Physical Activity and Fitness in Children with Developmental Disorder

Introduction: Developmental coordination disorder (DCD) is a prevalent condition characterized by poor motor proficiency that interferes with a child‟s activities of daily living. Children with DCD often experience compromised health-related fitness components such as cardiorespiratory fitness (CRF). Purpose: To better understand the physical activity and fitness characteristics of children with probable DCD (pDCD), with a particular focus on CRF. Specifically: (1) to present a synopsis of current literature; (2) to determine the longitudinal trajectories of CRF; (3) to compare the submaximal CRF of children with and without pDCD. Methods: A comprehensive, systematic literature review was conducted of the recent available data on fitness and physical activity and pDCD (Chapter 2). This review provided the background for the other two studies included in this thesis. In Chapter 3, a prospective cohort design was used to assess how CRF in children with pDCD changes over time (56 months) relative to a group of typically developing controls. Using a nested-case control design, 63 subjects with pDCD and 63 matched controls from the larger sample were recruited to participate in the lab-based component of the study (Chapter 4). In this investigation CRF was examined using the oxygen cost of work (VO2) during an incremental test on a cycle ergometer. Results: The literature review showed that fitness parameters, including CRF and physical activity levels, were consistently reduced in children with pDCD. Chapter 3 demonstrated that the difference in CRF between children with pDCD and typically developing children is substantial, and that it tends to increase over time. Results from VO2 assessments showed that children with pDCD utilized more oxygen to sustain the same submaximal workloads compared to typically developing children. Conclusions: Findings from this thesis have made several important contributions to our understanding of children with pDCD. Since differences in CRF between children with and without pDCD tend to worsen over time, this adds to the argument that interventions intended to improve CRF may be appropriate for children with motor difficulties. This thesis also presented the first evidence suggesting that DCD involves higher energy expenditure, and could help explain why children with pDCD perform poorly on tasks requiring CRF.

Entering Youthwork Through Love's Many Pathways: A Poetic Rendition

Entering Youth work Through Love's Many Pathways is a text that wanders and digresses to places where, through poetic inquiry and a Spinozist and Sufi framework, the concepts of immanence, love and becoming can be explored. This thesis is framed as a walk through which the researcher / youth worker along with the reader, traverses through five pathways that she considers necessary in cultivating a meaningful relationship with the youth: opening, strength, listening, trust and unconditional compassion. By means of engaging the “self”, this thesis approaches youth work as a field that is relational and socially interconnected. In this sense, this poetic inquiry seeks to rupture predictable patterns of behaviour. One of the ways I do this is through found poetry. Through this specific form of poetic inquiry, I bring together various voices, an assemblage – Rumi, Rilke, Whitman, Lalla, Mirabai and Song of Songs – in order to find my voice and by extension, to help the youth find their voice through a human connection that goes beyond colour, race, gender etc. In other words, my aim is to actualize the experiences of becoming youth worker while being in a field of immanence where similarities are understood and differences respected. My hope is that this project may offer an example of understanding, celebration, and engagement of our mutual differences, while still being able to relate to one another through the many pathways of love.

Using the Reliable Change Index Statistic to Analyze Developmental Changes in Infants at Risk for Autism Spectrum Disorder

Longitudinal studies of the development of autism spectrum disorders (ASD) provide an understanding of which variables may be important predictors of an ASD. The objective of the current study is to apply the reliable change index (RCI) statistic to examine whether the Parent Observation of Early Markers Scale (POEMS) is sensitive to developmental change, and whether these changes can be quantified along a child’s developmental trajectory. Ninety-six children with older siblings with autism were followed from 1-36 months of age. Group-based RCI analysis confirms that the POEMS is capable of detecting significant changes within pre-defined diagnostic groups. Within-subject analysis suggests that ongoing monitoring of a child at-risk for an ASD requires interpretation of both significant intervals identified by the RCI statistic, as well as the presence of repeated high (i.e., >70) scores. This study provides preliminary evidence for a reasonably sensitive and specific means by which individual change can be clinically monitored via parent report.

Families with Children with Autism, Developmental Delay, and Typical Development: The Relationships of Parenting Self-Efficacy, Parenting Strategies, and Child Problem Behaviour

Parents of children with autism spectrum disorders (ASD) and developmental delays (DD) may experience more child problem behaviours, report lower parenting selfefficacy (PSE), and be more reactive than proactive in their parenting strategies than those who have children with typical development (TD). Differences in PSE and parenting strategies may also influence the extent to which child problem behaviours are experienced by parents who have children with ASD and DD, compared to those who have children with TD. Using a convenience sample of parents of children with ASD (n = 48), DD (n = 51), and TD (n = 72), this study examined group differences on three key variables: PSE, parenting strategies, and child problem behaviour. Results indicated that those in the DD group scored lower on PSE in preventing child problem behaviour than the ASD group. The TD group used fewer reactive strategies than the DD group, and fewer proactive strategies than both the ASD and DD groups. For the overall sample, higher reactive strategies use was found to predict higher ratings of child problem behaviour, while a greater proportion of proactive to reactive strategies use predicted lower ratings of child problem behaviour. PSE was found to moderate DD diagnosis and child problem behaviour. Implications for a behavioural (i.e., parenting strategies) or cognitive (i.e., PSE) approach to parenting are discussed.

