The effect of attentional focus based on learning stages on motor learning in children with intellectual disabilities

Numerous efforts have been made to test the OPTIMAL theory of motor learning in healthy children and adult populations. However, only a small number of studies have tested this theory in children with cognitive-motor disorders, such as developmental coordination disorder (DCD). The present study aims to examine the individual and additive effects of a visual illusion and self-controlled practice on a golf putting task in children at risk for DCD based on the OPTIMAL theory. Forty children at risk for DCD (mean age = 8.57 ± 1.05 years) were randomly assigned to four experimental groups (1—small visual illusion + self-controlled practice; 2—big visual illusion + self-controlled practice; 3—small visual illusion + yoked; 4—big visual illusion + yoked). Following 12 pretest trials of a golf putting task, the participants completed 5 blocks of 12 trials of practice on the first day. A retention test (12 trials) and a transfer dual-task test (12 trials) were conducted on the second day. The results indicated that in retention test the big visual illusion + self-controlled practice group was significantly better than the small visual illusion + yoked group (p = 0.01), while there was not any other significant difference between groups at retention test as well as between all groups at practice phase and transfer test (p > 0.05 for all comparisons). In other words, an additive effect has been observed just in the retention test but not the practice phase as well as transfer test. In general, the results of this study support the OPTIMAL theory of motor learning in children at risk for DCD and suggests to all educators who work with these children to use the combination of the visual illusion with self-controlled practice to improve the motor learning of children at risk for DCD.

#25: Current Modeling High Definition and Conventional tDCS-enhanced motor learning in children

Background and aim Children with autism spectrum disorder (ASD) may experience coordination disorders, but the effects of different training conditions on motor learning in these children remain unclear. This study examined how constant versus variable practice impacts motor performance and learning in children with ASD and motor impairments. Methods Thirty-four children attending child development and daycare centers participated. Assessments included fine motor skills (Purdue Pegboard), gross motor skills (target-target task), visuospatial working memory (Corsi block tapping task), and the developmental disability questionnaire (Strengths and Difficulties Questionnaire). The primary outcome was the change in target-task performance before, during, and after practice, analyzed using repeated measures two-way ANOVA and Pearson's correlation. Results No significant differences were observed for practice conditions or time effects alone, but significant interactions were found (F = 6.641, p = 0.015). Variable practice resulted in reduced pre- to post-test scores (p = 0.047), while constant practice showed stronger correlations between practice improvements and overall performance changes (p = 0.004, r = 0.666). Prosocial behavior was positively associated with performance improvements in the constant practice group (p = 0.018, r = 0.564). No significant correlations were found in the variable practice group. Conclusions Constant practice yielded greater motor learning improvements than variable practice. Additionally, prosocial behavior positively influenced motor learning in structured settings, highlighting the potential benefits of integrating motor and social skill interventions for children with ASD.

Effect of internal versus external focus of attention on implicit motor learning in children with developmental coordination disorder.

Inability to acquire a new motor skill is a common motor difficulty in children with autism spectrum disorder. The purpose of this study is to examine whether the motor learning benefits of an external focus of attention for typically developing children and children with intellectual disabilities could also be applied to children with autism spectrum disorder. Children ( N = 65; mean age = 10.01 years) diagnosed with high-functioning autism spectrum disorder were randomly assigned into one of the three groups: external focus ( n = 22), internal focus ( n = 22), and control ( n = 21). They were required to throw beanbags at a static target for 50 acquisition trials, 10 retention trials, and 10 transfer trials. While all three groups learnt the skills in a similar manner during the acquisition phase, the internal focus group demonstrated more robust motor performance than the external focus group and the control group in both retention and transfer tests, while there was no difference between the external focus group and the control group in both retention and transfer tests. The findings provide evidence that internal focus of attention may be more effective for facilitating motor learning in children with autism spectrum disorder. However, further study is needed to determine the factors contributing to this finding.

Evidence of provision of extrinsic feedback for improvement and retention of upper limb kinematics in children with cerebral palsy (CP) is scarce, especially following training interventions using virtual environments. Benefits of using a virtual environment can range from increasing the participant's motivation to the ease of adapting extrinsic feedback for optimizing motor learning. In the proposed research, children with CP will be randomly allocated to one of three groups: no additional feedback, continuous feedback and faded feedback. For all groups, upper-limb motor training will be done in a virtual environment using the Jintronix virtual reality system. Motor improvements will be evaluated after an 8 hour training intervention and motor learning will be evaluated after one month. Transfer of motor gains to performance of a similar upper-limb task will also be used to assess learning. Findings from this research will provide crucial information on which frequency of feedback should be used to optimize motor learning and upper-limb rehabilitation in children with CP.

Childhood is an obvious period for motor learning, since children's musculoskeletal and nervous systems are still in development. Adults adapt movements based on reward feedback about success and failure, but it is less established whether school-age children also exhibit such reward-based motor learning. We designed a new 'circle-drawing' task suitable for assessing reward-based motor learning in both children (7-17 years old) and adults (18-65 years old). Participants drew circles with their unseen hand on a tablet. They received binary reward feedback after each attempt based on the proximity of the average radius of their drawing to a target radius set as double the radius of their baseline drawings. We rewarded about 50% of the trials based on a performance-dependent reward criterion. Both children (10.1 ± 2.5 (mean ± SD) years old) and adults (37.6 ± 10.2 years old) increased the radius of their drawings in the direction of the target radius. We observed no difference in learning between children and adults. Moreover, both groups changed the radius, less following reward than following reward absence, which is a sign of reward-based motor learning. We conclude that school-age children, like adults, exhibit reward-based motor learning.

