Example-based learning in heuristic domains: can using relevant content knowledge support the effective allocation of intrinsic, extraneous, and germane cognitive load?

Introduction: Worked examples support initial skill acquisition. They often show skill application on content knowledge from another, "exemplifying" domain (e.g., argumentation skills have to be applied to some contents). Although learners' focus should remain on the skill, learners need to understand the content knowledge to benefit from worked examples. Previous studies relied on exemplifying domains that are familiar and contain simple topics, to keep learners' focus on skill acquisition. Aim: We examined whether using a relevant exemplifying domain would allow learners to acquire both skills and content knowledge simultaneously, or whether relevant content distracts from the main learning goal of skill acquisition. Methods and results: In a training study with 142 psychology students, we used example-based learning materials with an exemplifying domain that was either relevant or irrelevant for participants' course outcomes. We assessed cognitive load, declarative knowledge about skills and course-related content knowledge, and argumentation quality. Incorporating relevant content knowledge in worked examples did not reduce learning outcomes compared to a condition using an irrelevant exemplifying domain. Discussion: Contrary to previous research, the results suggest that worked examples with a relevant exemplifying domain could possibly be an efficient teaching method for fostering skills and content knowledge simultaneously.

Optimizing Learning Outcomes when Teaching Sight Words using Fruits and Vegetables as Reinforcers.

Reinforcers frequently chosen may not offer the same nutritional value as fruits and vegetables. Prior researchers have explored preferences and the effectiveness of salty and sweet foods compared to fruits and vegetables, but the criteria for demonstrating effectiveness have often been arbitrary rather than academic. In addition, it remains unclear how the integration of these potentially nutritious reinforcers might affect learning or hinder learning efficiency. Therefore, the objective of this study was to investigate whether introducing fruits or vegetables as potential reinforcers could sustain responding achieved with salty or sweet reinforcers. The implications of this model for incorporating a variety of reinforcers while maintaining responding are also discussed.

A temporal quantitative analysis of visuomotor behavior during four twisting somersaults in elite and sub-elite trampolinists.

Vision has previously been correlated with performance in acrobatic sports, highlighting visuomotor expertise adaptations. However, we still poorly understand the visuomotor strategies athletes use while executing twisting somersaults, even though this knowledge might be helpful for skill development. Thus, the present study sought to identify the differences in gaze behavior between elite and sub-elite trampolinists during the execution of four acrobatics of increasing difficulty. Seventeen inertial measurement units and a wearable eye-tracker were used to record the body and gaze kinematics of 17 trampolinists (8 elites, 9 sub-elites). Six typical metrics were analyzed using a mixed analysis of variance (ANOVA) with the Expertise as inter-subject and the Acrobatics as intra-subject factors. To complement this analysis, advanced temporal eye-tracking metrics are reported, such as the dwell time on areas of interest, the scan path on the trampoline bed, the temporal evolution of the gaze orientation endpoint (SPGO), and the time spent executing specific neck and eye strategies. A significant main effect of Expertise was only evidenced in one of the typical metrics, where elite athletes exhibited a higher number of fixations compared to sub-elites (p = 0.033). Significant main effects of Acrobatics were observed on all metrics (p < 0.05), revealing that gaze strategies are task-dependent in trampolining. The recordings of eyes and neck movements performed in this study confirmed the use of "spotting" at the beginning and end of the acrobatics. They also revealed a unique sport-specific visual strategy that we termed as self-motion detection. This strategy consists of not moving the eyes during fast head rotations, a strategy mainly used by trampolinists during the twisting phase. This study proposes a detailed exploration of trampolinists' gaze behavior in highly realistic settings and a temporal description of the visuomotor strategies to enhance understanding of perception-action interactions during the execution of twisting somersaults.

Differential effects of theta-gamma tACS on motor skill acquisition in young individuals and stroke survivors: A double-blind, randomized, sham-controlled study.