Community Recreation and Leisure Activities in Adults with Developmental Disabilities who have Recently Relocated to Community-based Residences in Ontario

In 2009, the Ontario Government closed the last three remaining large-scale institutions for people with Developmental Disabilities (DD). The purpose of this study is to examine the community-based recreation and leisure activities of 87 adults with DD who have recently moved into the community. Study 1 provided a descriptive insight into the community recreation and leisure activities, and revealed that people with DD engage in low levels of community activities, however are reported to have the desire to engage more often. Staff reported that people with DD do not have the opportunities to engage in their preferable activities. Study 2 investigated the prbspective predictors of the number and frequency of community, recreation and leisure activities and found that a higher level of functioning predicted a greater number of community activities ([beta] = .26, P < .05), while both a higher level of functioning ([beta] = .38,p < .001) and greater preference ([beta] = .23. p < .05) predicted more frequent access to community activities. Future research and the implications of the findings for clinical practice and policy development were discussed.

The Effects of Body Posture on Emotion Perception: A Developmental and Theoretical Analysis

Previously, studies investigating emotional face perception - regardless of whether they involved adults or children - presented participants with static photos of faces in isolation. In the natural world, faces are rarely encountered in isolation. In the few studies that have presented faces in context, the perception of emotional facial expressions is altered when paired with an incongruent context. For both adults and 8- year-old children, reaction times increase and accuracy decreases when facial expressions are presented in an incongruent context depicting a similar emotion (e.g., sad face on a fear body) compared to when presented in a congruent context (e.g., sad face on a sad body; Meeren, van Heijnsbergen, & de Gelder, 2005; Mondloch, 2012). This effect is called a congruency effect and does not exist for dissimilar emotions (e.g., happy and sad; Mondloch, 2012). Two models characterize similarity between emotional expressions differently; the emotional seed model bases similarity on physical features, whereas the dimensional model bases similarity on underlying dimensions of valence an . arousal. Study 1 investigated the emergence of an adult-like pattern of congruency effects in pre-school aged children. Using a child-friendly sorting task, we identified the youngest age at which children could accurately sort isolated facial expressions and body postures and then measured whether an incongruent context disrupted the perception of emotional facial expressions. Six-year-old children showed congruency effects for sad/fear but 4-year-old children did not for sad/happy. This pattern of congruency effects is consistent with both models and indicates that an adult-like pattern exists at the youngest age children can reliably sort emotional expressions in isolation. In Study 2, we compared the two models to determine their predictive abilities. The two models make different predictions about the size of congruency effects for three emotions: sad, anger, and fear. The emotional seed model predicts larger congruency effects when sad is paired with either anger or fear compared to when anger and fear are paired with each other. The dimensional model predicts larger congruency effects when anger and fear are paired together compared to when either is paired with sad. In both a speeded and unspeeded task the results failed to support either model, but the pattern of results indicated fearful bodies have a special effect. Fearful bodies reduced accuracy, increased reaction times more than any other posture, and shifted the pattern of errors. To determine whether the results were specific to bodies, we ran the reverse task to determine if faces could disrupt the perception of body postures. This experiment did not produce congruency effects, meaning faces do not influence the perception of body postures. In the final experiment, participants performed a flanker task to determine whether the effect of fearful bodies was specific to faces or whether fearful bodies would also produce a larger effect in an unrelated task in which faces were absent. Reaction times did not differ across trials, meaning fearful bodies' large effect is specific to situations with faces. Collectively, these studies provide novel insights, both developmentally and theoretically, into how emotional faces are perceived in context.

Social Economy and Developmental Disabilities: An Employment Option that Promotes a Form of Authentic Work and Fosters Social Inclusion

Typical employment options for people with developmental disabilities are insufficient. Most employment opportunities that are community-based provide typical workplace and geographical inclusion but tend not to support social inclusion and "belonging". This study explored the innovative employment alternative of social businesses and considered this form of employment for persons with a developmental disability as a viable avenue for meaningful work and social inclusion. A total of six business partners with a developmental disability were interviewed; two partners from three separate worker owned businesses. The partners' descriptions of their job and their workplace composed the interpretative findings. The social businesses provided an avenue for this group of people who tend to be segregated in isolated workshops or marginalized in mainstream work environments and who feel a sense of being "outsiders" to participate in meaningful work in community settings. This group of partners described their job as authentic "work" and discussed the many skills and the work ethic learned from their employment opportunity. In addition to the instrumental aspects of the job, the partners also discussed the group autonomy and self-determination of being their own "bosses". The partners confidently expressed feeling valued, understood in the context of others with similar life experiences, attached to the workplace and connected to a larger community as important outcomes of their businesses. These criteria of social inclusion (Hall, 2010) were complemented by teamwork, friendship and ultimately, with a feeling of being genuine "insiders". Replication of this innovative employment model would be recommended for groups of marginalized people with DD in other geographic areas.

