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.

Benefits of a Light-Painting Technique for Learning to Write New Characters: A Proof of Concept With Adults.

Learning to write relies on the effective integration of sensory feedback and a transition from motor control based on written tracings to motor control based on expert writing movements. This study aimed to test whether the photographic technique of light painting (LP) would facilitate this transition. To achieve this, we conducted two experiments using different LP setups. LP involves moving a light source in a dark environment while taking a long-exposure photograph. LP entails both a real-time reduction of product-related visual information and a post-trial addition of process-related visual information. In the first experiment, we conducted a pre-test, training, and post-test in which 16 adults wrote four new characters with the non-dominant hand. During the training sessions, participants stood and wrote in a vertical frame (1 × 1.2 m) two characters in the control condition (with a marker on the vertical support) and two characters in the LP condition (with a flashlight in the air). In the test phases, participants were seated at a table and copied the four characters into a square (4 cm * 4 cm) on a fixed sheet of graphics paper. As in-air writing strongly differs from classical handwriting situations, we performed a second LP experiment. The aim was to implement LP training in a condition closer to writing. Sixteen new participants followed the same protocol but sat at a table and wrote in a horizontal square (20 cm * 20 cm). In both experiments, participants who trained with the LP method wrote faster and with less pressure than those trained in the control condition. We also observed an improvement in spatial accuracy in Experiment 2, whatever the training condition. LP seemed to have led participants to focus on the writing process, probably because it modified the nature and timing of the visual information used for writing. LP may be a promising technique for remediating writing difficulties.

Dysgraphia Differs Between Children With Developmental Coordination Disorder and/or Reading Disorder.

Handwriting deficits, or dysgraphia, are present in several neurodevelopmental disorders. To investigate whether dysgraphia differs according to the associated disorder, we performed a detailed analysis of handwriting in children with developmental coordination disorders (DCD), reading disorder (RD), or comorbid RD and DCD. Handwriting deficits were investigated at the product (quality of the trace) and the process (movement that generates the trace) levels. Nineteen children with singular RD (among which eight with dysgraphia), 13 children with singular DCD (among which seven with dysgraphia), 16 children with comorbid RD+DCD (among which 11 with dysgraphia), and 20 typically developing children, age 7 to 12, performed the BHK (Brave Handwriting Kinder) test, a standardized assessment of handwriting, on a graphic tablet. Developmental coordination disorders primarily affected handwriting quality, while RD affected slowness and, to a lesser extent, quality. Children with RD, solely or comorbid with DCD, wasted time by lifting and stopping the pen when writing. The comorbidity added to but did not worsen, handwriting difficulties. These results reflect distinct motor impairments and/or strategies in children with DCD or RD. We identified subtypes of dysgraphia and advocated for a fine-grained analysis of the writing process and the assessment of motor and reading skills when studying dysgraphia.

Six-month-old infants' communication in a comparative perspective: Do maternal attention and interaction matter?

Developmental precursors of the prelinguistic transition from gestures to word use can be found in the early pragmatic usage of auditory and visual signals across contexts. This study examined whether 6-month-old infants are capable of attention-sensitive communication with their mother, that is, adjusting the sensory modality of their communicative signals to their mother's attention. Proxies of maternal attention implemented in experimental conditions were the mother's visual attention (attentive/inattentive), interaction directed at the infant (interactive/non-interactive), and distance (far/close). The infants' signals were coded as either visual or auditory, following an ethological coding. Infants adjusted the sensory modality of their communicative signals mostly to maternal interaction. More auditory signals were produced when the mother was non-interactive than when she was interactive. Interactive conditions were characterized by higher rates of visual signaling and of gaze-coordinated non-vocal oral sounds. The more time infants spent looking at their attentive mother, the more they produced auditory signals, specifically non-vocal oral sounds. These findings are discussed within the articulated frameworks of evolutionary developmental psychology and early pragmatics.

Does modifying visual feedback facilitate learning to write new pseudoletters?