BACKGROUND: Theta-gamma transcranial alternating current stimulation (tACS) was recently found to enhance thumb acceleration in young, healthy participants, suggesting a potential role in facilitating motor skill acquisition. Given the relevance of motor skill acquisition in stroke rehabilitation, theta-gamma tACS may hold potential for treating stroke survivors. OBJECTIVE: We aimed to examine the effects of theta-gamma tACS on motor skill acquisition in young, healthy participants and stroke survivors. METHODS: In a pre-registered, double-blind, randomized, sham-controlled study, 78 young, healthy participants received either theta-gamma peak-coupled (TGP) tACS, theta-gamma trough-coupled (TGT) tACS or sham stimulation. 20 individuals with a chronic stroke received either TGP or sham. TACS was applied over motor cortical areas while participants performed an acceleration-dependent thumb movement task. Stroke survivors were characterized using standardized testing, with a subgroup receiving additional structural brain imaging. RESULTS: Neither TGP nor TGT tACS significantly modified general motor skill acquisition in the young, healthy cohort. In contrast, in the stroke cohort, TGP diminished motor skill acquisition compared to sham. Exploratory analyses revealed that, independent of general motor skill acquisition, healthy participants receiving TGP or TGT exhibited greater peak thumb acceleration than those receiving sham. CONCLUSION: Although theta-gamma tACS increased thumb acceleration in young, healthy participants, consistent with previous reports, it did not enhance overall motor skill acquisition in a more complex motor task. Furthermore, it even had detrimental effects on motor skill acquisition in stroke survivors.

Exploring decision-making practices during coaching sessions in grassroots youth soccer: a mixed-methods study.

Decision-making ability in players during match-play is mostly acquired through practice activities with the same underlying structure as competition. However, researchers have not fully investigated how coaches design practice sessions at the participation level of the sport (i.e. 'grassroots'), or why they use a particular activity at a specific time point. This study explores the practice activities employed by youth soccer coaches at the participation level in England and aims to understand their underlying intentions. Twelve male coaches working with players aged 9-11 years across ten clubs in the London region participated. Thirty-five practice sessions were filmed and analysed to assess the proportion of time spent in activities involving 'non-active decision-making' (e.g., technical practices, fitness training) versus 'active decision-making' (e.g., small-sided and conditioned games, skills practice with realistic opposition). A brief on-field interview with the coaches about the session purpose took place immediately after each systematic observation. Coaches allocated similar amounts of time to activities with active (M = 41%) and non-active (M = 42%) decision making, with the remaining 17% being transitions. There was a common progression from non-active decision-making activities early in the session towards increased active decision-making later in the session. Interviews with coaches revealed a belief in the necessity of frequent non-active decision-making practices for technique development, despite potential disparities with improving match performance. Findings highlight a potential gap between scientific understanding and coaching practices for young soccer players at the participation level, suggesting implications for coach education programmes and the optimisation of player development strategies.

Comparative analysis of motor skill acquisition in a novel bimanual task: the role of mental representation and sensorimotor feedback.

Introduction: This study investigates the multifaceted nature of motor learning in a complex bimanual task by examining the interplay between mental representation structures, biomechanics, tactile pressure, and performance. We developed a novel maze game requiring participants to maneuver a rolling sphere through a maze, exemplifying complex sequential coordination of vision and haptic control using both hands. A key component of this study is the introduction of cognitive primitives, fundamental units of cognitive and motor actions that represent specific movement patterns and strategies. Methods: Participants were divided into two groups based on initial performance: poor performers (PPG) and good performers (GPG). The experimental setup employed motion capture and innovative tactile sensors to capture a detailed multimodal picture of the interaction process. Our primary aims were to (1) assess the effects of daily practice on task performance, biomechanics, and tactile pressure, (2) examine the relationship between changes in mental representation structures and skill performance, and (3) explore the interplay between biomechanics, tactile pressure, and cognitive representation in motor learning. Results: Performance analysis showed that motor skills improved with practice, with the GPG outperforming the PPG in maze navigation efficiency. Biomechanical analysis revealed that the GPG demonstrated superior movement strategies, as indicated by higher peak velocities and fewer velocity peaks during task execution. Tactile feedback analysis showed that GPG participants applied more precise and focused pressure with their right-hand thumb, suggesting enhanced motor control. Cognitively, both groups refined their mental representation structures over time, but the GPG exhibited a more structured and sophisticated cognitive mapping of the task post-practice. Discussion: The findings highlight the intertwined nature of biomechanical control, tactile feedback, and cognitive processing in motor skill acquisition. The results support established theories, such as the cognitive action architecture approach, emphasizing the role of mental representation in planning and executing motor actions. The integration of cognitive primitives in our analysis provides a theoretical framework that connects observable behaviors to underlying cognitive strategies, enhancing the understanding of motor learning across various contexts. Our study underscores the necessity of a holistic approach to motor learning research, recognizing the complex interaction between cognitive and motor processes in skill acquisition.