Functional Characterization of Monoterpenoid Indole Alkaloid (MIA) Biosynthetic Genes in Catharanthus roseus

The monoterpenoid indole alkaloids (MIAs) of Madagascar periwinkle (Catharanthus roseus) are known to be among the most important source of natural drugs used in various cancer chemotherapies. MIAs are derived by combining the iridoid secologanin with tryptamine to form the central precursor strictosidine that is then converted to most known MIAs, such as catharanthine and vindoline that dimerize to form anticancer vinblastine and vincristine. While their assembly is still poorly understood, the complex multistep pathways involved occur in several specialized cell types within leaves that are regulated by developmental and environmental cues. The organization of MIA pathways is also coupled to secretory mechanisms that allow the accumulation of catharanthine in the waxy leaf surface, separated from vindoline found within leaf cells. While the spatial separation of catharanthine and vindoline provides an explanation for the low levels of dimeric MIAs found in the plants, the secretion of catharanthine to the leaf surface is shown to be part of plant defense mechanisms against fungal infection and insect herbivores. The transcriptomic databases of Catharanthus roseus and various MIA producing plants are facilitating bioinformatic approaches to identify novel MIA biosynthetic genes. Virus-induced gene silencing (VIGS) is being used to screen these candidate genes for their involvement in iridoid biosynthesis pathway, especially in the identification of 7-deoxyloganic acid 7-hydroxylase (CrDL7H) shown by the accumulation of its substrate, 7-deoxyloganic acid and decreased level of secologanin along with catharanthine and vindoline. VIGS can also confirm the biochemical function of genes being identified, such as in the glucosylation of 7-deoxyloganetic acid by CrUGT8 shown by decreased level of secologanin and MIAs within silenced plants. Silencing of other iridoid biosynthetic genes, loganic acid O-methyltransferase (LAMT) and secologanin synthase (SLS) also confirm the metabolic route for iridoid biosynthesis in planta through 7-deoxyloganic acid, loganic acid, and loganin intermediates. This route is validated by high substrate specificity of CrUGT8 for 7-deoxyloganetic acid and CrDL7H for 7-deoxyloganic acid. Further localization studies of CrUGT8 and CrDL7H also show that these genes are preferentially expressed within Catharanthus leaves rather than in epidermal cells where the last two steps of secologanin biosynthesis occur.

The Social Enterprise as an Alternative Work Option for Persons with Developmental Disabilities: A Case Study of Staff Perspectives at Common Ground Co-operative

Traditional employment options for persons with developmental disabilities are lacking. Employment options available for persons with developmental disabilities are reflective of the medical and social model perspectives of disability; with segregated and supported employment reinforcing the idea that persons with developmental disabilities are incapable and competitive employment missing the necessary accommodations for persons to be successful. This study examined social enterprises as an alternative employment option that can balance both medical and social model perspectives by accommodating for weaknesses or limitations and recognizing the strengths and capabilities of persons with developmental disabilities in the workplace. Moreover, this study is part of a broader case study which is examining the nature and impacts of a social enterprise, known as Common Ground Co-operative (CGC), which supports five social purpose businesses that are owned and operated by persons with developmental disabilities. This study is part of the Social Business and Marginalized Social Groups Community-University Research Alliance. To date, a case study has been written describing the nature and impacts of CGC and its related businesses from the perspectives of the Partners, board members, funders and staff (Owen, Readhead, Bishop, Hope & Campbell, in press & Readhead, 2012). The current study used a descriptive case study approach to provide a detailed account of the perceptions and opinions of CGC staff members who support each of the Partners in the five related businesses. Staff members were chosen for the focus of this study because of the integral role that they play in the successful outcomes of the persons they support. This study was conducted in two phases. In the first phase five staff members were interviewed. During this stage of interviews, several themes were presented which needed to be examined in further detail, specifically staff stress and burnout and duty of care for business Partners versus the promotion of their autonomy. A second phase of interviews was then conducted with one individual participant and a focus group of seven. During both interview phases, Staff participants described an employment model that creates a non-judgemental environment for the business Partners that promotes their strengths, accommodates for their limitations, provides educational opportunities and places the responsibility for the businesses on the persons with developmental disabilities cultivating equality and promoting independence. Staff described the nature of their role including risk factors for stress, the protective factors that buffer stress, and the challenges associated with balancing many role demands. Issues related to the replication of this social enterprise model are described.

