A systematic review of high quality randomized controlled trials investigating motor skill programmes for children with developmental coordination disorder

OBJECTIVE

To identify effective motor training interventions for children with developmental coordination disorder from research graded as high quality (using objective criteria) for the purpose of informing evidence-based clinical practice.

DATA SOURCES

We followed the guidance for conducting systematic reviews issued by the Centre for Reviews and Dissemination. Six OvidSP electronic databases (AMED, All EBM reviews (including Cochrane), Embase, Ovid MEDLINE, PsychARTICLES Full Text, PsycINFO) were searched systematically. We aimed to retain only randomized control trials and systematic reviews of randomized control trials, defined as the highest level of evidence by the Oxford Centre for Evidence-Based Medicine. We searched reference lists of retained articles to identify further appropriate articles.

REVIEW METHODS

Two reviewers critically appraised and categorized articles by effect size (including confidence intervals), inclusion of power calculations and quality using the Physiotherapy Evidence Database (PEDro) scale. Only studies scoring seven or more on the PEDro scale (classed by the PEDro as high reliability) were retained.

RESULTS

No systematic reviews met our criteria for inclusion from 846 articles yielded by the systematic search. Nine randomized control trials investigating 15 interventions to improve motor skills met our inclusion criteria for 'high quality'. Nevertheless, not all included studies were adequately powered for determining an effect.

CONCLUSION

Large effect sizes associated with 95 % confidence intervals suggest that 'Neuromotor Task Training', 'Task-oriented Motor Training' and 'Motor Imagery + Task Practice Training' are the most effective reported interventions for improving motor skills in children with developmental coordination disorder.

From gestures to words: spontaneous verbal labeling of complex sequential hand movements reduces fMRI activation of the imitation-related regions

The association of verbal labels with visuo-spatial patterns and sequences detectably alters neuronal activity in the brain in ways that have yet to be fully characterized. This study investigated the neural substrates involved in the effect of spontaneous verbal labeling on memorizing increasingly complex sequences of hand movements. We used functional magnetic resonance imaging (fMRI) to test our hypothesis that when verbal labels were employed, neuronal activity in imitation-related regions, such as the left inferior frontal gyrus (IFG), would be reduced, whereas without verbal labels, neuronal activation would increase. Sixteen healthy adults satisfactorily performed an immediate imitation task involving six levels of increasing complexity. After the fMRI experiment, participants reported at which complexity level they had formed verbal labels. Based on the self-report, we categorized the task blocks at each complexity level as either with verbal labeling (VL+) or without (VL-). Compared with VL+, the VL- condition activated the left IFG, bilateral middle frontal gyri, left precentral gyrus, and the right angular gyrus, whereas the opposite contrast revealed no significant brain activation. Verbal labeling seems to serve as an efficient heuristic that reduces the cost of cortical activation in the imitation-related regions.

A pilot study of family-focused tele-intervention for children with developmental coordination disorder: development and lessons learned

Developmental coordination disorder (DCD) is characterized by substantial delay in motor development, despite intact neuromuscular, intellectual, and social functions. Although it is estimated there is one child with DCD in every elementary school classroom, sufficient remedial treatment has not yet been provided in medical or educational systems. This article reports on the development of a family-focused tele-intervention program for children with DCD. Unlike conventional direct service delivery, the tele-intervention program offers parents a workbook, DVDs, telephone support, and a blog to teach children at home. This pilot work involved the development of prototype materials (Phase 1), trialing and process evaluation with 3 children and their families (Phase 2), refinement of the program, and a further trial with two other groups of 4 children and their families (Phases 3-4). The outcome of the pilot intervention was satisfactory, but more work is needed to resolve some outstanding issues regarding assessment, diagnosis, telephone consultation, Internet support systems, and discrepant intervention outcomes before tele-intervention is offered to a wider community.