Multi-limb coordination and rhythmic variability under varying sensory availability conditions in children with DCD

Children with Developmental Coordination Disorder (DCD) have sensory processing deficits; how do these influence the interface between sensory input and motor performance? Previously, we found that children with DCD were less able to organize and maintain a gross motor coordination task in time to an auditory cue, particularly at higher frequencies [Whitall, J., Getchell, N., McMenamin, S., Horn, C., Wilms-Floet, A., & Clark, J. (2006). Perception-action coupling in children with and without DCD: Frequency locking between task relevant auditory signals and motor responses in a dual motor task. Child: Care, Health, and Development, 32, 679-692]. In the present study, we examine the same task (clapping in-phase to marching on a platform) under conditions involving the removal of vision and hearing. Eleven children with DCD (mean=7.21, SD=0.52 years), 7 typically developing (TD) children (mean=6.95+/-0.72 years), and 10 adults performed continuous clapping while marching under four conditions: with vision and hearing, without vision, without hearing, and without both. Results showed no significant condition effects for any measure taken. The DCD group was more variable in phasing their claps and footfalls than both the adult group and the TD group. There were also significant group effects for inter-clap interval coefficient of variation and inter-footfall interval coefficient of variation, with the DCD group being the most variable for both measures. Coherence analysis between limb combinations (e.g., left arm-right arm, right arm-left leg) revealed that the adults exhibited significantly greater coherence for each combination than both of the children's groups. The TD group showed significantly greater coherence than the DCD group for every limb combination except foot-foot and left hand-right foot. Measures of approximate entropy indicated that adults differed from children both with and without DCD in the structure of the variability across a trial with adults showing more complexity. Children with DCD are able to accomplish a self-initiated gross-motor coordination task but with increased variability for most but not all measures compared to typically developing children. The availability of visual and/or auditory information does not play a significant role in stabilizing temporal coordination of this task, suggesting that these are not salient sources of information for this particular task.     

Differences in postural control and movement performance during goal directed reaching in children with developmental coordination disorder

Poor upper-limb coordination is a common difficulty for children with developmental coordination disorder (DCD). One hypothesis is that deviant muscle timing in proximal muscle groups results in poor postural and movement control. The relationship between muscle timing, arm motion and children's upper-limb coordination deficits has not previously been studied. The aim of this study was to investigate the relationship between functional difficulties with upper-limb motor skills and neuromuscular components of postural stability and coordination. Sixty-four children aged 8-10 years, 32 with DCD and 32 without DCD, participated in the study. The study investigated timing of muscle activity and resultant arm movement during a rapid, voluntary, goal-directed arm movement. Results showed that compared to children without DCD, children with DCD took significantly longer to respond to visual signals and longer to complete the goal-directed movement. Children with DCD also demonstrated altered activity in postural muscles. In particular, shoulder muscles, except for serratus anterior, and posterior trunk muscles demonstrated early activation. Further, anterior trunk muscles demonstrated delayed activation. In children with DCD, anticipatory function was not present in three of the four anterior trunk muscles. These differences support the hypothesis that in children with DCD, altered postural muscle activity may contribute to poor proximal stability and consequently poor arm movement control when performing goal-directed movement. These results have educational and functional implications for children at school and during activities of daily living and leisure activities and for clinicians assessing and treating children with DCD.     

Changes in dynamic balance control over time in children with and without Developmental Coordination Disorder

The aim of this study was to examine differences in underlying adaptations of dynamic balance in children with and without Developmental Coordination Disorder (DCD) during a Wii Fit game and to measure changes over time and after intervention.Twenty-eight children with DCD and 21 typically developing (TD) children participated in the study. Analyses of force plate variables showed that the TD group initially used a longer path length for the ski slope descent and tended toward more variation in Center of Pressure (CoP) displacement in lateral direction than the children with DCD. In contrast, the TD group showed a trend of fewer reversals per cm in both AP and lateral direction. After the nonintervention period, the TD group improved performance by decreasing the path length, while the DCD group improved by increasing the path length and by decreasing the number of reversals. After intervention, no changes were found in sway characteristics. Individual analyses within the DCD group showed that the path length per run fell more often within the 95% confidence Interval of the faultless runs. In conclusion both TD and DCD children modify the underlying kinetics of dynamic balance control, but in different ways and both lead to better performance.     

