Psychometric Properties of the French European Little Developmental Coordination Disorder Questionnaire (LDCDQ-FE): A Pilot Study.

AIMS: The Little Developmental Coordination Disorder Questionnaire (LDCDQ) is a parental questionnaire designed to identify preschool children at risk of Developmental Coordination Disorder (DCD). This study aimed to translate and cross-culturally adapt the LDCDQ for French European informants (Little Developmental Coordination Disorder Questionnaire-French European [LDCDQ-FE]) and to undertake a pilot examination of its psychometric properties on a French sample. METHODS: A thorough process of cultural adaptation was completed. The psychometric properties were examined with a sample of 154 French children aged to 5y11m (control = 121; clinically referred = 33). A sub-group of 34 children was assessed using the MABC-2 to measure convergent validity. RESULTS: Principal component analysis demonstrated a four-component structure, accounting for 67.5% of the variance. Internal consistency was acceptable to good (α = 0.74-0.89). Significant correlation between the LDCDQ-FE and the MABC-2 total scores showed convergent validity. Discriminant validity was supported by significant score differences between the clinically referred and a matched control sub-group. Using ROC curves, a cutoff of 67 was proposed for a sensitivity of 81.3% and a specificity of 77.8%. CONCLUSIONS: Results show initial evidence of the psychometric properties of the LDCDQ-FE and are encouraging of its use to identify young preschoolers at risk for DCD. In future studies, the test-retest reliability should be investigated, and study sample sizes expanded.

Procedural learning and retention of audio-verbal temporal sequence is altered in children with developmental coordination disorder but cortical thickness matters.

Rhythmic abilities are impaired in developmental coordination disorder (DCD) but learning deficit of procedural skills implying temporal sequence is still unclear. Current contradictory results suggest that procedural learning deficits in DCD highly depend on learning conditions. The present study proposes to test the role of sensory modality of stimulations (visual or auditory) on synchronization, learning, and retention of temporal verbal sequences in children with and without DCD. We postulated a deficit in learning particularly with auditory stimulations, in association with atypical cortical thickness of three regions of interesting: sensorimotor, frontal and parietal regions. Thirty children with and without DCD (a) performed a synchronization task to a regular temporal sequence and (b) practiced and recalled a novel non-regular temporal sequences with auditory and visual modalities. They also had a magnetic resonance imaging to measure their cortical thickness. Results suggested that children with DCD presented a general deficit in synchronization of a regular temporal verbal sequence irrespective of the sensory modality, but a specific deficit in learning and retention of auditory non-regular verbal temporal sequence. Stability of audio-verbal synchronization during practice correlated with cortical thickness of the sensorimotor cortex. For the first time, our results suggest that synchronization deficits in DCD are not limited to manual tasks. This deficit persists despite repeated exposition and practice of an auditory temporal sequence, which suggests a possible alteration in audio-verbal coupling in DCD. On the contrary, control of temporal parameters with visual stimuli seems to be less affected, which opens perspectives for clinical practice.

Developmental trajectories of motor skills during the preschool period.

Children with developmental coordination disorder also manifest difficulties in non-motor domains (attentional, emotional, behavioral and socialization skills). Longitudinal studies can help disentangle the complex relationships between the development of motor skills and other cognitive domains. This study aims to examine the contribution of early cognitive factors to changes in motor skills during the preschool period. Children (N = 1144) from the EDEN mother-child cohort were assessed for motor skills with the Copy Design task (NEPSY battery) and the parent-rated Ages and Stages Questionnaire (fine and gross motor skills scores) at ages 3 and 5-6 years. At 3 years, language skills were evaluated using tests from the NEPSY and ELOLA batteries. Emotional problems, conduct problems, inattention and hyperactivity symptoms, peer relationships and pro-social behavior were assessed with the Strengths and Difficulties Questionnaire (SDQ) also at 3 years. Linear and logistic regression models were performed to examine whether positive and negative changes in motor skills between 3 and 5-6 years are associated with specific cognitive skills at 3 years, while adjusting for a broad range of pre- and postnatal environmental factors. In the linear regression model, the SDQ Inattention symptoms score at 3 years was associated with negative changes in motor skills (standardized ß = - 0.09, SD = 0.03, p value = 0.007) and language skills at 3 years were associated with positive changes in motor skills (standardized ß = 0.05, SD = 0.02, p value = 0.041) during the preschool period. In logistic regression models, the SDQ Inattention symptoms score at 3 years was associated with a higher likelihood of a declining trajectory of motor skills (OR [95% CI] = 1.37 [1.02-1.84]). A higher language skills score at 3 years was associated with an increased likelihood of a resilient trajectory (1.67 [1.17-2.39]). This study provides a better understanding of the natural history of developmental coordination delays by identifying cognitive factors that predict changes in motor skills between the ages of 3 and 5-6 years.

