Bruininks-Oseretsky Test Of Motor Proficiency Research Articles

49,XXXXY syndrome: A study of neurological function in this uncommon X and Y chromosomal disorder.

49,XXXXY is a rare chromosomal variation characterized by deficits in motor, language, and cognitive domains. This study reports on the neurological function and dysmorphic features in the largest cohort to date. Seventy-two boys with 49,XXXXY were evaluated on a variety of domains including a neurological examination and neuromotor assessments including the Beery Buktenica Developmental Test of Visual-Motor Integration, Sixth Edition, the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), and the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition. Results supported previous literature by describing high occurrences of truncal and extremity hypotonia, which significantly impacts on motor milestones and ambulation in this population. The boys presented with dysmorphic features including epicanthal folds, frontal bossing, and synophrys. Visual perception skills were mildly impaired and cranial nerves were typically intact, however capabilities in motor coordination and fine motor precision were greatly delayed, supporting deficits in refined and controlled hand movements versus widespread visual deficits. Preschool boys treated with testosterone replacement had significantly increased scores when compared to the untreated group on the BSID-III Psychomotor Development Index, further supporting previous research indicating that testosterone replacement may have a positive impact on neurodevelopmental outcomes in males with additional X chromosomes. Boys with 49,XXXXY may benefit from hormonal treatment in conjunction with early intervention services to address their significant motor deficits.

Motor Abilities and the Motor Profile in Individuals with Williams Syndrome

ObjectivesMotor difficulties are present across a range of neurodevelopmental disorders, impacting on the development of other domains and on overall quality of life. One population that shows difficulties with their motor abilities is composed of individuals with Williams syndrome (WS). The purposes of the current study were to investigate the motor profile of individuals with WS and to investigate the relationships between physical activity and motor performance in this group.MethodsThe motor performance of 36 individuals with WS was measured using the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT2-SF) short form. Physical activity was also measured using our novel questionnaire. Performance on both measures was compared with that of typically developing (TD) children aged 4 to 7 years (N = 40).ResultsResults indicate that the individuals with WS (aged 12 to 50 years) performed at the level of TD 4- to 5-year olds with respect to overall motor ability. On examination of the motor profile, a relative strength in upper limb control and a relative weakness in balance were identified for this group. While a correlation was found between motor ability and the amount of physical activity that participants engaged in on a weekly basis in the TD group, no such relationship was found in the WS group.ConclusionsThe motor problems that individuals with WS show in childhood persist into older childhood and adulthood, and akin to the WS cognitive profile, there are relative strengths and weaknesses in the WS motor profile. The lack of correlation between physical activity and motor ability in the WS group may be due to the lack of opportunity to access age- and ability-appropriate activities.

Investigation of the effect of task-orientated rehabilitation program on motor skills of children with childhood cancer: a randomized-controlled trial.

Problems have been reported in the execution and development of motor skills and its treatment as a cause of cancer in children. The purpose of this study was to examine the effect of the task-orientated rehabilitation program (ToRP) on motor skills of children with childhood cancer. Following the consort guideline, 93 children (49 males and 44 females) with pediatric cancer were randomized to either study (n = 52; 12.35 ± 3.43 years) or control (n = 41; 11.89 ± 3.56 years) groups. The study group received ToRP, and the control group received a home-based therapeutic strategies program for 20 sessions. Motor skill outcomes were assessed with Bruininks-Oseretsky Test of Motor Proficiency, Short Form (BOTMP-SF) by assessor who was blind to group allocation and interventions. The groups were homogenous in terms of demographic characteristics and motor skills. The study group showed a significant increase in both gross and fine motor skills (P values for all subtests: P < 0.001), whereas running speed, bilateral coordination, strength, response speed and visual motor control did not show significant improvement with the control group (P > 0.05). The ToRP appears to provide beneficial effects in improving motor skills at the early stages of rehabilitation for children with childhood cancer.

