Motor Difficulties Research Articles

Motor outcomes in individuals born small for gestational age at term: a systematic review.

Being born small for gestational age (SGA) is a risk factor for motor difficulties. Previous reviews exploring this topic are mostly focused on children born preterm. We aimed to review the literature to determine the association between being born SGA at term and motor outcomes. PubMed and Embase were searched for relevant articles without any restrictions on publication year or participants' age. Inclusion criteria were SGA exposure at term (≥ 37 weeks of gestation), cohort studies or randomized controlled trials with motor outcome assessed by standardized motor tests with results reported as continuous scores (mean/median) compared with a control group. Exclusion criteria were abstracts, editorials and commentaries, articles in non-English language or no full text available. Reviews were screened for relevant articles. Quality of included studies was assessed by the Newcastle-Ottawa Scale. In total, 674 records were identified by the literature search and screened by two independent authors. Thirteen original articles were eligible and included in a qualitative synthesis, and five (38%) of these were included in a meta-analysis. Nine (69%) studies were from high-income countries. Most studies were carried out in early childhood, and only one study in adulthood. Seven (54%) articles reported that individuals born SGA at term had poorer scores on standardized motor tests compared with controls, while no differences were reported in five (38%) articles. One article did not report p-values, although the differences were comparable to the other studies. Group differences were of small to moderate effect size (0.19 to 0.65 standard deviation units). The pooled effect size was -0.43 (95% confidence interval: -0.60 to -0.25). Adjustment for covariates were reported in seven (54%) articles and did not change the results. Proportions of motor difficulties, reported in five (38%) articles, ranged from 8.9 to 50% in individuals born SGA from infancy to adolescence. This systematic review shows that being born SGA, also at term, may be a risk factor for poorer motor outcomes throughout childhood, confirmed by a meta-analysis in early childhood. Further research is needed to establish the risk of adult motor difficulties in individuals born SGA at term.

Developmental Coordination Disorder and Early Childhood Trajectories of Physical Activity.

Purpose: Developmental Coordination Disorder (DCD) is a common neurodevelopmental disorder characterized by motor impairments and subsequent physical activity (PA) deficits in middle childhood. It is not well understood when this gap in PA emerges. The purpose of the current study was to examine the longitudinal trajectories of device-assessed PA in a large cohort of children with and without DCD from age 4 to 8.Methods: Children (n = 535, 4- to 5-years old) completed 4 annual assessments as part of a prospective cohort study. Children were classified into 3 groups based on their average performance on the Movement Assessment Battery for Children- 2nd Edition: probable DCD (pDCD) <6th percentile (n = 72); at-risk for DCD (DCDr) between the 6 to 16th percentile (n = 127), and typically developing (TD) >16th percentile (n = 336). Moderate-to-vigorous PA (MVPA) and average PA volume (vector counts per minute) were assessed using ActiGraph accelerometers. A series of linear mixed effects models were used to examine longitudinal PA trajectories between groups.Results: Children in both the pDCD and DCDr groups engaged in significantly less MVPA compared to the TD group, whereas the deficit in PA volume was only evident in the DCD group. The rate of change did not differ by group indicating that this deficit is relatively consistent across the early childhood period.Conclusions: Young children with DCD are in a MVPA deficit that persists across early childhood. Early interventions targeting motor skills and PA may help to reduce this gap and promote positive trajectories of health among children with motor difficulties.

Developmental coordination disorder questionnaire – translation and adaptation into Danish

Background Developmental Coordination Disorder is a commonly occurring, but poorly recognised developmental condition characterised by difficulties with motor functions. Danish tests of children’s motor functioning, which are currently available, are outdated and only applicable up to the age of seven years old. New tools are needed to enable easy and efficient screening of motor difficulties experienced by children living in Denmark. Aims/Objectives We translated and adapted the Developmental Coordination Disorder Questionnaire (DCDQ’07) into Danish and aimed to evaluate its utility. Materials and Methods A team of translators prepared the Danish version of the DCDQ’07 – DCDQ-DK. In total, 36 parents completed the questionnaire. The children completed fine and gross motor tests. Concurrent validity was tested using Pearson correlation on the DCDQ-DK and motor performance scores. Internal consistency was tested using Cronbach’s alpha. Results The results show good concurrent validity (r = .311) and internal consistency (α = .80). Conclusions DCDQ-DK is well suited for use with Danish-speaking parents. Significance The tool will aid early assessment of motor difficulties in children of Danish-speaking parents. DCDQ-DK can be used by occupational therapists, educational and health professionals as well as researchers in national and international contexts.

