C. Emck

Gross motor performance and self-perceived motor competence in children with emotional, behavioural, and pervasive developmental disorders: a review

Aims Motor performance and self‐perceived motor competence have a great impact on the psychosocial development of children in general. In this review, empirical studies of gross motor performance and self‐perception of motor competence in children with emotional (depression and anxiety), behavioural, and pervasive developmental disorders are scrutinized, with the objective of identifying specific motor characteristics that may be relevant to clinical practice.

Patterns of postural sway in high anxious children

BackgroundCurrent research suggests that elevated levels of anxiety have a negative impact on the regulation of balance. However, most studies to date examined only global balance performance, with little attention to the way body posture is organized in space and time. The aim of this study is to examine whether posturographic measures can reveal (sub)clinical balance deficits in children with high levels of anxiety.MethodsWe examined the spatio-temporal structure of the centre-of-pressure (COP) fluctuations in children with elevated levels of anxiety and a group of typically developing children while maintaining quiet stance on a force plate in various balance challenging conditions. Balance was challenged by adopting sensory manipulations (standing with eyes closed and/or standing on a foam surface) and using a cognitive manipulation (dual-tasking).ResultsAcross groups, postural performance was strongly influenced by the sensory manipulations, and hardly by the cognitive manipulation. We also found that children with anxiety had overall more postural sway, and that their postural sway was overall less complex than sway of typically developing children. The postural differences between groups were present even in the simple baseline condition, and the group differences became larger with increasing task difficulty.ConclusionThe pattern of postural sway suggests that balance is overall less stable and more attention demanding in children with anxiety than typically developing children. The findings provide further evidence for a neuro-behavioral link between psychopathology and the effectiveness of postural control.

Gross motor performance and physical fitness in children with psychiatric disorders

Aim  Gross motor performance appears to be impaired in children with psychiatric disorders but little is known about which skill domains are affected in each disorder, nor about possible accompanying deficits in physical fitness. The present study has sought to provide information about these issues in children with emotional, behavioural, and pervasive developmental disorders (PDD).

Attentional and sensory contributions to postural sway in children with autism spectrum disorder

Postural control is known to depend on sensory and cognitive factors. Little is known about how children with autism spectrum disorder (ASD) regulate static balance, and to what extent vision and cognition contribute to the regulation of balance in this group. We compared a group of children with mild ASD and a group of age- and gender-matched controls on various postural tasks, standing on a Wii Balance Board. We tested a sensory disturbance (closing the eyes) and a cognitive disturbance (word memorization) on the control of quiet standing. Analysis of center-of-pressure excursions revealed moderate effects of cognitive load, but clear effects of vision. We found a greater destabilizing effect of closing the eyes (greater postural excursions in the medio-lateral direction) for the ASD group than for controls. No group differences were found on word recall and on a standardized balance test (Movement Assessment Battery for Children; M-ABC2). We suggest that the postural effects reflect tighter coupling between vision and motor adjustments in ASD than in controls, which is consistent with recent suggestions of greater reliance on vision in this group.

PsyMot: an instrument for psychomotor diagnosis and indications for psychomotor therapy in child psychiatry

Psychomotor therapy is a movement-oriented and body-oriented therapy which resembles dance movement psychotherapy, although some differences remain. Despite historical differences, theoretical backgrounds as well as practical methods of both therapies converge at large. Both fields are in need of assessment development to support diagnosis and treatment. In this article, we present a recently developed systematic tool for psychomotor assessment and diagnosis of children, the PsyMot. The construction of this instrument was inspired by the International Classification of Functioning, childrens version, of the World Health Organization. The PsyMot consists of an assessment procedure, guidelines for scoring items and a computer program for converting item scores into scores for clusters of treatment goals. Initial studies suggest that the PsyMot has adequate psychometric qualities, but further research is needed. Possibilities for the use of the PsyMot in different groups are currently being explored.

Body experience in children with intellectual disabilities with and without externalising disorders

Psychomotor therapy for children with mild intellectual disabilities (ID) often is aimed at improving body experiences. If children are able to recognise their bodily signals, they will be able to regulate emotions better and act more adequately. Because little is known about body experience in children with intellectual disabilities and externalising behaviour, the aim of this study was to shed more light on this topic. Thirty-one children with intellectual disabilities, aged eight to 12 years (M = 9.9, SD = 1.3) participated in this study. The PsyMot diagnostic procedure and the Body Experience Questionnaire for Children were used to measure body experience. In 41% of the cases problems in body experience were found. Children with ID and externalising disorders showed significant more problems in body experience than children with ID-only. Movement interventions aimed at improving body experience seem particularly relevant for these children, as they support the development of emotion regulation abilities.

