Understanding teachers' perceptions of the motor difficulties of children with developmental coordination disorder (DCD)

Background. Children with developmental coordination disorder (DCD) are often identified by classroom teachers and the identification process relies heavily on teachers' perceptions. The literature would suggest that teachers' perceptions may be influenced by a child's gender, behaviour and the type of motor problem they demonstrate. To date, the influence of these factors on teachers' perceptions of children with DCD has not been empirically tested. Aim. This study investigated whether child gender, behaviour and type of motor problem influenced teachers' ratings of concern and importance of intervening for children with motor difficulties. Sample. One hundred and forty‐seven teachers of children from 6 to 9 years of age participated in this study. Method. Hypothetical case scenarios were developed that experimentally manipulated the factors of child gender (male/female), behaviour (disruptive/non‐disruptive) and type of motor problem (fine motor/gross motor). Teachers were given two case scenarios of the same gender (that varied by behaviour) and rated: (a) their degree of concern about children's motor problems and (b) how important they thought it was for the child to receive intervention for that problem. Results. The effect of child gender on teachers' perceptions depends upon the type of motor problem. While child behaviour had a marginal influence on teachers' perceptions, interestingly, teachers appeared to recognize motor problems only in the absence of disruptive behaviour. The type of motor problem demonstrated also influenced teachers' perceptions. Conclusion. This study provides preliminary insight into factors that influence teachers' perceptions of children with DCD with clear implications for the classroom identification of children with DCD.     

Brief report: Response inhibition and processing speed in children with motor difficulties and developmental coordination disorder

A previous study reported that children with poor motor skills, classified as having motor difficulties (MD) or Developmental Coordination Disorder (DCD), produced more errors in a motor response inhibition task compared to typically developing (TD) children but did not differ in verbal inhibition errors. The present study investigated whether these groups differed in the length of time they took to respond in order to achieve these levels of accuracy, and whether any differences in response speed could be explained by generally slow information processing in children with poor motor skills. Timing data from the Verbal Inhibition Motor Inhibition test were analyzed to identify differences in performance between the groups on verbal and motor inhibition, as well as on processing speed measures from standardized batteries. Although children with MD and DCD produced more errors in the motor inhibition task than TD children, the current analyses found that they did not take longer to complete the task. Children with DCD were slower at inhibiting verbal responses than TD children, while the MD group seemed to perform at an intermediate level between the other groups in terms of verbal inhibition speed. Slow processing speed did not account for these group differences. Results extended previous research into response inhibition in children with poor motor skills by explicitly comparing motor and verbal responses, and suggesting that slow performance, even when accurate, may be attributable to an inefficient way of inhibiting responses, rather than slow information processing speed per se.     

The link between motor impairment level and motor imagery ability in children with developmental coordination disorder

The present study examined motor imagery ability in children with developmental coordination disorder (DCD). Specifically, it explored whether children with varying degrees of motor impairment differed in their ability to perform motor imagery tasks. Fourty-two children scoring below the 15th percentile on the Movement ABC were split into two groups--DCD severe (DCD-S), scoring on or below the 5th percentile, and DCD mild (DCD-M), scoring from the 6th to 15th percentiles--and compared to 21 age matched controls. Participants performed two motor imagery tasks--hand (performed without and with specific imagery instructions) and whole-body rotation. The results demonstrated that children in the DCD-S group had a generalized motor imagery deficit in that they were less accurate across tasks than controls (and the DCD-M group on the hand task) and showed little benefit when given specific imagery instructions. The DCD-M group appeared capable of performing simpler motor imagery transformations, but were less successful as task complexity increased. Unlike the DCD-S group, the DCD-M group did show some benefit from specific imagery instructions with increases in accuracy on the hand task. These results suggest that a motor imagery deficit does exist in many children with DCD but that its presentation can vary--factors such as the individual child's level of motor impairment and task complexity appear to be linked to the profile of deficits observed, which could explain the inconsistent findings of previous studies. Although this study lends support to the theory that a deficit in internal modeling is an underlying problem for children with DCD, still more research is required to develop the theory further.     