Purpose Motor learning interventions for children with cerebral palsy (CP) that elicit relatively permanent and transferable improvements in motor skill capability are essential. Knowledge is needed about the augmented feedback forms that most effectively promote this. This review aims to collect and analyze the current evidence for the effectiveness of different forms of feedback for motor learning in children with CP to improve motor task performance. Methods PubMed, PsycInfo, and Cochrane Library were searched to identify relevant studies. Studies were included if (1) they were conducted in children with CP or compared children with CP to TD children and (2) a form of augmented feedback related to a motor task was administered. Results Initially, 401 records were identified for screening. Ultimately, 12 articles were included in the review. The evidence thus far supports the expectancy that children with CP generally benefit from feedback provided during or after performing a movement task. Conclusion Due to the heterogeneity of existing studies, it is difficult to draw firm conclusions regarding relative effectiveness of feedback forms. This review showed that more high-quality research is warranted on the effectiveness of specific feedback forms on motor learning in children with CP. Implications for Rehabilitation Children with CP benefit from several forms of knowledge of performance or knowledge of results feedback provided during or after performing a movement task. Feedback should not be provided with every performed trial. Feedback frequency can best be reduced by letting children determine after which trials they want feedback. Learning curves under similar feedback conditions varied largely between children, warranting tailor-made forms of feedback to be applied during motor learning and rehabilitation.

A motor-learning framework is relevant to the planning of therapy sessions with children with movement disorders. Theoretical and practical consideration needs to be given to the child's learning stage and priority goal: learning or performance. Following a motor-teaching model, instructional factors related to the therapeutic intervention include: context, motivation and prior knowledge, instructions, modelling, taxonomy and sequencing of tasks, anticipation skills, mental and physical practice, repetition, facilitation-guidance and feedback. Further reflection on motor learning concepts in the selection of appropriate motor-teaching strategies may promote more effective physiotherapy interventions. Therapists are encouraged to document systematically their instructional strategies and the outcome on the children's motor learning.

Improving motor skill acquisition through analogy in children with autism spectrum disorders

Introduction: Children and adolescents living in shelters may present with impaired motor development, cognitive function, as well as speech and understanding; psychological alterations; and hyperactivity. All of these factors may be detrimental to motor learning. Objective: To investigate motor learning in children and adolescents living in shelters, and to compare it with that of individuals living in a family context. Methods: We assessed 36 individuals who were divided into groups: an experimental group, composed of institutionalized children and adolescents (EG, n=18), and a control group (CG, n = 18) that was matched by age and sex. Motor learning was assessed using a maze test in three stages: acquisition, retention and transfer. The data were analyzed using the Shapiro Wilk, Wilcoxon, Mann Whitney, Kruskal Wallis tests and Dunn’s post-test (p < 5%). Results: The EG had a longer task performance time than the CG. There was a significant reduction in task performance time between the first (EG = 11.05 [8.50-14.85]s; CG:7.65 [5.95-10.23]s) and the last task performance block (EG:8.02 [6.86-10.23]s; GC: 5.50 [4.50-6.82]s) in both groups. When comparing the variables of the last acquisition (GE:8.02[6.86-10.23]s; GC: 5.50[4.50-6.82]s), retention (GE:8.20[7.09-9.89]s;GC:5.35[4.50-6.22]s) and transfer blocks (GE:8.30[6.28-11.43]s; GC:5.30[4.90-6.82]s) in each group, we found no changes in task performance time between test batteries. Conclusion: Individuals living in shelters showed a motor learning deficit, as evidenced by longer task performance time when compared to their controls. Nevertheless, both groups performed the task in a similar manner.

Reduced feedback during motor skill practice benefits motor learning. However, it is unknown whether these findings can be applied to motor learning in children, given that children have different information-processing capabilities than adults. The purpose of this study was to determine the effect of different relative frequencies of feedback on skill acquisition in children compared with young adults. The participants were 20 young adults and 20 children. All participants practiced 200 trials of a discrete arm movement with specific spatiotemporal parameters. Participants from each group (adults and children) were randomly assigned to either a 100% feedback group or a reduced (62% faded) feedback group. Learning was inferred from the performance on the delayed (24-hour) retention and reacquisition tests. All participants improved accuracy and consistency across practice trials. During practice, the adults performed with significantly less error than the children. Adults who practiced with reduced feedback performed with increased consistency during the retention test compared with those who practiced with 100% feedback. In contrast, children who received reduced feedback during practice performed with less accuracy and consistency during the retention test than those who received 100% feedback. However, when feedback was reintroduced during the reacquisition test, the children in the reduced feedback group were able to improve their performance comparable to those in the 100% feedback group. During motor learning, children use feedback in a manner different from that of adults. To optimize motor learning, children may require longer periods of practice, with feedback reduced more gradually, compared with young adults.

Wii training versus non-Wii task-specific training on motor learning in children with developmental coordination disorder: A randomized controlled trial.

The present study examined whether the learning benefits of an external focus of attention (i.e., on the movement effect) relative to an internal focus (i.e. on the movement), found previously in non-disabled children and adults would also be found in children with intellectual disabilities (IDs). Participants (n = 24; average age: 12.2 years) with mild intellectual deficiency (IQ = 51-69) practiced throwing beanbags at a target. In the external focus group, participants were instructed to direct their attention to the movement of the beanbag, while in the internal focus group, participants were asked to direct their attention to the movement of their hand. The practice phase consisted of 40 trials, and attentional focus reminders were given after every third trial. Learning was assessed 1 day later by retention and transfer (greater target distance) tests, each consisting of 10 trials. No focus reminders were given on that day. The external focus group demonstrated more effective learning than the internal focus group, as evidenced by more accurate tosses on the transfer test. The present findings show that instructions that induce an external focus of attention can enhance motor learning in children with IDs.

F141. Sensorimotor robotic measures of tDCS and HD-tDCS enhanced motor learning in children