Effects of creative movement, general movement, or seated play interventions on motor performance in children with autism spectrum disorder: A pilot randomized controlled trial

BackgroundChildren with ASD experience significant gross motor challenges that could be addressed using motor interventions. However, contemporary ASD interventions that are sedentary in nature often target communication and fine motor skills and not children’s gross motor difficulties. MethodsIn the current pilot RCT, we evaluated changes in various motor outcomes (i.e., gross/fine motor coordination, locomotor skills, functional endurance, and praxis/imitation performance) following two types of whole-body motor interventions (Creative Movement (CM) or General Movement (GM)) and compared them to a Sedentary Play (SP) intervention focused on improving fine motor skills in children with ASD. Forty-five children with ASD (Mean Age ±SE: 8.7 ± 0.3, 38 males) were randomly assigned to the CM, GM, or SP groups and received 8 weeks of group-specific training. ResultsBoth CM and GM interventions led to medium-to-large improvements in gross motor performance, including improved body coordination, strength/agility, locomotor skills, and walking endurance. Children in the CM group additionally showed medium-to-large-sized improvements in praxis performance, while children in the SP group showed improvements in fine motor performance. These training-related improvements were supported by improvements reported via parental questionnaires. ConclusionsResearchers and clinicians should incorporate whole-body interventions targeting gross motor skills in the plan of care for children with ASD.

Exploring the Relationship Between Play During School Recess and Motor Performance in 6- to 8-Year-Old Children

Background: Playing with others, which in school occurs mainly during recess, might be an enabling factor to improve children’s motor performance, as behaviour is shaped by observing and imitating others. Objective: The aim of the current study was to examine whether children’s play activities and with whom 6- to 8-year-old children play during recess are related to their motor performance. Methods: The study sample consisted of 86 Dutch participants (mean age 6.92 ± 0.62 years, 58.1% boys). A modified version of the System for Observing Children’s Activity and Relationships during Play was used to observe the following play variables: sedentary or active behaviour, group size, activity type, and type of interaction. The Movement Assessment Battery for Children 2 was used to measure three components of motor performance: Manual Dexterity, Aiming and Catching, and Balance. Associations between the play variables and the motor components were investigated using compositional data analysis and logistic regressions. Results: The results showed that children who spent more time in sedentary behaviour rather than in active behaviour were less likely to have motor difficulties in the Aiming and Catching component. None of the other play variables were related to motor performance. Conclusions: One explanation might be that these play variables in itself are not related to motor performance, but that these variables should be investigated as an integrated whole rather than in isolation. Therefore, future research should investigate whether interactions between the play variables are related to motor performance.

Attention Deficit/Hyperactivity Disorder and Motor Planning Difficulties: A Confirmatory Study on the Overlap Between Neurodevelopmental Disorders

Attention deficit/hyperactivity disorder (ADHD) and developmental coordination disorder (DCD) represent two frequent neurodevelopmental disorders, which may be comorbid or have common characteristics with each other. The aim of the present study was to explore the presence of DCD or motor planning difficulties in children with behavioral disorders and/or ADHD, as already stated in the literature. Motor abilities were assessed in a sample of children which underwent a comprehensive neuropsychological evaluation. A total of 43 children were included in the study and were subdivided in three groups: those with ADHD and DCD, those with DCD, and those with ADHD but also presenting motor-praxic difficulties. The first group obtained clinical scores at the considered tests, with worse performances in the balance area; in the second and third groups lower scores were observed in the manual dexterity and balance, with more homogeneous profiles. Overall, 27.3% of ADHD subjects received a diagnosis of DCD as well, whereas 31.8% showed documented motor-praxic difficulties. Our results confirmed an increased prevalence of DCD or general motor difficulties in children with ADHD compared to the general population. Further research should investigate whether a poorer motor performance assessed by standardized tests could be either due to a comorbid neurodevelopmental condition or a direct consequence of the pivotal symptomatology of the disorder.

