Lecture 8 - Sensorimotor Development

Question 1

Outline Piagets Sensorimotor stage

Answer 1

0-2 years
Explores through direct sensory and motor contact
Object permanence and separation anxiety
Key stage
Automatic

Question 2

Outline Piagets Preoperational stage

Answer 2

2-6 years 
Uses symbols (words and images) represent objects 
Does not reason logically 
Ability to pretend 
Egocentric

Question 3

Outline Piagets Concrete Operational Stage

Answer 3

6-12 years
Think logically
Add and subtract
Understands conversation

Question 4

Outline Piagets Formal Operational Stage

Answer 4

12 years - adult
Reason abstractly
Think hypothetically

Question 5

What are the stages that Gowen and Hamilton 2013 suggest

Answer 5

1. Sensory Systems
2. State Estimation
3. Inverse Model
4. Forward Model
5. Motor Execution

Question 6

Outline Gowen and Hamilton’s 2013 Sensory Systems first stage

Answer 6

See image, sense space
Proprioception = understanding where body is in space
Vision

Question 7

Outline Gowen and Hamilton’s 2013 Second stage of State Estimation

Answer 7

Specifies Task relevant information help make a decision

Question 8

Outline Gowen and Hamilton’s 2013 third stage of Inverse Model

Answer 8

Desired state of world
Planning/Control
Planning process. Figure out from current motion what you want to achieve

—> inefficient as our sensory system is slow

Question 9

Outline Gowen and Hamilton’s 2013 fourth stage Forward Model

Answer 9

Predictor
Takes copy of motor demand and generates prediction of sensory output
Sensory motor integration

Question 10

Outline Gowen and Hamilton’s 2013 fifth stage Motor Execution

Answer 10

Converted muscle activity to form motor execution

Constant sensory feedback

Question 11

What can go wrong in Gowen and Hamilton’s 2013 stages

Answer 11

Sensory systems - atypical vision or proprioception. Can’t create accurate self-estimation and select relevant task info

Forward Model - need continuous error checked. Difficulty if incident is surprise/unexpected

Inverse Model - difficulty motor planning

Question 12

Outline Autism Spectrum Disorder as a disorder of Sensorimotor Development

Answer 12

Pronounced difficulties in communication, socialisation
Narrow interests
Repetitive behaviours. Sensory hypersensitivity

Question 13

Outline Developmental Coordination Disorder/Dyspraxia as a disorder of Sensorimotor Development

Answer 13

Pronounced difficulties: selection, timing and spatial organisation of purposeful movement and coordination

Social anxiety, social and communication skills

Question 14

What does Autism and Dyspraxia both encompass

Answer 14

Sensory and motor difficulties

Question 15

Outline Cassidy et al 2016 on Dyspraxia and Autism

Answer 15

Autism not categorical or dimensional but a continuum. All place somewhere.
Adults autism more like have DCD 7% than general population 0.8%
Pronounced sensory motor difficulties in autism
Adults DCD higher autistic traits and lower empathy

Question 16

Outline Motor Difficulties in Autism

Answer 16

General clumsiness 
80% have motor difficulties 
10% borderline 
Present from early infancy 
Tend be reported by parents as first area of concern at 15 months

Question 17

Outline impact of motor difficulties

Answer 17

Difficulties in 
Imitation 
Speech sound production 
Emotion recognition 
Anxiety in response to social interaction 
Important social development

Question 18

Outline sensory difficulties in autism

Answer 18

Part current diagnostic criteria for autism
Sensory intrusions
High prevalence in autism 65-95%
Proprioceptive impairment - determine where body is in space
Increased SU aesthetic - one sensory modality triggers another
Superior visual processing of detail
Difficulties processing motion biological vs non-biological
Contradictory - intact form but deficits in motion processing?

Question 19

Impact of sensory difficulties

Answer 19

Difficulties social and communication skills. Associated sensory reactivity.
Core feature autism and associated repetitive behaviours.
Insistence sameness and repetitive motor movements
Intolerance uncertainty
Restrictive, repetitive behaviours are calming, help with anxiety

Question 20

Summary on sensory and motor difficulties in Autism

Answer 20

Associated social and communication skills
Related and impact on anxiety and tolerance of uncertainty
Intrinsically connected
Increase likelihood diagnosis 3 years

Question 21

Outline Sensorimotor integration in autism

Answer 21

Less accurate moving eyes to new target
Slow initiative eye movement
Difficulties coordinating hand and eye movement
Explain delay in looking to social cues and downstream effects on social and communication ability

Question 22

Outline the rubber hand experiment by Cascio et al 2012

Answer 22

Fake and real hand which are covered
Can’t tell which is yours and which is fake
Poke fake hand attribute it to own hand

Question 23

Outline the rubber hand experiment by Cascio et al 2012 results on autistic participants

Answer 23

Children autism less susceptible
Reduced ability integrate visual and tactile info
Adults autism did experience illusion but were less sensitive to visual-tactile discrepancies
Less proprioceptive drift to rubber hand

Question 24

Outline Sensorimotor integration in autism

Answer 24

Difficulties incorporating visual info into motor learning in autism
Presence of visual distractor did not impact performance in children with autism
Less able correct movements from visual compared proprioceptive feedback
Difficulties with motor movements require integrating visual cues or other sensory signals

Question 25

Direct vs Mirror drawing Salowitz, Eccarius, Karst et al 2013

Answer 25

Direct drawings no difference autism vs non-autistic Mirror drawings autistic children struggle

Question 26

Summary of sensory inputs in autistic children

Answer 26

Do not tend incorporate other sensory inputs, particularly visual feedback in motor learning Difficulty coordinating visual and motor movements Impaired forward Model, lacking accuracy and flexibility

Question 27

Modifying the forward Model

Answer 27

Autistic people can learn new motor skills but takes longer Improve with age E.g. adults more susceptible to rubber hand illusion

Question 28

Outline Biological Basis to autism

Answer 28

Key role: Cerebellum Saccadic accuracy connected error-reducing function of cerebellum Cerebellum volume associated difficulties incorporating visual cues in motor learning Contains pathways link sensory and motor pathways in brain Abnormalities in those with autism Decreased activation in cerebellum during motor tasks in autism

Question 29

Where does Sensorimotor integration occur

Answer 29

Purkinje cells in cerebellum - Sensorimotor neurons Neurotypical - efficient synthesis of GABA. Sufficient receptors for GABA Autism - inefficient synthesis of GABA. Limited receptors for GABA. More glutamic acid.

Question 30

Impact of Sensorimotor difficulties in autism. Difficulties in:

Answer 30

Accuracy, speed and initiation eye movements Coordination eye and body Integrating visual and tactile info Integrating visual info into motor learning, increased reliance on proprioception Social learning opportunities Repetitive motor mannerisms - insistence sameness

Question 31

Can autistic adults benefit from psychological therapy?

Answer 31

Yes - Anderberg et al 2017 Treat mental health difficulties e.g. anxiety But it takes much longer, and prefer predictable routines

Question 32

What is the Sensorimotor theory

Answer 32

Sensory and motor difficulties first area concern early development 14.7 months prior obtaining autism diagnosis More likely diagnosed autism aged 3 Explain development and maintenance autism

Question 33

Summary of the different aspects of autism

Answer 33

``` Sustained unusual or repetitive play Uneven physical or verbal skills Inappropriate response or no response to sound Insistence on sameness Difficulty in interacting with others Echoes words or phrases Spins objects or self Inappropriate laughing/giggling ```