Static balance and developmental coordination disorder

The development of static balance is a basic characteristic of normal motor development. Most of the developmental motor tests include a measure of static balance. Children with a developmental coordination disorder (DCD) often fail this item. Twenty-four children at risk for DCD with balance problems (DCD-BP) and 24 matched control children in the age range of 6-12 years participated in a detailed study of balance control. Additional groups of children (6-7 years, N=25; 10-11 years, n=16; with M-ABC scores >15th percentile) were selected randomly to study developmental changes in balance control in the age range of interest. Three experiments were conducted to examine developmental and clinical differences in the control of static balance. In the first, we measured the excursion of the centre of pressure (force-plate) in conditions with and without vision while standing still on one or two legs for 20 s. In the second experiment, EMGs were measured while standing on one leg. In the third experiment, in which only a subgroup of the DCD-BP and matched control children participated, a short unexpected force in the back lightly perturbed normal standing and EMG and force-plate responses were measured during balance recovery. In conditions of one-leg stance, children were not always able to maintain balance. Only epochs of stable postural control (7.5-20 s) were analysed. The results showed improvement of static balance with age, but only subtle differences between the DCD and control groups. Centre of pressure measures differed in the more difficult conditions. DCD-BP children had more difficulty standing on one leg with eyes closed. While standing on the non-preferred leg the EMGs of the DCD-BP children showed slightly more co-activation of the muscles of lower and upper leg. Perturbation of standing resulted in longer duration of recovery in the first trial in this group. Apparently DCD children learn to compensate for the perturbation within a few trials as well as control children do. The clear improvement with age shows that our measures of balance control are sensitive to detect changes. The general conclusion that may be drawn from this study is that under normal conditions static balance control is not a problem for children with DCD. Only in difficult or novel situations they seem to suffer from increased postural sway as a result of non-optimal balance control.     

Effect of a motor skill-based intervention in the relationship of individual and contextual factors in children with and without Developmental Coordination Disorder from low-income families

Contextual opportunities facilitate skill acquisition, and the interaction between individual and contextual factors is fundamental to enhancing health and social parameters in children with DCD. This study examined (1) the influence of Mastery Motivational Climate (MMC) and Exercise Play Climate (EPC) interventions on motor performance, physical activity, self-perceptions, BMI, engagement in the lessons, playtime, and screen time of children without and with DCD, (2) the relationship between motor performance, self-perceptions, BMI, engagement in the physical education lessons, playtime, and screen factors in the children's physical activity levels in the lessons (PA) pre-and post-test. Children (N = 255, 98 children with Developmental Coordination Disorder - DCD; 157 children without DCD) were randomly assigned to MMC and EPC. Physical Activity levels in the lessons, motor performance, self-perceptions of physical competence, body mass indexes, appropriate motor engagement with success in the lessons, and active play and screen time were assessed. Regarding intervention impact, from pre-to post-tests, the results showed increases (1) PA in children with DCD in the EPC group and without DCD in the MMC group; (2) locomotor and ball skills for children with DCD in both climates; (3) locomotor and ball skills for children without DCD in the MMC group; (4) self-perceptions of competence for children with DCD in the MMC group; and (5) engagement with success for all children in both climates. A slight decrease in BMI for children with DCD in both climates was found. Regarding the associations, at post-test, engagement with success explained (1) PA levels for children with DCD in the MMC group and children without DCD in the EPC group; (2) active playtime explained PA for children with DCD in the EPC group; (3) ball skills explained PA for children without DCD in the MMC group. The intervention promoted overall increases in motor performance and children’s engagement in the lesson. The intervention strengthened the role of ball skills performance, engagement with success, and active play; however, these relationships were different across groups.     

Auditory and visual information do not affect self-paced bilateral finger tapping in children with DCD

Children with Developmental Coordination Disorder (DCD) are more variable in timing their fingers to an external cue. In this study, we investigated the intrinsic coordination properties of self-selected anti-phase finger tapping with and without vision and audition in children with and without DCD and compared their performance to that of adults. Ten children with DCD (Mean age = 7.12 ± 0.3 years), 10 age- and sex-matched typically developing (TD) children, and 10 adults participated in this study. Participants tapped their fingers in anti-phase at a self-selected speed under four different sensory conditions: (1) with vision and audition, (2) with vision but no audition, (3) with audition but no vision, and (4) without vision and audition. We assessed intertap interval (ITI), variability of ITI, mean relative phasing (RP) between the fingers and the variability in RP. Children with DCD adopted a similar mean frequency, but were less accurate and more variable than the other groups. The different sensory conditions did not affect performance in any of the groups. We conclude that visual and auditory feedback of tapping are not salient information sources for bilateral self-selected tapping and that children with DCD are intrinsically less accurate and more variable in their tapping frequency and coordination.     

