Tactile localization performance in children with developmental coordination disorder (DCD) corresponds to their motor skill and not their cognitive ability

When localizing touches to the hands, typically developing children and adults show a “crossed hands effect” whereby identifying which hand received a tactile stimulus is less accurate when the hands are crossed than uncrossed. This demonstrates the use of an external frame of reference for locating touches to one’s own body. Given that studies indicate that developmental vision plays a role in the emergence of external representations of touch, and reliance on vision for representing the body during action is atypical in developmental coordination disorder (DCD), we investigated external spatial representations of touch in children with DCD using the “crossed hands effect”. Nineteen children with DCD aged 7–11 years completed a tactile localization task in which posture (uncrossed, crossed) and view (hands seen, unseen) were varied systematically. Their performance was compared to that of 35 typically developing controls (19 of a similar age and cognitive ability, and 16 of a younger age but similar fine motor ability). Like controls, the DCD group exhibited a crossed hands effect, whilst their overall tactile localization performance was weaker than their peers of similar age and cognitive ability, but in line with younger controls of similar motor ability. For children with movement difficulties, these findings indicate tactile localization impairments in relation to age expectations, but apparently typical use of an external reference frame for localizing touch.     

Motor imagery ability and internal representation of movement in children with probable developmental coordination disorder

It has been hypothesised that deficits in the functioning of the mirror neuron system (MNS) and internal modelling may contribute to the motor impairments associated with DCD. These processes can be explored behaviourally through motor imagery paradigms. Motor imagery proficiency of children with and without probable DCD (pDCD) was examined using a complex hand rotation task to explore whether motor imagery strategies could be used during more complex tasks. Forty-four boys aged 7–13 years participated, 22 with pDCD (mean = 9.90 years ± 1.57) and 22 controls (mean = 9.68 years ± 1.53). Participants completed the task twice: with and without motor imagery instructions. Stimuli were presented in two rotational axes – palm/back, and eight 45° rotational steps. Both groups showed evidence of following the biomechanical and postural constraints of actual movements. Responses of children with pDCD were slower and less accurate than controls, with group differences increasing alongside task complexity. A greater impact of biomechanical constraints for accuracy was observed in the DCD group. The response characteristics of children with pDCD likely reflects a reduced capacity to mentally manipulate a body schema and reduced visuo-motor processing capabilities. Behaviourally, these processes are linked to MNS and internal modelling function, suggesting deficits in these systems may contribute to the movement difficulties characteristic of DCD.     

Increased visual bias in children with developmental coordination disorder: Evidence from a visual-tactile temporal order judgment task

BackgroundPrevious studies have suggested that children with developmental coordination disorder (DCD) rely heavily on vision to perform movements, which may contribute to their clumsy movements. However, few studies have objectively and quantitatively investigated the perceptual biases of children with DCD.MethodsA visual-tactile temporal order judgment (TOJ) task was used to measure and compare the perceptual biases of 19 children with DCD and 19 age- and sex-matched typically developing children. The point of subjective equality, which demonstrates when “visual first” and “tactile first” judgment probabilities are equal (50%), obtained by analyzing the results of the visual-tactile TOJ task, was used as an indicator of perceptual biases. Further, variables (age and manual dexterity in all participants; motor function, autism spectrum disorder and attention-deficit hyperactivity disorder traits, and depressive symptoms in children with DCD) associated with perceptual biases were examined with correlation analysis.ResultsChildren with DCD had significantly stronger visual bias than typically developing children. Overall correlation analysis showed that increased visual bias was significantly correlated with poor manual dexterity.ConclusionChildren with DCD had a strong visual bias, which was associated with poor manual dexterity.     

Poor Imitative Performance of Unlearned Gestures in Children with Probable Developmental Coordination Disorder

It has been hypothesized that deficits in imitation, linked to abnormal functioning of the mirror neuron system (MNS), may contribute to the motor impairments associated with developmental coordination disorder (DCD). The authors aimed to examine imitation of complex novel postures and sequences of gestures in children with and without probable DCD (pDCD), using the postural praxis and sequencing praxis subtests of the Sensory Integration and Praxis Tests (Ayres, 1989 Ayres, A. J. (1989). Sensory Integration and Praxis Tests: SIPT manual. Los Angeles, CA: Western Psychological Services. [Google Scholar]). Participants were 29 boys with pDCD between 6.08 and 13.33 years old, and 29 group age-matched typically developing boys between 6.08 and 13.83 years old. Responses of children with pDCD on both imitation tasks were less accurate than controls, with group differences more apparent with increasing task complexity. Furthermore, as a group, children with pDCD were slower and had a higher number of non–mirror-imitated responses. There was considerable variability within the pDCD group, with some children displaying imitation scores within the normative range. Given the importance of imitation and visual learning for motor development, the difficulties in imitation displayed by some children with pDCD have the potential to impact on movement acquisition. Interventions to target imitation may be beneficial for these children. The results show that children with pDCD had difficulty imitating complex novel postures, children with pDCD had difficulty imitating gesture sequences, children with pDCD had slower responses than controls, group differences in imitation performance increased with task complexity, and not all children with pDCD displayed imitation deficits.     

