Cerebellar and brainstem differences in children with developmental coordination disorder: A voxel-based morphometry study

Developmental coordination disorder (DCD) is a neurodevelopmental disorder that significantly impairs a child’s ability to learn motor skills and to perform everyday activities. The cause of DCD is unknown; however, evidence suggests that children with DCD have altered brain structure and function. While the cerebellum has been hypothesised to be involved in developmental coordination disorder, no studies have specifically examined cerebellar structure in this population. The purpose of our study was to examine cerebellar differences in children with DCD compared to typically-developing children. Using voxel-based morphometry, we assessed cerebellar morphology in children 8–12 years of age. Forty-six children (12 typically-developing and 34 with DCD) were investigated using high resolution T1-weighted images, which were then processed using the spatially unbiased atlas template of the cerebellum and brainstem (SUIT) toolbox for a region of interest-based examination of the cerebellum. Results revealed that children with DCD had reduced grey matter volume in several regions, namely: the brainstem, right/left crus I, right crus II, left VI, right VIIb, and right VIIIa lobules. Further, Pearson correlations revealed significant positive associations between the total motor percentile score on the Movement Assessment Battery for Children-2 and regions that had reduced grey matter volume in our cohort (brainstem, left crus I, right VIIb, and right VIIIa). These findings indicate that reductions in cerebellar grey matter volume are associated with poorer motor skills. Given the cerebellum’s involvement in internal models of movement, results of this study may help to explain why children with DCD struggle to learn motor skills

Assessing children to identify developmental coordination disorder: A survey of occupational therapists in Australia

Background: Developmental coordination disorder (DCD), a prevalent neurodevelopmental disorder with motor and psychosocial consequences, can significantly impact children\u27s quality of life. In Australia, most children with diagnosed/suspected DCD have received occupational therapy services, more so than any other health service. As such, occupational therapists are key in identification and treatment and require a sound knowledge of diagnostic criteria and the best evidence for practice. This study explored current occupational therapy services for children with DCD. Areas for development are identified to improve the identification of, and subsequent intervention for, children with DCD. Methods: In this cross-sectional study, an online survey was completed in September and October 2020 by 175 occupational therapists working in Australia. Results: Although all therapists worked with children who met the criteria for DCD diagnosis, 70% worked with children with no specific diagnosis and 50% worked with children with outdated diagnostic labels. Australian occupational therapists used similar models/frameworks (commonly a multisensory/sensory processing approach) to guide practice with children with DCD, regardless of therapist characteristics, practice setting (clinic/community, rural/urban), how therapy is funded, or the state where the therapists completed their training/currently practiced. Although assessment practices did not differ significantly, therapists with greater years of paediatric practice and those who studied and/or practiced in Western Australia were more likely to assess to identify DCD. Half of the therapists did not assess to identify DCD; however, 60% of assessing therapists reported best practice methods in assessment for DCD, indicating emerging best practices in the Australian context. Conclusion: The findings from this study suggest that small adaptations to current occupational therapy practice may enhance the early identification of children with DCD in Australia. The existing gaps in evidence to practice must be addressed to improve current Australian practice and increase access to appropriate services and ultimately improve the quality of life for children with DCD

Awareness and knowledge of developmental coordination disorder: A survey of caregivers, teachers, allied health professionals and medical professionals in Australia

Background To allow for accurate and timely diagnosis of developmental coordination disorder (DCD) key stakeholders must be familiar with and be able to identify features of this disorder. No studies to date have investigated the awareness of DCD among key stakeholders in Australia. Methods An online survey was complete by 494 Australian participants: primary caregivers (n = 153), teachers (n = 149), allied health professionals (n = 165) and medical professionals (n = 27). Results DCD and related terms were among the least known childhood disorders. Approximately half of the sample were familiar with the term DCD but every stakeholder group were more familiar with the term dyspraxia. Allied health professionals demonstrated greater knowledge of the features of DCD, particularly motor features. Every stakeholder group showed poor recognition of the social and psychological effects of DCD. A relatively low percentage of allied health (53%) and medical (33%) professionals reported they had identified or diagnosed DCD and less than 20% of these felt that the DSM‐5 contained adequate information to make a DCD diagnosis. Most teachers (82%) believed they should play a role in identifying early warning signs of this disorder, and 80% believed there are children in the school system who were labelled as lazy or defiant when they have motor skills impairments. Primary caregivers were supportive of a diagnosis of DCD being provided; however, only 16% were confident that a physician would provide an accurate and timely diagnosis. Conclusion Key stakeholders play a unique and important role in the identification of children with DCD. Though most participants acknowledge the role that they play, all stakeholder groups demonstrated poor familiarity with the term DCD and low levels of knowledge about the features of this disorder. Improved familiarity and knowledge of the disorder is needed for access to appropriate services and improved long‐term outcomes for this condition