Contributions of trunk muscles to anticipatory postural control in children with and without developmental coordination disorder

Current evidence suggests that movement quality is impacted by postural adjustments made in advance of planned movement. The trunk inevitably plays a key role in these adjustments, by creating a stable foundation for limb movement. The purpose of this study was to examine anticipatory trunk muscle activity during functional tasks in children with and without developmental coordination disorder (DCD). Eleven children with DCD (age 7 to 14 years) and 11 age-matched, typically-developing children performed three tasks: kicking a ball, climbing stairs, and single leg balance. Surface electromyography (EMG) was used to examine the neuromuscular activity of bilateral transversus abdominis/internal oblique, external oblique and L3/4 erector spinae, as well as the right tibialis anterior and rectus femoris muscles. Onset latencies for each muscle were calculated relative to the onset of rectus femoris activity. In comparison to the children with DCD, the typically-developing children demonstrated earlier onsets for right tibialis anterior, bilateral external oblique, and right transversus abdominis/internal oblique muscles. These results suggest that anticipatory postural adjustments may be associated with movement problems in children with DCD, and that timing of both proximal and distal muscles should be considered when designing intervention programs for children with DCD.     

A comparison of characteristics,developmental disorders and motor progression between children with and without developmental coordination disorder

Background and aimChildren with Developmental Coordination Disorder (DCD) have difficulty in the development of motor coordination and with learning new motor skills. Studies demonstrate that children with DCD differ in terms of the nature and severity of their motor difficulties, the incidence of co occurring conditions and family background. However, little is known whether these profiles may relate to motor progression over time. The aim of this study was to describe the profiles of children with and without DCD and track motor progression over time.MethodThe characteristics of thirty-four 7–14 year old children (M = 10.07, 85.3% boys) with and without DCD were compared and their motor progression monitored over a two academic years. DCD was identified using DSM5 criteria. The Movement Assessment Battery for Children-2 (MABC-2) was used to classify children as TD (≥25th percentile), having moderate motor coordination difficulties (6-16th percentile) or severe motor coordination difficulties (≤ 5th percentile). The Kaufman Brief Intelligence Test – 2 (KBIT-2) was used to measure full scale IQ. Parent questionnaires were used to gather information on socio economic status and co occurrence of other developmental disorders. We used ANOVA to assess whether there were differences in characteristics between the TD children, children with severe motor coordination difficulties and children with moderate motor coordination difficulties. Linear mixed effect modelling was used to estimate any change in motor performance over time and whether this differed between the three groups of children.ResultsChildren with severe motor coordination difficulties had distinct profiles in motor and non-motor domains, lower IQ and a greater likelihood of having associated characteristics of 2 or more developmental disorders. We found significant differences between the poor motor performance of the severe group compared to the other two groups. Longitudinal analyses revealed stable, persistent and lower motor competence for the severe group. The rate of change in motor proficiency for the typical and severe groups was similar. However, the group with moderate motor difficulties gained on average more points per week compared to the typical group and achieved motor scores in the typically developing range over time.ConclusionsThis is one of the first studies to compare the characteristics and rate of motor progression of children with and without DCD using different motor proficiency cut off scores. The children with severe motor coordination difficulties progressed at the same rate as typically developing peers but remained in the severe group over time, whereas the children with moderate motor coordination difficulties caught up to TDC. The results indicate that different intervention may be required according to the nature and severity of the characteristics in both the motor and non-motor domains of children with DCD.     