Atypical inter-hemispheric communication correlates with altered motor inhibition during learning of a new bimanual coordination pattern in developmental coordination disorder.

Impairment of motor learning skills in developmental coordination disorder (DCD) has been reported in several studies. Some hypotheses on neural mechanisms of motor learning deficits in DCD have emerged but, to date, brain-imaging investigations are scarce. The aim of the present study is to assess possible changes in communication between brain areas during practice of a new bimanual coordination task in teenagers with DCD (n = 10) compared to matched controls (n = 10). Accuracy, stability and number of mirror movements were computed as behavioural variables. Neural variables were assessed by electroencephalographic coherence analyses of intra-hemispheric and inter-hemispheric fronto-central electrodes. In both groups, accuracy of the new coordination increased concomitantly with right intra-hemispheric fronto-central coherence. Compared to typically developing teenagers, DCD teenagers presented learning difficulties expressed by less stability, no stabilization of the new coordination and a greater number of mirror movements despite practice. These measures correlated with reduced inter-hemispheric communication, even after practice of the new coordination. For the first time, these findings provide neuro-imaging evidence of a kind of inter-hemispheric 'disconnection' related to altered inhibition of mirror movements during motor learning in DCD.

Is there a link between sensorimotor coordination and inter-manual coordination? Differential effects of auditory and/or visual rhythmic stimulations.

The purpose of this study was to test how the sensory modality of rhythmic stimuli affects the production of bimanual coordination patterns. To this aim, participants had to synchronize the taps of their two index fingers with auditory and visual stimuli presented separately (auditory or visual) or simultaneously (audio-visual). This kind of task requires two levels of coordination: (1) sensorimotor coordination, which can be measured by the mean asynchrony between the beat of the stimulus and the corresponding tap and by mean asynchrony stability, and (2) inter-manual coordination, which can be assessed by the accuracy and stability of the relative phase between the right-hand and left-hand taps. Previous studies show that sensorimotor coordination is better during the synchronization with auditory or audio-visual metronomes than with visual metronome, but it is not known whether inter-manual coordination is affected by stimulation modalities. To answer this question, 13 participants were required to tap their index fingers in synchrony with the beat of auditory and/or visual stimuli specifying three coordination patterns: two preferred inphase and antiphase patterns and a non-preferred intermediate pattern. A first main result demonstrated that inphase tapping had the best inter-manual stability, but the worst asynchrony stability. The second main finding revealed that for all patterns, audio-visual stimulation improved the stability of sensorimotor coordination but not of inter-manual coordination. The combination of visual and auditory modalities results in multisensory integration, which improves sensorimotor coordination but not inter-manual coordination. Both results suggest that there is dissociation between processes underlying sensorimotor synchronization (anticipation or reactivity) and processes underlying inter-manual coordination (motor control). This finding opens new perspectives to evaluate separately the possible sensorimotor and inter-manual coordination deficits present in movement disorders.

A parsimonious oscillatory model of handwriting.

We propose an oscillatory model that is theoretically parsimonious, empirically efficient and biologically plausible. Building on Hollerbach's (Biol Cybern 39:139-156, 1981) model, our Parsimonious Oscillatory Model of Handwriting (POMH) overcomes the latter's main shortcomings by making it possible to extract its parameters from the trace itself and by reinstating symmetry between the [Formula: see text] and [Formula: see text] coordinates. The benefit is a capacity to autonomously generate a smooth continuous trace that reproduces the dynamics of the handwriting movements through an extremely sparse model, whose efficiency matches that of other, more computationally expensive optimizing methods. Moreover, the model applies to 2D trajectories, irrespective of their shape, size, orientation and length. It is also independent of the endeffectors mobilized and of the writing direction.