Learning to write relies on the efficient integration of visual and proprioceptive feedback, with a transition from a control, based on the visual inspection of the written trace at the beginning of the learning process to a more predictive control, based mainly on handwriting movement, in proficient writers. The aim of this study was to test the effect of a partial deletion of the written trace, as well as the effect of supplementary visual information, on handwriting kinematics in a learning task. Twenty-four adults learned to write six new pseudoletters using their non-dominant hand on a touch screen digital tablet. Three pseudoletters were trained with modified visual feedback conditions and the other three, in the control condition, i.e. without any visual modification. Results revealed that, in the short-term, the pseudoletters learned with modified visual feedback were traced faster and more fluently than those learned in the control condition, without spatial accuracy reduction. This method seems to be efficient in adults, which is a prerequisite before testing a method with children.

The determinants of saccade targeting strategy in neurodevelopmental disorders: The influence of suboptimal reading experience.

Whether eye-movements deficits are causal in reading disorders (RD) or rather a consequence of linguistic processing difficulty experienced by disabled readers has been extensively debated.Since RD are frequently comorbid with the Neurofibromatosis type1 (NF1), children with NF1 were used as a comparison group for children with dyslexia in this study.Eye movements were recorded while 21 dyslexic, 20 NF1, and 20 typically developing children performed an oculomotor lateralized bisection task. In this experiment, we manipulated the type of stimulus - discrete (words and strings of hashes) versus continuous (solid lines) - and the visual field where the stimulus was displayed (left vs right). The results showed that (1) only proficient readers (TD and NF1 without RD) showed fully developed oculomotor mechanisms for efficient reading, with a clear preferred viewing location located to the left of the word's centre in both visual fields, and fine-tuned saccade targeting guided by the between-character space information and (2) NF1 poor readers mirrored the dyslexic eye movement behaviour, with less accuracy and more variability in saccadic programming, no sensitivity to the discreteness of the stimuli, particularly in the left visual field. We concluded that disruption to oculomotor behaviour reflectsthe fact that many of the processes involved in reading are not yet automatized for children with RD, independently of NF1. This suggests that the differences in saccade targeting strategy between children with and without RD would be secondary consequences of their reduced reading experience.

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.

Visual-processing deficits in children with neurofibromatosis type 1: A clinical marker of reading difficulties.

Today's estimates indicate that nearly 50% of children with Neurofibromatosis type 1 (NF1) suffer from reading disabilities, with a high impact on their academic achievement. In addition to the well-documented importance of phonological skills in reading acquisition and neurodevelopmental disorders, visual-attention processes also appear as important factors in learning to read. The present study aimed at assessing the role of visual-processing dysfunction in the high prevalence of reading disabilities in NF1 children and providing a useful tool for clinician in the early detection of reading impairment in this neurogenetic disorder. Forty-two children with NF1 and 42 typically developing children (TD) participated in the study. All were right-handed and did not present intellectual disability or attention deficit hyperactivity disorder. Visual-attention processes were assessed with the Developmental Eye Movement (DEM) test, together with the NF1 children's reading level. NF1 children with and without reading disabilities were then compared. The results showed that visual-processing deficits were highly present among the NF1 children included in our study. Furthermore, poor readers with NF1 presented an increased risk of visual-processing deficits compared to peers. This finding supports the role of visual-processing deficits in the reading difficulties encountered in nearly half of children with NF1. Finally, in NF1 children without intellectual or attention disability, visual-processing deficits emerge as one of the clinical markers of reading disabilities. The study holds important clinical implications both for the identification, by providing a useful screening tool, and the management of reading disabilities in NF1 children.

Effect of comorbid developmental dyslexia on oculomotor behavior in children with developmental coordination disorder: A study with the Developmental Eye Movement test.