The influence of age, sex and player position on skill demands in junior Australian football.

This study aimed to investigate how ecological constraints influence individual player skill demands in community-level junior Australian Football (AF). Footage from 68 junior AF games, incorporating 1874 unique players, were analysed for individual skill demands such as disposals, kicks, handballs, tackles, marks, and shots at goal per player per game. Multiple linear mixed effect models were created for each skill, using player as a random effect. The impact of age, relative area per player (RAPP), number of players on the team, quarters in midfield, and weather on skill demands was assessed in U9-U14 boys. Finally, the influence of sex on the same skills was explored in U11-U14 boys and girls. Younger players were found to have fewer disposals and handballs, but more tackles, per player than older players (all p < 0.05). Further, more quarters in the midfield increased all skill demands (all p < 0.001). Finally, girls had fewer disposals and marks, but more tackles, per player than boys (all p < 0.05). Overall, age, sex, and position significantly impacted players' exposure to skills in junior AF. Game designers should consider methods to improve skill involvement and reduce tackling exposure early in the junior pathway, with further emphasis on the girls' game.

Perceptuomotor skill acquisition in a solo manual ball-and-beam task with varying accuracy requirements.

In the manual ball-and-beam task, participants have to control a ball that is rolling continuously on a long and hand-held beam. Since the task can be performed individually, in a solo action setting, as well as collaboratively, in a (dyadic) joint action setting, it allows us to investigate how joint performances arise from individual performances, which we investigate in a series of interrelated studies. Here we focused on individual skill acquisition on the ball-and-beam task in the solo action setting, with the goal to characterize the behavioral dynamics that arise from learning to couple (ball motion) perception and (beam motion) action. By moving a beam extremity up and down to manipulate the beam's inclination angle, the task's objective was to roll the ball as fast as and accurately as possible between two indicated targets on the beam. Based on research into reciprocal aiming tasks, we hypothesized that the emergent dynamics of the beam's inclination angle would be constrained by the size of the targets, such that large targets would evoke a continuous beam movement strategy, while small targets would lead to a discrete beam movement strategy. 16 participants individually practiced the task in two separate six-block sessions. Each block consisted of one trial per target-size condition (small, medium and large). Overall, the number of target hits increased over trials, due to a larger range of motion of the beam's inclination angle, a stronger correlation between the ball and beam motion and a smaller variability of the beam motion. Contrary to our expectations, target size did not appreciably affect the shape of the beam movement patterns. Instead, we found stable inter-individual differences in the movement strategies adopted that were uncorrelated with the number of target hits on a trial. We concluded that multiple movement strategies may lead to success on the task, while individual skill acquisition was characterized by the refinement of behavioral dynamics that emerged in an early stage of learning. We speculate that such differences in individual strategies on the task may affect the interpersonal coordination that arises in joint-action performances on the task.

Comparing Neurodevelopmental Outcomes in Infants With Patent Ductus Arteriosus Stenting Versus Blalock-Taussig-Thomas Shunt: A Pilot Study.