Motor Adaptation Deficits in Children with Developmental Coordination Disorder and/or Reading Disorder.

Procedural learning has been mainly tested through motor sequence learning tasks in children with neurodevelopmental disorders, especially with isolated Developmental Coordination Disorder (DCD) and Reading Disorder (RD). Studies on motor adaptation are scarcer and more controversial. This study aimed to compare the performance of children with isolated and associated DCD and RD in a graphomotor adaptation task. In total, 23 children with RD, 16 children with DCD, 19 children with DCD-RD, and 21 typically developing (TD) children wrote trigrams both in the conventional (from left to right) and opposite (from right to left) writing directions. The results show that movement speed and accuracy were more impacted by the adaptation condition (opposite writing direction) in children with neurodevelopmental disorders than TD children. Our results also reveal that children with RD have less difficulty adapting their movement than children with DCD. Children with DCD-RD had the most difficulty, and analysis of their performance suggests a cumulative effect of the two neurodevelopmental disorders in motor adaptation.

A preliminary study of the different memory systems in neurofibromatosis type 1: What is impaired and what is spared?

BACKGROUND: Since 1990's, the cognitive profile of children with a neurofibromatosis type 1 (NF1) has been refined by many different studies. Children with NF1 may exhibit a variety of cognitive dysfunctions. Memory difficulties have been reported, but the results are contradictory and, compared to other cognitive functions, memory has been less evaluated. OBJECTIVE: The aim of this study was to investigate the memory profile in NF1 with a particular population, children with NF1 without attention deficit hyperactivity disorder (ADHD). METHODS: Eighteen children with NF1 without ADHD and eighteen typically developing aged from 8 to 12.6 years were compared in terms of both their verbal and visual working memory, anterograde memory, and procedural perceptual-motor memory. We also assessed semantic and autobiographical memory. RESULTS: Our results indicate the existence of memory difficulties in children with NF1 without ADHD in verbal working and anterograde memory but not in terms of the visual domain. They also experienced difficulties recalling personal memories but these were improved by cueing. However, semantic memory and procedural perceptual-motor memory was preserved. CONCLUSIONS: These results highlight a difference between memory systems in children with NF1 without ADHD and the importance to assess the different memory systems, the nature of information and the processes in long-term memory in NF1 population. However, our results raise questions about the possible links between these difficulties and the executive functions. The specifics of memory profile in children with NF1 must be taken into consideration in these children's clinical follow-up, in order to understand their learning difficulties and to make adaptations to their care.

Efficacy of an explicit handwriting program.

The aim of this study was to investigate the effects of an explicit handwriting program introduced during the first grade of elementary school. Grade 1 children (N=23) with an age range of 6.1 to 7.4 yr. (15 girls, 8 boys) were administered an additional handwriting program of two weekly sessions of 45 min. over six weeks. Another group of 19 Grade 1 children (11 girls, 8 boys) received only the regular handwriting program of one weekly session. The Concise Assessment Scale for Children's Handwriting was administered to measure the changes in quality and speed of handwriting. The children given the explicit program showed better quality and speed of handwriting than did the control group. Their handwriting was more regular, with fewer ambiguous letters and fewer incorrect relative heights.

The Differential Effects of Auditory and Visual Stimuli on Learning, Retention and Reactivation of a Perceptual-Motor Temporal Sequence in Children With Developmental Coordination Disorder.