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.     

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.     

Static balance in children with developmental coordination disorder

The purpose of this study was to compare the postural sway profiles of 9/10-year-old children with developmental coordination disorder and balance problems (DCD-BP, n=64) with those of non-DCD children (n=71). We measured center of pressure excursions in conditions with and without vision for 30s while standing still on the dominant leg, the non-dominant leg, or both legs. Sway area, total path length, and Romberg's quotient were analyzed. Most measures differed significantly between groups, except sway area when the children stood with vision on either the dominant leg or both legs. When standing on the dominant leg or both legs, DCD-BP children demonstrated greater total path length in all conditions and a greater sway area in without-vision conditions. DCD-BP children showed more difficulty standing on the non-dominant leg with eyes both open and closed. While boys showed results similar to the total group, the girls with DCD-BP only exhibited significant differences in three conditions with eyes closed, but not with eyes open. Analysis of Romberg's coefficient also indicated that children with DCD-BP did not over-rely on visual information.     

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.     

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.     

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.     

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.     

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.     

A comparison of working memory skills and learning in children with developmental coordination disorder and moderate learning difficulties

The present study compared 6–11 years old with developmental coordination disorder (DCD) and those with moderate learning difficulties (MLD) on measures of memory (verbal short‐term and working memory, visuo‐spatial short‐term and working memory), literacy and numeracy, and IQ. The findings indicate that children with DCD appear to be impaired in all four areas of memory function; in particular they performed at significantly lower levels than children with MLD in measures of verbal short‐term memory, visuo‐spatial short‐term and working memory. In contrast, performance of children with MLD in the memory measures was within age‐expected levels, with deficits observed only in verbal working memory tasks. There were also differential links between memory and attainment between the two groups, and these were significant even after statistically accounting for the contribution of IQ. Reasons for why working memory contributes to learning in these two developmental groups are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

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.     

Fine motor deficiencies in children with developmental coordination disorder and learning disabilities: an underlying open-loop control deficit

Thirty-two children with Developmental Coordination Disorder (DCD) and learning disabilities (LD) and their age-matched controls attending normal primary schools were investigated using kinematic movement analysis of fine-motor performance. Three hypotheses about the nature of the motor deficits observed in children with LD were tested: general slowness hypothesis, limited information capacity hypothesis, and the motor control mode hypothesis. Measures of drawing movements were analyzed under different task conditions using a Fitts' paradigm. In a reciprocal aiming task, the children drew straight-line segments between two targets 2.5 cm apart. Three Target Sizes were used (0.22, 0.44, and 0.88 cm). Children used an electronic pen that left no trace on the writing tablet. To manipulate the degree of open-loop movement control, the aiming task was performed under two different control regimes: discrete aiming and cyclic aiming. The kinematic analysis of the writing movements of the 32 children with DCD/LD that took part in the experimental study confirmed that besides learning disabilities they have a motor learning problem as well. Overall, the two groups did not differ in response time, nor did they respond differently according to Fitts' Law. Both groups displayed a conventional trade-off between Target Size and average Movement Time. However, while movement errors for children with DCD/LD were minimal on the discrete task, they made significantly more errors on the cyclic task. This, together with faster endpoint velocities, suggests a reduced ability to use a control strategy that emphasizes the terminal control of accuracy. Taken together, the results suggest that children with DCD/LD rely more on feedback during movement execution and have difficulty switching to a feedforward or open-loop strategy.     

