Ashleigh L. Thornton

Cognitive Orientation to (Daily) Occupational Performance intervention leads to improvements in impairments, activity and participation in children with Developmental Coordination Disorder

Abstract Introduction: Children diagnosed with Developmental Coordination Disorder (DCD) present with a variety of impairments in fine and gross motor function, which impact on their activity and participation in a variety of settings. This research aimed to determine if a 10-week group-based Cognitive Orientation to Daily Occupational Performance (CO-OP) intervention improved outcome measures across the impairment, activity and participation levels of the International Classification of Functioning, Disability and Health (ICF) framework. Methods: In this quasi-experimental, pre–post-test, 20 male children aged 8–10 years (9y1m ± 9 m) with a confirmed diagnosis of DCD participated in either the 10 week group intervention based on the CO-OP framework (n = 10) or in a control period of regular activity for 10 weeks (n = 10). Outcome measures relating to impairment (MABC-2, motor overflow assessment), activity (Handwriting Speed Test) and participation [Canadian Occupational Performance Measure, (COPM) and Goal Attainment Scale) were measured at weeks 0 and 10 in the intervention group. Results: Children who participated in the CO-OP intervention displayed improvements in outcome measures for impairment, activity and participation, particularly a reduction in severity of motor overflow. Parent and child performance and satisfaction ratings on the COPM improved from baseline to week 10 and all goals were achieved at or above the expected outcome. No significant changes were reported for the control group in impairment and activity (participation was not measured for this group). Conclusion: The strategies implemented by children in the CO-OP treatment group, targeted towards individualised goal attainment, show that CO-OP, when run in a group environment, can lead to improvements across all levels of the ICF. Implications for Rehabilitation Development Coordination Disorder is a condition which has significant physical, academic and social impacts on a child and can lead to activity limitations and participation restrictions. Cognitive Orientation to Daily Occupational Performance is an approach which uses cognitive-based strategies to improve performance of specific tasks based on child chosen goals. The intervention program had a positive effect on self-perceived levels of performance which may lead to changes in quality of life. Parents felt the intervention enhanced socialisation, peer modelling and encouragement and felt that this increased confidence and independence.

A systematic review of mirror neuron system function in developmental coordination disorder: Imitation, motor imagery, and neuroimaging evidence

PURPOSE The aim of this systematic review was to investigate the evidence of abnormal functioning of the mirror neuron system (MNS) in children and adults with developmental coordination disorder (DCD), through examination of imitation, motor imagery, and neuroimaging literature. METHODS The following databases were comprehensively searched for relevant articles: CINAHL Plus, Embase, MEDLINE, PsycINFO, Pubmed, and Web of Science. Full-text articles of all potentially relevant citations were obtained and assessed for eligibility by two authors. Outcome measures of interest at a motor behaviour level were any measures of imitation or motor imagery proficiency and, at a neurological level, were any measures of neural activity in MNS brain regions. Due to differences in outcome measures between studies and the variables reported, a narrative review was undertaken to synthesise findings from the studies. RESULTS Overall, 31 articles met the inclusion criteria. Children and adults with DCD display deficits imitating meaningful and novel gestures and demonstrate different response patterns to controls when undertaking complex motor imagery tasks. Children with DCD present reduced activation and connectivity of frontal, parietal, and temporal MNS regions. CONCLUSIONS Preliminary evidence indicates some deficit in the functioning of the MNS at a motor behaviour and neurological level. As no published neuroimaging studies have been designed specifically to explore MNS function, these results must be interpreted with caution. Further research to explore the MNS hypothesis in greater detail, particularly from a neuroimaging perspective, has the potential to provide information on the underlying mechanisms of DCD, inform future research into the aetiology of this disorder, and inform intervention approaches.

Does movement proficiency impact on exergaming performance

There is growing interest in the use of consumer level exergames in movement skill acquisition. The purpose of this study was to investigate the relationship between movement proficiency and performance in virtual exergaming. Twenty seven children, aged 10-15years participated in an experiment completing the Movement Assessment Battery for Children 2 (MABC-2) and a series of XBOX360 Kinect Sports exergaming tasks. Significant correlations were observed between MABC-2 aiming and catching percentile and exergame javelin and target kick, where the more proficient movers tended to perform better in the exergame. Statistically significant correlations were observed between MABC-2 balance percentile and exergaming sprint and target kick performance. In this study children who scored better in real life gross motor movement tasks performed better in most related exergaming activities. This suggests current exergaming technology has advanced to a point where body movement unencumbered by a physical or remote game device tether can extract movements resembling real life tasks, translate them into game play and reward proficient movers with higher in-game performance. It is possible that benefit gained in an exergaming environment by more proficient movers was a result of either their more proficient movement, or a greater ability to adapt to the exergame.

