Understanding motor coordination and its cognitive, academic, and psychosocial correlates in an adolescent normative sample

Over the past three decades, increasing attention has been paid to the importance of motor competence in relation to other areas of a child’s development, including cognitive functioning, academic achievement, and emotional outcomes. For example, a number of studies now show that children with motor difficulties are at increased risk for internalising problems such as anxiety, and may also experience deficits in complex cognitive processes, namely, executive functions. Furthermore, evidence suggests that without intervention, these motor difficulties and associated problems may continue, yet research in older age-groups is limited. The primary aim of this thesis was to explore the relationships between motor coordination and the cognitive, academic, and psychosocial domains in an adolescent sample aged 12 to16 years. This is imperative given the changes that occur, particularly in social and cognitive domains, during this developmental period. Furthermore, given that most of the existing studies have identified these relationships in groups of children with motor problems, this points to the need to investigate whether the close links between these areas exist along a continuum, extending to individuals without problems in the motor domain. The series of papers presented in this thesis therefore examine the association between motor coordination and these areas from a normative perspective.The first two papers of this thesis relate to the link between motor ability and emotional outcomes. Although the number of studies on this topic has increased, longitudinal evidence is limited. Therefore, the first study is based on a longitudinal project examining the predictive relationship between early motor development, from infancy to early childhood, and later emotional outcomes at school-age (i.e., 6 to 12 years old). The paper aims to present a preliminary analysis of the association between motor development and emotional functioning. Using parent-rated questionnaires, it was found that the stability of early gross motor development predicted later anxiety and depressive symptomatology. Importantly, the study provides an indication of the possible causal relationship between these areas which is important when considering the focus of the second paper in a normative sample of adolescents.Although it is plausible that the relationship between motor problems and internalising difficulties may be explained by organic factors, it has been suggested that the negative environmental experiences associated with motor problems may in turn, lead to negative self-appraisals and subsequently, increased risk for internalising problems. Thus, the second paper examined whether selfperceived competencies in social, academic, and physical areas play an important mediating role in the relationship between motor coordination and emotional functioning in adolescents. A standardised motor performance test (namely, Movement Assessment Battery for Children-2) provided indicators of motor coordination; manual dexterity, aiming and catching, and balance. Questionnaires on self-perceptions, anxiety, and depressive symptomatology were completed by adolescents. Structural equation modeling revealed that motor coordination had an indirect link with emotional functioning, through the mediating influence of selfperceptions. It also appeared that aiming and catching, and balance skills (and not manual dexterity) were important for the emotional outcomes of these adolescents.The focus of the following two papers aimed to further understand the relationship between these motor components and cognitive areas, including executive functions and academic achievement. The third paper examined possible specific relationships between the different motor components and various executive functions, namely working memory, inhibition, and set-shifting. Attention deficit hyperactivity (ADHD) symptomatology were also taken into account which is important given the close association between ADHD and both executive function and motor problems. Specific relationships between motor coordination components and the various executive functions were found which may suggest possible shared neural processes, including cerebellar mechanisms. Importantly, this study reveals relationships that may have been masked in studies that involved an overall measure of motor performance or groups of children with overall motor impairment.Given the significant links found between motor coordination and executive functions, it is plausible that certain executive functions may play an important role in understanding the relationship between motor problems and academic underachievement. Recently, working memory difficulties in children with motor problems were found to be important when understanding the academic underachievement often displayed by these children. In the fourth paper, structural equation modeling was used to examine whether the relationship between motor coordination and academic achievement (word reading, spelling, and numerical operations) is mediated by working memory in adolescents, whilst controlling for covariates such as ADHD symptomatology, verbal ability, and socio-economic status. It was found that motor coordination, specifically aiming and catching skills, has an indirect impact on these learning outcomes via working memory.In the final paper, the importance of identifying those adolescents at risk of motor problems is highlighted, particularly given the associated difficulties in the cognitive and psychosocial domains. Consequently, the fifth paper evaluates the revised Developmental Coordination Disorder Questionnaire (DCDQ), a parent-rated screening tool designed to assess motor difficulties, using the MABC-2 as a criterion standard. The DCDQ was found to have high internal consistency and demonstrated a relationship with the MABC-2. However, although the DCDQ appeared to meet the recommended standard for sensitivity, this was not met for specificity. Preliminary results for the psychometric properties of the revised DCDQ were promising suggesting that it may suitable for initial screening particularly in large samples, however, further assessment using a standardised motor performance test is warranted for those identified at risk of motor problems.The ultimate aim of this thesis, presented over five papers, was to increase awareness and recognition of the possible associated problems of motor coordination difficulties. The results across the five studies highlight the importance of motor ability in relation to cognitive and psychosocial areas in adolescents, with important implications for assessment and intervention. Furthermore, the papers provide information on the theoretical understanding of the links between these areas with some insight into possible underlying processes explaining the relationships