This study investigates the procedural learning, retention, and reactivation of temporal sensorimotor sequences in children with and without developmental coordination disorder (DCD). Twenty typically-developing (TD) children and 12 children with DCD took part in this study. The children were required to tap on a keyboard, synchronizing with auditory or visual stimuli presented as an isochronous temporal sequence, and practice non-isochronous temporal sequences to memorize them. Immediate and delayed retention of the audio-motor and visuo-motor non-isochronous sequences were tested by removing auditory or visual stimuli immediately after practice and after a delay of 2 h. A reactivation test involved reintroducing the auditory and visual stimuli after the delayed recall. Data were computed via circular analyses to obtain asynchrony, the stability of synchronization and errors (i.e., the number of supplementary taps). Firstly, an overall deficit in synchronization with both auditory and visual isochronous stimuli was observed in DCD children compared to TD children. During practice, further improvements (decrease in asynchrony and increase in stability) were found for the audio-motor non-isochronous sequence compared to the visuo-motor non-isochronous sequence in both TD children and children with DCD. However, a drastic increase in errors occurred in children with DCD during immediate retention as soon as the auditory stimuli were removed. Reintroducing auditory stimuli decreased errors in the audio-motor sequence for children with DCD. Such changes were not seen for the visuo-motor non-isochronous sequence, which was equally learned, retained and reactivated in DCD and TD children. All these results suggest that TD children benefit from both auditory and visual stimuli to memorize the sequence, whereas children with DCD seem to present a deficit in integrating an audio-motor sequence in their memory. The immediate effect of reactivation suggests a specific dependency on auditory information in DCD. Contrary to the audio-motor sequence, the visuo-motor sequence was both learned and retained in children with DCD. This suggests that visual stimuli could be the best information for memorizing a temporal sequence in DCD. All these results are discussed in terms of a specific audio-motor coupling deficit in DCD.

Developmental coordination disorder.

Developmental coordination disorder (DCD) is a neurodevelopmental disorder that affects children's ability to execute coordinated motor actions, resulting in slow, clumsy, or inaccurate motor performances and learning difficulties (of new motor tasks or to adapt previously learned gestures to a modified or additional constraint). In the course of development, children with DCD exhibit a diversity of motor signs, including fine and gross motor problems with impaired postural control and balance, and sensorimotor coordination or motor learning difficulties. The prevalence ranges between 1.8% and 8%, depending on the diagnostic criteria used, based on the cutoff of motor scores from standardized scales. Four main hypotheses have been postulated to explain DCD in terms of deficits in visuospatial functions, procedural learning, internal modeling, or executive functions. Neuroimaging studies are scarce but have highlighted several brain regions, including the parietal, frontal, and cerebellar cortices. Meta-analyses have supported task-oriented approaches as effective therapies to improve motor performance in children with DCD.

Intrinsic Cortico-Subcortical Functional Connectivity in Developmental Dyslexia and Developmental Coordination Disorder.

Developmental dyslexia (DD) and developmental coordination disorder (DCD) are distinct diagnostic disorders. However, they also frequently co-occur and may share a common etiology. It was proposed conceptually a neural network framework that explains differences and commonalities between DD and DCD through impairments of distinct or intertwined cortico-subcortical connectivity pathways. The present study addressed this issue by exploring intrinsic cortico-striatal and cortico-cerebellar functional connectivity in a large (n = 136) resting-state fMRI cohort study of 8-12-year-old children with typical development and with DD and/or DCD. We delineated a set of cortico-subcortical functional circuits believed to be associated with the brain's main functions (visual, somatomotor, dorsal attention, ventral attention, limbic, frontoparietal control, and default-mode). Next, we assessed, using general linear and multiple kernel models, whether and which circuits distinguished between the groups. Findings revealed that somatomotor cortico-cerebellar and frontoparietal cortico-striatal circuits are affected in the presence of DCD, including abnormalities in cortico-cerebellar connections targeting motor-related regions and cortico-striatal connections mapping onto posterior parietal cortex. Thus, DCD but not DD may be considered as an impairment of cortico-subcortical functional circuits.

Developmental coordination disorder and dysgraphia: signs and symptoms, diagnosis, and rehabilitation.

Developmental coordination disorder (DCD) is a common and well-recognized neurodevelopmental disorder affecting approximately 5 in every 100 individuals worldwide. It has long been included in standard national and international classifications of disorders (especially the Diagnostic and Statistical Manual of Mental Disorders). Children and adults with DCD may come to medical or paramedical attention because of poor motor skills, poor motor coordination, and/or impaired procedural learning affecting activities of daily living. Studies show DCD persistence of 30-70% in adulthood for individuals who were diagnosed with DCD as children, with direct consequences in the academic realm and even beyond. In particular, individuals with DCD are at increased risk of impaired handwriting skills. Medium-term and long-term prognosis depends on the timing of the diagnosis, (possible) comorbid disorders (and their diagnosis), the variability of signs and symptoms (number and intensity), and the nature and frequency of the interventions individuals receive. We therefore chose to investigate the signs and symptoms, diagnosis, and rehabilitation of both DCD and developmental dysgraphia, which continues to receive far too little attention in its own right from researchers and clinicians.