Understanding factors that influence physical activity behavior in people with developmental coordination disorder (DCD): a mixed-methods convergent integrated systematic review

This systematic review synthesizes the literature on physical activity amongst people with DCD using the COM-B framework. The review questions were: (1) what is the Capability (C), Opportunity (O) and Motivation (M) for physical activity and (2) what does physical activity behavior (B) look like? A mixed-methods systematic review was conducted by searching eight databases (PubMed, APA PsycINFO, EMBASE, Scopus, Child Development and Adolescent Studies, Cochrane Library, Web of Science, CINAHL) up to July 2023. Data were extracted, thematically analyzed, and mapped to the COM-B model. The quality of studies was assessed with the Joanna Briggs Institute (JBI) critical appraisal tool. The protocol was registered with PROSPERO (CRD42022319127). Forty-three papers, 42 of which related to children, were included. Fifteen aligned with physical activity behavior, nine with physical capability, thirteen with psychological capability, one with social opportunity, one with physical opportunity, one with reflective motivation and three with automatic motivation. Pre-school-aged children with DCD engage in comparable levels of physical activity behavior, but differences emerge from 6 years of age. Characteristics of DCD result in reduced physical capability and less varied participation in physical activity. This impacts psychological capability, whereby lower self-perceptions result in a negative feedback loop and reduce the motivation to participate. Barriers relating to social opportunities may result in poor reflective and automatic motivation, although there is evidence that interventions can enhance enjoyment in the short term

Reliability of Early Magnetic Resonance Imaging (MRI) and Necessity of Repeating MRI in Noncooled and Cooled Infants with Neonatal Encephalopathy

In cooled newborns with encephalopathy, although late magnetic resonance imaging (MRI) scan (10-14 days of age) is reliable in predicting long-term outcome, it is unknown whether early scan (3-6 days of life) is. We compared the predominant pattern and extent of lesion between early and late MRI in 89 term neonates with neonatal encephalopathy. Forty-three neonates (48%) were cooled. The predominant pattern of lesions and the extent of lesion in the watershed region agreed near perfectly in noncooled (kappa = 0.94; k = 0.88) and cooled (k = 0.89; k = 0.87) infants respectively. There was perfect agreement in the extent of lesion in the basal nuclei in noncooled infants (k = 0.83) and excellent agreement in cooled infants (k = 0.67). Changes in extent of lesions on late MRI occurred in 19 of 89 infants, with higher risk in infants with hypoglycemia and moderate-severe lesions in basal nuclei. In most term neonates with neonatal encephalopathy, early MRI (relative to late scan) robustly predicts the predominant pattern and extent of injury. </jats:p

Sleep in Offspring of Parents With Mood Disorders

Background: Sleep problems in childhood are an early predictor of mood disorders among individuals at high familial risk. However, the majority of the research has focused on sleep disturbances in already diagnosed individuals and has largely neglected investigating potential differences between weeknight and weekend sleep in high-risk offspring. This study examined sleep parameters in offspring of parents with major depressive disorder or bipolar disorder during both weeknights and weekends.Methods: We used actigraphy, sleep diaries, and questionnaires to measure several sleep characteristics in 73 offspring aged 4–19 years: 23 offspring of a parent with major depressive disorder, 22 offspring of a parent with bipolar disorder, and 28 control offspring.Results: Offspring of parents with major depressive disorder slept, on average, 26 min more than control offspring on weeknights (95% confidence interval, 3 to 49 min, p = 0.027). Offspring of parents with bipolar disorder slept, on average, 27 min more on weekends than on weeknights compared to controls, resulting in a significant family history × weekend interaction (95% confidence interval, 7 to 47 min, p = 0.008).Conclusions: Sleep patterns in children and adolescents were related to the psychiatric diagnosis of their parent(s). Future follow-up of these results may clarify the relations between early sleep differences and the risk of developing mood disorders in individuals at high familial risk