Comprehensive motor skills assessment in children with autism spectrum disorder yields global deficits

Purpose Although children with autism spectrum disorder (ASD) often display motor deficits, the nature of these motor deficits remains unspecified. The purpose of this study was to establish a robust motor profile in children with ASD across a wider range of motor skills by using two professionally administered standardized motor assessments alongside a parent report measure to capture a comprehensive view of motor performance compared to a group of neurotypical peers. Methods Complex motor skills, balance and global motor performance were compared in twenty-four children, between the ages of 5–12 years, split into two groups: ASD and typically developing. The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) and the Movement Assessment Battery for Children, Second Edition (MABC-2) were used to examine skill performance. Motor proficiency was also collected using the parent/caregiver form of the Vineland Adaptive Behavior Scales, 3rd edition (Vineland-3). Results Children with ASD presented with significant differences in complex motor skills, balance skills, and global motor performance when compared to their neurotypical peers across all three measures. Conclusion This preliminary study indicated that the children with ASD had greater difficulty with global motor performance, including more difficulty performing complex motor tasks and balance tasks compared to their neurotypical peers. The parents of the children with ASD reported decreased proficiency of motor skills. Overall, the children with ASD demonstrated deficits performing tasks that targeted strength, speed, agility, coordination and both static and dynamic balance. While manifestations of motor skill deficits specific to the ASD population are variable, physical therapists should be included in the ongoing assessment and implementation of comprehensive therapeutic plans for children with ASD.

Prediction of school-age IQ, academic achievement, and motor skills in children with positional plagiocephaly

Children with positional plagiocephaly and/or brachycephaly (PPB) are at risk of early developmental delay, but little is known about early life factors associated with school-age neurodevelopment. This study examined associations of demographic characteristics, prenatal risk factors and early neurodevelopment assessment with school-age IQ, academic performance, and motor development in children with PPB. The study sample consisted of 235 school-age children with PPB followed since infancy. Outcome measures included IQ using the Differential Ability Scales-Second Edition, academic achievement as measured by the Wechsler Individualized Achievement Tests-Third Edition), and motor function using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition. Linear regression was used to examine the incremental improvement of model fit of demographics, prenatal and early life characteristics, severity of PPB, and neurodevelopment at ages 7, 18, and 36 months as measured by the Bayley-3 on school-age scores. Mean age at school-age assessment was 9.0 years. Adjusted r2 for demographic, prenatal, and early life risk factors ranged from 0.10 to 0.22. Addition of PPB severity and Bayley-3 measures at ages 7 and 18 months did not meaningfully change model fit. Adjusted r2 after inclusion of Bayley-3 at 36 months ranged from 0.35 to 0.41. This study suggests that PPB severity and very early life neurodevelopment have little association with school-age neurodevelopment above and beyond demographic and early life risk factors. However, preschool-age neurodevelopmental assessment may still be useful in identifying children with PPB at risk for delay and who may benefit from early intervention.

Use of the Bruininks-Oseretsky test of motor proficiency (BOT-2) to assess efficacy of velmanase alfa as enzyme therapy for alpha-mannosidosis

ObjectivesAlpha-mannosidosis is a rare autosomal recessive lysosomal storage disorder resulting from deficient lysosomal alpha-mannosidase activity. Clinical manifestations include progressive balance disorders, immune deficiency, skeletal abnormalities and cognitive deficits beginning in early childhood. Enzyme replacement therapy with recombinant human alpha-mannosidase (velmanase alfa) is scheduled for clinical development in the US beginning in 2020 and has been approved in the EU for treatment of non-neurological manifestations in cases of mild to moderate disease. This study assessed effects of velmanase alfa on fine and gross motor proficiency in children and adults. MethodsIntegrated Bruininks-Oseretsky (BOT-2) test of Motor Proficiency data from velmanase alfa clinical trials was stratified by age for 14 adults and 19 children treated for up to 4 years. ResultsPatients showed global developmental delays at baseline. For the combined adult and pediatric group there was a statistically significant increase (improvement) in BOT-2 total point score of 13% (p = .035, 95% CI 1.0, 25.0) from baseline to last observation. When stratified by pediatric versus adult patients, there was improvement in BOT-2 total point score in patients <18 years (mean percent increase from baseline to last observation 23%) compared to adults (mean decrease of −0.7%). Subtest analysis of individual BOT-2 items captured some improvement following velmanase alfa treatment in pediatric patients. ConclusionsThere was limited ability to assess the BOT-2 change responses in adults. Pediatric patients showed stability or improvement in scaled scores relative to healthy peers, indicating continued skill acquisition, which may increase independence and contribute to improved patient quality of life.

