Developmental coordination disorder Flashcards
1
Q
DSM5 criteria
DCD
A
- 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)
2
Q
self-care challenges for those with DCD
Zwicker et al. (2012)
further reading
A
- dressing
- managing buttons and zippers
- tying shoelaces
- using a knife and fork
- toileting
3
Q
school-related challenges for those with DCD
zwicker et al. (2012)
further reading
A
- copying
- drawing
- painting
- printing
- handwriting
- using scissors
- organising
- finishing work on time
- PE
4
Q
non-motor deficits DCD
A
- motor imagery problems (Noten et al., 2014)
- visual-perceptual & spatial processing (Tsai et al., 2008)
- ppl with dyspraxia (and/or other conditions) often focus on other symptoms
5
Q
demographics DCD
A
- 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
6
Q
clinical assessments for DCD
A
- MABC-2
- BOT
- DCDQ’07
7
Q
movement assessment battery for children
A
- dev from test of motor impairment (TOMI, 1972, revised 1984)
- MABC-2 assesses three domains of movement with 8-10 tasks, in three age bands (4-7, 8-10, 11-16 yrs)
- bottom 5%ile (<2DS) = probable DCD
- bottom 15%ile (<1SD) = at risk for DCD
8
Q
domains the MABC-2 assesses
A
- manual dexterity e.g. drawing a trail
- aiming and catching
- balance e.g. standing on one leg
9
Q
patterns of difficulty and MABC-2
A
- worst 15% in each of three movement domains are mostly non-overlapping: includes 36% of children
- Holmes et al. (unpublished) - correlations between domains, overall relatively low corr (0.2-0.3) between movement domains within MABC-2
- diff movement skills separate - why corr is low
- calibration: 7 out of 8 tasks poorly calibrated, not normally distributed
- only throwing is normally distributed
- doesn’t make sense to standardise scores if not normally distributions
10
Q
BOT-2
movement assessment
A
- covers wider age range than the MABC-2 (4-21yrs)
- better able to discriminate between children with good performance (MABC-2 is better for impairment)
- 8 motor domains
11
Q
8 motor domains in BOT-2
A
- fine motor precision
- fine motor integration
- manual dexterity
- bilateral coordination
- balance
- running speed and agility
- upper-limb coordinatoin
- strength
12
Q
DCDQ-7
A
- 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)
13
Q
clinic and lab being far apart
DCD
A
- most clinical tests are based on longer, more continuous, complex movements
- most human movement science is based on short, discrete eye and/or hand movements
14
Q
current intervention approaches for DCD
zwicker et al. (2012)
further reading
A
- 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
15
Q
internal modelling deficit hypothesis (DCD)
adams et al. (2014), wilson et al. (2013)
A
- 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
16
Q
double-step reaching paradigm
hyde & wilson
A
- 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)
17
Q
blanchard et al. (2017)
A
- 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
18
Q
motor imagery
williams et al. (2008)
A
- 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
19
Q
mirror neuron system hypothesis
werner et al. (2012)
A
- 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
20
Q
imitation of gestures
sinani et al. (2011)
A
- transitive gestures - involve an object
- intransitive gestures - no object
- children with DCD were less good at imitating transitive & intransitive actions than age-matched controls
21
Q
evidence for mirror neuron from neuroimaging
A
- 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
22
Q
how the cerebellum could be linked to DCD
A
- postural control
- motor coordination
- motor adaptation
- fine movement coordination
- motor learning
23
Q
how the basal ganglia could be linked to DCD
A
- motor control
- movement initiation - patients with damage to the basal ganglia struggle to start movements
- movement learning
- automisation
24
Q
how the parietal lobe could be linked to DCD
A
- motor imagery
- action prediction - predicting outcomes of a movement
- action observation - imitation
- facial recognition
- visuospatial processing - hand eye coordination
25
Q
neuroimaging meta-analysis (DCD)
biotteau et al. (2016)
A
- 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
26
Q
reasons for inconsistencies in neuroimaging studies
biotteau et al. (2016)
A
- 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
27
Q
hybrid model of DCD
wilson et al. (2017)
A
- 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
28
Q
etiology and neurobiology of DCD
zwicker et al. (2012)
further reading
A
- 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
29
Q
motor skills in ADHD
kaiser et al. (2015)
A
- 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
30
Q
motor imagery in ADHD
williams et al. (2013)
A
- ADHD & DCD group, but not ADHD only group were less accurate on hand rotation task
- suggests motor imagery linked to motor, not att difficulties
31
Q
motor network connectivity in ADHD
mcleod et al. (2016)
A
- 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
32
Q
DCD and autism
A
- 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?
33
Q
structural correlation networks
caeyenberghs et al. (2016)
A
- 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