Neuroradiologic, clinic and genetic characterization of cerebellar heterotopia: a pediatric multicentric study.

Background and purpose:Cerebellar heterotopia (CH) is a neuroradiological abnormality poorly reported and investigated in the literature. It can be observed as an isolated finding, but it has been mainly reported in the context of cerebellar dysgenesis and in syndromic conditions. The aim of this study is to provide a comprehensive neuroradiological, clinical, and genetic characterization of a cohort of pediatric patients with cerebellar heterotopia.Materials and methods:Patients with a diagnosis of CH were systematically selected from the neuroimaging databases of the four Italian Centers participating in this retrospective study. For each patient, information regarding demographic, clinical, genetic and neuroradiological data were collected.Results:Thirty-two pediatric patients were recruited and subdivided into two groups: patients with isolated CH and/or cerebellar malformations (n= 18) and patients with CH associated with cerebral malformations (n=14). Isolated CH consistently showed a peripheral subcortical localization in the inferior portion of cerebellar hemispheres, with either unilateral or bilateral distribution. Ten patients belonging to the second group had a diagnosis of CHARGE syndrome, and their nodules of CH were mainly but not exclusively bilateral, symmetric, located in the peripheral subcortical zone and in the inferior portion of the cerebellar hemispheres; the remaining 4 patients of the second group, showed either bilateral or unilateral CH, located in both peripheral cortex and deep white matter and in the superior and inferior portions of cerebellum. Patients with isolated CH showed high prevalence of language development delay; neurodevelopmental disorders were the most represented clinical diagnoses. Recurring features were behavioral problems and motor difficulties. A conclusive genetic diagnosis was found in 18/32 patients.Conclusions:We found distinctive neuroradiological patterns of CH. Genetic results raise the possibility of a correlation between cerebellar morphological and functional developmental disruption, underscoring the importance of CH detection and reporting to orient the diagnostic path.Abbreviations CH Cerebellar heterotopia; MRI Magnetic resonance imaging; CC Corpus callosum; ASD autism spectrum disorder; IVH inferior vermian hypoplasia.

Clinical Characteristics of Charcot-Marie-Tooth Disease Type 4J.

Charcot-Marie-Tooth disease type 4J (CMT4J) is caused by autosomal recessive variants in the Factor-Induced Gene 4 (FIG4) gene. Recent preclinical work has demonstrated the feasibility of adeno-associated virus serotype 9-FIG4 gene therapy. This study aimed to further characterize the CMT4J phenotype and evaluate feasibility of validated CMT-related outcome measures for future clinical trials. This cross-sectional study enrolled children and adults with genetically confirmed CMT4J, with 2 documented disease-causing variants in the FIG4 gene. Patients were recruited through the Inherited Neuropathy Consortium network. Disease severity was assessed using standardized CMT-specific outcome measures and exploratory biomarkers including muscle MRI fat fraction, electrophysiology, and neurofilament light chain levels. Descriptive statistics and correlation analyses were conducted to explore relationships between variables. We recruited a total of 19 patients, including 14 pediatric patients (mean age 10.9 ± 3.9 years) and 5 adults (mean age 40.0 ± 13.9 years). The most frequent symptoms were gross motor delay and distal more than proximal muscle weakness, which were observed in 14 of 19 patients. The most common non-neuromuscular symptoms were cognitive and respiratory deficits, each seen in 8 of 19 patients. We denoted asymmetric weakness in 2 patients and nonuniform slowing of conduction velocities in 6 patients. Charcot-Marie-Tooth Disease Pediatric Scale (CMTPedS), Pediatric Quality of Life Inventory, and Vineland Adaptive Behavior Scale scores were affected in most patients. We observed a significant positive correlation between neurofilament light chain levels and CMTPedS, but the study was underpowered to observe a correlation between CMTPedS and MRI fat fraction. We obtained baseline clinical and biomarker data in a broad cohort with CMT4J in pediatric and adult patients. Motor delay, muscle weakness, and respiratory and cognitive difficulties were the most common clinical manifestations of CMT4J. Many patients had nerve conduction studies with nonuniform slowing, and 2 had an asymmetric pattern of muscle weakness. We observed that the neurofilament light chain levels correlated with the CMTPedS in the pediatric population. This study showed feasibility of clinical outcomes including CMTPedS in assessment of disease severity in the pediatric patient population and provided baseline characteristics of exploratory biomarkers, neurofilament light chain levels, and muscle MRI fat fraction. The coronavirus disease 2019 pandemic affected some of the visits, resulting in a reduced number of some of the assessments.