The relationship between motor skills, social problems, and ADHD symptomatology: does it vary according to parent and teacher report?

Objective: This study investigated the relationship between motor performance; attentional, hyperactive, and impulsive symptoms; and social problems. Correlations between parents' versus teachers' ratings of social problems and ADHD symptomatology were also examined. Method: A total of 129 children aged 9 to 12 years were included. ADHD symptoms and social problems were identified based on Conners' Rating Scales–Revised: L, and the McCarron Assessment of Neuromuscular Development was used to assess motor skills. Results: After controlling for ADHD symptomatology, motor skills remained a significant predictor of social problems in the teacher model but not in the parent model. After controlling for motor skills, inattentive (not hyperactive-impulsive) symptoms were a significant predictor of social problems in the parent model, whereas hyperactive-impulsive (not inattentive) symptoms were a significant predictor of social problems in the teacher model. Conclusion: The findings suggested that intervention strategies should consider the interaction between symptoms and environmental contexts

Motor development of children with attention deficit hyperactivity disorder

Objective: To compare both global and specific domains of motor development of children with attention deficit hyperactivity disorder (ADHD) with that of typically developing children. Methods: Two hundred children (50 children with clinical diagnoses of ADHD, according to the DSM-IV-TR and 150 typically developing controls), aged 5 to 10 years, participated in this crosssectional study. The Motor Development Scale was used to assess fine and global motricity, balance, body schema, and spatial and temporal organization. Results: Between-group testing revealed statistically significant differences between the ADHD and control groups for all domains. The results also revealed a deficit of nearly two years in the motor development of children with ADHD compared with the normative sample. Conclusion: The current study shows that ADHD is associated with a delay in motor development when compared to typically developing children. The results also suggested difficulties in certain motor areas for those with ADHD. These results may point to plausible mechanisms underlying the relationship between ADHD and motor difficulties

Developmental coordination disorder

Historically, Developmental Coordination Disorder (DCD) has perhaps been the most poorly recognized of the neurodevelopmental disorders. As we will canvass in this chapter, the reasons are complex and varied, ranging from considerable variation in the application of diagnostic labelling and criterion, to issues surrounding the appropriateness of assessment methods and the frequent comorbid presentation of DCD with other neurodevelopmental disorders. However, there is a growing awareness of the serious impact that delayed motor development has on the dayto-day lives of these individuals and their broader psycho-social and physical development. While the genetic basis of the disorder has received little attention, the available evidence nonetheless suggests a shared role for familial and environmental factors. Neuropsychological models of the disorder have received greater attention and here we review two particularly promising accounts of motor delay, including impaired internal modelling and executive dysfunction. While each is supported by empirical evidence to some degree, their efficacy will ultimately be judged by their capacity to inform effective treatment. Presently, evidence to this effect is largely lacking. Interestingly, although investigation into the neuropathology of DCD has only recently emerged, there is a strong case that atypical neural activation, white matter microstructure and neural connectivity in critical motor circuitry differentiate children with DCD from typical peers. The suggestion of neural markers for the disorder is interesting, given that neurological impairment is presently an exclusionary criterion for DCD. Taken together, however, despite the continued focus on better understanding the aetiology of DCD, no universal account has emerged. It is perhaps unsurprising then, that evidence as to the efficacy of available intervention methods is mixed, at best