Developmental coordination disorder pertains to a deficit in perceptuo-motor synchronization independent of attentional capacities

We investigated from a dynamic pattern perspective to motor coordination whether the deficiency in motor coordination characterizing Developmental Coordination Disorder children pertains to a general disorder in synchronization leading to a lower stability of the performed coordination pattern, and the extent to which the trouble is linked to attentional capacities. Twenty-four DCD children without ADHD aged eight to thirteen and 60 control children were asked (1) to perform a Continuous Performance Test assessing sustained attention; (2) to flex one finger either in synchrony or in syncopation with a visual periodic signal whose frequency was increased stepwise, assessing synchronization abilities. For the attentional task, percentage of exact responses, number of errors and reaction time were recorded. For the synchronization task, we measured relative phase (i.e., the ratio between the stimulus and the response onset and the time separating two successive stimuli). DCD children were significantly more variable than controls in both conditions and the difficulty in synchronization was unrelated to attentional disorders (ANCOVA). These findings support the idea of a general synchronization disorder in DCD children underlying their poor motor coordination. Moreover, this synchronization disorder does not appear to be strictly dependent on the level of sustained attentional capacities.     

Atypical inter‐hemispheric communication correlates with altered motor inhibition during learning of a new bimanual coordination pattern in developmental coordination disorder

Impairment of motor learning skills in developmental coordination disorder (DCD) has been reported in several studies. Some hypotheses on neural mechanisms of motor learning deficits in DCD have emerged but, to date, brain‐imaging investigations are scarce. The aim of the present study is to assess possible changes in communication between brain areas during practice of a new bimanual coordination task in teenagers with DCD (n = 10) compared to matched controls (n = 10). Accuracy, stability and number of mirror movements were computed as behavioural variables. Neural variables were assessed by electroencephalographic coherence analyses of intra‐hemispheric and inter‐hemispheric fronto‐central electrodes. In both groups, accuracy of the new coordination increased concomitantly with right intra‐hemispheric fronto‐central coherence. Compared to typically developing teenagers, DCD teenagers presented learning difficulties expressed by less stability, no stabilization of the new coordination and a greater number of mirror movements despite practice. These measures correlated with reduced inter‐hemispheric communication, even after practice of the new coordination. For the first time, these findings provide neuro‐imaging evidence of a kind of inter‐hemispheric ‘disconnection’ related to altered inhibition of mirror movements during motor learning in DCD.     

Development of motor imagery ability in children with developmental coordination disorder – A goal-directed pointing task

Children with developmental coordination disorder (DCD) have difficulties with the predictive control of movements. This was shown in studies that target motor imagery and motor planning, and appears to become particularly evident with increases in task complexity. In this study, we used a complex mental chronometry paradigm to examine the development of motor imagery ability in children with DCD, using a longitudinal design. Thirty children were included in the DCD group (aged 6–11 years) and age- and gender-matched to 30 controls. The DCD group had a Movement Assessment Battery for Children-2 score ≤16th percentile and the control group ≥25th percentile. Results of this study showed that children with DCD indeed had a significantly lower correlation between executed and imagined movements. Importantly, the increase in the correlation and linear fit during subsequent measurements was comparable for the DCD and control group. Together, these findings suggest a delayed developmental onset of motor imagery ability in DCD, but a similar rate of development over time compared to the control group. Based on these results, it seems likely that explicit motor imagery instructions can be used to improve predictive control in children with DCD.     