Effect of Balance Training on Balance Performance, Motor Coordination, and Attention in Children with Hearing Deficits

Background: Studies indicate that balance disorder, motor development problems, and weak postural control are likely to occur in children with severe to profound hearing deficits. Children with hearing deficits also indicate behavioral problems related to impulse control, distraction, and disability to maintain attention in the visual modality. Objectives: The present study, therefore, aimed to investigate the effect of balance exercises on balance performance, motor coordination, and attention in children with hearing deficits. Methods: In this experimental study, 36 children aged 7 to 12 years with severe to profound hearing deficits were randomly divided into two control and experimental groups using permuted block randomization. The experimental group performed a 12-session balance and vestibular sensory, motor exercise program. Assessments were performed as pretest and posttest by four subtests of the Bruininks-Oseretsky test of Motor Proficiency and Continuous Performance test. Then, the mean scores were compared between the pretest and posttest phases and between control and experimental groups by the paired t-test, Wilcoxon signed-rank test, two-sample t-test, and Mann-Whitney U test. Results: The results indicated a significant difference between the control and experimental groups in the pretest and posttest scores of balance (P = 0.000), upper limb coordination (P = 0.000), bilateral coordination (P = 0.004), and visual-motor control (P = 0.023) subtests of Bruininks-Oseretsky test and Continuous Performance test (P = 0.017) in children with hearing deficits. Conclusions: Balance training including vestibular sensory and motor exercise program can simultaneously affect balance performance, motor coordination, and attention in children with hearing deficits.

Associations between motor proficiency and academic performance in mathematics and reading in year 1 school children: a cross-sectional study

BackgroundA key priority for learning during the early years of school is for children to develop skills in numeracy and literacy. Consequently, less time may be allocated in the curriculum to foster other important developmental areas, including the ongoing motor skill development of school children, which has been positively linked to academic performance. In order to promote holistic approaches to teaching and learning in the early years of school, it is necessary to further delineate the nature of associations between motor skills and foundation academic skills. The aim of this study was to examine associations between fine and gross motor proficiency and academic performance in mathematics and reading in Year 1 children.MethodsA cross-sectional study was conducted with Year 1 children from two primary schools in New South Wales, Australia (N = 55; 25 boys, 30 girls; mean age 6.77 ± 0.40 years). The Bruininks-Oseretsky Test of Motor Proficiency (2nd Edition) and the Wechsler Individual Achievement Test II (Australian Edition) were used to assess motor proficiency and academic performance in mathematics and reading, respectively. Associations between the components of motor proficiency and academic outcomes were examined using Pearson’s and Spearman’s correlation analyses. Hierarchical multiple linear regression analyses were conducted to determine how much variance in mathematics and reading composite scores could be explained by motor proficiency after controlling for age.ResultsA significant moderate positive association was found between total motor composite and mathematics composite scores (r = .466, p < .001). Fine manual control composite scores were significantly associated with both mathematics (rs = .572, p < .001) and reading (rs = .476, p = .001) composite scores. After controlling for age, fine motor integration was the only component of motor proficiency that explained significant variance in mathematics and reading composite scores.ConclusionsThe results of the study revealed that Year 1 children’s overall motor proficiency was significantly related to their mathematical ability. Children’s fine motor integration skills were also predictive of mathematics and reading ability. These study findings may interest both early childhood educators and paediatric health professionals.

Percentile curves for Brazilian children evaluated with the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition

Abstract This study aimed to (1) create percentile curves and norms for the eight subtests of the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2) for 6- to 10-year-old Brazilian children and to (2) compare them to the values of the original test manual. To that, we tested a sample of 931 Brazilian children (477 girls, 454 boys) with ages between 6 to 10 with the BOT-2 assessment. The LMS method was used to generate the percentile curves and normative values, with the LMSchartmaker Pro software version 2.54. Results demonstrate that girls had significantly higher scores for the fine motor precision, fine motor integration, manual dexterity and balance subtests, while boys had significantly higher scores on upper-limb coordination, running speed and agility, and the strength subtests. The findings also indicated higher values for the Brazilian group in the subtests of bilateral coordination, running speed and agility, balance, and upper-limb coordination when compared to the North American normative sample. The percentile curves illustrate the increase in motor proficiency levels as age increases, with different trajectories for each subtest. Future studies should continue the investigation of cultural norms and appropriate assessments for the Brazilian population. Here, the creation of percentile curves and norms that are better suited for the Brazilian population can significantly help with assessment and intervention for motor development in distinct settings and with typical and atypical school-age children.

