Roles of Visual Information for Control of Reaching Movements in Children

Poststroke hemiparetic individuals (n = 9) and a control group (n = 9) completed a frequency-scaled circle-drawing task in unimanual and bimanual conditions. Measures of intralimb spatial and temporal task accuracy and interlimb coordination parameters were analyzed. Significant reductions in task performance were seen in both limbs of the patients and controls with the introduction of bimanual movement. Spatial performance parameters suggested that the 2 groups focused on different hands during bimanual conditions. In the controls, interlimb coordination variables indicated predictable hand dominance effects, whereas in the patient group, dominance was influenced by the side of impairment and prior handedness of the individual. Therefore, in this particular bimanual task, performance improvements in the hemiplegic side could not be elicited. Intrinsic coupling asymmetries between the hands can be altered by unilateral motor deficits.     

Dissecting online control in Developmental Coordination Disorder: a kinematic analysis of double-step reaching

In a recent study, children with movement clumsiness (or Developmental Coordination Disorder-DCD) were shown to have difficulties making rapid online corrections when reaching, demonstrated by slower and less accurate movements to double-step targets (Hyde & Wilson, 2011). These results suggest that children with DCD have difficulty using predictive estimates of limb position when making rapid adjustments to movement, in-flight. However, chronometric data alone does not provide strong evidence for this hypothesis: it remains unclear whether early (and rapid) control parameters or post-correction stages of the movement trajectory are affected. Thus, the overarching aim of this study was to conduct a kinematic analysis of double-step reaching in order to isolate the different control parameters that might explain the slower and less accurate double-step reaching performance of children with DCD. Participants were a new sample of 13 children with DCD aged between 8-12 years and 13 age-matched controls. Children were required to reach and touch one of three possible targets presented at the coordinates -20°, 0° and 20° on a 17 in. LCD touch-screen. For most trials (80%) the target remained stationary for the duration of movement (non-jump trials), while for the remainder (20%), the target jumped randomly to one of two peripheral locations at movement onset (jump trials). Consistent with earlier work, children with DCD were slower to initiate reaching compared to controls and showed longer MT and more errors on jump trials. Kinematic data showed that while the two groups did not differ on time to peak velocity or acceleration, children with DCD were slower to correct reach trajectory on jump trials. No group differences were observed on late kinematic markers, e.g., post-correction time. The pattern of results support and extend earlier work showing deficits in ROC in DCD. From a computational perspective, delayed corrections to the reach trajectory suggests some difficulty integrating information about the target perturbation with a predictive (or forward) estimate of limb position relative to the initial target. These conclusions are discussed, along with directions for future research.     

Neuroimaging and Occupational Therapy: Bridging the Gap to Advance Rehabilitation in Developmental Coordination Disorder

Developmental coordination disorder (DCD) is a neurodevelopmental disorder characterized by poor motor skills that interfere with a child's ability to perform everyday activities. Little is known about the neural mechanisms that implicate DCD, making it difficult to understand why children with DCD struggle to learn motor skills and selecting the best intervention to optimize function. Neuroimaging studies that utilize magnetic resonance imaging techniques have the capacity to play a critical role in helping to guide clinicians to optimize functional outcomes of children with DCD using evidence-based rehabilitation interventions. The authors' goal is to describe how neuroimaging research can be applied to occupational therapy and rehabilitation sciences by highlighting projects that are at the forefront of the field and elucidate future directions.     

Selective Mutism in Children: Comparison to Youths With and Without Anxiety Disorders

Fifteen children with selective mutism (SM), 15 children with anxiety disorders (AD) without selective mutism, and 15 children without anxiety disorders or selective mutism (CN) were compared to examine the relationship between selective mutism and anxiety. Data were collected from children (age 4–10 years), parents, teachers, and clinicians. Results indicated that children with SM closely resemble children with AD. All children with SM received a diagnosis of social anxiety disorder and 53% received a diagnosis for an additional anxiety disorder. In addition, the SM and AD groups differed substantially from controls with respect to parent- and teacher-rated internalizing behavior problems. No differences among the groups were found with respect to parent-and teacher-reported externalizing behavior problems. The results are consistent with prior research emphasizing the association between selective mutism and anxiety disorders, and suggest that selective mutism may be conceptualized, assessed, and treated as an anxiety-related problem.     