Sensory-motor deficits in children with developmental coordination disorder, attention deficit hyperactivity disorder and autistic disorder

Children who have been diagnosed with any one developmental disorder are very likely to meet diagnostic criteria for some other developmental disorder. Although comorbidity has long been acknowledged in childhood disorders, little is understood about the mechanisms that are responsible for the high level of comorbidity. In a series of studies, we have investigated the link between sensory-motor deficits and developmental disorders. Poor sensory-motor integration has long been implicated as a cause of motor problems in developmental disorders such as developmental coordination disorder (DCD), and our recent research has also investigated sensory-motor deficits in children with attention deficit hyperactivity disorder (ADHD) and autistic disorder. Based on a critical examination of relevant literature and some of our recent research findings, we argue that the importance of poor sensory-motor functioning in discriminating children with different disorders has been underestimated. Poor sensory-motor coordination appears to be linked to DCD, but not ADHD. Also, sensory-motor deficits in children with DCD and autistic disorder may provide insight into some of the social difficulties found in these groups of children. This research will increase our understanding of why children with one developmental disorder typically also have problems in other areas.     

Procedural learning and automatization process in children with developmental coordination disorder and/or developmental dyslexia

ObjectiveThere is increasing evidence to suggest that developmental dyslexia (DD) and developmental coordination disorder (DCD) actually form part of a broader disorder. Their frequent association could be justified by a deficit of the procedural memory system, that subtends many of the cognitive, motor and linguistic abilities that are impaired in both DD and DCD. However, studies of procedural learning in these two disorders have yielded divergent results, and in any case no studies have so far addressed the issue of automatization (dual-task paradigm).MethodsWe administered a finger tapping task to participants aged 8–12 years (19 DCD, 18 DD, and 22 with both DD and DCD) to explore procedural learning and automatic movements in these three groups of children, comparing motor performances at the prelearning stage, after 2 weeks of training, and in a post-training dual-task condition.ResultsFirst, results indicated that all the children were able to learn a sequence of movements and even automatize their movements. Second, they revealed between-groups differences in procedural/automatization learning abilities, setting the DCD group apart from the other two. Third, contrary to our expectations concerning comorbidity, they suggested that the DD + DCD association does not have an additional impact on behavioral performances.     

Role of visual-perceptual skills (non-motor) in children with developmental coordination disorder

The purposes of this study were to examine test-retest reliability of the Test of Visual-Perceptual Skills (Non-Motor)-Revised (TVPS-R), to explore motor-free visual-perceptual skills, and to categorize subtypes thereof in children with developmental coordination disorder (DCD). One hundred and seventy-eight children, aged 9 and 10 years, identified as having DCD with the Movement Assessment Battery for Children (M-ABC), were assessed, along with 200 typically developing children. The results showed good test-retest reliability for the total perceptual quotient scores of the TVPS-R, but not for all subtests. Children with DCD performed significantly poorer compared to typically developing children on the visual-perceptual test, but the deficits were not common to all children with DCD. This study supported the stance that we should consider the heterogeneous characteristics of children with DCD when designing experimental studies or developing educational interventions.     

Standing balance of children with developmental coordination disorder under altered sensory conditions

Maintenance of standing balance requires that sensory inputs be organized with the motor system. Current data regarding the influence of sensory inputs on standing balance in children with developmental coordination disorder (DCD) are limited. This study compared the influence of sensory organization and each sensory input on the standing stability between a group of 20 children, 4-6 years old, with DCD and an age- and gender-matched control group of 20 children. Three types of visual inputs (eyes open, eyes closed, or unreliable vision) and two types of somatosensory inputs (fixed or compliant foot support) were varied factorially to yield six sensory conditions. Standing stability was measured with a Kistler force plate for 30s and expressed as the center of pressure sway area. The results showed that the standing stability of the children with DCD was significantly poorer than that of the control children under all sensory conditions, especially when the somatosensory input was unreliable (compliant foot support) compared to when it was reliable (fixed foot support). The effectiveness of an individual sensory system, when it was the dominant source of sensory input, did not significantly differ between the groups. The results suggest that children with DCD experience more difficulty coping with altered sensory inputs, and that such difficulty is more likely due to a deficit in sensory organization rather than compromised effectiveness of individual sensory systems.     

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.