The relationship between motor proficiency and mental health outcomes in young adults: A test of the Environmental Stress Hypothesis

Growing evidence has highlighted the importance of motor proficiency in relation to psychosocial outcomes including self-perceived competence in various domains, perceived social support, and emotional areas such as anxiety and depression. The Environmental Stress Hypothesis-elaborated (Cairney, Rigoli, & Piek, 2013) is a proposed theoretical framework for understanding these relationships and recent studies have begun examining parts of this model using child and adolescent populations. However, the extent to which the relationships between these areas exist, persist or change during early adulthood is currently unclear. The current study aimed to investigate the Environmental Stress Hypothesis in a sample of 95 young adults aged 18-30years and examined the mediating role of physical self-worth and perceived social support in the relationship between motor proficiency and internalising symptoms. The McCarron Assessment of Neuromuscular Development (McCarron, 1997) was used to assess motor proficiency, the Depression Anxiety Stress Scale (Lovibond & Lovibond, 1995) provided a measure of internalising symptoms, and the Physical Self Perceptions Profile (Fox & Corbin, 1989) and the Multidimensional Scale of Perceived Social Support (Zimet, Dahlem, Zimet, & Farley, 1988) were used to investigate the possible mediating role of physical self-worth and perceived social support respectively. Potential confounding variables such as age, gender and BMI were also considered in the analysis. Structural Equation Modelling revealed that perceived social support mediated the relationship between motor proficiency and internalising symptoms, whereas, the mediating role of physical self-worth was non-significant. The current results provide support for part of the model pathways as described in the Environmental Stress Hypothesis and suggest an important relationship between motor proficiency and psychosocial outcomes in young adults. Specifically, the results support previous literature regarding the significant role of perceived social support for mental well-being and suggest that an intervention that considers social support may also indirectly influence mental health outcomes in young adults who experience movement difficulties.

Adaptation of the Resistance Training Skills Battery for Use in Children Across the Motor Proficiency Spectrum

PURPOSE The study aim was to adapt the Resistance Training Skills Battery for use in children and assess its interrater and intrarater reliability. The RTSBc provides an assessment of resistance training (RT) skill competency and an indication of readiness to perform RT. The RTSBc includes 6 basic RT skills. Scoring for individual RT skills is based on the number of performance criteria correctly demonstrated and a gross resistance training skills quotient for children (RTSQc) is calculated by summing the individual skill scores. METHODS Twenty participants (mean age = 8.2 ± 1.8 years) were assessed while performing the RTSBc on 2 occasions. The 3 raters completing the assessments had varying levels of movement analysis and RT experience and received training in how to appraise RT skill competency using the RTSBc. RESULTS Interrater reliability for the 3 raters was very good for the RTSQc (ICC = 0.92) and individual RT skills (ICC range = 0.82-0.94). Intrarater reliability of the live rater was also very good for the RTSQc (ICC = 0.97) and individual RT skills (ICC range = 0.87-0.95). CONCLUSION This study has demonstrated the interrater and intrarater reliability of the RTSBc for children with varying levels of motor proficiency. The RTSBc can be used reliably within and between-raters to assess the RT skill competency of children.

Assessing motor proficiency in young adults: The Bruininks Oseretsky Test-2 Short Form and the McCarron Assessment of Neuromuscular Development

Currently, only two motor tests have norms extending into young adulthood - the McCarron Assessment of Neuromuscular Development (MAND, McCarron 1997) and the Bruininks Oseretsky Test of Motor Proficiency-2 (BOT-2, Bruininks & Bruininks, 2005). Research into the motor difficulties in early adulthood and health outcomes has been impeded because there is no agreed gold standard motor test for this group. The purposes of this study were to compare the discrimination accuracy, classification agreement, and predictive values, and gender distribution and prevalence of each test in identifying motor impairment (MI) in relation to DSM-V diagnostic criteria for DCD. Ninety-one young, healthy adults (M=21.4years, SD=3.3) were recruited. Those classified as MI by each test scored at one standard deviation or more below the overall mean standard score. Small, statistically significant correlations were found between the MAND and BOT-2 SF tests for score rank (r=0.370, p=0.01) and standard score values (r=0.404; p=0.01). The overall decision agreement for non-MI cases was relatively high at 85% but very low for MI cases (4.4%). Unexpectedly, gender was balanced in MI cases. BOT-2 SF identified twice as many MI cases than MAND (13.2% vs 6.6%), yet overall comparative test specificity was high (89%). Predictive values for MAND, compared against BOT-2 SF as the standard, indicated broad independence between these tests and overall, the decision statistics indicated that the two tests identified different adult cohorts with MI. Objective classification of adult motor proficiency using a gold standard assessment tool including complex and ecologically valid tasks is still elusive.