Determinants of Offline Processing of Visual Information for the Control of Reaching Movements

The authors investigated the use of visual feedback as a form of knowledge of results (KR) for the control of rapid (200-250 ms) reaching movements in 40 participants. They compared endpoint accuracy and intraindividual variability of a full-vision group (FV) with those of no-vision groups provided with KR regarding (a) the endpoint in numerical form, (b) the endpoint in visual form, or (c) the endpoint and the trajectory in visual form (DEL). The FV group was more accurate and less variable than were the no-vision groups, and the analysis of limb trajectory variability indicated that their superior performance resulted primarily from better movement planning rather than from online visual processes. The FV group outperformed the DEL group even though both groups were obtaining the same amount of spatial visual information from every movement. That finding suggests that the effectiveness with which visual feedback is processed offline is not a simple function of the amount of visual information available, but depends on how that information is presented.     

Procedural learning,consolidation, and transfer of a new skill in Developmental Coordination Disorder

The aim of this study was to explore the differences in procedural learning abilities between children with DCD and typically developing children by investigating the steps that lead to skill automatization (i.e., the stages of fast learning, consolidation, and slow learning). Transfer of the skill to a new situation was also assessed. We tested 34 children aged 6–12 years with and without DCD on a perceptuomotor adaptation task, a form of procedural learning that is thought to involve the cerebellum and the basal ganglia (regions whose impairment has been associated with DCD) but also other brain areas including frontal regions. The results showed similar rates of learning, consolidation, and transfer in DCD and control children. However, the DCD children's performance remained slower than that of controls throughout the procedural task and they reached a lower asymptotic performance level; the difficulties observed at the outset did not diminish with practice.     

A Preliminary Investigation of Quality of Life Satisfaction Reports in Emerging Adults With and Without Developmental Coordination Disorder

Developmental coordination disorder (DCD) affects around 5% of the population and is diagnosed on the basis of poor motor coordination. Although we know rather little about the lifetime consequences of this disorder, it is clear that significant difficulties remain through adolescence and into adulthood for the majority. It is also clear that significant psychosocial consequences exist for many individuals with DCD. In the current study, quality of life satisfaction was investigated in a group of emerging adults with and without DCD using the Quality of Life Satisfaction Questionnaire (Endicott et al. Psychopharmacology Bulletin, 29, 321–326, 1993). Overall, the group of adults with DCD reported significantly lower levels of quality of life satisfaction across all domains on the scale. This finding has important implications for consideration of early and later intervention for these individuals, as well as for studies to consider the risk and protective factors at play in long-term outcome with respect to both the motor skills and psychosocial aspects of this disorder.     

Posttraumatic Stress Disorder in Children and Adolescents: A Review and Analysis

Only recently has the mental health community recognized the applicability of diagnostic criteria for posttraumatic stress disorder (PTSD) in children and adolescents, including a consideration of specific age-related features. This paper provides a current review of the literature on PTSD pertaining to children and adolescents. Following a discussion of issues on diagnostic criteria and assessment of this affective disorder in this population, there is an overview of the existing literature on prevalence, comorbidity, risk factors, parental and family factors, and issues of gender and age of onset. The remainder of the paper focuses on the range of traumatic stressors in children and adolescents that can result in PTSD, including natural or human disasters, war and violence, chronic or life-threatening medical conditions, community violence and the witnessing of traumatic events, and physical and/or sexual abuse and other forms of interpersonal violence. Throughout the paper, there is an emphasis on the importance of considering developmental factors. Finally, implications of the existing literature for future areas of research are addressed.     

Self-Sitting and Reaching in 5- to 8-Month-Old Infants: The Impact of Posture and Its Development on Early Eye-Hand Coordination

The relation between progress in the control of posture (i.e., the achievement of self-sitting posture) and the developmental transition from two-handed to one-handed engagement in infant reaching was investigated. Two groups of 5- to 8-month-old infants, who were either able or yet unable to sit on their own, were videotaped while they reached for objects in four different posture conditions that provided varying amounts of body support. Videotapes of infant reaches were microanalyzed to determine the relative engagement of both hands during reaches. Results demonstrate the interaction between postural development and the morphology of infant reaching. Nonsitting infants displayed symmetrical and synergistic engagement of both arms and hands while reaching in all but the seated posture condition. Sitting infants, by contrast, showed asymmetrical and lateralized (one-handed) reaches in all posture conditions. Results also show that, aside from posture, the perceived spatial arrangement of the object display is a determinant of infant reaching. Combined, these results are discussed as evidence for the interaction between postural and perceptual development in the control of early eye-hand coordination.     

Family Unification with Reactive Attachment Disorder Children: A Brief Treatment

This is a case study of a family with a child (age eight) with reactive attachment disorder and the subsequent individual and family therapy. Treatment of choice for the child was Eye Movement Desensitization and Reprocessing (EMDR) and supportive educational counseling for the parents and family. Qualitative evaluation of the process demonstrated that the parents observed an instant change in the child's attitude. The child reported that she felt better about family, school, and truthfulness, and stated about the therapy: It opened a window for me. A 12-month evaluation demonstrated continued positive effects.     