Auditory-motor coupling of bilateral finger tapping in children with and without DCD compared to adults

The ability to modulate bilateral finger tapping in time to different frequencies of an auditory beat was studied. Twenty children, 7 years of age, 10 with and 10 without developmental coordination disorder (DCD), and 10 adults tapped their left index and right middle fingers in an alternating pattern in time with an auditory signal for 15s (four trials each, randomly, at 0.8, 1.6, 2.4, 3.2 Hz per finger). Dominant and non-dominant finger data were collapsed since no differences emerged. All three groups were able to modulate their finger frequency across trials to closely approximate the signal frequency but children with DCD were unable to slow down to the lowest frequency. Children with DCD were more variable in tap accuracy (SD of relative phase) and between finger coordination than typically developing children who were respectively more variable than the adults. Children with DCD were unable to consistently synchronize their finger with the beat. Adults were tightly synchronized and often ahead of the beat while children without DCD tended to be behind the beat. Overall, these results indicated that children with DCD can only broadly match their finger movements to an auditory signal with variability and poor synchronicity as key features of their auditory-fine-motor control. Individual inspection of the data revealed that five children with DCD had difficulty matching the slowest frequencies and that these children also had higher variability and lower percentile MABC scores from the movement assessment battery for children (MABC) than other children with DCD. Three children with DCD were more variable only at higher frequencies and two performed like typically developing children.     

Movement Control Strategies in a Dynamic Balance Task in Children With and Without Developmental Coordination Disorder

Abstract

Our study aimed to analyze movement control strategies using predefined criteria for amplitude and differences in these strategies between children with and without DCD. Children with (n?=?28) and without DCD (n?=?15) were included. A video-observation-tool was used to score the moving body parts during a Wii Fit slalom task over multiple time points. Two-step cluster analysis was used to extract distinct movement strategies. Two different movement strategies were identified that were independently validated by a measure of task performance and a subjective mark of quality of the movement. Initial differences between groups and changes over time toward the more successful strategy were found in both groups, albeit in a different percentage. This study shows that the more efficient movement strategy is seen in the majority of the TD children and only in a small number of children with DCD, even after practice.     

Impaired re-weighting of sensory feedback for maintenance of postural control in children with developmental coordination disorder

To further the understanding of postural control impairments seen in children with developmental coordination disorder (DCD) and the effect of these impairments on motor performance in these children, 30 children with and without DCD (mean age=9 years, 7 months +/- 1 year, 10 months) were administered the Movement Assessment Battery for Children (M-ABC), Wechsler Abbreviated Scale of Intelligence and the Sensory Organization Test. Analyses of covariance revealed that children with DCD had greater difficulty maintaining postural control when visual and somatosensory feedback were compromised in sensory conflict environments (p=.031). Group differences in postural control were independent of age. Additionally, no correlation was seen between motor performance on the M-ABC and postural control measures for the Sensory Organization Test. Our results demonstrate that impaired ability to utilize vestibular feedback while re-weighting somatosensory and visual feedback for orientation may be responsible, in part, for the postural control impairments observed in some children with DCD.     

The effect of exergames on functional strength,anaerobic fitness,balance and agility in children with and without motor coordination difficulties living in low-income communities

Children with Developmental Coordination Disorder (DCD) are physically less active, preferring more sedentary behavior and are at risk of developing health problems or becoming overweight. 18 children (age 6–10 years) with lower levels of motor coordination attending a primary school in a low-income community in South Africa (score on Movement Assessment Battery for Children Second edition equal to or below the 5th percentile) were selected to participate in the study and were age-matched with typically developing peers (TD). Both groups of children engaged in 20 min of active Nintendo Wii Fit gaming on the balance board, twice a week for a period of five weeks. All children were tested before and after the intervention using the lower limb items of the Functional Strength Measurement, the 5 × 10 meter sprint test, the 5 × 10 meter slalom sprint test, and the Balance, Running speed and Agility subtest of the Bruininks Oseretsky Test of Motor Proficiency 2nd edition (BOT-2).After intervention, both groups of children improved in functional strength and anaerobic fitness. The magnitude of these changes was not related to participant’s motor coordination level. However, differences in change between the TD and DCD group were apparent on the motor performance tests; children with DCD seemed to benefit more in balance skills of the BOT-2, while the TD children improved more in the Running speed and Agility component of the BOT-2. Compliance to the study protocol over 5 weeks was high and the effect on physical functioning was shown on standardized measures of physical performance validated for children with and without DCD.     

