[W5] - L5 Flashcards
How do children learn motor skills?
Neuro-motor processes are developed through action and movement.
Genetic make-up plays a role, but so does nurturing (well-fed, secure etc.)
In early infancy, the brain is a sensitive period of development. Both safety and stimulation are needed in this stage.
Degrees of Joint Freedom and Development
When learning to stand/walk, children often hold up their arms – this is because some joints need to be Frozen to Facilitate other movements (lesser degree of freedom in the joints than adults have)
The coordination of movement is the process of mastering redundant degrees of freedom of the moving organ into a controllable system.
Four Processes of Attention
Alertness: how sensible is the brain to detect information?
Sustained attention (how long can a child maintain attention while practicing a task)
Divided attention (splitting attention between different sources of information)
Selected attention (focusing on 1 aspect of all information from the environment; hence suppressing/filtering out environmental/other sources)
The DSM-V Criteria for Developmental Coordination Disorder
A. The Acquisition and Execution of Coordinated Motor Skills is substantially below expected; given chronological age and sufficient opportunities to
acquire motor skills.
B. The motor skills deficit significantly and persistently interferes
with the activities of everyday living; and impacts upon academic/school productivity, prevocational and vocational activities, leisure, and play.
C. Onset of symptoms in childhood (although not always identified until adolescence or
adulthood).
D. The motor skills deficits are not better accounted for by any other medical,
neurodevelopmental, psychological, social condition or cultural background
How do you determine whether a child is acquiring and executing motor skills in a way that is substantially below what is expected for their age?
Valid and reliable motor tests are used which identify
children with motor problems using cut-off scores. The tasks used are more demanding as the age band of the child increases [note that motor performance during handwriting and typing should be assessed separately]
Examples include: Movement Assessment
Battery for Children 2nd ed.
(MABC-2); Bruininks Oseretsky Test 2nd
edition (BOT-2); and Körperkoordinationstest Für
Kinder (KTK) [cross-motor test]
How do you determine whether motor deficits are interfering in daily life, started in childhood and cannot be accounted for by other conditions/factors?
Parental insight is required, specifically on:
- cognitive, social and motor development of the child,
- the medical history,
- their opportunity to practice motor skills
- ADL (daily living) problems
- Whether their IQ >70
For parental questionnaires you can use: Developmental Coordination Disorder Parent Questionnaire (DCDQ), its revised version (DCDQ-R), the DCD-Daily
For teacher questionnaires: MABC-2 checklist (MABC-2-C)
The Internal Modelling Deficit Hypothesis for DCD
Children with DCD struggle to plan movements or anticipate how a limb will react. They’re not coordinated, and misjudgments occur (i.e., height).
Throughout development we develop an internal model of our body. In children with DCD, there is an Internal modeling deficit (IMD) hypothesis: specifically the lack of a good forward model. In other words, they have a reduced ability to use predictive motor control. As an example, such children would skip to the middle stage of opening a bottle and hence would not be able to generate the excess force required at the beginning of the process.
During action planning tasks, this predictive motor control (based on information from internal models) is needed to anticipate the end state of a movement (turning the lid of a jar of jam). Hence, there are a greater number of mismatches between predictions and reality.
The role of the Cerebellum in DCD
This region is relevant for implicit motor learning (learning without specific instructions, just by doing and adjusting one’s movements accordingly).
This appears to be dysfunctional in children with DCD (i.e., no improvement for motor accuracy on a fine motor task following three days of skilled practice).
DCD children demonstrate under-activation in cerebellar–parietal and cerebellar– prefrontal networks [and in brain regions associated with visual-spatial learning] - suggesting there MIGHT be a neurobiological correlation with poor motor skill acquisition.
The role of the Parietal Cortex in DCD
This region is relevant for the processing of sensorimotor information.
More specifically: for the processing of sensorimotor transformations; building of internal models; motor learning.
The role of the Basal Ganglia in DCD
Relevant to sequence learning and control of force.
The heterogeneity observed in individuals with DCD suggests that multiple brain regions might contribute to the motor coordination problems (i.e., spinal networks’ role in reflex)
The relevance of a strong Internal Working Model for catching
To catch something you need to be able to predict how long your arm is (note that the length of the arm changes rapidly during puberty and mismatches occur because one has not yet adjusted to this new length), how open your hand needs to be, anticipate the speed and direction of the bean bag, close your hand in a timely manner on the right spot, and responding with sufficient speed during the catch.
When an individual has a very strong internal working model, such a task is much easier and visual control is needed to a much lesser extent.
WII-Fit Study and Learning with DCD
WII – Fit study: you get augmented feedback. Study looked at developing the base of support in children with DCD over 6 weeks (as they have larger/more variable shifts of weight within their base of support than controls)
Results: Control group were more successful at the game – in the DCD group there were more directional changes per cm travelled in the anterior-posterior and lateral (side to side) direction (much more head movements?)
The main takeaway was that DCD is by definition a deficit in coordination: these children had more reversals and sub-movements, and less consistent goal related movements.
The intervention mainly improved the temporal part of the task (on time reaching the next gate, faster) and would need more task related assignments to facilitate changes in kinetics.
Children with DCD can learn – even if the final execution of tasks does not look exactly the same.
The impact of DCD on daily life
DCD has far-reaching impacts on daily motor tasks/physical activities like self-care, school tasks, leisure activities (biking, sports, social engagement, isolation/bullying/picked last/knocked out first in tag). Parents usually give up when there is no success so the children get even LESS motor stimulation/practice – and these environmental consequences can have even further knock-on effects.
Secondary problems in social and emotional health may arise when DCD is not well understood by the child, parents, or the environment. Problems with executive function, attention, and anxiety are often reported, as well as symptoms of depression and low global self-esteem.
How might DCD impact on attention?
The delay in achieving automatized movement milestones means that more attentional resources are needed for a child with DCD to perform motor tasks than for their peers. This high cognitive load might make it difficult to focus; and it may manifest itself as an attentional deficit.
Is DCD a motor LEARNING deficit?
The research would suggest that it’s not!
Children were trained from a beginner’s level on active computer games (WII-Fit).
Children with DCD learned motor skills at a similar rate/similar learning curve to their peers – although they started at a lower base skill level and finished lower as well; but it does suggest that DCD is NOT a motor learning deficit.
Were these motor learnings transferrable? Yes! Improved performance in other motor domains was observed as a result of this training with augmented feedback in both control and DCD groups (i.e., greater overall bodily control)
When it comes to learning and transferring, there are more similarities than differences. DCD children are slower, however, in applying learned skills to another performance situation than TD peers.