基于直线临摹的ADHD儿童眼手协调能力研究

ADHD儿童在精细动作方面通常伴随眼手协调运动障碍。以往采用的研究方法多为定性研究,且未在ADHD儿童的运动协调性与同龄正常儿童的差异上得出统一结论。本研究针对精细动作中眼手协调能力进行定量分析。实验要求被试在计算机触摸屏上分别临摹水平线、垂直线和斜线,通过记录临摹直线与呈现直线的偏差程度和拐点数,以分析ADHD儿童眼手协调能力与正常儿童之间的差异。结果表明,ADHD儿童在眼手协调和空间知觉能力上与正常儿童存在显著性差异。此外,本研究表明,改进的定量方法具有良好的可行性。     

Visual Information and Object Size in the Control of Reaching

The role of vision in the control of reaching and grasping was investigated by varying the available visual information. Adults (N = 7) reached in conditions that had full visual information, visual information about the target object but not the hand or surrounding environment, and no visual information. Four different object diameters were used. The results indicated that as visual information and object size decreased, subjects used longer movement times, had slower speeds, and more asymmetrical hand-speed profiles. Subjects matched grasp aperture to object diameter, but overcompensated with larger grasp apertures when visual information was reduced. Subjects also qualitatively differed in reach kinematics when challenged with reduced visual information or smaller object size. These results emphasize the importance of vision of the target in reaching and show that subjects do not simply scale a command template with task difficulty.     

Modified Comprehensive Behavioral Intervention for Tics: Treating Children With Tic Disorders,Co-Occurring ADHD,and Psychosocial Impairment

Our objective was to evaluate the feasibility and acceptability, and preliminary efficacy of a modified comprehensive behavioral intervention for tics (MCBIT) therapy for youth with chronic tic disorders (CTDs), co-occurring attention-deficit hyperactivity disorder (ADHD), and associated psychosocial impairment. Seventeen youth ages 10–17 with CTD and co-occurring ADHD were randomly assigned to the MCBIT group (n = 9) or to a control group where they received traditional comprehensive behavioral intervention for tics (CBIT) therapy (n = 8). Both groups received ten 55-minute weekly treatment sessions, and two 55-minute biweekly relapse prevention sessions. Sixteen of the 17 participants completed the study, and acceptability ratings in both treatment groups were high with no significant differences in expectation of improvement. The MCBIT and CBIT groups in combination showed significant improvement in tic severity, ADHD symptom severity, and tic-related impairment. Group differences were not significant. The results indicate that MCBIT treatment is feasible and acceptable for youth with CTD and ADHD, and is similarly well tolerated relative to traditional CBIT. Results were not sufficiently superior to recommend MCBIT over CBIT for this population. However, given the demonstrated benefit of behavioral treatments that target co-occurring conditions concurrently, continuing to examine novel behavioral approaches that can target tics and related conditions simultaneously and successfully is recommended.     

Autism,Attachment and Parenting: A Comparison of Children with Autism Spectrum Disorder,Mental Retardation,Language Disorder,and Non-clinical Children

Children with Autism Spectrum Disorder (ASD) have severe and pervasive impairments in the development of social interaction, which may affect the attachment relationship with their parents and may have an impact on parenting. In the current investigation 89 families with young children (mean age 26.5 months) were involved, who were diagnosed as ASD, mentally retarded (MR), or language delayed (LD), or part of a non-clinical comparison group. Attachment security was observed with the Brief Attachment Screening Questionnaire, and several parental self-report questionnaires assessed the parenting style, parental efficacy, parental experiences of daily hassles, social support, and psychological problems. Children with ASD were rated as less secure compared to the other clinical and normal comparison groups. Parents of non-clinical children reported higher levels of authoritative parenting than parents in the ASD group and in the total clinical group, and they also received less social support. Parents of children with ASD coped remarkably well with the challenges of raising a child with ASD.     

进化论医学在防治小儿直立性疾病中的应用

直立性疾病是人类从俯卧位转变为直立位后,因自身重力的改变所导致的一类疾病。小儿的常见病有：直立性调节障碍、胡桃夹综合征、排尿性晕厥、腹股沟疝、鞘膜积液、发育性髋脱位和股骨头无菌性坏死等。因其致病因素是人体的重力,所以防治本病的原则为反重力作用或改变体位。     

Preliminary Evaluation of Sleepwise Program for Children With Sleep Disturbance and Developmental Delay

Sleep disturbances are very prevalent in children with developmental delay. Parental-assisted behavioral strategies have been used effectively in school-aged children; however, multimodal treatment for preschool-aged children is lacking. The current study is a preliminary investigation of the effectiveness of a parent group program called Sleepwise designed for young children with developmental delay and incorporating behavioral, communicative, and sensory strategies. Six parents attended three workshop sessions and implemented individualized treatment plans. Initial results revealed significant posttreatment reductions in child sleep disturbances and behavioral problems, with high treatment acceptability ratings by parents. Outcomes were generally maintained at 1-month follow-up.     