Background: Patent ductus arteriosus stenting (PDAS) is a nonsurgical alternative to Blalock-Taussig-Thomas shunt (BTTS) for infants with ductal-dependent congenital heart disease. In this single-center study, we aimed to compare neurodevelopmental outcomes in children who underwent BTTS as initial palliation versus PDAS. Methods: Bayley Scales of Infant and Toddler Development Screening Test (Bayley-III) reports and mode of feeding data were collected for any patient who underwent PDAS or BTTS at Rady Children's Hospital from 2013 to 2021. We also prospectively administered the Parents' Evaluation of Development Status questionnaire (PEDS) to parents of children aged 2-8 years in this patient population. Results: Of the 99 patients, 64 received a Bayley-III assessment and/or PEDS screen. Of the 35 who had a Bayley-III, there was a higher proportion of patients with PDAS who scored as developmentally appropriate compared with BTTS. PEDS screen showed that a higher proportion of patients with PDAS had no parental concern for delay than that of patients with BTTS (63% vs 30%). Patients with BTTS were more likely to undergo gastrostomy tube placement than patients with PDAS. Conclusions: Our study suggests that neurodevelopmental measures are feasible, clinically relevant, and should be included in comparative effectiveness studies of infant congenital interventions. Whether PDAS offers neurodevelopmental benefit over BTTS should be confirmed in a prospective powered randomized controlled clinical trial.

Lateralization of acquisition and consolidation in direction but not amplitude of a motor skill task.

Previous research suggests that the neural processes underlying specification of movement direction and amplitude are independently represented in the nervous system. However, our understanding of acquisition and consolidation processes in the direction and distance learning remains limited. We designed a virtual air hockey task, in which the puck direction is determined by the hand direction at impact, while the puck distance is determined by the amplitude of the velocity. In two versions of this task, participants were required to either specify the direction or the distance of the puck, while the alternate variable did not contribute to task success. Separate groups of right-handed participants were recruited for each task. Each participant was randomly assigned to one of two groups with a counter-balanced arm practice sequence (right to left, or left to right). We examined acquisition and, after 24 h, we examined two aspects of consolidation: 1) same hand performance to test the durability and 2) the opposite hand to test the effector-independent consolidation (interlimb transfer) of learning. The distance task showed symmetry between hands in the extent of acquisition as well as in both aspects of consolidation. In contrast, the direction task showed asymmetry in both acquisition and consolidation: the dominant right arm showed faster and greater acquisition and greater transfer from the opposite arm training. The asymmetric acquisition and consolidation processes shown in the direction task might be explained by lateralized control and mapping of direction, an interpretation consistent with previous findings on motor adaptation paradigms.

Be prepared! Impact of structured video-assisted coaching on performance in a simulated bleeding exercise during laparoscopic surgery.

BACKGROUND: Bleeding during laparoscopic surgery is stressful and requires immediate efficient management. Skills for complication management are rarely trained. This study aims to investigate the impact of video-assisted coaching on laparoscopic skills acquisition and performance in emergency bleeding situations. METHODS: Participants faced simulated emergency scenarios during laparoscopy involving bleeding management in porcine aorta/kidney specimens. Four sequences were conducted over two days, with a structured video-assisted coaching provided between sequences. Performance was assessed using the Global Operative Assessment of Laparoscopic Skills (GOALS) score. The study involved 27 participants attending the advanced colorectal surgery module at the 40th Annual Davos Course in 2023. RESULTS: 54 video sequences were analyzed. Structured video-assisted coaching improved the GOALS sum score by 0.36 (95%CI: 0.21-0.50, P < 0.001) in contrast to simple repetition (0.05 with 95%CI: -0.43 to 0.53, P = 0.826). This association was observed for depth of perception (P < 0.001), bimanual dexterity (P < 0.001), tissue handling (P < 0.001), overall performance (P < 0.001), and efficiency (P < 0.001). Autonomy did not significantly improve (P = 0.55). Findings were consistent regardless of age, gender, and overall laparoscopic experience of the participants. However, a weaker effect of structured video-assisted coaching was observed in participants with experience in laparoscopic surgery. CONCLUSION: Structured video-assisted coaching improved performance in laparoscopic skills in complex and stress-inducing bleeding scenarios. The findings of this study support the incorporation of video-assisted coaching and complication management exercises into surgical training curricula.

Fundamental processes in sensorimotor learning: Reasoning, refinement, and retrieval.