Atypical speech lateralization in adults with developmental coordination disorder demonstrated using functional transcranial Doppler ultrasound

Research using clinical populations to explore the relationship between hemispheric speech lateralization and handedness has focused on individuals with speech and language disorders, such as dyslexia or specific language impairment (SLI). Such work reveals atypical patterns of cerebral lateralization and handedness in these groups compared to controls. There are few studies that examine this relationship in people with motor coordination impairments but without speech or reading deficits, which is a surprising omission given the prevalence of theories suggesting a common neural network underlying both functions. We use an emerging imaging technique in cognitive neuroscience; functional transcranial Doppler (fTCD) ultrasound, to assess whether individuals with developmental coordination disorder (DCD) display reduced left‐hemisphere lateralization for speech production compared to control participants. Twelve adult control participants and 12 adults with DCD, but no other developmental/cognitive impairments, performed a word‐generation task whilst undergoing fTCD imaging to establish a hemispheric lateralization index for speech production. All participants also completed an electronic peg‐moving task to determine hand skill. As predicted, the DCD group showed a significantly reduced left lateralization pattern for the speech production task compared to controls. Performance on the motor skill task showed a clear preference for the dominant hand across both groups; however, the DCD group mean movement times were significantly higher for the non‐dominant hand. This is the first study of its kind to assess hand skill and speech lateralization in DCD. The results reveal a reduced leftwards asymmetry for speech and a slower motor performance. This fits alongside previous work showing atypical cerebral lateralization in DCD for other cognitive processes (e.g., executive function and short‐term memory) and thus speaks to debates on theories of the links between motor control and language production.     

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.     

Perceptual skills of children with developmental coordination disorder

The aim of this study was to investigate whether children with a Developmental Coordination Disorder (DCD) experience problems in the processing of visual, proprioceptive or tactile information. Different aspects of visual perception were tested with the Developmental Test of Visual Perception (DTVP-2), tactile perception was assessed with the Tactual Performance Test (TPT), and a manual pointing task was employed to measure the ability to use visual and proprioceptive information in goal-directed movements. Nineteen children with DCD and nineteen age and sex-matched controls participated in this study. Differences between groups were most pronounced in the subtests measuring visual-motor integration of the DTVP-2, and in two subtests measuring visual perception (visual closure and position in space). On average the children with DCD performed slightly below the norm for tactile perception, with only three children failing the norm. On the manual pointing task, children with DCD made inconsistent responses towards the targets in all three conditions (visual, visual-proprioceptive and proprioceptive condition). No significant differences between groups were found for absolute error. Inspection of the individual data revealed that only two children failed on the majority of perceptual tasks in the three modalities. Across tasks, no consistent pattern of deficits appeared, illustrating the heterogeneity of the problems of children with DCD.     

End-state comfort planning after explicit goal instructions in children with and without probable developmental coordination disorder

BackgroundWhen completing grip-selection tasks, healthy adults generally plan for the most comfortable end-posture which is termed the end-state comfort (ESC) effect. Children with and without developmental coordination disorder (DCD) are less likely to plan for ESC which begs the question as to whether they are not able to perform this type of planning or whether they prioritize other aspects of the task.Aims(1) Examine if children with and without probable DCD (pDCD) are able to plan for ESC if they are explicitly instructed to and (2) if this transfers to another similar task. (3) Examine if children with and without pDCD perceive the level of comfort of the grips that they use differently and if this relates to ESC planning.MethodsTwelve children with and 12 children without probable DCD (pDCD) (aged 5–9 years) received a 10-min training session in which children were explicitly instructed to end their movement in ESC, after which they formulated their own plan to reach this goal. The study consisted of a pre-post-test design in which changes in the proportion of ESC were analyzed on the task that was trained as well as on an untrained transfer-task. Furthermore, the perceived level of comfort was examined.ResultsBoth groups of children showed a higher proportion of ESC on the post-test compared with the pre-test, on the task that was trained as well as on the transfer-task. There were no group differences regarding the perceived level of comfort of the different grip postures.ConclusionThe majority of the children with and without pDCD seems to be able to adjust their planning strategy and prioritize ESC if they are explicitly instructed to.     

Constrained action selection in children with developmental coordination disorder

The effect of advance ('precue') information on short aiming movements was explored in adults, high school children, and primary school children with and without developmental coordination disorder (n=10, 14, 16, 10, respectively). Reaction times in the DCD group were longer than in the other groups and were more influenced by the extent to which the precue constrained the possible action space. In contrast, reaction time did not alter as a function of precue condition in adults. Children with DCD showed greater inaccuracy of response (despite the increased RT). We suggest that the different precue effects reflect differences in the relative benefits of priming an action prior to definitive information about the movement goal. The benefits are an interacting function of the task and the skill level of the individual. Our experiment shows that children with DCD gain a benefit from advance preparation in simple aiming movements, highlighting their low skill levels. This result suggests that goal-directed RTs may have diagnostic potential within the clinic.     

