motor performance that is substantially below expected levels, given the person's chronological age and previous opportunities for skill acquisition poor motor performance may manifest as coordination problems, poor balance, clumsiness, dropping or bumping into things; marked delayes in achieving developmental motor milestones (e.g. walking, crawling, sitting) or in the acquisition of basic motor skills (e.g. catching, throwing, kicking, running, jumping, hopping, cutting, colouring, printing, writing) the disturbance, without accommodations, significantly and persistently intereferes with activities of daily living or academic achievement onset of symptoms in early dev period the motor skill deficits are not better explained by intellectual disability (intellectual development disorder) or visual impairment, and are not attributable to a neurological condition affecting movement (e.g. cerebral palsy, muscular dystrophy, degenerative disorder)

1.8-6% of children ~3% have some impairment in activities of daily living or school work and for ~2% of children there is a sig impact on school & daily life lifelong burden: increased anxiety, depression, decreased educational achievement, life-satisfaction

short questionnaire for parents to compare their child's movement skills with their peers' 15 questions 3 subscales: control during movement, fine motor/handwriting, general coordination Wilson et al. (2000,2009)

Developmental coordination disorder Flashcards by Sophie Gent

DSM5 criteria

DCD

motor performance that is substantially below expected levels, given the person’s chronological age and previous opportunities for skill acquisition
poor motor performance may manifest as coordination problems, poor balance, clumsiness, dropping or bumping into things; marked delayes in achieving developmental motor milestones (e.g. walking, crawling, sitting) or in the acquisition of basic motor skills (e.g. catching, throwing, kicking, running, jumping, hopping, cutting, colouring, printing, writing)
the disturbance, without accommodations, significantly and persistently intereferes with activities of daily living or academic achievement
onset of symptoms in early dev period
the motor skill deficits are not better explained by intellectual disability (intellectual development disorder) or visual impairment, and are not attributable to a neurological condition affecting movement (e.g. cerebral palsy, muscular dystrophy, degenerative disorder)

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self-care challenges for those with DCD

Zwicker et al. (2012)

further reading

deficit-oriented approaches include sensory integration therapy, sensorimotor-oriented treatment and process-oriented treatment
premise targeted at underlying process deficit
it is not known what type & amount of training is required to induce neuroplastic change, or what training, if any, can facilitate updating of the internal model of movement

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internal modelling deficit hypothesis (DCD)

adams et al. (2014), wilson et al. (2013)

theory of movement action
when brain sends motor plan, send a copy of signal to muscles but also an efference copy to the cerebellum
cerebellum compares command and where hand etc. in space to see if match or mismatch
if mismatch then correct this
DCD - something wrong with the efference copy to be able to compare if match or mismatch, strong focus on visual

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double-step reaching paradigm

hyde & wilson

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touchscreen angled on the table
green circle at the bottom of the screen acting as a ‘home base’, 3 possible yellow target locations 30cm from the home base
at the start of a trial the home base was illuminated & child had to touch it
non-jump trial: 500-1500ms later the central target was illuminated & child had to move & touch that, then return to the home base
jump trial: on 20% of trials when the home base was released the target light moved to one of the two peripheral lights
children with DCD (7-12yos) were slower on jump trials, but not non-jump trials, compared to control
also more likely to touch the central target on jump trials (centre touch errors)

blanchard et al. (2017)

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DCD worse at changing direction
changing direction correlates with MABC
reaching & grasping parameters predicted scores on MABC-2 but not DCD-Q
strongest corrs were with aiming & catching

motor imagery

williams et al. (2008)

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mental simulation of any motor act without motor execution
involves many of the same neural & physiological components as its real counterpart
sims between real & imagined movements –> suggestions that motor imagery reflects the internal model of a movement (full motor pathway rather than just cerebellum)
DCD-S group (<6%ile on MABC) were less accurate on hand rotation task even when instructed to use motor imagery
can be linked to cerebellum

mirror neuron system hypothesis

werner et al. (2012)

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network of brain areas that fire both when performing an action & observing someone else performing that action
thought to be a mechanism for learning new skills by modelling beh & action
“given that the MNS mediates imitation, action execution, and motor imagery, which all assist in skill learning, deficits in mirror neuron function may underlie the motor difficulties characteristic of DCD” - Reynolds et al. (2015)
maybe children with DCD have problems with their mirror neurons

imitation of gestures

sinani et al. (2011)