Pediatric onset neuronal ceroid lipofuscinoses: Unraveling clinical and genetic specifications.

To unravel the clinical and genetic specifications of Neuronal ceroid lipofuscinosis (NCL). This is a retrospective cross-sectional study conducted in the Department of Pediatric Neurology Children Hospital and University of Child Health Sciences, Lahore, Pakistan from March 2017 to March 2022. The primary outcome was to measure genotype-phenotype correlation by segregation of phenotypes according to genotype. The secondary outcomes included a correlation between genotype and distribution of age(s) of onset. One hundred fifty three patients clinically diagnosed with NCL underwent genetic testing and pathologic mutation was identified in 32.7% of patients. About 59.6% were male and 37.2% had an affected sibling. The median age was 5.46±1.95 years at the onset of the first symptom i.e., myoclonic seizures in 68%, and motor difficulty in 24%. Other features found were global developmental delay (56%), hypotonia (23%), visual impairment (80%), ataxia (22%), and disc pallor (56%). The most common type was CLN6 (Ceroid lipofuscinosis neuronal) (42%), CLN2 (16%) followed by CLN7 (12%). When 50 patients with recognized mutations were compared with 103 patients with no mutation, family history (p=0.049), early visual loss (p=0.016), hypotonia (p=0.001), white matter signals (p=0.026) and pan-atrophy(p=0.047) was statistically significant in the genetically confirmed NCL. Multiple pairwise comparisons indicated that the estimated age of onset for the CLN1 and CLN2 mutation group was significantly lower than other genotypes including CLN6 (p 0.012), CLN10 (p 0.007) and CLN12 (p 0.007). Following a detailed review of NCL symptomatology, a clinically-oriented approach should be used for a rapid diagnosis with confirmation by targeted molecular testing for future genetic counseling.

Behavioural and neurodevelopmental characteristics of SYNGAP1

BackgroundSYNGAP1 variants are associated with varying degrees of intellectual disability (ID), developmental delay (DD), epilepsy, autism, and behavioural difficulties. These features may also be observed in other monogenic conditions. There is a need to systematically compare the characteristics of SYNGAP1 with other monogenic causes of ID and DD to identify features unique to the SYNAGP1 phenotype. We aimed to contrast the neurodevelopmental and behavioural phenotype of children with SYNGAP1-related ID (SYNGAP1-ID) to children with other monogenic conditions and a matched degree of ID.MethodsParticipants were identified from the IMAGINE-ID study, a UK-based, national cohort study of neuropsychiatric risk in children with ID of known genetic origin. Thirteen children with SYNGAP1 variants (age 4–16 years; 85% female) were matched (2:1) with 26 controls with other monogenic causes of ID for chronological and mental age, sex, socio-economic deprivation, adaptive behaviour, and physical health difficulties. Caregivers completed the Development and Wellbeing Assessment (DAWBA) and physical health questionnaires.ResultsOur results demonstrate that seizures affected children with SYNGAP1-ID (84.6%) more frequently than the ID-comparison group (7.6%; p = < 0.001). Fine-motor development was disproportionally impaired in SYNGAP1-ID, with 92.3% of children experiencing difficulties compared to 50% of ID-comparisons(p = 0.03). Gross motor and social development did not differ between the two groups. Children with SYNGAP1-ID were more likely to be non-verbal (61.5%) than ID-comparisons (23.1%; p = 0.01). Those children able to speak, spoke their first words at the same age as the ID-comparison group (mean = 3.25 years), yet achieved lower language competency (p = 0.04). Children with SYNGAP1-ID compared to the ID-comparison group were not more likely to meet criteria for autism (SYNGAP1-ID = 46.2%; ID-comparison = 30.7%; p = .35), attention-deficit hyperactivity disorder (15.4%;15.4%; p = 1), generalised anxiety (7.7%;15.4%; p = .49) or oppositional defiant disorder (7.7%;0%; p = .15).ConclusionFor the first time, we demonstrate that SYNGAP1-ID is associated with fine motor and language difficulties beyond those experienced by children with other genetic causes of DD and ID. Targeted occupational and speech and language therapies should be incorporated early into SYNGAP1-ID management.