Parameterization of movement execution in children with developmental coordination disorder

The Rhythmic Movement Test (RMT) evaluates temporal and amplitude parameterization and fluency of movement execution in a series of rhythmic arm movements under different sensory conditions. The RMT was used in combination with a jumping and a drawing task, to evaluate 36 children with Developmental Coordination Disorder (DCD) and a matched control group. RMT errors in space and in time were significantly larger for children with DCD. Omission of sensory information decreased the accuracy of movement parameterization in children with DCD more than in the control group, suggesting that children with DCD have more problems in building up an internal representation of the movement. Errors in time correlated significantly with the jumping and drawing task, while errors in space did not. Deficits of temporal movement parameterization might be one of the underlying causes of poor motor performance in some children with DCD.     

Testing predictive control of movement in children with developmental coordination disorder using converging operations

Recent systematic reviews (Wilson et al., 2013, Dev. Med. Child Neurol., 55, 217; Adams et al., 2014, Neurosci. Biobehav. Rev., 47C, 225) suggest that a common underlying problem in developmental coordination disorder (DCD) is the internal modelling deficit. The study presented here is the first to test this hypothesis using a within‐subject design, assessing motor imagery, action planning, and rapid online control (ROC) in a sample of children screened rigorously for DCD. Participants were 66 children; 33 children (26 boys and seven girls) aged 6–11 years in the DCD group and 33 controls (gender and age matched). Motor imagery was assessed with the hand rotation task (HRT), action planning with an end‐state comfort effect test, and ROC with the double‐step pointing task. Results showed that children with DCD were slower and less accurate than controls in the HRT. Reduced forward planning for comfortable end‐state was also shown in DCD. Finally, no group differences were found on the ROC task. Collectively, children with DCD manifest deficits in the internal modelling of movements, but this varies under different task constraints, particularly those related to movement complexity.     

Abnormalities of motor and praxis imagery in children with DCD

In an earlier study using the visually guided pointing task (VGPT) the authors showed that the timing of imagined movement sequences in children with developmental coordination disorder (DCD) does not conform to the conventional speed-for-accuracy trade-off (or Fitts' law [P.M. Fitts, Journal of Experimental Psychology 47 (1954) 381-391]) that occurs when the distance and accuracy requirements of movements are varied [P. Maruff, P.H. Wilson, M. Trebilcock, J. Currie, Neuropsychologia 37 (1999b) 1317-1324]. The present study sought to replicate this earlier finding and to examine (using a weight manipulation) whether this deficit was also attributable to inaccurate programming of relative force. The chronometry of real and imagined movements was investigated in a group of 20 children with DCD aged between 8 and 12 years and a group of controls matched on age and verbal IQ (VIQ). Movement duration was tested for real and imagined movements using the preferred hand, with the VGPT performed under two load conditions: with and without the addition of a weight attached to a pen. Group means of each subjects' mean movement duration were calculated and plotted against target width for each of the four conditions [Movement type (2) x Load (2)] and a logarithmic curve was fitted to the data points. In the control group, the speed-for-accuracy trade-off for both real and imagined performance conformed to Fitts' law under each load condition. In the DCD group only real movements conformed to Fitts' law. Moreover, the effect of load differed between groups--for real movements, movement duration did not differ between load and no-load conditions for either group, while for imagined movements, movement duration increased under the load condition for the control group only. These results replicate and extend the results of our earlier study. This pattern of performance suggests that children with DCD have an impairment in the ability to generate internal representations of volitional movements which may reflect an impaired ability to process efference copy signals. The ability to programme both relative force and timing appears to underly this difficulty. Results have implications for the use of (guided) motor imagery training in order to facilitate the development of motor skill in 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.     

