Poor penmanship in children correlates with abnormal rhythmic tapping: a broad functional temporal impairment

Enhancing Motor Performance and Physical Fitness in Children with Developmental Coordination Disorder Through Fundamental Motor Skills Exercise

Background: A lack of evidence exists regarding the effects intervention has on the motor performance, including the timing ability and health-related physical fitness, of children with developmental coordination disorder (DCD). Objectives: We aimed to assess the effects of school-based intervention that improves fundamental motor skills (FMS) on the motor performance and health-related physical fitness of children with DCD. Methods: The participants were 55 children (age 8-9 years) with DCD. Children with DCD were randomly assigned to either the intervention group (n = 27) or control group (n = 28). The intervention group participated in FMS training. The control group participated in a conventional physical education class. Motor performance was evaluated before and after the intervention using the Test of Gross Motor Development, second edition; Movement Assessment Battery for Children, second edition; and the Interactive Metronome. Health-related physical fitness was assessed using the physical activity promotion system. Results: A significant difference was observed when we considered the interaction effect of the intervention and time regarding motor performance and health-related physical fitness; however, no significant difference was observed regarding body composition. Conclusions: the intervention showed significant improvements in the parameters evaluated, suggesting that a school-based intervention to improve FMS may effectively improve the motor performance and health-related physical fitness of children with DCD.

Exploratory Investigation of Handwriting Disorders in School-Aged Children from First to Fifth Grade

Handwriting disorders (HDs) are prevalent in school-aged children, with significant interference with academic performances. The current study offers a transdisciplinary approach with the use of normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The aim is to provide objective data for a better understanding of the nature and the etiology of HDs. Data from these clinical assessments were analyzed for 27 school-aged children with HD (first to fifth grade). The results underline a high heterogeneity of the children presenting HDs, with many co-occurrences often unknown. However, it was possible to highlight three levels of HDs based on BHK scores: mild HD not detected by the BHK test (26% of children), moderate HD (33%) and dysgraphia (41% of children). The mild nature of the HDs not detected by the BHK test appears to occur at a relatively low frequency of the associated disorders identified during clinical evaluations. On the contrary, dysgraphia appears to be associated with a high frequency of co-occurring disorders identified in the clinical assessment, with a predominance of oculomotor disorders (55% of children), leading to visual-perceptual difficulties and a high level of handwriting deterioration. Finally, children with moderate HD have fewer co-occurrences than children with dysgraphia, but have more difficulties than children with mild HD. This highlights the importance of differentiating between different degrees of HDs that do not respond to the same semiologies. Our findings support the interest in performing a transdisciplinary and standardized clinical examination with developmental standards (neuropsychomotor, neuropsychological and oculomotor) in children with HD. Indeed, HDs can therefore be associated with a multitude of disorders of different natures ranging from poor coordination of the graphomotor gesture to a more general and more complex impairment affecting perceptual-motor, cognitive and/or psycho-affective functions.

Handwriting in Children with Developmental Coordination Disorder: Is Legibility the Only Indicator of a Poor Performance?

Research on the use of speed, as an indicator of motor handwriting problems, is controversial and the legibility of the text is the measure mostly examined in children. This case-control study compared handwriting legibility and speed in 25 children with Developmental Coordination Disorder (DCD) and 75 typically developing peers matched by school grade (third and fourth grade). Children with DCD achieved significantly lower scores than their peers in both legibility and speed measures, overall and in the third and in the fourth grade independently. These measures represent a good insight into children's writing abilities and could be both used to screen and monitor.

A Tablet App for Handwriting Skill Screening at the Preliteracy Stage: Instrument Validation Study

Background

Difficulties in handwriting, such as dysgraphia, impact several aspects of a child’s everyday life. Current methodologies for the detection of such difficulties in children have the following three main weaknesses: (1) they are prone to subjective evaluation; (2) they can be administered only when handwriting is mastered, thus delaying the diagnosis and the possible adoption of countermeasures; and (3) they are not always easily accessible to the entire community.