Motor Coordination and Psychosocial Correlates in a Normative Adolescent Sample

OBJECTIVES: Previous research has revealed an important relationship between motor coordination difficulties and internalizing problems such as anxiety and depressive symptoms. However, further research is needed to understand the potential mediating factors in this relationship. The aim of the current study was to examine whether the association between motor coordination and emotional functioning is mediated by self-perceptions in a normative sample of adolescents. METHODS: Participants included 93 adolescents aged 12 to 16 years. The Movement Assessment Battery for Children–2 provided 2 indicators of motor coordination; the Mood and Feelings Questionnaire and Spence Children’s Anxiety Scale provided 2 indicators of emotional functioning; and the Self-Description Questionnaire–II provided 6 indicators for self-perceived competence. RESULTS: Structural equation modeling revealed that motor coordination affects emotional functioning via self-perceptions. CONCLUSIONS: These results suggest that the relationship between motor coordination and emotional functioning in adolescents from a normative sample may be understood in terms of a mechanism by which motor coordination has an indirect impact on emotional outcomes through various self-perception domains. These findings have important implications for increasing awareness and developing appropriate treatment programs for motor coordination and emotional difficulties

Developmental coordination disorder and internalizing problems in children: The environmental stress hypothesis elaborated

There is a growing literature connecting poor motor coordination to physical and mental health outcomes in children and adolescents. These studies suggest that children with disorders such as developmental coordination disorder (DCD) are at greater risk for depression and anxiety, as well as obesity, and poor physical fitness. With regard to internalizing problems (symptoms of depression and anxiety), there is also evidence to suggest that the environment may play an important role in the etiology of psychological distress in this population. Cairney, Veldhuizen & Szatmari (2010) used the phrase “environmental stress hypothesis” to highlight the role that negative exposure to personal and interpersonal stressors might play in accounting for higher rates of internalizing symptoms in children with DCD. In this paper, we elaborate further on this basic premise, offering a model linking DCD to internalizing problems based on Pearlin’s stress process framework. In addition to stressors (risk) and protective factors, we incorporate both physical activity and obesity into our stress model. Next, we review the existing literature to see if there is evidence supporting specific components (pathways) of the model. In doing so, areas in need of further research are identified. Implications for intervention are also provided

An examination of the relationship between motor coordination and executive functions in adolescents

Aim: Research suggests important links between motor coordination and executive functions. The current study examined whether motor coordination predicts working memory, inhibition, and switching performance, extending previous research by accounting for attention-deficit–hyperactivity disorder (ADHD) symptomatology and other confounding factors, in an adolescent normative sample. Method: Ninety-three adolescents (38 females, 55 males) aged 12 to 16 years (mean age 4y 2mo, SD 1y 1mo) were assessed on the Movement Assessment Battery for Children-2 (MABC-2), Wechsler Intelligence Scale for Children-IV, N-back task, the inhibition subtest from the NEPSY-II: A Developmental Neuropsychological Assessment, second edition, and the parent-rated Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour Questionnaire. Results: The MABC-2 total score accounted for a significant proportion of the variance in visuospatial working memory (p=0.041) but not for verbal working memory. The MABC-2 aiming and catching component, however, was found to account for unique variance in both verbal (p=0.019) and visuospatial working memory (p=0.016). The MABC-2 total score was found to account for a significant proportion of the variance in inhibition total completion time (p=0.017). Finally, balance skills accounted for unique variance in a NEPSY-II inhibition total errors variable (p=0.020). Interpretation: The results provide support for an overlap between motor coordination and executive functions, which has important practical implications. The study also suggests shared mechanisms underpinning the relationship between these areas, including possible cerebellar involvement

The Revised DCDQ: Is it a suitable screening measure for motor difficulties in adolescents?

The parent-rated Developmental Coordination Disorder Questionnaire (DCDQ) has been revised to incorporate a wider age range, including adolescence. In this exploratory study, internal consistency and validity of the DCDQ-2007 was assessed using a community-based sample of 87 adolescents. Psychometric properties of the DCDQ-2007 were investigated and concurrent validity, sensitivity, and specificity were assessed with the MABC-2 as a criterion standard. The results demonstrated high internal consistency for the DCDQ-2007 and a relationship with the MABC-2 was found. The DCDQ-2007 met the recommended standard for sensitivity, although the confidence interval was large; however, it failed to meet the recommended standard for specificity. This has important implications concerning the suitability of the DCDQ-2007. Although promising psychometric properties were found within the current study, the applicability of the DCDQ-2007 as a screening measure for motor difficulties requires careful consideration