The Effect of the combination of active vestibular interventions and occupational therapy on Balance in Children with Bilateral Spastic Cerebral Palsy: A pilot randomized Controlled trial.

The current study aimed to examine the effect of the combined administration of active vestibular interventions and occupational therapy on balance and the relationship between balance changes and Activity of Daily Living in school-aged children with cerebral palsy (CP). Twenty-four children with Spastic CP, at the level I and II (according to the "Gross Motor Function Classification System) aged 7-12 years were enrolled and randomly assigned into control and intervention groups. Pediatric Balance Scales and Bruininks-Oseretsky Test of Motor Proficiency II were employed to assess the functional balance changes as well as Force Plate (eyes closed and open) to assess changes in the parameters of balance (e.g. center of pressure excursion). The activity of Daily Living was assessed by "Activity Scales for Kids (performance version)". Participants in the intervention group received active vestibular intervention for 20 min and a regular occupational therapy program for 25 min. The control group received a regular occupational therapy program for 45 min. Interventions were provided 3 d/week for 6 weeks in each group. The participants were assessed in three stages: baseline, immediately after, and eight weeks after the intervention. Data were analyzed by ANOVA and linear regression. The results demonstrated that only functional balance, according to Pediatric Balance Scales scores, was significantly increased in the active vestibular interventions group (p=0.02). There was no significant association between functional balance and Activity of Daily Living (P>0.05). The combined administration of active vestibular interventions and occupational therapy could improve the functional balance in children with spastic CP. It may be related to the reorganization of the vestibular system with a controlled and precise application of stimuli.

Reducing the Object Control Skills Gender Gap in Elementary School Boys and Girls

Purpose: This study was aimed to understand the effect of a customized physical education (PE) program on object control skills (OCS) in third grade schoolgirls, and to compare their skills to their male counterparts. Methods: Seventy-six children (32 girls, 44 boys) aged 8 - 9 years were assessed at baseline, after an all-girls six-week intervention program (post-test), and after six weeks of resuming co-educational regular PE (retention). Assessments included the upper limb coordination subtest from the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), and the ball skills component of the Test of Gross Motor Development, version three (TGMD-3). Results: Findings from both assessment tools showed that boys had significantly better upper limb coordination and ball skills at baseline (P -0.1, 2.9) for upper limb coordination and +2.8 (P Conclusion: This research suggests that a six-week all-girls intervention program reduces the variance in OCS proficiency in pre-adolescent boys and girls.

The Assessment of Movement Competence in Czech School Age Children Using BOT-2 Test

Introduction: A sufficient level of movement competence (MC) is a significant health and psychosocial factor. Overall, there is a strong consensus that movement competence is positively associated with all health-related variables. A lower level of movement competence in childhood is reflected in physical activity participation and engagement in physical activity later in life. The Bruininks-Oseretsky test of motor proficiency, 2nd version (BOT-2), is considered the most comprehensive diagnostic tool. There are no normative criteria of this test in the Czech Republic. The aim of this pilot study was to estimate a cross-cultural validity of the BOT-2 in a sample of Czech school children. Methods: The research sample was comprised of 83 school children (43 girls and 40 boys) of average age 10.15 ± 1.66 years. For the estimation of a MC we used the BOT-2, 2nd version - complete form. Results: The results of our tested group show that the group’s MC is in the lower part of the average level in the area of total motor composite (standard score 46.4±11.8). On average, the weakest performance was recorded in the area of fine manual control. More in-depth analysis showed that the weakest subcomponent of the area of fine manual control was fine motor precision (scale score 10.1±5.5). The group’s most successful area was the component concerning strength and agility. Conclusion: As a pilot study the project indicated that the BOT-2 can be valid for the Czech school children in 4 motor area composites regarding the manual coordination, coordination, strength and agility assessment only. It is not valid for the assessment of fine manual control. In a more detailed analysis of 8 subcategories we observe significantly worse results of Czech children in the area of fine motor precision.