Comparison of motor praxis and performance in children with varying levels of developmental coordination disorder

The praxis test is a less well-documented method to determine functional manifestations of childhood dyspraxia. For this study, children aged 6–8 years were recruited as follows: 17 children with DCD, 18 at risk of DCD and 35 without obvious problems in motor coordination. The Movement Assessment Battery for Children (MABC-2) was used to measure motor performance and identify the motor incoordination. This study developed a battery of tests to assess limb praxis using a praxis imagery questionnaire, gesture representation, and questions about knowledge of object use. In the comparison of subtests within the praxis test, significant differences were observed across groups on the praxis imagery questionnaire and gesture representation tests but not on knowledge of object use. Similar results were observed in the correlation analyses, in which a weak relationship between MABC-2 and praxis tests was observed. The DCD group had lower scores on the praxis imagery questionnaire, whereas the group at risk of DCD had lower scores on most gesture production tests. Our study provides a better understanding of the nature of the childhood dyspraxia and sheds light on its effect on motor coordination to identify praxis tests with specific clinical meanings in children with movement disorders.     

Effects of exercise intervention on event-related potential and task performance indices of attention networks in children with developmental coordination disorder

The study investigated whether 10-week soccer training can benefit the inhibitory control and neuroelectric indices in children with developmental coordination disorder (DCD). Fifty-one children were divided into groups of typically developing (TD, n=21), DCD-training (n=16), and DCD non-training (n=14) individuals using the for Children test, and, before and after training, were assessed with the visuospatial attention orienting task with their lower extremities, while brain event-related potentials (ERPs) were concurrently recorded. The results indicated that, when compared to TD children, children with DCD responded significantly more slowly across conditions of the visuospatial attention orienting task and showed a deficit of inhibitory control capacity in their lower extremities, whereas no group differences were observed for the accuracy rate. Neuroelectric data indicated that, before training, P3 amplitude was smaller and P3 latency was slower for both DCD groups compared to TD children across conditions of the visuospatial attention orienting task; after training, the beneficial effects were seen in the strength of inhibitory control and P3 latency in the DCD-training group. The data suggest that soccer training resulted in significant improvements in ERP and task performance indices for the children with DCD.     

Reliance on visual feedback from ocular accommodation on motor skills in children with developmental coordination disorder and typically developing controls

Children with developmental coordination disorder (DCD) present with marked impairments in motor skills, including visual-motor integration. Oculomotor anomalies are more prevalent in children with DCD than typically developing children. Children with DCD further demonstrate altered use of visual feedback compared to typically developing controls. We investigated whether the accommodation system, a key component of the oculomotor system, contributes to visual feedback during fine and gross motor skills performance; and whether children with DCD demonstrate differences in reliance on visual feedback from accommodation. Minus dioptre lenses were used to maximally induce accommodation and impede accommodation dynamics. Children with DCD and typically developing controls performed motor skills tests assessing balance, upper limb coordination, visual-motor performance, gross and fine dexterity. Motor skills performance in controls was significantly affected by impeded accommodation in all tasks. Children with DCD demonstrated reliance on accommodation feedback in upper limb and visual-motor tasks only. Children with DCD may be less reliant on visual feedback obtained from accommodation due to adaptive mechanisms to overcome faulty information in the presence of oculomotor anomalies. These results strengthen our previous findings that accommodation anomalies contribute to motor skills impairment, and suggest that performance on these motor tasks is heavily reliant on visual feedback from accommodation.     

Co-occurring disorders: a possible key to visual perceptual deficits in children with developmental coordination disorder?

A study was conducted to examine how visual perceptual functioning in children with DCD may be influenced by co-occurring learning problems such as reading disabilities (RD) and/or attention deficit hyperactivity disorder (ADHD). Participants included seven groups of children: 27 children with DCD only, 11 with ADHD only, 14 with RD only, 63 with DCD and at least one other disorder (i.e., DCD + ADHD, DCD + RD, DCD + ADHD + RD), and 73 typically developing controls. Visual perceptual skills were assessed using the Test of Visual Perceptual Skills (TVPS) and the Rey Osterreith Complex Figure (ROCF; copy and delayed recall). Children with DCD and at least one other disorder were found to have impairments on the TVPS compared to children with DCD only, ADHD only, and typically developing controls, particularly on subtests assessing visual memory. On the ROCF, children with DCD and at least one other disorder scored significantly lower than children with ADHD only or RD only. Children with DCD plus one other disorder were then subdivided into three groups: DCD + ADHD, DCD + RD, and DCD + ADHD + RD and compared to children with DCD only, ADHD only, and RD only. Results indicated that children with DCD + ADHD + RD had significant impairments on the TVPS compared to children with DCD only and children with ADHD only. On the ROCF, children with DCD + ADHD + RD scored significantly lower than all of the groups, except the DCD+RD group. These findings suggest that DCD on its own is not associated with visual perceptual problems; rather, it is the presence of co-occurring disorders that is a possible key to visual perceptual deficits in children with DCD. The number of co-occurring disorders present with DCD is associated with the severity of the visual perceptual dysfunction. Deficits in visual memory skills appear to be a specific area of difficulty for children with DCD and co-occurring RD and/or ADHD.     