Sensory symptoms associated with autistic traits and anxiety levels in children aged 6–11 years

BackgroundAutism spectrum conditions (ASC) and quantitative autistic traits (QATs) are associated with sensory symptoms, which may contribute to anxiety and adversely affect social and cognitive development. Although sensory symptoms can occur across all senses, the relative roles of specific sensory modalities as contributors to the autistic phenotype and to anxiety are not well understood. The objective of this study was to examine which sensory symptoms were most predictive of high anxiety.MethodsWe recruited 257 female primary caregivers of children aged 6 to 11 years (49% girls) to a questionnaire study comprising parent-report measures for classical QATs (social, communicative, and rigid), autism-related sensorimotor symptoms (visual, auditory, tactile, olfactory, gustatory, vestibular, proprioceptive, and motor), and anxiety symptoms. First, Bayesian stochastic search variable selection (SSVS) was used to identify the most probable sensorimotor predictors of specific QATs as well as diagnosed ASC. Then, the selected predictors were used in another SSVS, using anxiety symptoms as a dependent variable, to identify which of the autism-relevant sensorimotor symptoms were most robustly predictive of anxiety. Finally, the effect sizes of anxiety-related sensory symptoms were estimated with linear regressions.ResultsWe found that auditory symptoms and motor difficulties were most predictive of ASC diagnosis. Developmental motor difficulties were also strongly related to all individual QATs, whereas auditory symptoms were more selectively predictive of rigid traits. Tactile symptoms robustly predicted social interaction QATs, and proprioceptive symptoms predicted communicative QATs. Anxiety outcomes were most strongly predicted by difficulties with auditory and olfactory processing.ConclusionsThe results support the clinical importance of being alert to complaints about sounds and hearing in neurodevelopmental populations, and that auditory processing difficulties may be evaluated as an early marker of poor mental health in children with and without diagnosed autism. Olfactory processing differences appeared to be an anxiety marker less strongly associated with ASC or QATs, while motor difficulties were highly autism-relevant but not equally strongly associated with anxiety outcomes. We suggest that future studies may focus on the mechanisms and consequences of neurodevelopmental central auditory processing dysfunction and its potential relationship to anxiety disorders.

Exploring adults’ recollections of growing up with childhood motor difficulties: a qualitative study using systematic text condensation

ObjectiveTo explore the ramifications of childhood motor difficulties, providing insights into their impact and consequences over time.DesignA qualitative study using semistructured individual interviews. Data were analysed using systematic text condensation.SettingNeonatal...

Pitt Hopkins syndrome – TCF4 gene deletion causing severe psychomotor delay

Pitt-Hopkins syndrome (PTHS) is a rare genetic disorder due to haploinsufficiency of TCF4 and is clinically characterized by developmental delay, intellectual disability (ID), autism spectrum disorders, typical facial gestalt, seizures, high myopia and hyperventilation-apneic spells. Approximately in three-fourth cases of PTHS, a de novo pathogenic variant in TCF4 is identified. In other instances, deletion of the chromosome region 18q21.2 in which encompasses TCF4 is responsible and only chromosomal microarray (CMA) can reveal the microdeletion. This report describes the case of a 10 year-old girl with PTHS phenotype caused by a chromosome 18q21.2q22.1 deletion that included the TCF4 gene. The patient had severe developmental and cognitive delay, autistic spectrum disorder, motor difficulties, and behavioral issues, all of which are typical with PTHS. Understanding the phenotypic variation is critical for accurate diagnosis in this syndrome, since deletions in TCF4 may be missed if exome sequencing is sought instead of chromosomal microarray analysis (CMA).

