exemplified in the variability of development that is seen across tasks and individuals. Furthermore, variability in performance is omnipresent within individuals across repetitions of a task and across individuals performing the same task. Previously, this variability was thought to reflect error of measurement or error of execution. On this account, variability reflects noise that should be filtered or averaged out of the data in order to reveal the "true" underlying characteristics of the performance. Although errors of measurement and execution indeed contribute to variability in movements, research in the last 2 decades has revealed characteristics of variability that are far more interesting than just noise. These characteristics can be deeply informative about underlying control processes and point to directions for clinical practice. This perspective article reviews different ways of characterizing variability, illustrates changes in variability as a result of development and learning, and discusses different theoretical perspectives on the role of variability that give clues about how to understand changes in variability and how to deal with variability in clinical settings.

Embodiment in early development

'Embodiment' has come to represent the many ways in which the body influences the functioning of the brain and cognitive processing. This article on embodiment and early development reviews several examples of studies demonstrating embodiment in cognitive tasks. Our overall message is that what the body does during cognitive processing influences cognition in important ways. This might be especially true during early development, before actions are automatized. WIREs Cogn Sci 2011 2 117-123 DOI: 10.1002/wcs.109 For further resources related to this article, please visit the WIREs website.

Learning by doing: action performance facilitates affordance perception

We investigated the effect of action performance on perceptual judgments by evaluating accuracy in judging whether doorways allowed passage. Participants made judgments either before or after walking through doorways of varying widths. Participants in the action-first group benefited from action feedback and made more accurate judgments compared to a perception-first group that judged doorways before walking through them. Action feedback aided perceptual judgments by facilitating scaling to body dimensions: Judgments in the action-first group were strongly related to height, weight, and torso size, whereas judgments in the perception-first group were not.

Inoculation against falls: rapid adaptation by young and older adults to slips during daily activities

OBJECTIVE

To determine whether aging diminishes one's ability to rapidly learn to resist falls on repeated-slip exposure across different activities of daily living.

DESIGN

Quasi-experimental controlled trial.

SETTING

Two university-based research laboratories.

PARTICIPANTS

Young (n=35) and older (n=38) adults underwent slips during walking. Young (n=60) and older (n=41) adults underwent slips during a sit-to-stand task. All (N=174) were healthy and community dwelling.

INTERVENTION

Low-friction platforms induced unannounced blocks of 2 to 8 repeated slips interspersed with blocks of 3 to 5 nonslip trials during the designated task.

MAIN OUTCOME MEASURES

The incidence of falls and balance loss. Dynamic stability (based on center of mass position and velocity) and limb support (based on hip height) 300 ms after slip onset.

RESULTS

Under strictly controlled, identical low-friction conditions, all participants experienced balance loss, but older adults were over twice as likely as young to fall on the first, unannounced, novel slip in both tasks. Independent of age or task, participants adapted to avoid falls and balance loss, with most adaptation occurring in early trials. By the fifth slip, the incidence of falls and balance loss was less than 5% and 15%, respectively, regardless of age or task. Reductions in falls and balance loss for each task were accomplished through improved control of stability and limb support in both age groups. A rapidly reversible age- and task-dependent waning of motor learning occurred after a block of nonslip trials. Adaptation to walk slips reached a steady state in the second slip block regardless of age.

CONCLUSIONS

The ability to rapidly acquire fall-resisting skills on repeated-slip exposure remains largely intact at older ages and across functional activities. Thus, repeated-slip exposure might be broadly effective in inoculating older adults against falls.

The use of virtual reality in acrophobia research and treatment

Acrophobia, or fear of heights, is a widespread and debilitating anxiety disorder affecting perhaps 1 in 20 adults. Virtual reality (VR) technology has been used in the psychological treatment of acrophobia since 1995, and has come to dominate the treatment of numerous anxiety disorders. It is now known that virtual reality exposure therapy (VRET) regimens are highly effective for acrophobia treatment. This paper reviews current theoretical understanding of acrophobia as well as the evolution of its common treatments from the traditional exposure therapies to the most recent virtually guided ones. In particular, the review focuses on recent innovations in the use of VR technology and discusses the benefits it may offer for examining the underlying causes of the disorder, allowing for the systematic assessment of interrelated factors such as the visual, vestibular and postural control systems.

Emergence of neuromuscular patterns during walking in toddlers with typical development and with Down syndrome

During the development of walking, toddlers with Down syndrome (DS) and typical development (TD) face challenges controlling muscles, joints, and body segments. Toddlers with DS have additional challenges including increased joint laxity and decreased muscle tone and show delayed walking onset; the underlying activity of the neuromotor system remains unclear. Here we investigated the emergence of muscle activity from walking onset through 6 months of practice in eight toddlers with DS and eight with TD. We monitored the activity of core gait muscles and motion of leg segments as toddlers walked at their self-selected speeds. At walking onset muscle bursts were frequent with inconsistent burst durations. Over time, both groups of toddlers began to activate their leg muscles by using energy-efficient strategies: decreased muscle burst frequency (Wilks' Lambda=0.364, F(12, 103.476)=4.009, p< .001) and increased muscle burst duration (Wilks' Lambda=0.346, F(12, 71.727)=2.946, p= .002). Toddlers with TD increased normalized inter-burst intervals over time but toddlers with DS decreased these interval durations. By 6 months of experience toddlers with TD showed an efficient synergy among muscles, allowing increased relaxation time between bursts. Toddlers with DS improved the rhythmicity of their muscle burst, sustaining longer bursts but timing remained inconsistent. We propose increased muscle burst duration in toddlers with DS may add control by stabilizing their lax joints. Thus, their similar yet different emergent strategy may reflect their unique biomechanical and neurophysiological constraints and represent an efficient control strategy.

Infant manual exploration of composite substrates

Everyday environments, even small regions within reach, vary dramatically in terms of material composition. Adapting one's manual behavior to such transitions can be considered to be an important element of skilled action. To investigate the origins of this ability, we presented 8-month-olds (n=24) and 10-month-olds (n=24) hard or soft objects on a composite tabletop substrate that was half rigid and half flexible. Results indicated infants explored the objects selectively and geared their manual behaviors, with or without an object in hand, to the particular substrate they contacted. More broadly, the study suggests that infant manual exploration is flexible even in the face of abrupt transitions in material structure. Such flexibility may support early attempts at problem solving and tool use.

Comportamento locomotor de crianças e adultos jovens em ambiente doméstico simulado

Observamos o comportamento locomotor de 40 crianças (de 5 a 8 anos) e de 40 adultos jovens (de 19 a 28 anos) frente a restrições ambientais, que percorreram dois circuitos em condições de luminosidade total e reduzida e transporte de carga (sem carga, 3% e 7% da massa corporal), andando o mais rápido possível e evitando contato com objetos. O tempo gasto na tarefa foi obtido por meio de um cronômetro digital, em três tentativas por condição. ANOVA para três fatores (circuito x iluminação x carga) revelou que: as crianças demoraram mais tempo para realizar a tarefa quando carga foi adicionada; crianças mais jovens percorreram o circuito em tempo maior que crianças mais velhas; as condições não alteraram a locomoção dos adultos. Concluímos que crianças necessitam integrar as informações sensoriais e acoplá-las ao sistema efetor. Programas de intervenção são necessários para facilitar essa integração sem restrição da mobilidade das crianças.