Studies have suggested a dysfunction in oculomotor skills in children with developmental coordination disorder (DCD). It has been proposed that the Developmental Eye Movement (DEM) test is useful in testing the dyslexics' (DD) oculomotor behavior during reading, in a simple and indirect manner. The present study aimed at exploring the oculomotor behavior in children with DCD as assessed with the DEM test. We thus compared children with DCD to children with DD and to children with both DCD and DD in order to investigate the specificity of the oculomotor difficulties, as measured by the DEM test. Results showed that 1) children with DCD presented mild atypical performance at the DEM test (error z-score only), 2) children with DD presented particularly poor performance at the DEM test, and 3) the co-morbid condition (DCD + DD) did not add to the severity of atypical performance at the DEM test. In sum, children with DCD were the less affected according to the DEM test, and children with DD (isolated or comorbid) presented the most atypical performance. Results at the DEM test did not allow to highlight clear oculomotor atypicalities in DCD. We thus concluded that more research using eye-tracking techniques is needed to explore the nature of oculomotor atypicalities in DCD children, to distinguish DD and DCD oculomotor behavior, and to understand the profile of children with dual diagnosis.

Influence of comorbidity on working memory profile in dyslexia and developmental coordination disorder.

OBJECTIVE: Many studies report a deficit in working memory in children with Developmental Dyslexia (DD) and Developmental Coordination Disorder (DCD) compared to children with Typical Development (TD). In this study, we questioned the working memory profile of children with co-occurring Developmental Dyslexia and Developmental Coordination Disorder (DD-DCD). First, we hypothesized that children with DD would have a more substantial deficit in verbal working memory, while children with DCD would have a more substantial deficit in visuospatial working memory. For the comorbid group, we postulated a deficit in both the verbal and visuospatial domains. Second, we determined whether we could correctly distinguish between the four groups based on their working memory profiles. METHOD: 47 children with DD, 22 children with DCD, 27 children with DD-DCD, and 42 TD children aged from 7.6 to 12.6 years were tested on the phonological loop, the visuospatial sketchpad, and the central executive using the Digit Span and Wechsler's Block-tapping tests. RESULTS: Children with DD had a deficit in verbal working memory including a specific deficit in the phonological loop and children with DCD had a deficit in visuospatial working memory. Comorbid children had poorer performance in verbal working memory (like group with DD) and in visuospatial working memory (like group with DCD). Exploratory cluster analysis resulted in four subgroups: (1) one cluster with good working memory performance made up of most of the TD children; (2) one cluster with a phonological loop deficit mainly made up of the children with DD; (3) one cluster with poor visuospatial working memory capacities mostly made up of the children with DCD (± DD) and (4) one cluster with average performance made up of children from all the groups. CONCLUSION: Our results underline the importance of taking comorbidity into account when testing working memory in children with learning disabilities.

Psychometric assessment of the French European Developmental Coordination Disorder Questionnaire (DCDQ-FE).

BACKGROUND: The Developmental Coordination Disorder Questionnaire'07 (DCDQ'07) is a parent-report measure to identify children at risk for Developmental Coordination Disorder (DCD). We developed a French version of the DCDQ'07 (DCDQ-FE) that has shown excellent inter-language reliability (intraclass correlation coefficient (ICC) = 0.91) and is culturally relevant for use in European countries. The aims of this study were to examine the internal consistency, test-retest reliability, construct validity of the Developmental Coordination Disorder Questionnaire-French European (DCDQ-FE), as well as establish a cut-off score. METHODS: The psychometric properties of the DCDQ-FE were examined with a clinical group of 30 children (mean age: 9.4 years, SD = 2.6) and a control group of 43 children (mean age: 9.1 years, SD = 2.4). Their parents (n = 73) filled out the DCDQ-FE at a first sitting and 70 of them filled it out 38 days later in average for test-retest reliability. The children were assessed using the Movement Assessment Battery for Children-2 (MABC-2) so as to measure the convergent validity of the DCDQ-FE. The cut-off score was determined with an additional sample of 42 children according to scores on the MABC-2 (≥ 16th percentile) (n = 115). RESULTS AND IMPLICATIONS: Internal consistency of the DCDQ-FE was excellent (Cronbach's alpha = 0.96) and test-retest reliability was good (ICC = 0.956) with no differences between scores obtained at the two sittings (p > 0.05). Differences in scores between children in the clinical and control groups (Z = -6.58, p < 0.001) provide evidence of construct validity. The correlation obtained between DCDQ-FE and MABC-2 scores (Spearman's rho correlation coefficient = 0.802, p < 0.001) supports convergent validity. Using a cut-off of 56, overall sensitivity and specificity were 85.0% and 81.6% respectively (area under the curve = 0.896). The DCDQ-FE is a reliable and valid questionnaire for detecting children who are at risk for DCD in a European-French population of children aged 5 to 15 years old.

