The preparation of reach-to-grasp movements in adults, children, and children with movement problems

This study explored the use of advance information in the control of reach-to-grasp movements. The paradigm required participants to reach and grasp illuminated blocks with their right hand. Four target blocks were positioned on a table surface, two each side of the mid-saggital plane. In the complete precue condition, advance information precisely specified target location. In the partial precue condition, advance information indicated target location relative to the midsaggital plane (left or right). In the null condition, the advance information was entirely ambiguous. Participants produced fastest responses in the complete precue condition, intermediate response times in the partial condition, and the slowest responses in the null condition. This result was observed in adults and four groups of children including a group aged 4-6 years. In contrast, children with Developmental Coordination Disorder (DCD, n = 11, aged 7-13 years) showed no advantage of partial precueing. Movement duration was determined by target location but was unaffected by precue condition. Movement duration was a clear function of age apart from children in the DCD group who showed equivalent movement times to those of the youngest children. These findings provide important insights into the control of reach-to-grasp movements and highlight that partial cues are exploited by children as young as 4 years but are not used in situations of abnormal development.

The effect of caudal block on functional residual capacity and ventilation homogeneity in healthy children

Caudal block results in a motor blockade that can reduce abdominal wall tension. This could interact with the balance between chest wall and lung recoil pressure and tension of the diaphragm, which determines the static resting volume of the lung. On this rationale, we hypothesised that caudal block causes an increase in functional residual capacity and ventilation distribution in anaesthetised children. Fifty-two healthy children (15-30 kg, 3-8 years of age) undergoing elective surgery with general anaesthesia and caudal block were studied and randomly allocated to two groups: caudal block or control. Following induction of anaesthesia, the first measurement was obtained in the supine position (baseline). All children were then turned to the left lateral position and patients in the caudal block group received a caudal block with bupivacaine. No intervention took place in the control group. After 15 nun in the supine position, the second assessment was performed. Functional residual capacity and parameters of ventilation distribution were calculated by a blinded reviewer. Functional residual capacity was similar at baseline in both groups. In the caudal block group, the capacity increased significantly (p < 0.0001) following caudal block, while in the control group, it remained unchanged. In both groups, parameters of ventilation distribution were consistent with the changes in functional residual capacity. Caudal block resulted in a significant increase in functional residual capacity and improvement in ventilation homogeneity in comparison with the control group. This indicates that caudal block might have a beneficial effect on gas exchange in anaesthetised, spontaneously breathing preschool-aged children with healthy lungs.

Distortion product otoacoustic emissions in school children: Effects to gender, ear asymmetry and handedness

Accurate interpretation of distortion product otoacoustic emission (DPOAE) data cannot be made without realizing the effects of non-pathological factors on DPOAEs. The present study aimed to examine the effects of ear asymmetry, gender and handedness on DPOAEs obtained from school children. One thousand and three children (528 boys and 475 girls) with a mean age of 6.2 years (SD = 0.4, range = 5.2 7.9 years) were tested in a quiet room at their schools using the GSI-60 DPOAE system. The stimuli consisted of two pure tones of different frequencies f1 and f2 presented at 65 and 55dB SPL respectively. A DP-gram was obtained for each ear with f2 varying from 1.1 to 6.0 kHz and the ratio of f2/f1 being kept at 1.21. The signal-to-noise ratios (SNR) (DPOAE amplitude minus the mean noise floor) at the tested frequencies 1.1, 1.5, 1.9, 2.4, 3.0, 3.8, 4.8, and 6.0 kHz were measured. The results revealed a small, but significant difference in SNR between ears, with right ears showing a higher mean SNR than left ears at 1.9, 3.0, 3.8 and 6.0 kHz. At these frequencies, the difference in mean SNR between ears was less than 1 dB. A significant gender effect was also found, with girls exhibiting a higher SNR than boys at 3.8, 4.8 and 6.0 kHz. The difference in mean SNR, as a result of the gender effect, was about 1 to 2 dB at these frequencies. The results from the present study indicated no significant difference in mean SNR between left-handed and right-handed children for all tested frequencies. In conclusion, these non-pathological characteristics of DPOAEs should be considered in the interpretation of DPOAE results for school children.