Perinatal phthalates exposure decreases fine-motor functions in 11-year-old girls: Results from weighted Quantile sum regression

IntroductionPhthalates are a group of high production chemicals, generally used as plasticizers and odor enhancers. Phthalates cross the blood-placenta barrier and are associated with deficits in cognitive functions and behavior problems in offspring. We previously reported sex-specific associations with motor function when phthalates are considered singly. Because exposure to phthalates usually occurs as mixtures, here we assess these associations between a mixture of phthalates and motor function at age 11 years. MethodsData come from the prospective cohort study of mothers and offspring who participated in the Columbia Center for Children’s Environmental Health birth cohort (CCCEH). Seven phthalate metabolites were measured in maternal spot urine obtained during the third trimester and motor function was evaluated using the short form of the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2) at the age of 11 years. We used Weighted Quartile Sum (WQS) regression models to examine the effect of phthalate metabolites in males and females separately. The models were adjusted for child age in months, child BMI, maternal race (African-American vs. Dominican), prenatal alcohol consumption, maternal demoralization score, HOME score, and urine specific gravity. In a secondary analysis we used linear regression models to examine the association between the sum of molar concentrations of both DEHP and non-DEHP metabolites, and outcomes of gross and fine motor functions. Results209 mother-child pairs were eligible for this analysis. A significant decrease in fine-motor functions was observed among females, but not among males, following exposure to high levels of weighted quartile sum of seven phthalate metabolites (Covariates-adjusted coefficient estimate B = −2.7, 95% Confidence Interval [CI] −4.64 to −0.75, p = 0.01 for females [n = 116] and B = −1.63, 95%CI −3.94 to 0.69, p = 0.16 for males [n = 93]). The most highly weighted phthalate metabolites, associated with fine-motor functions among females, were MBP, MBZP, and MIBP, all non-DEHP phthalates.No significant associations were found between the weighted quartile sum of seven phthalate metabolites and gross-motor functions at the age of 11 years for males (B = −0.81, 95%CI −1.17 to 1.96, p = 0.23).With the molar sum of four non-DEHP phthalates as main predictor of linear regression models, we found significant decrease in gross and fine motor functions among females prenatally exposed to non-DEHP phthalates B = −0.98, 95%CI −1.98 to 0.03, p = 0.05 and B = −0.85, 95%CI −1.49 to −0.20, p = 0.01, respectively). ConclusionsPhthalate exposure during pregnancy was associated with decreased motor functions among 11-year-old girls.

Motor Competence Levels in Young Children: A Cross-Cultural Comparison Between Belgium and Greece

The targeted continent and/or country driven promotion of physical activity and health from an early age onwards requires more insight into cross-cultural differences in motor competence. Using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition Short Form (BOT-2 SF), this study assessed and compared both fine and gross motor skill performances of 5- and 6-year-old children from Belgium (n = 325) and Greece (n = 245). Linear mixed effect models and a χ2test analyzed between-country differences in BOT-2 SF scores and the distribution across descriptive performance categories. Overall, Belgian and Greek participants displayed quite similar levels of motor competence, with fewer children performing (well-)below average than could be expected. On test item level, however, several significant differences emerged. Large effect sizes were found for knee push-ups (Hedges’g = 1.46) and copying a square (Hedges’g = 2.59), which demonstrated a better outcome for Belgian and Greek preschoolers, respectively. These findings might be attributed to different (physical) education practices in both European countries. The present study also highlights the importance of using an assessment tool covering the entire range of motor skills as well as a focusing primarily on raw performance scores, containing and explaining more variance, for international comparative research purposes.

Microbial invasion of the amniotic cavity is associated with impaired cognitive and motor function at school age in preterm children.

Chorioamnionitis is an important cause of preterm delivery. Data on neurodevelopmental outcome in exposed infants are inconsistent due to difficulties in diagnosing intrauterine infection/inflammation and lack of detailed long-term follow-up. We investigate cognitive and motor function in preterm infants at early school age and relate the findings to bacteria in amniotic fluid obtained by amniocentesis (microbial invasion of the amniotic cavity (MIAC)) or placenta findings of histological chorioamnionitis (HCA) or fetal inflammatory response syndrome (FIRS). Sixty-six infants with gestational age <34 weeks at birth and without major disabilities were assessed using WISC-III and the Bruininks-Oseretsky Test of Motor Proficiency. Results were corrected for gestational age and sex. Children exposed to MIAC had significantly lower scores for full-scale IQ and verbal IQ compared to the non-MIAC group and the difference in full-scale IQ remained after correction for confounding factors. The MIAC group had also significantly lower motor scores after correction. In contrast, motor function was not affected in infants exposed to HCA or FIRS and differences between groups for cognitive scores were lost after corrections. Exposure to bacteria in amniotic fluid is associated with lower motor and cognitive scores in school age preterm infants without major disabilities.

