Exploring the presence and impact of sensory differences in children with Developmental Coordination Disorder

BACKGROUND

Children with Developmental Coordination Disorder (DCD) can experience sensory differences. There has been limited exploration of these differences and their impact on children with DCD.

AIMS

i) To explore the presence and impact of sensory differences in children with DCD compared to children without DCD; ii) To examine whether sensory differences are related to motor ability, attention deficit hyperactivity disorder (ADHD), or autistic traits.

METHOD

Parents of children (8-12 years) with (n = 23) and without (n = 33) DCD used standardised questionnaires to report on their children's sensory differences, autistic traits, and ADHD traits. Motor abilities were assessed through the Movement Assessment Battery for Children-2. Data were explored both categorically (between-groups) and dimensionally.

RESULTS

Children with DCD had significantly higher levels of sensory differences than children without DCD. Sensory differences also had a significantly greater impact on daily activities for children with DCD. Higher levels of ADHD and autistic traits, but not motor ability, were significant independent predictors of higher levels of sensory difference.

CONCLUSION

Children with DCD experience high levels of sensory differences, which impact on their daily lives. These sensory differences may be a marker for additional neurodivergence in children with DCD. Practitioners should consider the sensory needs of children with DCD.

WHAT THIS PAPER ADDS

This paper provides insight into the sensory features of children with DCD and the impact that sensory differences can have on daily living. Using parent-report, we found that children with DCD had increased sensory differences relative to children without DCD. These included increased hyperresponsiveness, increased hyporesponsiveness, and increased sensory interests, repetitions, and seeking behaviours (SIRS). We also found that sensory differences had a greater impact on daily living for children with DCD compared to children without DCD. Across the whole sample, autistic traits predicted hyperresponsivity and hyporesponsivity patterns; whereas traits of hyperactivity and impulsivity predicted SIRS. Motor abilities did not uniquely predict sensory differences, suggesting that other traits of neurodivergence may contribute to the sensory differences in DCD. Taken together, these findings highlight the necessity of considering sensory needs when supporting children with DCD. They also suggest that if sensory differences are identified in children with DCD, it may be due to the presence of co-occurring neurodivergent traits or conditions.

Possible disrupted biological movement processing in Developmental Coordination Disorder

AIM

There is emerging evidence that the Mirror Neuron System (MNS) might contribute to the motor learning difficulties characteristic of Developmental Coordination Disorder (DCD). This study aimed to identify whether MNS activity differed between children with and without DCD during action observation, action execution and during a non-action baseline.

METHODS

Electroencephalography (EEG) was used to measure mu rhythm (a proxy for MNS activation) in 8-12-year-old children either with (n = 20) or without (n = 19) a diagnosis of DCD. The mu rhythm was recorded at rest and during five experimental conditions: (1) observation of gross motor and (2) fine motor actions; (3) execution of gross motor and (4) fine motor actions; and (5) non-biological movement. To address whether potential co-occurring traits of other neurodevelopmental conditions were associated with differences in mu rhythm, parents reported their child's attention and social communication skills. Mixed and repeated measure ANOVAs were conducted to examine differences in mu desynchronization and mu power respectively.

RESULTS

The non-DCD group showed greater mu rhythm desynchronization than children with DCD (i.e., more MNS activity), with both groups demonstrating increasing desynchronization from observation of fine actions to execution of gross actions. However, we also found that the children with DCD had less mu power during the non-biological movement condition than the non-DCD children, although mu power did not differ between groups during the resting condition. Correlations between mu desynchronization and children's attention and motor skills showed that poorer attention and motor abilities were associated with reduced MNS activity.

CONCLUSION

Compared to children without DCD, the MNS in children with DCD did not distinguish between biological and non-biological movement. It is possible that the reduced specificity of the MNS in children with DCD is an underlying factor in the motor impairments observed in the disorder. The differential MNS activity could reflect broader atypical activity in perceptual networks that feed into the MNS in DCD.