Motor learning is often viewed as a unitary process that operates outside of conscious awareness. This perspective has led to the development of sophisticated models designed to elucidate the mechanisms of implicit sensorimotor learning. In this review, we argue for a broader perspective, emphasizing the contribution of explicit strategies to sensorimotor learning tasks. Furthermore, we propose a theoretical framework for motor learning that consists of three fundamental processes: reasoning, the process of understanding action-outcome relationships; refinement, the process of optimizing sensorimotor and cognitive parameters to achieve motor goals; and retrieval, the process of inferring the context and recalling a control policy. We anticipate that this '3R' framework for understanding how complex movements are learned will open exciting avenues for future research at the intersection between cognition and action.

The effectiveness of different attentional foci on the acquisition of sport-specific motor skills in healthy adults: a systematic review with network meta-analysis.

Background: The acquisition of motor skills is a key element in many sports. A motor learning principle, which is frequently used to support skill acquisition is the application of different attentional foci. The effectiveness of different attentional foci on performance and the learning of motor skills has been investigated in various sports using randomised controlled trials. The aim of the present study was to investigate the effectiveness of different attentional foci (such as external (EFA) and internal attentional foci (IFA), but also holistic and switching foci) on the performance and learning of a sport-specific motor task in healthy individuals. Methods: This study was a systematic review with network meta-analysis. We followed the Prisma reporting guideline and the Cochrane handbook for systematic reviews. Cinahl, Embase, Medline and Cochrane Central were searched for eligible studies. Network meta-analyses were performed for the post-acquisition, retention and transfer test endpoints. Results: Twelve studies were included in the review. At post-acquisition an EFA was the most effective intervention compared to the control intervention (SMD: 0.9855; 95% CI [0.4-1.57]; p: 0.001). At the retention and transfer test endpoints, a holistic focus of attention had the highest effectiveness compared to an IFA (SMD 0.75; 95% CI [-0.1 to 1.6]; p: 0.09) and (SMD 1.16; 95% CI [0.47-1.86]; p: 0.001). Discussion: For all three endpoints, we analysed a greater effectiveness of an EFA and holistic focus compared to an IFA. Several promising different attentional focus interventions were identified. The largest effects were analysed for a holistic focus. However, only one study used this intervention and therefore there remains uncertainty about the effectiveness. With regard to the inconsistency observed, the analysis at post-acquisition should be interpreted with caution. Modified versions of the EFA were the imagined and the dynamic EFA. Both were only explored in single studies and should therefore be investigated in further follow-up studies that directly compare them.

Exploring learning characteristics and progression of GP trainees based in regional, rural and remote settings: A qualitative study.

OBJECTIVE: Globally, most doctors train and work in metropolitan areas but a key strategy for developing the rural health workforce is expanding rural training. The aim of this study was to describe the scope and quality of learning along with skill acquisition of GP trainees based in regional, rural, and remote settings. SETTING: Regional, rural and remote settings in Queensland Australia excluding Brisbane. PARTICIPANTS: Thirty-seven general practice trainees who had undertaken their first community placement were recruited from regional, rural and remote learning settings within Queensland. DESIGN: Qualitative descriptive methodology based on constructionist epistemology was employed which allowed for the exploration of current GP trainees' experiences. Trainees were interviewed and data were thematically analysed as to the scope and quality of learning by the setting of training. Learning experiences were then mapped against the Dreyfus and Dreyfus model to explore skill acquisition. RESULTS: In terms of the scope and quality of learning, rural and remote trainees mainly focused on the diverse and unique (sometimes challenging) experiences their setting offered compared with regionally based trainees. Mapping of the trainee comments to the Dreyfus model of skill acquisition demonstrated that regardless of setting, equivalent learning occurred by GP trainees. CONCLUSIONS: This exploratory study provides evidence that rural and remote learning may provide a more diverse and challenging experience. It suggests an equivalence of quality of education and skill acquisition across settings rural, regional and remote. This suggests that the training distribution policies may not disadvantage GP trainees and the scope and quality of more remote learning may increase uptake of remote placements.

Enhancing the Central Venous Catheterization Competency of Medical Students through a Specialized Team and an Interactive Response System: A pre-post study.