Objective

This work aims at developing a solution able to: (1) quantitatively measure handwriting features whose alteration is typically seen in children with dysgraphia; (2) enable their study in a preliteracy population; and (3) leverage a standard consumer technology to increase the accessibility of both early screening and longitudinal monitoring of handwriting difficulties.

Methods

We designed and developed a novel tablet-based app Play Draw Write to assess potential markers of dysgraphia through the quantification of the following three key handwriting laws: isochrony, homothety, and speed-accuracy tradeoff. To extend such an approach to a preliteracy age, the app includes the study of the laws in terms of both word writing and symbol drawing. The app was tested among healthy children with mastered handwriting (third graders) and those at a preliterate age (kindergartners).

Results

App testing in 15 primary school children confirmed that the three laws hold on the tablet surface when both writing words and drawing symbols. We found significant speed modulation according to size (P<.001), no relevant changes to fraction time for 67 out of 70 comparisons, and significant regression between movement time and index of difficulty for 44 out of 45 comparisons (P<.05, R²>0.28, 12 degrees of freedom). Importantly, the three laws were verified on symbols among 19 kindergartners. Results from the speed-accuracy exercise showed a significant evolution with age of the global movement time (circle: P=.003, square: P<.001, word: P=.001), the goodness of fit of the regression between movement time and accuracy constraints (square: P<.001, circle: P=.02), and the index of performance (square: P<.001). Our findings show that homothety, isochrony, and speed-accuracy tradeoff principles are present in children even before handwriting acquisition; however, some handwriting-related skills are partially refined with age.

Conclusions

The designed app represents a promising solution for the screening of handwriting difficulties, since it allows (1) anticipation of the detection of alteration of handwriting principles at a preliteracy age and (2) provision of broader access to the monitoring of handwriting principles. Such a solution potentially enables the selective strengthening of lacking abilities before they exacerbate and affect the child’s whole life.

Developmental coordination disorder and dysgraphia: signs and symptoms, diagnosis, and rehabilitation

Developmental coordination disorder (DCD) is a common and well-recognized neurodevelopmental disorder affecting approximately 5 in every 100 individuals worldwide. It has long been included in standard national and international classifications of disorders (especially the Diagnostic and Statistical Manual of Mental Disorders). Children and adults with DCD may come to medical or paramedical attention because of poor motor skills, poor motor coordination, and/or impaired procedural learning affecting activities of daily living. Studies show DCD persistence of 30-70% in adulthood for individuals who were diagnosed with DCD as children, with direct consequences in the academic realm and even beyond. In particular, individuals with DCD are at increased risk of impaired handwriting skills. Medium-term and long-term prognosis depends on the timing of the diagnosis, (possible) comorbid disorders (and their diagnosis), the variability of signs and symptoms (number and intensity), and the nature and frequency of the interventions individuals receive. We therefore chose to investigate the signs and symptoms, diagnosis, and rehabilitation of both DCD and developmental dysgraphia, which continues to receive far too little attention in its own right from researchers and clinicians.

The effect of synchronised metronome training: A case study in a single leg, below knee Paralympic sprinter

Background

To optimise sprint performance, one needs to understand how motor control affects motor performance. Researchers have proposed that the Dynamic Systems Theory be adopted for explaining motor performance, skill acquisition and the development of pedagogical methods. Within this theory, the individual is seen as a complex system that functions as the interaction of many sub-systems. Entrained movements would be characterised by optimal sequencing, timing and grading of muscle activation. One of the identified control parameters for running is the rhythm in the coordination pattern.

Objectives

The objectives of this study were twofold: firstly to investigate whether 6 weeks of timing and rhythmicity training using the computer-based Interactive Metronome™ (IM™) system improves motor timing and rhythmicity, and secondly to investigate whether such effects of IM™ influence the kinematic variables of a sprint.

Methods

This study followed a semi-quantitative analysis case study approach using a Paralympic sprinter with a single below knee amputation participated in this study. Data for acceleration and maximal running velocity phases were collected using video recorders.