Epidemiological Study on Developmental Coordination Disorder in School Going Children

Introduction: Developmental coordination disorder (DCD) has garnered significant attention in recent years, with rapid advancements in our understanding of this condition. Despite this progress, DCD often goes undiagnosed, making it challenging for children, parents, and educators to access essential resources. The motor difficulties associated with DCD can lead to social exclusion, as peers may be reluctant to invite these children to participate in play activities. Consequently, children with DCD may withdraw from leisure pursuits, perceiving themselves as lacking the necessary skills to engage fully. Objective: The primary objective of this study was to identify DCD in non-referred school-aged children. Early identification enables these individuals to access crucial resources, such as physiotherapy interventions, which can maximize their functional, academic, and psychosocial performance, and overall quality of life. Materials and Methods: The study involved 200 non-referred school-going children aged 4-12 years from Bangalore, selected through random sampling. The Movement Assessment Battery for Children (M-ABC), consisting of 32 organized tasks across four sets covering manual dexterity, ball skills, and dynamic balance, was administered. Additionally, the Test of Gross Motor Development (TGMD), comprising 12 tasks that assess a child’s ability to accomplish various motor skills, and the Child Behavior Checklist (CBCL), a 113-item inventory describing children’s psychosocial behavior, were utilized to evaluate overall development. Results: Multivariate analysis identified a significant prevalence of DCD among the study participants. The findings underscore the imperative nature of early identification using comprehensive assessment tools for the well-being and psychosocial adaptation of school-aged children. Conclusions: These findings indicate that children with movement problems are at risk for difficulties in attention, learning, and psychosocial adjustment. Regardless of the kind or intensity, a child’s assessment for movement issues should cover a broad variety of functions in addition to motor skills. This comprehensive approach will enable access to essential resources, such as physiotherapeutic interventions, crucial for their overall development.

Prevalence of Motor Difficulties in Greek Preschoolers: The Effect of Gender, Age, BMI, Place of Residence, and Hand Preference

The main aim of the present study was to identify motor difficulties in Greek preschoolers. Secondary aims were to identify possible differences in prevalence of motor difficulties related to gender, age, body mass index, place of residence, and hand preference. 302 preschoolers were assessed using the first age band (3–6 years) of the Movement Assessment Battery for Children (2nd edition). The results showed high prevalence of significant (12.3%) and moderate (12.3%) motor difficulties in preschool children. Moreover, gender, age, BMI, residence, and hand preference effects showed no statistically significant differences (p &gt; 0.05) and need further consideration among preschool children. However, there was evidence that some differences may exist between boys and girls, 4- and 5-year-old children, children with high and typical body mass index, children living in rural or urban areas, and right and left-handed children, regarding the occurrence of motor difficulties. These findings highlighted the need for early assessment in domains of motor development, such as hand dexterity, ball skills and balance in order for developmentally appropriate preschool physical education programs to be applied, with the aim to help preschoolers improve their difficulties and be physically active later in life. L'objectif principal de la présente étude était d'identifier les difficultés motrices chez les enfants grecs d'âge préscolaire. Les objectifs secondaires étaient d'identifier les différences possibles dans la prévalence des difficultés motrices liées au sexe, à l'âge, à l'indice de masse corporelle, au lieu de résidence et à la préférence manuelle. 302 enfants d'âge préscolaire ont été évalués à l'aide de la première tranche d'âge (3-6 ans) de la batterie d'évaluation du mouvement pour les enfants (2e édition). Les résultats ont montré une forte prévalence de difficultés motrices importantes (12,3 %) et modérées (12,3 %) chez les enfants d'âge préscolaire. Deuxièmement, les effets du sexe, de l'âge, de l'IMC, du lieu de résidence et de la préférence manuelle n'ont pas montré de différences statistiquement significatives (p &gt; 0,05) et nécessitent un examen plus approfondi chez les enfants d'âge préscolaire. Toutefois, des éléments indiquent qu'il peut exister des différences entre les garçons et les filles, les enfants de 4 et 5 ans, les enfants ayant un indice de masse corporelle élevé et ceux ayant un indice de masse corporelle normal, les enfants vivant dans des zones rurales ou urbaines, et les enfants droitiers et gauchers, en ce qui concerne l'apparition de difficultés motrices. Ces résultats soulignent la nécessité d'une évaluation précoce dans les domaines du développement moteur, tels que la dextérité manuelle, les habiletés avec le ballon et l'équilibre, afin d'appliquer des programmes d'éducation physique préscolaire adaptés au développement, dans le but d'aider les enfants d'âge préscolaire à surmonter leurs difficultés et à être physiquement actifs plus tard dans la vie.