Background: Central venous catheterization (CVC) is a critical clinical procedure. To avoid complications, possessing good knowledge regarding the CVC care bundle and skills for the proper insertion and maintenance of CVC are important. Objectives: To evaluate the effectiveness of an educational intervention and the use of an interactive response system in enhancing the CVC bundle care and insertion skills of medical students undergoing critical care medicine training. Materials and Methods: Sixth-year medical students (equivalent to fourth-year students in the United States) engaged in didactic lessons, interactive demonstrations, and simulator training facilitated by a CVC team comprising three thoracic and two vascular surgeons (all with a minimum 5 years of experience in central venous access) during their intensive care unit (ICU) rotation. Self-reported knowledge and confidence levels were assessed using pre-and posttests administered through the Zuvio App, an interactive response system. Results: A total of 60 students underwent the educational intervention, of which 54 completed the pretest and 40 completed the posttest. In the posttest, significant improvement was found in the CVC bundle care competency and understanding (P = 0.002), preprocedural preparation (P = 0.002), insertion procedures (P = 0.004), complications (P = 0.003), and insertion depth decisions (P = 0.001). Staff and students reported that assessment and interaction via the Zuvio App were valuable, practical, and feasible in a clinical setting, providing trainees with an individual competency portfolio of receiving precise medical education. Conclusions: Integrating the training provided by a specialized team with an interactive response system enhanced the knowledge and competency level in CVC insertion among medical students in this study.

Does using artificial intelligence assistance accelerate skill decay and hinder skill development without performers' awareness?

Artificial intelligence in the workplace is becoming increasingly common. These tools are sometimes used to aid users in performing their task, for example, when an artificial intelligence tool assists a radiologist in their search for abnormalities in radiographic images. The use of artificial intelligence brings a wealth of benefits, such as increasing the efficiency and efficacy of performance. However, little research has been conducted to determine how the use of artificial intelligence assistants might affect the user's cognitive skills. In this theoretical perspective, we discuss how artificial intelligence assistants might accelerate skill decay among experts and hinder skill acquisition among learners. Further, we discuss how AI assistants might also prevent experts and learners from recognizing these deleterious effects. We then discuss the types of questions: use-inspired basic cognitive researchers, applied researchers, and computer science researchers should seek to answer. We conclude that multidisciplinary research from use-inspired basic cognitive research, domain-specific applied research, and technical research (e.g., human factors research, computer science research) is needed to (a) understand these potential consequences, (b) design artificial intelligence systems to mitigate these impacts, and (c) develop training and use protocols to prevent negative impacts on users' cognitive skills. Only by answering these questions from multidisciplinary perspectives can we harness the benefits of artificial intelligence in the workplace while preventing negative impacts on users' cognitive skills.

Systematic Review of Differential Reinforcement in Skill Acquisition.

The purpose of this article was to review and summarize the literature investigating the impact of differential reinforcement on skill acquisition. Researchers synthesized data from 10 articles across the following categories: (1) participant characteristics; (2) setting; (3) reinforcement procedures; (4) within-subject replication; (5) results; and (6) secondary measures (e.g., social validity). Results indicated that most of the participants were male, had a diagnosis of autism, and communicated vocally. The differential reinforcement condition in which reinforcement favored independent responses (e.g., edible for independent; praise for prompted responses) was the most frequently employed differential reinforcement condition and it resulted in the acquisition of more responses or faster acquisition for most participants. In addition, when differing reinforcement procedures manipulating different parameters of reinforcements were compared, better outcomes were attained when the schedule of the reinforcer was manipulated within the differential reinforcement procedure relative to when quality or magnitude were manipulated. Limitations of the previous research, recommendations for future research, and implications for clinical practice are discussed.

Family-Centric Applied Behavior Analysis Promotes Sustained Treatment Utilization and Attainment of Patient Goals.