The presence of high level physical difficulties in children and young people with severe acquired brain injuries who regain independent mobility

Background/Aims Children and young people with acquired brain injuries take part in less physical activity than age-matched peers. A possible cause of this is reduced high level motor proficiency. This study aimed to determine whether children and young people who regain independent mobility following a severe acquired brain injury continue to experience high-level physical difficulties. Methods A retrospective review of routinely collected Bruininks-Oseretsky Test of Motor Proficiency 2 assessments was performed. Descriptive data analysis of motor proficiency results, both overall and within the different subsections, was conducted. Results Out of 26 participants (5–17 years) with severe traumatic and non-traumatic acquired brain injury, 22 scored below or well below average in overall motor composite score. The mean standard scores across all participants in three of the subsections were below average: manual coordination 35.9; body coordination 37.1; and strength and agility 37.9. The only subsection that produced scores within the average for participants' ages was fine motor control (mean 41.8). Conclusions Children and young people demonstrate reduced motor proficiency following acquired brain injury despite regaining functionally independent mobility. Those not participating in physical activities should be screened for high level motor difficulties that may impact on their participation.

BalanCI: Head-Referenced Cochlear Implant Stimulation Improves Balance in Children with Bilateral Cochleovestibular Loss

Introduction: To determine the impact of a head-referenced cochlear implant (CI) stimulation system, BalanCI, on balance and postural control in children with bilateral cochleovestibular loss (BCVL) who use bilateral CI. Methods: Prospective, blinded case-control study. Balance and postural control testing occurred in two settings: (1) quiet clinical setting and (2) immersive realistic virtual environment (Challenging Environment Assessment Laboratory [CEAL], Toronto Rehabilitation Institute). Postural control was assessed in 16 and balance in 10 children with BCVL who use bilateral CI, along with 10 typically developing children. Children with neuromotor, cognitive, or visual deficits that would prevent them from performing the tests were excluded. Children wore the BalanCI, which is a head-mounted device that couples with their CIs through the audio port and provides head-referenced spatial information delivered via the intracochlear electrode array. Postural control was measured by center of pressure (COP) and time to fall using the Wii^TM (Nintendo, WA, USA) Balance Board for feet and the BalanCI for head, during the administration of the Modified Clinical Test of Sensory Interaction in Balance (CTSIB-M). The COP of the head and feet were assessed for change by deviation, measured as root mean square around the COP (COP-RMS), rate of deviation (COP-RMS/duration), and rate of path length change from center (COP-velocity). Balance was assessed by the Bruininks-Oseretsky Test of Motor Proficiency 2, balance subtest (BOT-2), specifically, BOT-2 score as well as time to fall/fault. Results: In the virtual environment, children demonstrated more stable balance when using BalanCI as measured by an improvement in BOT-2 scores. In a quiet clinical setting, the use of BalanCI led to improved postural control as demonstrated by significant reductions in COP-RMS and COP-velocity. With the use of BalanCI, the number of falls/faults was significantly reduced and time to fall increased. Conclusions: BalanCI is a simple and effective means of improving postural control and balance in children with BCVL who use bilateral CI. BalanCI could potentially improve the safety of these children, reduce the effort they expend maintaining balance and allow them to take part in more complex balance tasks where sensory information may be limited and/or noisy.

A Serious Game-Derived Index for Detecting Children With Heterogeneous Developmental Disabilities: Randomized Controlled Trial.