Embracing neurodiversity in doll play: Investigating neural and language correlates of doll play in a neurodiverse sample

Doll play may provide opportunities for children to rehearse social interactions, even when playing alone. Previous research has found that the posterior superior temporal sulcus (pSTS) was more engaged when children played with dolls alone, compared to playing with tablet games alone. Children's use of internal state language (ISL) about others was also associated with pSTS activity. As differences in social cognition are frequently observed in autistic people, we were interested in the brain and language correlates of doll play in children with varying levels of autistic traits. We investigated children's (N = 57, mean age = 6.72, SD = 1.53) use of ISL and their pSTS brain activity using functional near-infrared spectroscopy (fNIRS) as they played with dolls and tablet games, both alone and with a social partner. We also investigated whether there were any effects of autistic traits using the parent-report Autism Spectrum Quotient-Children's Version (AQ-Child). We found that the left pSTS was engaged more as children played with dolls or a tablet with a partner, and when playing with dolls alone, compared to when playing with a tablet alone. Relations between language and neural correlates of social processing were distinct based on the degree of autistic traits. For children with fewer autistic traits, greater pSTS activity was associated with using ISL about others. For children with more autistic traits, greater pSTS activity was associated with experimenter talk during solo play. These divergent pathways highlight the importance of embracing neurodiversity in children's play patterns to best support their development through play.

Doll play prompts social thinking and social talking: Representations of internal state language in the brain

Doll play provides opportunities for children to practice social skills by creating imaginary worlds, taking others' perspectives, and talking about others' internal states. Previous research using functional near-infrared spectroscopy (fNIRS) found a region over the posterior superior temporal sulcus (pSTS) was more active during solo doll play than solo tablet play, implying that doll play might present opportunities for rehearsing theory of mind and empathy skills, even when playing alone. In this research, we addressed this more directly by investigating 4-8-year-old children's (N = 33) use of internal state language (ISL; i.e., references to emotions, desires, and cognitions) when playing with dolls and on tablets, both by themselves and with a social partner, and their associated brain activity in the pSTS using fNIRS. We found that children used more ISL about others when playing with dolls than when playing on tablets, particularly when they were playing alone. This mirrored the patterns seen in pSTS activity in previous research. When individual variability in ISL about others was considered, more ISL about others was linked to stronger pSTS activation. Thus, variability in pSTS activity during play is not about the perceptual or physical differences between toys (e.g., dolls are more human-like) but about what children think about when they engage in different kinds of play. This is the first research to investigate brain activity during spontaneously occurring ISL and indicates that children have a tendency to take and discuss others' perspectives during doll play, with implications for social processing in the brain. A video abstract of this article can be viewed at https://youtu.be/58HgxbuhBzU.

Exploring the Benefits of Doll Play Through Neuroscience

It has long been hypothesized that pretend play is beneficial to social and cognitive development. However, there is little evidence regarding the neural regions that are active while children engage in pretend play. We examined the activation of prefrontal and posterior superior temporal sulcus (pSTS) regions using near-infrared spectroscopy while 42 4- to 8-year-old children freely played with dolls or tablet games with a social partner or by themselves. Social play activated right prefrontal regions more than solo play. Children engaged the pSTS during solo doll play but not during solo tablet play, suggesting they were rehearsing social cognitive skills more with dolls. These findings suggest social play utilizes multiple neural regions and highlight how doll play can achieve similar patterns of activation, even when children play by themselves. Doll play may provide a unique opportunity for children to practice social interactions important for developing social-emotional skills, such as empathy.

Young Children's Memories for Social Actions: Influences of Age, Theory of Mind, and Motor Complexity

Children learn actions performed by a social partner better when they misremember these actions as their own. Identifying the factors that alter the propensity to make appropriation errors is critical for optimizing social learning. In two experiments (N = 110), we investigate the developmental trajectory of appropriation errors and examine social-cognitive and motor-related factors in 3- to 8-year-olds. Children with better theory of mind (ToM) skills made fewer appropriation errors for motorically complex actions. Appropriation errors did not differ as a function of ToM if children could perform the corresponding actions. A second experiment replicated this effect and found no influence of collaborative context on appropriation errors. This research sheds light on the complex relations among development, social-cognition, and motor-related factors.

Unravelling the contributions of motor experience and conceptual knowledge in action perception: A training study

Prior knowledge affects how we perceive the world and the sensorimotor system actively guides our perception. An ongoing dispute regards the extent to which prior motor knowledge versus conceptual knowledge modulates the observation of others’ actions. Research indicates that motor experience increases motor activation during action perception. Other research, however, has shown that conceptual familiarity with actions also modulates motor activation, i.e., increased motor activation during observation of unfamiliar, compared to conceptually familiar, actions. To begin to disentangle motor from conceptual contributions to action perception, we uniquely combined motoric and conceptual interventions into one design. We experimentally manipulated participants’ experience with both motoric skills and conceptual knowledge, via motor training of kinematically challenging actions and contextual information about the action, respectively, in a week-long training session. Measurements of the effects on motor activity measured via electroencephalography (EEG) during pre- and post-training action observation were compared. We found distinct, non-interacting effects of both manipulations: Motor training increased motor activation, whereas additional conceptual knowledge decreased motor activation. The findings indicate that both factors influence action perception in a distinct and parallel manner. This research speaks to previously irreconcilable findings and provides novel insights about the distinct roles of motor and conceptual contributions to action perception.