Development of a Kinect Software Tool to Classify Movements during Active Video Gaming

While it has been established that using full body motion to play active video games results in increased levels of energy expenditure, there is little information on the classification of human movement during active video game play in relationship to fundamental movement skills. The aim of this study was to validate software utilising Kinect sensor motion capture technology to recognise fundamental movement skills (FMS), during active video game play. Two human assessors rated jumping and side-stepping and these assessments were compared to the Kinect Action Recognition Tool (KART), to establish a level of agreement and determine the number of movements completed during five minutes of active video game play, for 43 children (m = 12 years 7 months ± 1 year 6 months). During five minutes of active video game play, inter-rater reliability, when examining the two human raters, was found to be higher for the jump (r = 0.94, p < .01) than the sidestep (r = 0.87, p < .01), although both were excellent. Excellent reliability was also found between human raters and the KART system for the jump (r = 0.84, p, .01) and moderate reliability for sidestep (r = 0.6983, p < .01) during game play, demonstrating that both humans and KART had higher agreement for jumps than sidesteps in the game play condition. The results of the study provide confidence that the Kinect sensor can be used to count the number of jumps and sidestep during five minutes of active video game play with a similar level of accuracy as human raters. However, in contrast to humans, the KART system required a fraction of the time to analyse and tabulate the results.

Exercise in the Treatment of Youth Substance Use Disorders: Review and Recommendations

Substance use disorders among youth represent a significant public health concern. It is well established that regular exercise provides important physical and mental health benefits; however, evidence for the role of exercise as an adjunct component within substance use disorder treatment is scarce. In this review, we identify factors associated with the development and persistence of substance use disorders among youth, identify current treatment modalities, and present evidence to support the efficacy of incorporating exercise participation during rehabilitation. We also provide a series of recommendations for future research that explores the feasibility and effectiveness of exercise participation as a complement to substance use disorder treatment among youth.

Re-thinking anxiety: Using inoculation messages to reduce and reinterpret public speaking fears

Inoculation theory offers a framework for protecting individuals against challenges to an existing attitude, belief, or state. Despite the prevalence and damaging effects of public speaking anxiety, inoculation strategies have yet to be used to help individuals remain calm before and during public speaking. We aimed to test the effectiveness of an inoculation message for reducing the onset of public speaking anxiety, and helping presenters interpret their speech-related anxiety more positively. Participants (Mage = 20.14, SD = 2.72) received either an inoculation (n = 102) or control (n = 128) message prior to engaging a public speaking task and reported a range of anxiety-related perceptions. Accounting for personality characteristics and perceptions of task importance, and relative to control participants, those who received the inoculation message reported significantly lower pre-task anxiety, and following the task, reported that they had experienced lower somatic anxiety, and that the inoculation message had caused them to view their nerves in a less debilitating light. Inoculation messages may be an effective strategy for helping participants reframe and reduce their apprehension about public speaking, and investigating their efficacy in other stress-inducing contexts may be worthwhile.

Physiological characteristics, self-perceptions, and parental support of physical activity in children with, or at risk of, developmental coordination disorder

Children with low movement proficiency have been identified as having poorer physiological and psychosocial outcomes; however, the varied measurement approaches used to assess these outcomes have varied resulting in conflicting evidence regarding the presence and magnitude of differences compared to Typically Developing (TD) children. Additionally, there has been limited research into the role of parental support for physical activity (PA) in this group. We compared children with varying levels of movement proficiency on physiological characteristics and self-perceptions regarding PA. In addition, these childrens parents were compared on physiological characteristics and support of their childrens PA. Children (N = 117) aged 6 to 12 years, along with their parent/guardian, participated in this study. Children were classified according to the Movement Assessment Battery for Children-2 test (Typically Developing (TD) = 60; At Risk = 19; Developmental Coordination Disorder (DCD) = 38). Childrens PA, muscle strength, cardio-respiratory fitness (CRF), body composition, and self-perceptions regarding PA were assessed, with parents assessed on CRF, body composition, and PA support. Compared to TD children, children with DCD had lower PA (p = 0.036), predilection (p ≤0.001) and adequacy (p ≤0.001) regarding PA, higher body fat percentage (p = 0.019), and received less logistic support (i.e., transportation) from their parents (p = 0.012). TD children had increased muscle strength compared to the DCD (p ≤ 0.001) and At Risk (p ≤ 0.001) groups. Results indicated that, relative to TD children, children with DCD have multiple physiological deficits, receive less parental logistic support for PA involvement, and report lower scores on psychological constructs that are predictive of PA involvement.