BackgroundDevelopmental disabilities are a set of heterogeneous delays or difficulties in one or more areas of neuropsychological development. Considering that childhood is an essential stage of brain development and developmental delays lead to personal or social burdens, the early detection of childhood developmental disabilities is important. However, early screening for developmental disabilities has been a challenge because of the fear of positive results, expensive tests, differences in diagnosis depending on examiners’ abilities, and difficulty in diagnosis arising from the need for long-term follow-up observation.ObjectiveThis study aimed to assess the feasibility of using a serious game–derived index to identify heterogeneous developmental disabilities. This study also examines the correlation between the game-derived index and existing neuropsychological test results.MethodsThe randomized controlled trial involved 48 children with either normal development or developmental disabilities. In this clinical trial, we used 19 features (6 from the Korean-Wechsler Preschool and Primary Scale of Intelligence, 8 from the Psychoeducational Profile Revised, 2 from the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, and 3 from the Pediatric Evaluation of Disability Inventory) from neuropsychological tests and 9 (7 game scores, path accuracy, and completion rate) from the serious game, DoBrain. The following analysis was conducted based on participants’ baseline information and neuropsychological test and game-derived index data for one week: (1) we compared the baseline information between the normal development and developmental disabilities groups; (2) then we measured the correlation between the game-derived index and the neuropsychological test scores for each group; and (3) we built a classifier based on the game-derived index with a Gaussian process method and then compared the area under the curve (AUC) with a model based on neuropsychological test results.ResultsA total of 16 children (normal development=9; developmental disabilities=7) were analyzed after selection. Their developmental abilities were assessed before they started to play the serious games, and statistically significant differences were found in both groups. Specifically, the normal development group was more developed than the developmental disabilities group in terms of social function, gross motor function, full-scale IQ, and visual motor imitation, in that order. Similarly, the normal development group obtained a higher score on the game-derived index than the developmental disabilities group. In the correlation analysis between the game-derived index and the neuropsychological tests, the normal development group showed greater correlation with more variables than the developmental disabilities group. The game-derived index–based model had an AUC=0.9, a similar detection value as the neuropsychological test–based model’s AUC=0.86.ConclusionsA game-derived index based on serious games can detect children with heterogenous developmental disabilities. This suggests that serious games can be used as a potential screening tool for developmental disabilities.Trial RegistrationClinical Research Information Service KCT0003247; https://cris.nih.go.kr/cris/en/search/search_result_st01 .jsp?seq=12365

Relations between gross motor skills and executive functions, controlling for the role of information processing and lapses of attention in 8-10 year old children.

This study aimed to systematically investigate the relation between gross motor skills and aspects of executive functioning (i.e. verbal working memory, visuospatial working memory, response inhibition and interference control) in 8–10 year old children. Additionally, the role of information processing (speed and variability) and lapses of attention in the relation between gross motor skills and executive functions was investigated. Data of 732 Dutch children from grade 3 and 4 were analyzed (50.0% boys, 50.4% grade 3, age = 9.16 ± 0.64 years). Gross motor skills were assessed using three items of the Körper Koordinationstest für Kinder and one item of the Bruininks-Oseretsky test of Motor Proficiency, Second Edition. Executive functions were assessed using the Wechsler Digit Span task (verbal working memory), the Visuospatial Memory task (visuospatial working memory), the Stop Signal task (response inhibition) and a modified version of the Flanker task (interference control). Information processing and lapses of attention were obtained by applying an ex-Gaussian analysis on go trials of the Stop Signal task. Multilevel regression analysis showed that gross motor skills were significantly related to verbal working memory, visuospatial working memory and response inhibition, but not to interference control. Lapses of attention was a significant predictor for all executive functions, whereas processing speed was not. Variability in processing speed was only predictive for visuospatial working memory. After controlling for information processing and lapses of attention, gross motor skills were only significantly related to visuospatial working memory and response inhibition. The results suggest that after controlling for information processing and lapses of attention, gross motor skills are related to aspects of executive functions that are most directly involved in, and share common underlying processes with, gross motor skills.

Associations Between the Developmental Coordination Disorder Questionnaire – Brazilian Version (DCDQ-BR) and Motor Competence in School-Age Children

Aim: Parental screening of children’s motor skills can be helpful for early identification of Developmental Coordination Disorder (DCD). The present study examined the associations between the Developmental Coordination Disorder Questionnaire – Brazilian version (DCDQ-BR) and motor competence in school-age children.Methods: 707 children (332 boys, 375 girls) aged between 6- to 10-years and one of their parents participated in the study. Parents completed the DCDQ-BR and children’s motor competence was determined using the Bruininks-Oseretsky Test of Motor Proficiency – 2nd edition (BOT-2).Results: The agreement between the BOT-2 and DCDQ-BR results was comparable across age, ranging from 74-84 percent. In general, there were low- to moderate correlations between all aspects of the parent report and children’s motor competence. Sensitivity and specificity of the DCDQ-BR were 70% and 81%, respectively. Overall, boys had higher motor competence than girls, but parent reports were similar for gender.Conclusions: Parental assessment of their child’s motor ability is moderately associated with motor competence, and this association is similar for boys and girls, even though boys scored higher in motor competence. Our findings suggest that it may be possible to reduce the length of clinical assessment by only testing children that flag as suspect for DCD in the DCDQ-BR.