A study of EEG coherence in DCD children during motor synchronization task.

This paper investigates the hypothesis that the coordination difficulties of DCD children are associated with an increased coherence in the cortical motor regions, which persists with age. Forty-eight children participated in the study (24 DCD and 24 Controls). Their ages ranged from 8 to 13 years, divided into three groups (8-9, 10-11, and 12-13 years old). Children were required to perform finger flexion or extension either in synchrony or in syncopation with a rhythmic metronome, while a 32-channel EEG was recorded. Along with stability measures of motor performance, we analyzed the spectral EEG coherence between intrahemispheric (left frontal/left central; left central/left parietal) and interhemispheric (left central/right central) sites. Spectral coherence assesses functional coupling between distant areas of the brain. Two frequency bands related to sensorimotor activation were chosen: alpha (8-12 Hz) and beta (12-30 Hz). The synchrony task was chosen as a rest condition against which the two syncopation conditions at 0.5 Hz and 1.3 Hz were contrasted. For intrahemispheric comparison, 8-9-year-old DCD children showed that coherence between fronto-central regions increased for both rhythms and conditions, as compared to controls. No difference was found for interhemispheric comparisons. As frontal sites are related to motor planning, our results suggest that youngest DCD children were forced to maintain a high level of pre-programming to compensate for the difficulties caused by the perceptual-motor requirements of the task in light of their coordination disorder.

The development of haptic processing skills from childhood to adulthood by means of two-dimensional materials.

Research into haptic perception has mostly focused on 3-dimensional objects, and more needs to be known about the processing of 2-dimensional materials (e.g., raised dots and lines and raised-line shapes, patterns and pictures). This study examines the age-related changes in various skills related to the haptic exploration of 2-dimensional raised-line and dot materials and how these skills are related to haptic picture perception. Ninety-one participants, aged 4 years to adult, were asked to perform a series of haptic tasks that entailed (a) finding dots and following lines; (b) matching elements based on texture, shape, and size; (c) matching elements based on spatial location and orientation; (d) memorising sequences of dots and shapes; and (e) identifying complete and incomplete raised-line pictures. On all the tests, the results showed that scores improved with age. Shape discrimination scores accounted for variability in comprehension scores for outline pictures. We suggested that identifying tactile pictures by touch improved with age and mainly depended on the improvement of shape discrimination skills. (PsycINFO Database Record

Motor impairment in dyslexia: the influence of attention disorders.

Developmental dyslexia is a heterogeneous syndrome with a phonological core deficit and frequent association with other developmental disorders. Controversies exist about the influence of motor difficulties frequently encountered in dyslexia. According to different theoretical approaches, these motor impairments would reflect either a frequent co-morbid entity or a cerebellar dysfunction that could constitute the causal factor of reading disabilities. The principal aim of this study was to determine the frequency of motor impairments in a population of children with phonological dyslexia and specify possible links with attention deficit. We analysed retrospectively motor and attention abilities of 58 children with phonological dyslexia. An important sub-group of children with dyslexia (40-57% depending on the severity of motor difficulties) presented a motor impairment affecting co-ordination, balance and manual dexterity suggesting a cerebellar dysfunction. There was a significant association between attention deficit and motor impairments, with a specific impact on balance and co-ordination deficits. The comparison of performance in four groups defined according to the presence versus absence of attention deficit and motor impairment, respectively, were not in favour of a unequivocal causal link between reading disabilities and motor or attention disorders.

Developmental coordination disorder pertains to a deficit in perceptuo-motor synchronization independent of attentional capacities.