Results and conclusions

As found by previous research, the IM™ programme improved the motor timing and rhythmicity of the athlete. However, in contrast to previous research, only minimal improvements, non-significant improvements, were seen in the actual motor performance. This athlete was an older more established athlete and it is therefore recommended that these types of programmes should be followed by young participants in the more fundamental phases of their movement development, to show best results.

Examining the relationship between motor assessments and handwriting consistency in children with and without probable developmental coordination disorder

Children with Developmental Coordination Disorder (DCD) often experience difficulties in handwriting. The current study examined the relationships between three motor assessments and the spatial and temporal consistency of handwriting. Twelve children with probable DCD and 29 children from 7 to 12 years who were typically developing wrote the lowercase letters "e" and "l" in cursive and printed forms repetitively on a digitizing tablet. Three behavioral assessments, including the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), the Minnesota Handwriting Assessment (MHA) and the Movement Assessment Battery for Children (MABC), were administered. Children with probable DCD had low scores on the VMI, MABC and MHA and showed high temporal, not spatial, variability in the letter-writing task. Their MABC scores related to temporal consistency in all handwriting conditions, and the Legibility scores in their MHA correlated with temporal consistency in cursive "e" and printed "l". It appears that children with probable DCD have prominent difficulties on the temporal aspect of handwriting. While the MHA is a good product-oriented assessment for measuring handwriting deficits, the MABC shows promise as a good assessment for capturing the temporal process of handwriting in children with DCD.

At-risk elementary school children with one year of classroom music instruction are better at keeping a beat

Temporal processing underlies both music and language skills. There is increasing evidence that rhythm abilities track with reading performance and that language disorders such as dyslexia are associated with poor rhythm abilities. However, little is known about how basic time-keeping skills can be shaped by musical training, particularly during critical literacy development years. This study was carried out in collaboration with Harmony Project, a non-profit organization providing free music education to children in the gang reduction zones of Los Angeles. Our findings reveal that elementary school children with just one year of classroom music instruction perform more accurately in a basic finger-tapping task than their untrained peers, providing important evidence that fundamental time-keeping skills may be strengthened by short-term music training. This sets the stage for further examination of how music programs may be used to support the development of basic skills underlying learning and literacy, particularly in at-risk populations which may benefit the most.

Timing abilities among children with developmental coordination disorders (DCD) in comparison to children with typical development

Timing ability is essential for common everyday performance. The aim of the study was to compare timing abilities and temporal aspects of handwriting performance and relationships between these two components among children with Developmental Coordination Disorders (DCD) and a control group. Forty two children, 21 diagnosed as DCD and 21 with typical development, aged 7-12, were matched for age, gender and school performed 14 tasks of the interactive metronome (IM) and three functional handwriting tasks on an electronic tablet that was part of a computerized system (ComPET--computerized penmanship evaluation tool). The IM supplies response time, while on-paper and in-air time per written stroke is received from the ComPET. Results indicated significant differences between the groups for both IM and handwriting tasks (ComPET). Linear regression indicated that the mean IM response time explained 37% of variance of the in-air time per stroke during a paragraph-copying task. Furthermore, based on one discriminate function including two measures reflected timing ability, 81% of all participants were correctly classified into groups. Study results strongly recommend consideration of the IM as an evaluation and intervention tool for children with DCD who are faced with timing deficits in their everyday functioning.

Increasing viscosity and inertia using a robotically controlled pen improves handwriting in children

The aim of this study was to determine the effect of mechanical properties of the pen on quality of handwriting in children. A total of 22 school-aged children, aged 8 to 14 years, wrote in cursive using a pen attached to a robot. The robot was programmed to increase the effective weight (inertia) and viscosity of the pen. Speed, frequency, variability, and quality of the 2 handwriting samples were compared. Increased inertia and viscosity improved handwriting quality in 85% of children (P < or = .05). Handwriting quality did not correlate with changes in speed, suggesting that improvement was not due to reduced speed. Measures of movement variability remained unchanged, suggesting improvement was not due to mechanical smoothing of pen movement by the robot. Because improvement was not explained by reduced speed or mechanical smoothing, we conclude that children alter handwriting movements in response to pen mechanics. Altered movement could be caused by changes in sensory feedback.