Childhood motor difficulties and cognitive impairment in midlife: A 40-year cohort study.

We aimed to examine the association of childhood motor difficulties (MD) with cognitive impairment in midlife. We studied 357 participants from a cohort born in 1971-1975. At age 9, they had completed the Test of Motor Impairment, which classified them into three groups: childhood MD (cMD), borderline cMD (bcMD), or no cMD. Participants with attention-deficit/hyperactivity disorder were excluded. At age 40, participants comprised 18 (5.0%) with cMD, 43 (12.0%) with bcMD, and 296 (82.9%) with no cMD. They underwent neuropsychological assessment covering six domains: executive functions, processing speed, attention and working memory, learning and memory, verbal symbolic abilities, and visuoperceptual and visuospatial abilities. A participant was considered to have an impairment if their performance was in the 15th percentile of a normative group. Participants with cMD were more likely than those with no cMD to have an impairment in executive functions (OR = 6.73, p < .01), processing speed (OR = 3.85, p < .05), attention and working memory (OR = 4.79, p < .01), and a cross-domain impairment (OR = 3.62, p < .01). These differences remained significant after adjusting for parents' occupation, sex, and low birth weight and after multiple imputation. No consistent difference emerged between participants with bcMD and no cMD. Childhood MD are associated with midlife cognitive impairment, which underscores their long-term implications. In the neuropsychological assessment of an adult patient, information on childhood motor development is of value. The assessment may help adapt the patient's physical or occupational therapy to the patient's cognitive profile. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Supplemental Material for Childhood Motor Difficulties and Cognitive Impairment in Midlife: A 40-Year Cohort Study

Supplemental Material for Childhood Motor Difficulties and Cognitive Impairment in Midlife: A 40-Year Cohort Study

Classroom coping strategies of children with motor difficulties

ABSTRACT Children with low motor competency have additional classroom struggles when coping with their first year of mainstream education. This study identified and examined the classroom coping strategies and behaviours of children with motor difficulties. Eleven students were recruited after the Test of Gross Motor Skills (TGMD 2nd) identified as having poor gross motor development. The primary research method was classroom observations conducted after obtaining ethical approval and parental consent. Parental Interviews and a nine-month observation period commenced in term two of the Australian School System, which aimed to identify specific behaviours and the coping strategies adopted by the individual participants in the classroom. The participants were observed on different school days at various times so individual coping behaviours could be recorded. An inductive approach and thematic analysis identified emerging themes, behaviours, and coping strategies. Results indicated that all participants demonstrated multifaceted coping behaviours, divided into several common emerging categories: emotional, physical, social, and cognitive responses. Coping strategies were further classified as productive (positive) or non-productive (negative), emotionally based or problem-solving. The lack of motor competency significantly influenced the participants’ behaviours when displaying strategies to cope with classroom activities.

Gross Motor Skills Are Associated with Symptoms of Attention Deficit Hyperactivity Disorder in School-Aged Children.

Attention deficit hyperactivity disorder (ADHD) is among the most prevalent disorders in children and is frequently linked with motor difficulties that can impact both daily motor tasks and overall developmental trajectories. The objective of this study was to analyse the association between gross motor skills and ADHD symptoms. Using a cross-sectional research design, data were collected from a sample of primary school children (N = 2677; mean age = 8.58 years, SD = 1.49 years). The Gross Motor Development-3 Test (TGMD-3) was employed to assess participants' gross motor skills, whereas the ADHD Rating Scale (SDAI), completed by teachers, evaluated ADHD symptoms through two subscales: inattention and impulsivity/hyperactivity. The results revealed an association between motor development and ADHD symptoms, with greater proficiency in gross motor skills correlating with lower symptoms reported on the SDAI. Logistic regression analyses indicated that the TGMD-3 was significantly associated with the risk of ADHD in matched samples of at-risk children and controls. The evaluation of gross motor development proves to be a useful tool for monitoring global development, paying attention to any critical issues, particularly in relation to the variables of inattention and hyperactivity.

Mental health of caregivers of children with medical complexity: group-based trajectory modelling

ObjectiveTo describe the mental health trajectories of caregivers of children with medical complexity (CMC) and explore child characteristics associated with below-average caregiver mental health.DesignA secondary analysis of prospectively collected data...