Feedforward motor control in developmental dyslexia and developmental coordination disorder: Does comorbidity matter?

BACKGROUND AND AIM: Feedforward and online controls are two facets of predictive motor control from internal models, which is suspected to be impaired in learning disorders. We examined whether the feedforward component is affected in children (8-12 years) with developmental dyslexia (DD) and/or with developmental coordination disorder (DCD) compared to typically developing (TD) children. METHODS: Children underwent a bimanual unloading paradigm during which a load supported to one arm, the postural arm, was either unexpectedly unloaded by a computer or voluntary unloaded by the subject with the other arm. RESULTS: All children showed a better stabilization (lower flexion) of the postural arm and an earlier inhibition of the arm flexors during voluntary unloading, indicating anticipation of unloading. Between-group comparisons of kinematics and electromyographic activity of the postural arm revealed that the difference during voluntary unloading was between DD-DCD children and the other groups, with the former showing a delayed inhibition of the flexor muscles. CONCLUSION: Deficit of the feedforward component of motor control may particularly apply to comorbid subtypes, here the DD-DCD subtype. The development of a comprehensive framework for motor performance deficits in children with learning disorders will be achieved only by dissociating key components of motor prediction and focusing on subtypes and comorbidities.

Exploring the Link between Visual Perception, Visual-Motor Integration, and Reading in Normal Developing and Impaired Children using DTVP-2.

Reading is known to be primarily a linguistic task. However, to successfully decode written words, children also need to develop good visual-perception skills. Furthermore, motor skills are implicated in letter recognition and reading acquisition. Three studies have been designed to determine the link between reading, visual perception, and visual-motor integration using the Developmental Test of Visual Perception version 2 (DTVP-2). Study 1 tests how visual perception and visual-motor integration in kindergarten predict reading outcomes in Grade 1, in typical developing children. Study 2 is aimed at finding out if these skills can be seen as clinical markers in dyslexic children (DD). Study 3 determines if visual-motor integration and motor-reduced visual perception can distinguish DD children according to whether they exhibit or not developmental coordination disorder (DCD). Results showed that phonological awareness and visual-motor integration predicted reading outcomes one year later. DTVP-2 demonstrated similarities and differences in visual-motor integration and motor-reduced visual perception between children with DD, DCD, and both of these deficits. DTVP-2 is a suitable tool to investigate links between visual perception, visual-motor integration and reading, and to differentiate cognitive profiles of children with developmental disabilities (i.e. DD, DCD, and comorbid children). Copyright © 2017 John Wiley & Sons, Ltd.

Social interaction is associated with changes in infants' motor activity.

BACKGROUND: In developmental research, infants are commonly assumed to be early stakeholders in interactions with their caregivers. The tools that infants can use to interact with others vary from visual contact to smiling or vocalizing, and also include motor activity. However, surprisingly few studies have explored how the nature and context of social interactions affect infants' engagement in motor activity. METHODS: We investigated the kinematic properties of foot and face movements produced by 11 infants aged between 5 and 9 months during six contrasting dyadic episodes (i.e. passive presence of a stranger or the infant's mother, weak or intense interaction with the stranger/mother as she sings a nursery play song). RESULTS: The infants' face and foot motor activity was significantly reduced during the interactive episodes, compared with the episodes without any interaction, in both the mother and stranger conditions. Furthermore, the level of their motor activity was significantly lower in the stranger condition than in the mother one for some parameters. CONCLUSION: These results are in line with those reported by previous studies and confirm the relevance of using motor activity to delineate the early forms of interactive episodes in infants.