Toddlers' action prediction: Statistical learning of continuous action sequences

The current eye-tracking study investigated whether toddlers use statistical information to make anticipatory eye movements while observing continuous action sequences. In two conditions, 19-month-old participants watched either a person performing an action sequence (Agent condition) or a self-propelled visual event sequence (Ghost condition). Both sequences featured a statistical structure in which certain action pairs occurred with deterministic transitional probabilities. Toddlers learned the transitional probabilities between the action steps of the deterministic action pairs and made predictive fixations to the location of the next action in the Agent condition but not in the Ghost condition. These findings suggest that young toddlers gain unique information from the statistical structure contained within action sequences and are able to successfully predict upcoming action steps based on this acquired knowledge. Furthermore, predictive gaze behavior was correlated with reproduction of sequential actions following exposure to statistical regularities. This study extends previous developmental work by showing that statistical learning can guide the emergence of anticipatory eye movements during observation of continuous action sequences.

Hypervigilance to Rejecting Stimuli in Rejection Sensitive Individuals: Behavioral and Neurocognitive Evidence

Individuals who are high in rejection sensitivity are vigilant toward social cues that signal rejection, and they exhibit attention biases towards information that confirms expectations of rejection. Little is known, however, about the neural correlates of rejection sensitivity. The present study examined whether rejection sensitivity is associated with individuals' neural responses to rejection-relevant information. Female participants, classified as high or average in rejection sensitivity, completed a modified dot-probe task in which a neutral face was paired with either another neutral face or a gaze-averted ("rejecting") face while EEG was collected and ERP components were computed. Behavioral results indicated that average rejection sensitive participants showed an attention bias away from rejecting faces, while high rejection sensitive participants were equally vigilant to neutral and rejecting faces. High rejection sensitivity was associated with ERP components signaling elevated attention and arousal to faces. These findings suggest that rejection sensitivity shapes behavioral and neurocognitive responses to faces.

Active Drumming Experience Increases Infants' Sensitivity to Audiovisual Synchrony during Observed Drumming Actions

In the current study, we examined the role of active experience on sensitivity to multisensory synchrony in six-month-old infants in a musical context. In the first of two experiments, we trained infants to produce a novel multimodal effect (i.e., a drum beat) and assessed the effects of this training, relative to no training, on their later perception of the synchrony between audio and visual presentation of the drumming action. In a second experiment, we then contrasted this active experience with the observation of drumming in order to test whether observation of the audiovisual effect was as effective for sensitivity to multimodal synchrony as active experience. Our results indicated that active experience provided a unique benefit above and beyond observational experience, providing insights on the embodied roots of (early) music perception and cognition.

Short-term Motor Training, but Not Observational Training, Alters Neurocognitive Mechanisms of Action Processing in Infancy

The role of motor experience in the processing of perceived actions is hotly debated on both behavioral (e.g., action understanding) and neural (e.g., activation of the motor system) levels of interpretation. Whereas some researchers focus on the role of motor experience in the understanding of and motor activity associated with perceived actions, others emphasize the role of visual experience with the perceived actions. The question of whether prior firsthand motor experience is critical to motor system activation during perception of actions performed by others is best addressed through studies with infants who have a limited repertoire of motor actions. In this way, infants can receive motor or visual training with novel actions that are not mere recombinations of previously acquired actions. In this study, 10-month-old infants received active training with a motorically unfamiliar action that resulted in a distinct sound effect. They received observational experience with a second, similarly unfamiliar action. Following training, we assessed infants' neural motor activity via EEG while they listened to the sounds associated with the actions relative to a novel sound. We found a greater decrease in mu power to sounds associated with the motorically learned action than to those associated with the observed action that the infants had never produced. This effect was directly related to individual differences in the degree of motor learning via motor training. These findings indicate a unique effect of active experience on neural correlates of action perception.

Shifting goals: effects of active and observational experience on infants' understanding of higher order goals

Action perception links have been argued to support the emergence of action understanding, but their role in infants’ perception of distal goals has not been fully investigated. The current experiments address this issue. During the development of means-end actions, infants shift their focus from the means of the action to the distal goal. In Experiment One, we evaluated whether this same shift in attention (from the means to the distal goal) when learning to produce multi-step actions is reflected in infants’ perception of others’ means-end actions. Eight-months-old infants underwent active training in means-end action production and their subsequent analysis of an observed means-end action was assessed in a visual habituation paradigm. Infants’ degree of success in the training paradigm was related to their subsequent interpretation of the observed action as directed at the means versus the distal goal. In Experiment Two, observational and control manipulations provided evidence that these effects depended on the infants’ active engagement in the means-end actions. These results suggest that the processes that give rise to means-end structure in infants’ motor behavior also support the emergence of means-end structure in their analysis of others’ goals.