The feasibility of psychomotor therapy in acute mental health services for adults with intellectual disability

ABSTRACT Background Psychomotor therapy enables people to reflect on the relationship between experiences and feelings by starting from awareness of bodily responses rather than from awareness of emotion. In this study we examine PsyMot (ID), an assessment that directs this psychological therapy. Method Twelve suitable consecutive admissions were recruited from a specialist intellectual disability (ID) assessment and treatment unit for adults. Video-recordings of PsyMot (ID) allowed assessment of interrater reliability (IRR). Treatment goals indicated by PsyMot (ID) were addressed using psychomotor therapy as part of a comprehensive program of interventions. Results Psychomotor therapy was both feasible and popular with patients who participated without any adverse effects. Nine patients completed PsyMot (ID). IRR of the treatment goals identified by all 3 raters was good to excellent in 81% cases, but there were discrepancies for individual items. Conclusions PsyMot (ID) and psychomotor therapy is feasible within this context, and enriched the clinical teams formulation. Further studies of reliability and efficacy should be undertaken.

Balance performance in autism : A brief overview

Children with autism not only have limited social and communicative skills but also have motor abnormalities, such as poor timing and coordination of balance. Moreover, impaired gross motor skills hamper participation with peers. Balance control is interesting from a cognitive science perspective, since it involves a complex interplay between information processing, motor planning, and timing and sequencing of muscle movements. In this paper, we discuss the background of motor problems in children with autism, focusing on how posture is informed by sensory information processing. We also discuss the neurobiological basis of balance problems, and how this is related to anxiety in this group. We then discuss possible avenues for treatment of autism spectrum disorder (ASD) symptoms, especially as regards movement-related interventions. Finally, we present a theoretical outlook and discuss whether some of the symptoms in ASD can be understood from an embodied cognition perspective.

A Psychomotor Diagnostic Instrument for Patients with Post-traumatic Stress Disorder.

Abstract Posttraumatic stress disorder (PTSD) is associated with an increased risk of physical disorders as a consequence of chronic stress reactions and adverse lifestyle behaviours. In addition, various other physical signs and symptoms may be present, as well as problems with emotional awareness, such as alexithymia, which may impede verbal information processing. Therefore, a psychomotor diagnostic instrument (PMDI) is developed, based on non-verbal information to contribute to a careful and reliable diagnostic procedure. The PDMI is designed to identify specific goals for body and movement oriented treatments of PTSD. It consists of a manual with an assessment procedure, guidelines for scoring items and for the calculation of cluster scores based on item scores. In this paper, the PMDI and its development are discussed, and illustrated by brief vignettes.

Beter in balans: over de rol van motoriek, balans en bewegingsinterventies bij kinderen met autisme

SamenvattingKinderen met autisme hebben niet alleen problemen met communicatie en sociale interactie. Ze hebben ook motorische problemen, zoals stereotype bewegingen, slechte coördinatie en zwakke motorische vaardigheden. Al deze vaardigheden zijn van belang om te kunnen participeren in schoolse en buitenschoolse activiteiten. Uit veel studies blijkt dat kinderen met autisme afwijkingen vertonen in de balanshandhaving. Deze verminderde lichaamsstabiliteit ligt mogelijk ten grondslag aan diverse grofmotorische problemen. Twee mechanismen spelen daarbij een rol. Ten eerste een abnormale sensorische integratie, hetgeen waarschijnlijk gerelateerd is aan afwijkingen in het cerebellum en ten tweede verhoogde angstniveaus, die gerelateerd zijn aan overactiviteit in neurale kernen, waarin een koppeling plaatsvindt tussen angstregulatie en balanshandhaving, zoals de nucleus parabrachialis. Bewegingsinterventies, zoals psychomotorische balanstraining, kunnen effectief zijn in het verbeteren van de sociale en motorische competenties. Ze kunnen leiden tot betere balanshandhaving, maar ook zorgen voor angstreductie, wat participatie aan sport- en spelactiviteiten ondersteunt, wat op haar beurt sociaal isolement helpt verminderen. Op deze wijze dragen bewegingsinterventies bij aan een optimale ontwikkeling van kinderen met autismespectrumstoornissen.