BACKGROUND/OBJECTIVES:  Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication difficulties and restricted repetitive behaviors or interests. Applied behavior analysis (ABA) has been shown to significantly improve outcomes for individuals on the autism spectrum. However, challenges regarding access, cost, and provider shortages remain obstacles to treatment delivery. To this end, parents were trained as parent behavior technicians (pBTs), improving access to ABA, and empowering parents to provide ABA treatment in their own homes. We hypothesized that patients diagnosed with severe ASD would achieve the largest gains in overall success rates toward skill acquisition in comparison to patients diagnosed with mild or moderate ASD. Our secondary hypothesis was that patients with comprehensive treatment plans (>25-40 hours/week) would show greater gains in skill acquisition than those with focused treatment plans (less than or equal to 25 hours/week).  Methods: This longitudinal, retrospective chart review evaluated data from 243 patients aged two to 18 years who received at least three months of ABA within our pBT treatment delivery model. Patients were stratified by utilization of prescribed ABA treatment, age, ASD severity (per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), and treatment plan type (comprehensive vs. focused). Patient outcomes were assessed by examining success rates in acquiring skills, both overall and in specific focus areas (communication, emotional regulation, executive functioning, and social skills). RESULTS: Patients receiving treatment within the pBT model demonstrated significant progress in skill acquisition both overall and within specific focus areas, regardless of cohort stratification. Patients with severe ASD showed greater overall skill acquisition gains than those with mild or moderate ASD. In addition, patients with comprehensive treatment plans showed significantly greater gains than those with focused treatment plans. CONCLUSION: The pBT model achieved both sustained levels of high treatment utilization and progress toward patient goals. Patients showed significant gains in success rates of skill acquisition both overall and in specific focus areas, regardless of their level of treatment utilization. This study reveals that our pBT model of ABA treatment delivery leads to consistent improvements in communication, emotional regulation, executive functioning, and social skills across patients on the autism spectrum, particularly for those with more severe symptoms and those following comprehensive treatment plans.

Applying different levels of practice variability for motor learning: More is not better.

Background: Variable practice is a broadly used tool to improve motor learning processes. However, controversial results can be found in literature about the success of this type of practice compared to constant practice. This study explored one potential reason for this controversy: the manipulation of variable practice load applied during practice and its effects according to the initial performance level and the initial intrinsic variability of the learner. Method: Sixty-five participants were grouped into four practice schedules to learn a serial throwing task, in which the training load of variable practice was manipulated: one constant practice group and three groups with different variable practice loads applied. After a pre-test, participants trained for 2 weeks. A post-test and three retests (96 h, 2 weeks and 1 month) were carried out after training. The participants' throwing accuracy was assessed through error parameters and their initial intrinsic motor variability was assessed by the autocorrelation coefficient of the error. Results: The four groups improved their throwing performance. Pairwise comparisons and effect sizes showed larger error reduction in the low variability group. Different loads of variable practice seem to induce different performance improvements in a throwing task. The modulation of the variable practice load seems to be a step forward to clarify the controversy about its benefits, but it has to be guided by the individuals' features, mainly by the initial intrinsic variability of the learner.

Distinct mechanisms for online and offline motor skill learning across human development.

The human central nervous system (CNS) undergoes tremendous changes from childhood to adulthood and this may affect how individuals at different stages of development learn new skills. Here, we studied motor skill learning in children, adolescents, and young adults to test the prediction that differences in the maturation of different learning mechanisms lead to distinct temporal patterns of motor learning during practice and overnight. We found that overall learning did not differ between children, adolescents, and young adults. However, we demonstrate that adult-like skill learning is characterized by rapid and large improvements in motor performance during practice (i.e., online) that are susceptible to forgetting and decay over time (i.e., offline). On the other hand, child-like learning exhibits slower and less pronounced improvements in performance during practice, but these improvements are robust against forgetting and lead to gains in performance overnight without further practice. The different temporal dynamics of motor skill learning suggest an engagement of distinct learning mechanisms in the human CNS during development. In conclusion, adult-like skill learning mechanisms favor online improvements in motor performance whereas child-like learning mechanisms favors offline behavioral gains. RESEARCH HIGHLIGHTS: Many essential motor skills, like walking, talking, and writing, are acquired during childhood, and it is colloquially thought that children learn better than adults. We investigated dynamics of motor skill learning in children, adolescents, and young adults. Adults displayed substantial improvements during practice that was susceptible to forgetting over time. Children displayed smaller improvements during practice that were resilient against forgetting. The distinct age-related characteristics of these processes of acquisition and consolidation suggest that skill learning relies on different mechanisms in the immature and mature central nervous system.