Mirroring and the development of action understanding

The discovery of mirror neurons in the monkey motor cortex has inspired wide-ranging hypotheses about the potential relationship between action control and social cognition. In this paper, we consider the hypothesis that this relationship supports the early development of a critical aspect of social understanding, the ability to analyse others' actions in terms of goals. Recent investigations of infant action understanding have revealed rich connections between motor development and the analysis of goals in others' actions. In particular, infants' own goal-directed actions influence their analysis of others' goals. This evidence indicates that the cognitive systems that drive infants' own actions contribute to their analysis of goals in others' actions. These effects occur at a relatively abstract level of analysis both in terms of the structure infants perceive in others' actions and relevant structure in infants' own actions. Although the neural bases of these effects in infants are not yet well understood, current evidence indicates that connections between action production and action perception in infancy involve the interrelated neural systems at work in generating planned, intelligent action.

Labels Facilitate Infants' Comparison of Action Goals

Understanding the actions of others depends on the insight that these actions are structured by intentional relations. In a number of conceptual domains, comparison with familiar instances has been shown to support children's and adults' ability to discern the relational structure of novel instances. Recent evidence suggests that this process supports infants' analysis of others' goal-directed actions (Gerson & Woodward, 2012). The current studies evaluated whether labeling, which has been shown to support relational learning in other domains, also supports infants' sensitivity to the goal structure of others' actions. Ten-month-old infants observed events in which a familiar action, grasping, was aligned (simultaneously presented) with a novel tool use action, and both actions were accompanied by a matched label. Following this training, infants responded systematically to the goal structure of the tool use actions in a goal imitation paradigm. In control conditions, when the aligned actions were accompanied by non-word vocalizations, or when labeling occurred without aligned actions, infants did not respond systematically to the tool use action. These findings indicate that labels supported infants' comparison of the aligned actions, and this comparison facilitated their understanding of the novel action as goal-directed.

The joint role of trained, untrained, and observed actions at the origins of goal recognition

Recent findings across a variety of domains reveal the benefits of self-produced experience on object exploration, object knowledge, attention, and action perception. The influence of active experience may be particularly important in infancy, when motor development is undergoing great changes. Despite the importance of self-produced experience, we know that infants and young children are eventually able to gain knowledge through purely observational experience. In the current work, three-month-old infants were given experience with object-directed actions in one of three forms and their recognition of the goal of grasping actions was then assessed in a habituation paradigm. All infants were given the chance to manually interact with the toys without assistance (a difficult task for most three-month-olds). Two of the three groups were then given additional experience with object-directed actions, either through active training (in which Velcro mittens helped infants act more efficiently) or observational training. Findings support the conclusion that self-produced experience is uniquely informative for action perception and suggest that individual differences in spontaneous motor activity may interact with observational experience to inform action perception early in life.

Learning from their own actions: the unique effect of producing actions on infants' action understanding

Prior research suggests that infants' action production affects their action understanding, but little is known about the aspects of motor experience that render these effects. In Study 1, the relative contributions of self-produced (n = 30) and observational (n = 30) action experience on 3-month-old infants' action understanding was assessed using a visual habituation paradigm. In Study 2, generalization of training to a new context was examined (n = 30). Results revealed a unique effect of active over observational experience. Furthermore, findings suggest that benefits of trained actions do not generalize broadly, at least following brief training.

The goal trumps the means: Highlighting goals is more beneficial than highlighting means in means-end training

Means-end actions are an early-emerging form of problem-solving. These actions require initiating initial behaviors with a goal in mind. In this study, we explored the origins of 8-monthold infants' means-end action production using a cloth-pulling training paradigm. We examined whether highlighting the goal (toy) or the means (cloth) was more valuable for learning to perform a well-organized means-end action. Infants were given the opportunity to both practice cloth-pulling and view modeling of the action performed by an adult throughout the session. Infants either saw the same toy or the same cloth in successive trials so that the goal or means were highlighted prior to modeling of the action. All infants improved throughout the session regardless of which aspect of the event was highlighted. Beyond this general improvement, repetition of goals supported more rapid learning and more sustained learning than did repetition of means. These findings provide novel evidence that, at the origins of means-end action production, emphasizing the goal that structures an action facilitates the learning of new meansend actions.