Recruitment, use, and satisfaction with a web platform supporting families of children with suspected or diagnosed developmental coordination disorder: A randomized feasibility trial

Objectives. To determine the feasibility of recruiting families of children with suspected or diagnosed developmental coordination disorder (sdDCD) and explore their satisfaction with a web-based intervention Design. A feasibility randomized trial was conducted. Participants were the parents of 5-12-year-old children with sdDCD. The intervention group had access to online resources, group and private forums, and videoconferencing with a therapist. Main outcomes were recruitement and retention rates. Satisfaction was documented through a post-intervention survey and interview. Results. The recruitment rate was seven participants per month (n = 28 participants) and retention rate was 68%. Satisfaction was moderate. No differences in use and satisfaction were observed between groups. Participants formulated recommendations for improving the intervention, including targeting families earlier in the diagnosis process, and pre-scheduling meetings with therapists. Conclusions. This study demonstrated the feasibility of future trials, and highlighted avenues for improvement. Parent involvement during the development of the intervention is discussed at length. Abbreviations: DCD: Developmental Coordination Disorder; sdDCD: suspected or diagnosed Developmental Coordination Disorder; RCT: randomized-controled trial

Neural and behavioural correlates of motor performance in children with developmental coordination disorder

Introduction: With a prevalence of 5-6%, developmental coordination disorder (DCD) is one of the most common disorders of childhood. Children with DCD struggle to learn new motor skills, but the neurological mechanisms underlying the disorder are essentially unknown. Purpose: The purpose of this thesis was three-fold: (1) to present a synopsis of current literature examining the potential neural correlates of DCD; (2) to determine if patterns of brain activity differed between children with and without DCD while performing a fine-motor task; and (3) to investigate whether children with DCD are able to demonstrate improved motor learning as evidenced by increased accuracy on a fine-motor task and/or shifts in patterns of brain activation. Methods: A comprehensive literature review of possible neural correlates of DCD was conducted, which provided the background for the two studies included in this thesis. Both of these studies employed a block design and used functional magnetic resonance imaging to map patterns of brain activation associated with motor performance (Chapter 3) and motor learning (Chapter 4) of a fine-motor task. Seven children who met the diagnostic criteria for DCD (ages 8-12 years) and seven typically-developing (TD), closely age-matched children participated in the studies. Results: The literature review implicated the cerebellum as a likely source of dysfunction associated with DCD. Chapter 3 showed that, despite similar levels of behavioural motor performance, substantial differences in patterns of brain activity were noted between children with DCD and TD children. Differences in motor behaviour emerged in Chapter 4, with the DCD group showing little change in tracing accuracy compared to the improvements noted in the TD group. Neuroimaging results from Chapter 4 suggest that children with DCD may have a deficit in updating internal models of movement through under-activation of the cerebellum and/or the cerebello-thalamo-cortical pathway. Conclusion: Findings from this thesis have made several important and novel contributions to our understanding of children with DCD. This work has suggested support for several hypotheses related to the mechanisms underlying DCD and provided some of the first neuroimaging evidence to suggest possible explanations for findings of previous research in children with DCD.Medicine, Faculty ofGraduat

Rehabilitation Approaches for Children with Spinal Muscular Atrophy: A Scoping Review

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A dynamic systems approach to understanding adaptive locomotion in individuals with developmental coordination disorder : a systematic review

Purpose of ReviewMultiple times per day, individuals need to navigate their environment and maintain their balance in order to reach their various destinations. Such adaptive walking is challenging for individuals with developmental coordination disorder (DCD), a condition affecting motor control and coordination. Using Dynamic Systems Theory, this systematic review compared the motor behaviours of individuals with and without DCD during adaptive walking tasks.Recent FindingsSeventeen articles met inclusion criteria. Parameters of the task (i.e. dual-task, obstacle navigation, stair negotiation) and environment constraints (i.e. irregular terrain, visual manipulation, non-immersive virtual reality) resulted in behavioural differences in individuals with DCD compared to controls.SummaryIndividuals with DCD prioritized stability by compensating their gaze and gait during adaptive walking tasks. Individuals with DCD appear to have a discrepancy in the perception-action cycle. Future research should explore this relationship in the context of complex adaptive locomotion tasks, such as collision avoidance