Attention and suppression affect tactile perception in reach-to-grasp movements

Reaching with the hand is characterized by a decrease in sensitivity to tactile stimuli presented to the moving hand. Here, we investigated whether tactile suppression can be canceled by attentional orienting. In a first experiment, participants performed a dual-task involving a goal-directed movement paired with the speeded detection of a tactile pulse. The pulse was either delivered to the moving or stationary hand, during movement preparation, execution, or the post-movement phase. Furthermore, stimulation was delivered with equal probability to either hand, or with a higher probability to either the moving or resting hand. The results highlighted faster RTs under conditions of higher probability of stimulation delivery to both moving and resting hands, thus indicating an attentional effect. For the motor preparation period, RTs were faster only at the resting hand under conditions where tactile stimulation was more likely to be delivered there. In a second experiment, a non-speeded perceptual task was used as a secondary task and tactile discrimination thresholds were recorded. Tactile stimulation was delivered concomitantly at both index fingers either in the movement preparation period (both before and after the selection of the movement effector had taken place), in the motor execution period, or, in a control condition, in the time-window of motor execution, but the movement of the hand was restrained. In the preparation period, tactile thresholds were comparable for the two timings of stimulation delivery; i.e., before and after the selection of the movement effector had taken place. These results therefore suggest that shortly prior to, and during, the execution of goal-directed movements, a combined facilitatory and inhibitory influence acts on tactile perception.     

Procedural learning in children with developmental coordination disorder

Despite the fact that developmental coordination disorder (DCD) is characterised by a deficit in the ability to learn or automate motor skills, few studies have examined motor learning over repeated trials. In this study we examined procedural learning in a group of 10 children with DCD (aged 8-12 years) and age-matched controls without DCD. The learning task was modelled on that of Nissen and Bullemer. Children performed a serial reaction time (SRT) task in which they were required to learn a spatial sequence that repeated itself every 10 trials. Children were not aware of the repetition. Spatial targets were four (horizontal) locations presented on a computer monitor. Children responded using four response keys with the same horizontal mapping as the stimulus. They were tested over five blocks of 100 trials each. The first four blocks presented the same repeating sequence, while the fifth block was randomised. Procedural learning was indexed by the slope of the regression of RT on blocks 1-4. Results showed that most children displayed strong procedural learning of the sequence, despite having no explicit knowledge about it. Overall, there was no group difference in the magnitude of learning over blocks of trials - most children performed within the normal range. Procedural learning for simple sequential movements appears to be intact in children with DCD. This suggests that cortico-striatal circuits that are strongly implicated in the sequencing of simple movements appear to be function normally in DCD.     

Screening for motor coordination challenges in children using teacher ratings of physical ability and activity

We examined the effectiveness of a teacher-based rating scale called the teacher estimation of activity form (TEAF) to screen for developmental coordination disorder (DCD) in children. A random selection of 15 of 75 schools from the District School Board of Niagara in Ontario, Canada was chosen for this study. Every consented child in Grade 4 (n=502) was evaluated for probable DCD (pDCD) in school using the short form Bruininks-Oseretsky test of motor proficiency (BOTMP-SF). Each student also completed the children's self perceptions of adequacy in and predilection toward physical activity (CSAPPA) scale, participation questionnaire, and Léger 20-meter shuttle run, and had their height and weight measured. The 27 children (5.1%) who scored below the 5th percentile on BOTMP-SF were designated as pDCD cases and the 475 children who scored above the 5th percentile served as controls. Results showed that mean TEAF scores were significantly lower for pDCD children than controls (p<.001). Total TEAF scores ranging from 28 to 32 were preferred in maintaining good sensitivity (.74, 95% CI=.55-.87 to .85, 95% CI=.68-.94). The area under the ROC curve was .77 (95% CI, .68-.86) for the TEAF total score, and some individual items performed approximately as well as the full scale. The TEAF was positively correlated with measures of physical activity and fitness. The TEAF appears to be an effective tool in screening for DCD, particularly in a population setting. Considering the brevity of the TEAF and the discriminative power of individual items, this instrument would be effective in an abbreviated version.     

Mental rotation performance in young adults with and without developmental coordination disorder

While there have been consistent behavioural reports of atypical hand rotation task (HRT) performance in adults with developmental coordination disorder (DCD), this study aimed to clarify whether this deficit could be attributed to specific difficulties in motor imagery (MI), as opposed to broad deficits in general mental rotation. Participants were 57 young adults aged 18–30 years with (n = 22) and without DCD (n = 35). Participants were compared on the HRT, a measure of MI, and the letter number rotation task (LNRT), a common visual imagery task. Only participants whose behavioural performance on the HRT suggested use of a MI strategy were included in group comparisons. Young adults with DCD were significantly less efficient compared to controls when completing the HRT yet showed comparable performance on the LNRT relative to adults with typical motor ability. Our data are consistent with the view that atypical HRT performance in adults with DCD is likely to be attributed to specific difficulties engaging in MI, as opposed to deficits in general mental rotation. Based on the theory that MI provides insight into the integrity of internal action representations, these findings offer further support for the internal modelling deficit hypothesis of DCD.