We investigated from a dynamic pattern perspective to motor coordination whether the deficiency in motor coordination characterizing Developmental Coordination Disorder children pertains to a general disorder in synchronization leading to a lower stability of the performed coordination pattern, and the extent to which the trouble is linked to attentional capacities. Twenty-four DCD children without ADHD aged eight to thirteen and 60 control children were asked (1) to perform a Continuous Performance Test assessing sustained attention; (2) to flex one finger either in synchrony or in syncopation with a visual periodic signal whose frequency was increased stepwise, assessing synchronization abilities. For the attentional task, percentage of exact responses, number of errors and reaction time were recorded. For the synchronization task, we measured relative phase (i.e., the ratio between the stimulus and the response onset and the time separating two successive stimuli). DCD children were significantly more variable than controls in both conditions and the difficulty in synchronization was unrelated to attentional disorders (ANCOVA). These findings support the idea of a general synchronization disorder in DCD children underlying their poor motor coordination. Moreover, this synchronization disorder does not appear to be strictly dependent on the level of sustained attentional capacities.

Neuropsychological status of French children with developmental dyslexia and/or developmental coordination disorder: Are both necessarily worse than one?

Developmental dyslexia (DD) and developmental coordination disorder (DCD) co-occur frequently, raising the underlying question of shared etiological bases. We investigated the cognitive profile of children with DD, children with DCD, and children with the dual association (DD + DCD) to determine the inherent characteristics of each disorder and explore the possible additional impact of co-morbidity on intellectual, attentional, and psychosocial functioning. The participants were 8- to 12-year-olds (20 DD, 22 DCD, and 23 DD + DCD). Cognitive abilities were assessed by the Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV) and the Continuous Performance Test - Second Edition (CPT-II) and behavioral impairments were evaluated by the Child Behavior Checklist (CBCL). No differences were found between the three groups on attention testing (CPT-II) or psychosocial characteristics (CBCL), but a higher percentage of DD + DCD children had pathological scores on psychosocial scales. Significant between-group differences were observed on Processing Speed Index scores and the block design and symbol search subtests, where DD children fared better than DCD children. No significant differences were evident between the co-morbid vs. the pure groups. Our results clearly show significant differences between children with DD only and children with DCD only. In particular, visuo-spatial disabilities and heterogeneity of intellectual profile seem to be good markers of DCD. However, it should be noted that despite these distinct and separate characteristics, a common cognitive profile (weaknesses and strengths) is likely shared by both neurodevelopmental disorders. Surprisingly, concerning co-morbidity, DD + DCD association is not associated with a decrease in intellectual or attentional capacities.

Alteration of rhythmic unimanual tapping and anti-phase bimanual coordination in Alzheimer's disease: A sign of inter-hemispheric disconnection?

Little attention is paid to motor control in Alzheimer's disease (AD) although it is a relevant sign of central nervous system integrity and functioning. In particular, unimanual and bimanual tapping is a relevant paradigm because it requires intra- and inter-hemispheric transfer (IHT). Previous results indicate that both unimanual and anti-phase tapping requires more IHT than in-phase tapping, especially produced without external stimulation. The aim of the present study was to test the production of unimanual, bimanual in-phase and anti-phase tapping with a synchronization-continuation paradigm with and without visual stimulation in AD patients (N=9) and control participants (N=12). In accordance with our hypothesis, these results suggest that unimanual and anti-phase tapping is more altered in AD than in control participants. Moreover, performance is globally more variable in the AD group. These alterations are discussed in terms of possible IHT modulation, in line with functional and structural findings in AD, revealing changes in the connectivity of brain regions across hemispheres and white matter damage.

Lack of Motor Inhibition as a Marker of Learning Difficulties of Bimanual Coordination in Teenagers With Developmental Coordination Disorder.

This study tested the learning of a new bimanual coordination in teenagers with and without Developmental Coordination Disorder (DCD). Both groups improved accuracy of the new coordination. No difference was found on stability. But DCD teenagers exhibited an overall higher number of additional taps, suggesting a persistent lack of motor inhibition during learning. Moreover, teenagers with the lowest scores of motor abilities present the highest number of additional taps. All these results suggest that this number of additional taps (rather than traditional measures of accuracy and stability) could be a good marker of perceptual-motor learning deficit in DCD.