Graphomotor skills in children with developmental coordination disorder (DCD): Handwriting and learning a new letter.

The aim of the present study was to analyze handwriting difficulties in children with developmental coordination disorder (DCD) and investigate the hypothesis that a deficit in procedural learning could help to explain them. The experimental set-up was designed to compare the performances of children with DCD with those of a non-DCD group on tasks that rely on motor learning in different ways, namely handwriting and learning a new letter. Ten children with DCD and 10 non-DCD children, aged 8-10 years, were asked to perform handwriting tasks (letter/word/sentence; normal/fast), and a learning task (new letter) on a graphic tablet. The BHK concise assessment scale for children's handwriting was used to evaluate their handwriting quality. Results showed that both the handwriting and learning tasks differentiated between the groups. Furthermore, when speed or length constraints were added, handwriting was more impaired in children with DCD than in non-DCD children. Greater intra-individual variability was observed in the group of children with DCD, arguing in favor of a deficit in motor pattern stabilization. The results of this study could support both the hypothesis of a deficit in procedural learning and the hypothesis of neuromotor noise in DCD.

Hand preferences in preschool children: Reaching, pointing and symbolic gestures.

Manual asymmetries emerge very early in development and several researchers have reported a significant right-hand bias in toddlers although this bias fluctuates depending on the nature of the activity being performed. However, little is known about the further development of asymmetries in preschoolers. In this study, patterns of hand preference were assessed in 50 children aged 3-5 years for different activities, including reaching movements, pointing gestures and symbolic gestures. Contrary to what has been reported in children before 3 years of age, we did not observe any difference in the mean handedness indices obtained in each task. Moreover, the asymmetry of reaching was found to correlate with that of pointing gestures, but not with that of symbolic gestures. In relation to the results reported in infants and adults, this study may help deciphering the mechanisms controlling the development of handedness by providing measures of manual asymmetries in an age range that has been so far rather neglected.

Development of motor planning for dexterity tasks in trisomy 21.

We examined the macroscopic aspects of motor planning in two manual dexterity tasks, comparing children, adolescents, and young adults with trisomy 21 (T21) with typically developing controls from a developmental perspective. We analyzed the order in which objects were picked up from a table during two manual tasks of the Movement Assessment Battery for Children (M-ABC). Participants with T21 were always slower than controls. Task completion times depended on the strategy used by participants to gather up the pegs or coins. A structured strategy, in which the participants picked the items up moving methodically along each row/column, contributed to rapid task completion by younger children and participants with T21. This study highlights the ability of children with T21 to select and maintain an efficient strategy that takes account of their motor difficulties. Developmental trajectories help to explain T21 functioning in these dexterity tasks.

Morphological differences between imperative and declarative pointing: hand shape, arm extension, and body posture.

The authors used frame-by-frame video analyses to describe the features of imperative and declarative pointing gestures produced by young children, in comparison to reaching actions. First, the results showed that imperative pointing shared common features with reaching actions (hand shape, arm extension), but body posture observed in reaching differed from the one observed in pointing, both in imperative and declarative contexts. Second, hand shape was influenced by precision constraints: imperative gestures shifted from whole-hand pointing to index-finger pointing when the target was surrounded by distractors. This study is the first of its kind to highlight the effect of several variables on morphological features of pointing using quantitative measures and may provide insights into the nature of imperative and declarative pointing.

Hand preference for pointing gestures and bimanual manipulation around the vocabulary spurt period.

This study investigated the development of hand preference for bimanual manipulative activities and pointing gestures in toddlers observed longitudinally over a 5-month period, in relation to language acquisition. The lexical spurt was found to be accompanied by an increase in the right-sided bias for pointing but not for manipulation. Moreover, results revealed a significant correlation between hand preference for imperative pointing gestures and manipulative activities in children who did not experience the lexical spurt during the observational period. By contrast, measures of handedness for declarative pointing were never correlated with those of handedness for manipulation. This study illustrates the complex relationship between handedness and language development and emphasizes the need to take the different functions of pointing gestures into account.