Children with Autism and Their Friends: A Multidimensional Study of Friendship in High-Functioning Autism Spectrum Disorder

This study of Israeli and American preadolescent children examined characteristics of friendship in 44 children with high-functioning autism spectrum disorder (HFASD) compared to 38 typically developing children (TYP), as they interacted with a close friend Participants were 8-12 years of age (HFASD: Israel, n = 24; USA, n = 20; TYP: Israel, n = 23; USA, n = 15), and were matched on SES, receptive language vocabulary, child age, and gender (each study group included one girl). Multidimensional assessments included: individual behaviors of target children and observed child-friend interactions during construction and drawing scenarios; target child's and friend's self-perceived mutual friendship qualities; and mother-reported characteristics (friendship's duration/frequency; friend's age/gender/disability status). Overall, children with HFASD displayed a number of differences on individual and dyadic friendship measures. Both age and verbal abilities affected friendship behaviors. Children with HFASD and their friends perceived friendship qualities similarly, suggesting that preadolescents with HFASD have capacities for interpersonal awareness. Between-group similarities also emerged on several complex social behaviors, suggesting that friendship follows a developmental trajectory in autism and may enhance social interaction skills in autism.     

Working Memory and Motor Activity: A Comparison Across Attention-Deficit/Hyperactivity Disorder,Generalized Anxiety Disorder,and Healthy Control Groups

Converging findings from recent research suggest a functional relationship between attention-deficit/hyperactivity disorder (ADHD)-related hyperactivity and demands on working memory (WM) in both children and adults. Excessive motor activity such as restlessness and fidgeting are not pathognomonic symptoms of ADHD, however, and are often associated with other diagnoses such as generalized anxiety disorder (GAD). Further, previous research indicates that anticipatory processing associated with anxiety can directly interfere with storage and rehearsal processes of WM. The topographical similarity of excessive motor activity seen in both ADHD and anxiety disorders, as well as similar WM deficits, may indicate a common relationship between WM deficits and increased motor activity. The relationship between objectively measured motor activity (actigraphy) and PH and visuospatial WM demands in adults with ADHD (n = 21), adults with GAD (n = 21), and healthy control adults (n = 20) was examined. Although all groups exhibited significant increases in activity from control to WM conditions, the ADHD group exhibited a disproportionate increase in activity, while activity exhibited by the GAD and healthy control groups was not different. Findings indicate that ADHD-related hyperactivity is uniquely related to WM demands, and appear to suggest that adults with GAD are no more active relative to healthy control adults during a cognitively demanding laboratory task.     

Effects of Visual Information and Task Constraints on Intersegmental Coordination in Playground Swinging

The authors investigated how and to what extent visual information and associated task constraints are negotiated in the coordinative structure of playground swinging. Participants (N = 20) were invited to pump a swing from rest to a prescribed maximal amplitude under 4 conditions: normal vision, no vision, and 2 visual conditions involving explicit phasing constraints. In the latter conditions, participants were presented with a flow pattern consisting of a periodically expanding and contracting optical structure. They were instructed to phase the swing motion so that the forward turning point coincided with either the maximal size (enhanced optical flow) or the minimal size (reduced optical flow) of the presented flow pattern. Removal of visual information clearly influenced the swinging behavior, in that intersegmental coordination became more stereotyped, reflecting a general stiffening of the swinger. The conditions involving explicit phasing requirements also affected the coordination, but in an opposite way: The coordination became less stereotyped. The two phasing instructions had differential effects: The intersegmental coordination deviated more from normal swinging (i.e., without phasing constraints) when optical flow was enhanced than when it was reduced. Collectively, those findings show that visual information plays a formative role in the coordinative structure of swinging, in that variations of visual information and task constraints were accompanied by subtle yet noticeable changes in intersegmental coordination.     

认知行为疗法治疗儿童青少年强迫症的应用研究

强迫症已经被认为是儿童青少年常见的心理障碍之一。强迫症的认知行为模型在成人研究中得到了大量的实证支持,但这个模型在儿童青少年群体中研究相对较少。认知行为疗法被广泛认为是治疗儿童青少年强迫症的有效心理治疗方案,但对于认知行为治疗儿童青少年强迫症的实证研究还有待进一步深入。