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transitive gestures - involve an object
intransitive gestures - no object
children with DCD were less good at imitating transitive & intransitive actions than age-matched controls

evidence for mirror neuron from neuroimaging

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Reynolds et al. (2015) - DCD group showed decreased activation in precentral gyrus & inferior frontal gyrus (IFG) which are part of the mirror neuron system
Reynolds et al. (2019) - no difference in activation of mirror neuron system between two groups
ev for mirror neuron system seen much more mixed

how the cerebellum could be linked to DCD

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postural control
motor coordination
motor adaptation
fine movement coordination
motor learning

how the basal ganglia could be linked to DCD

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motor control
movement initiation - patients with damage to the basal ganglia struggle to start movements
movement learning
automisation

how the parietal lobe could be linked to DCD

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motor imagery
action prediction - predicting outcomes of a movement
action observation - imitation
facial recognition
visuospatial processing - hand eye coordination

neuroimaging meta-analysis (DCD) | biotteau et al. (2016)

* huge variability between studies * brain areas linked - parietal lobe, basal ganglia, cerebellum * 3 critical stages in search for a link between brain characteristics and symptoms of DCD: * assumptions based on brain lesions * brain hypotheses based on behavioural data * neuroimaging studies, especially MRI

reasons for inconsistencies in neuroimaging studies | biotteau et al. (2016)

* too few MRI studies using too many diff tasks and durations * samples are small and non-homogenous * could be high levels of comorbidity with a range of other disorders * small cluster sizes and no correction for multiple comparisons

hybrid model of DCD | wilson et al. (2017)

* multi-component model that explains performance deficits in DCD through dynamical interactions at the individual, task, and environmental levels * integrates various perspectives on DCD including motor control, cognitive, and perceptual factors * dynamical interactions: motor performance is not simply determined by a single factor but rather by the interplay of all three levels * implications for intervention: a multi-faceted approach is needed to address the various factors that contribute to motor difficulties

etiology and neurobiology of DCD | zwicker et al. (2012) ## Footnote further reading

* largely unknown but may be related to central nervous system pathology * minimal neurological dysfunction (MND) reflects 'a distinct form of perinatally acquired brain dysfunction, which is likely associated with a structural deficit of the brain' * MND has been proposed to result from stress associated with preterm birth: 12.5% to over 50% of children born preterm have motor impairments consistent with DCD and are 6-8 times more likely to develop the disorder * automisation hypothesis suggests that children with DCD may have difficulty making motor skills automatic - link to cerebellum * internal modelling deficit hypothesis - also suggests cerebellum involvements, successful motor control is thought to result from an internal model that accurately predicts the sensory consequences of motor command

motor skills in ADHD | kaiser et al. (2015)

* systematic review of motor skills & motor control in children with ADHD * probable risk of DCD (below 15%ile on MABC) varied from 51-73% * gross & fine motor skills affected in ADHD * fewer motor difficulties in hyperactive subtype than in combined or inattentive subtypes * ADHD medication improved dynamic balance & fine motor skills * motor skills possibly implicated in ADHD

motor imagery in ADHD | williams et al. (2013)

* ADHD & DCD group, but not ADHD only group were less accurate on hand rotation task * suggests motor imagery linked to motor, not att difficulties

motor network connectivity in ADHD | mcleod et al. (2016)

* children with DCD, ADHD & ADHD+DCD show a diff pattern of within- & between-hemisphere connections of the thalamus & cerebellum with SM1, compared to typically developing controls * in TD & ADHD (with or without DCD) within-hemisphere connections with the putamen were stronger than between hemisphere, but they were equal strength in the DCD alone group

DCD and autism

* motor difficulties are common in autism * when making a diagnosis, how decide whether motor difficulties are part of autism or warrant a concurrent diagnosis of DCD?

structural correlation networks | caeyenberghs et al. (2016)

* just autism - increase in path lenght, nodes functionally more clustered, overconnections * just DCD - clustering increasing in right lateral OFC * both - differences hard to summarise in clustering, separate third group

Developmental coordination disorder Flashcards

(33 cards)