Developmental coordination disorder: associated problems in attention,learning, and psychosocial adjustment

This study investigated the problems of attention, learning and psychosocial adjustment evidenced by children with developmental coordination disorder (DCD). Forty-five children identified with DCD, 51 children identified as being suspect for DCD and 78 comparison children without motor problems on standardized tests of motor function participated in this study. Results revealed that both children with DCD and children suspect for DCD obtained significantly poorer scores on measures of attention and learning (reading, writing and spelling) than comparison children. Children with DCD and those suspect for DCD were also found to evidence a relatively high level of social problems and display a relatively high level of somatic complaints based on parent report. These findings indicate that all children with movement problems are at risk for problems in attention, learning and psychosocial adjustment. Assessment of children with movement problems, regardless of the degree or severity of these problems should examine a wide range of functions in addition to motor functioning. Such an approach, would assist in determining the types of intervention that would provide the most benefit to these children.     

Online corrections in children with and without DCD

Human arm movements need 'online' corrections due to noise in perception and action. A Step-Perturbation paradigm explored online corrections in control children and children with DCD aged between 7 and 13 years. Control children found the task straightforward: a distracter had no effect and they managed to stop relatively quickly. Children with DCD found the task difficult and the apparatus was modified accordingly (decreased postural and force production demands). The distracter affected some children with DCD and some found it difficult to stop. All of the DCD population showed poorer performance in both the perturbation and non-perturbation condition. Nevertheless, there was no interaction between group and condition. Thus, this study found no evidence for specific deficits in online correction mechanisms in DCD. We suggest that: (i) fundamental problems in generating basic movements can account for the documented difficulties in correcting on-going movements, and (ii) such fundamental difficulties make it very difficult to pinpoint specific mechanism deficits.     

Mechanisms that underlie coordination in children with developmental coordination disorder

The authors examined potential mechanisms underlying motor coordination in children with developmental coordination disorder (DCD). Because children with DCD experience difficulty processing visual, auditory, and vibrotactile information, the authors explored patterns of choice reaction time (RT) in young (6-7 years) and older (9-10 years) children with and without DCD by using a compatibility-incompatibility paradigm and different sensory modalities. Young children responded more slowly than older children to visual, auditory, and vibrotactile stimuli. Children with DCD took longer than typical children to process visual and vibrotactile stimuli under more complex stimulus-response mappings. Young children with DCD responded more slowly than typical children to visual and vibrotactile information under incompatible conditions. Children with DCD responded faster than unaffected children to auditory stimuli. The results suggest that there is a developmental nature in the processing of visual and auditory input and imply that the vibrotactile sensory modality may be key to the motor coordination difficulties of children with DCD.     

Developmental coordination disorder: exploration of a cerebellar hypothesis

This study explored the hypothesis of a specific cerebellar dysfunction in children with developmental coordination disorder (DCD): motor adaptation. The performance of a group of children with DCD (3 girls and 6 boys) was compared to that of a control group (5 girls and 6 boys) on a measure of motor adaptation, the prism adaptation test (PAT). Children were between 6 years 11 months and 11 years 10 months of age. Between-group differences were only found for PAT variables related to throwing accuracy, the DCD group being more variable and less accurate than the control group. While no between-group differences were found for the adaptation variables, individual data analysis revealed that only three children in the DCD group obtained normal adaptation variables. While these findings do not confirm the hypothesis of a cerebellar dysfunction, they also do not refute it. It is possible that the poor throwing accuracy of the DCD group masked the findings for some of the PAT variables. Further exploration of the function of the cerebellum among children with DCD is needed.