The γ-tocopherol-like family of N-methyltransferases: A taxonomically clustered gene family encoding enzymes responsible for N-methylation of monoterpene indole alkaloids

The plant family Apocynaceae accumulates thousands of monoterpene indole alkaloids (MIAs) which originate, biosynthetically, from the common secoiridoid intermediate, strictosidine, that is formed from the condensation of tryptophan and secologanin molecules. MIAs demonstrate remarkable structural diversity and have pharmaceutically valuable biological activities. For example; a subunit of the potent anti-neoplastic molecules vincristine and vinblastine is the aspidosperma alkaloid, vindoline. Vindoline accumulates to trace levels under natural conditions. Research programs have determined that there is significant developmental and light regulation involved in the biosynthesis of this MIA. Furthermore, the biosynthetic pathway leading to vindoline is split among at least five independent cell types. Little is known of how intermediates are shuttled between these cell types. The late stage events in vindoline biosynthesis involve six enzymatic steps from tabersonine. The fourth biochemical step, in this pathway, is an indole N-methylation performed by a recently identified N-methyltransfearse (NMT). For almost twenty years the gene encoding this NMT had eluded discovery; however, in 2010 Liscombe et al. reported the identification of a γ-tocopherol C-methyltransferase homologue capable of indole N-methylating 2,3-dihydrotabersonine and Virus Induced Gene Silencing (VIGS) suppression of the messenger has since proven its involvement in vindoline biosynthesis. Recent large scale sequencing initiatives, performed on non-model medicinal plant transcriptomes, has permitted identification of candidate genes, presumably involved, in MIA biosynthesis never seen before in plant specialized metabolism research. Probing the transcriptome assemblies of Catharanthus roseus (L.)G.Don, Vinca minor L., Rauwolfia serpentine (L.)Benth ex Kurz, Tabernaemontana elegans, and Amsonia hubrichtii, with the nucleotide sequence of the N-methyltransferase involved in vindoline biosynthesis, revealed eight new homologous methyltransferases. This thesis describes the identification, molecular cloning, recombinant expression and biochemical characterization of two picrinine NMTs, one from V. minor and one from R. serpentina, a perivine NMT from C. roseus, and an ajmaline NMT from R. serpentina. While these TLMTs were expressed and functional in planta, they were active at relatively low levels and their N-methylated alkaloid products were not apparent our from alkaloid isolates of the plants. It appears that, for the most part, these TLMTs, participate in apparently silent biochemical pathways, awaiting the appropriate developmental and environmental cues for activity.

ARTERIAL STIFFNESS IN CHILDREN WITH AND WITHOUT DEVELOPMENTAL COORDINATION DISORDER

The purpose of this study was to determine whether children with potential developmental coordination disorder (p-DCD) demonstrate increased arterial stiffness and thickness compared to age and school matched controls (mean age 14.7 yrs). We also assessed whether these measures differed by sex. Compliance, distensibility, and intima-media thickness (IMT) were measured at the common carotid artery for 28 children with p-DCD and 47 controls. ECG-R-wave-toe pulse wave velocity (PWV) was also measured for 29 children with p-DCD and 45 controls. We found that compared to controls males with p-DCD had significantly higher PWV (3.8±0.2 vs. 4.1±0.3, p=0.001) and lower distensibility (0.82± 0.19 vs. 0.70± 0.17, p=0.034) while females showed no significant differences (p=0.523 and p=0.123 respectively). As a result, it is apparent that sex differences exist with respect to arterial health within this population and that children with p-DCD may be more likely to develop cardiovascular disease later in life.

The Association of Energy Intake with Body Mass in Children With and Without Probable Developmental Coordination Disorder

Objective To determine if there is an association between energy intake (EI) and overweight or obesity status (OWOB) in children with and without probable developmental coordination disorder (p-DCD). Methods 1905 children were included. The Bruininks-Oseretsky Test of Motor Proficiency was used to assess p-DCD, body mass index for OWOB, and the Harvard Food Frequency Questionnaire for EI. Comparative tests and logistic regressions were performed. Results Reported EI was similar between p-DCD and non-DCD children among boys (2291 vs. 2281 kcal/day, p=0.917), but much lower in p-DCD compared to non-DCD girls (1745 vs.. 2068 kcal/day, p=0.007). EI was negatively associated with OWOB in girls only (OR: 0.82 (0.68, 0.98)). Conclusions Girls with p-DCD have a lower reported EI compared to their non-DCD peers. EI is negatively associated with OWOB in girls with p-DCD. Future research is needed to assess longitudinally the potential impact of EI on OWOB in this population.