Psychometric properties of the caregiver assessment of movement participation scale for screening children with development coordination disorders

Using Rasch analysis, the psychometric properties of a newly developed 35-item parent-proxy instrument, the Caregiver Assessment of Movement Participation (CAMP), designed to measure movement participation problems in children with Developmental Coordination Disorder, were examined. The CAMP was administered to 465 school children aged 5–10 years. Thirty of the 35 items were retained as they had acceptable infit and outfit statistics. Item separation (7.48) and child separation (3.16) were good; moreover, the CAMP had excellent reliability (Reliability Index for item = 0.98; Person = 0.91). Principal components analysis of item residuals confirmed the unidimensionality of the instrument. Based on category probability statistics, the original five-point scale was collapsed into a four-point scale. The item threshold calibration of the CAMP with the Movement Assessment Battery for Children Test was computed. The results indicated that a CAMP total score of 75 is the optimal cut-off point for identifying children at risk of movement problems.

Internal representation of movement in children with developmental coordination disorder : a mental rotation task

Recent studies show that children with developmental coordination disorder (DCD) have difficulties in generating an accurate visuospatial representation of an intended action, which are shown by deficits in motor imagery. This study sought to test this hypothesis further using a mental rotation paradigm. It was predicted that children with DCD would not conform to the typical pattern of responding when required to imagine movement of their limbs. Participants included 16 children with DCD and 18 control children; mean age for the DCD group was 10 years 4 months, and for controls 10 years. The task required children to judge the handedness of single-hand images that were presented at angles between 0° and 180° at 45° intervals in either direction. Results were broadly consistent with the hypothesis above. Responses of the control children conformed to the typical pattern of mental rotation: a moderate trade-off between response time and angle of rotation. The response pattern for the DCD group was less typical, with a small trade-off function. Response accuracy did not differ between groups. It was suggested that children with DCD, unlike controls, do not automatically enlist motor imagery when performing mental rotation, but rely on an alternative object-based strategy that preserves speed and accuracy. This occurs because these children manifest a reduced ability to make imagined transformations from an egocentric or first-person perspective.

Assessment of movement participation for children with developmental coordination disorders

The Caregiver Assessment of Movement Participation was developed to identify children of 5-10 years old for movement participation difficulties in home contexts. Its psychometric properties were investigated including its usefulness as a screening instrument using both classical test theory methods and Rasch analysis. Results confirmed its validity and reliability.

Screening children with developmental coordination disorder : the development of the caregiver assessment of movement participation

This study investigated the psychometric properties of the Caregiver Assessment of Movement Participation (CAMP), which was developed to measure and identify children with movement participation problems in home contexts. The test-retest reliability, as well as the concurrent and contrast-group validity of the 35-item parent-proxy CAMP, was examined on 312 children aged 5 to 8 years using intraclass correlation, factor analysis, and the Rasch model. Initial findings on the CAMP appeared to support its validity. Testing on other properties from a practical perspective, such as finding the best rating scale structure and cutpoints, are recommended before using the instrument for child health surveillance screening.

Learning to minimize energy costs and maximize mechanical work in a bimanual coordination task

The authors addressed the hypothesis that economy in motor coordination is a learning phenomenon realized by both reduced energy cost for a given workload and more external work at the same prepractice metabolic and attentional energy expenditure. "Self-optimization" of movement parameters has been proposed to reflect learned motor adaptations that minimize energy costs. Twelve men aged 22.3 [+ or -] 3.9 years practiced a 90[degrees] relative phase, upper limb, independent ergometer cycling task at 60 rpm, followed by a transfer test of unpracticed (45 and 75 rpm) and self-paced cadences. Performance in all conditions was initially unstable, inaccurate, and relatively high in both metabolic and attentional energy costs. With practice, coordinative stability increased, more work was performed for the same metabolic and attentional costs, and the same work was done at a reduced energy cost. Self-paced cycling was initially below the metabolically optimal, but following practice at 60 rpm was closer to optimal cadence. Given the many behavioral options of the motor system in meeting a variety of everyday movement task goals, optimal metabolic and attentional energy criteria may provide a solution to the problem of selecting the most adaptive coordination and control parameters.

Energetics of interlimb coordination

While the traditional dependent variables of motor skill learning are accuracy and consistency of movement outcome, there has been increasing interest in aspects of motor performance that are described as reflecting the ‘energetics’ of motor behaviour. One defining characteristic of skilled motor performance is the ability to complete the task with minimum energy expenditure (Sparrow & Newell, 1998). A further consideration is that movements also have costs in terms of cognitive ‘effort’ or ‘energy’. The present project extends previous work on energy expenditure and motor skill learning within a coordination dynamics framework. From the dynamic pattern perspective, a coordination pattern lowest on the 11KB model potential curve (Haken, Kelso & Bunz, 1985) is more stable and least energy is required to maintain pattern stability (Temprado, Zanone, Monno & Laurent, 1999). Two experiments investigated the learning of stable and unstable coordination patterns with high metabolic energy demand. An experimental task was devised by positioning two cycle ergometers side-by-side, placing one foot on each, with the pedals free to move independently at any metronome-paced relative phase, Experiment 1 investigated practice-related changes to oxygen consumption, heart rate, relative phase, reaction time and muscle activation (EMG) as participants practiced anti-phase, in-phase and 90°-phase cycling. Across six practice trials metabolic energy cost reduced and AE and VE of relative phase declined. The trend in the metabolic and reaction time data and percent co-contraction of muscles was for the in-phase cycling to demonstrate the highest values, anti-phase the lowest and 90°-phase cycling in-between. It was found that anti- and in-phase cycling were both kinematically stable but anti-phase coordination revealed significantly lower metabolic energy cost. It was, therefore, postulated that of two equally stable coordination patterns, that associated with lower metabolic energy expenditure would constitute a stronger attractor. Experiment 2 was designed to determine whether a lower or higher energy-demanding coordination pattern was a stronger attractor by scanning the attractor layout at thirty-degree intervals from 0° to 330°. The initial attractor layout revealed that in-phase was most stable and accurate, but the remaining coordination patterns were attracted to the low energy cost anti-phase cycling. In Experiment 2 only 90°- phase cycling was practiced with a post-test attractor layout scan revealing that 90°-phase and its symmetrical partner 270°-phase had become attractors of other coordination patterns. Consistent with Experiment 1, practicing 90°-phase cycling revealed a decline in AE and VE and a reduction in metabolic and cognitive cost. Practicing 90°-phase cycling did not, however, destabilise the in-phase or anti-phase coordination patterns either kinematically or energetically. In summary, the findings suggest that metabolic and mental energy can be considered different representations of a ‘global’ energy expenditure or ‘energetic’ phenomenon underlying human coordination. The hypothesis that preferred coordination patterns emerge as stable, low-energy solutions to the problem of inter-and intra-limb coordination is supported here in showing that the low-energy minimum of coordination dynamics is also an energetic minimum.

Impaired online control in children with developmental coordination disorder reflects development immaturity

The present study aimed to clarify whether a reduced ability to correct movements in-flight observed in children with developmental coordination disorder (DCD) reflects a developmental immaturity or deviance from the typical trajectory. Eighteen children with DCD (8–12 years), 18 age-matched controls, and 12 younger controls (5–7 years) completed a double-step reaching task. Compared to older controls, children with DCD and younger controls showed similarly prolonged reaching when the target unexpectedly shifted at movement onset and were equally slow to correct their reaching trajectory. These results suggest that impaired online control in DCD reflects developmental immaturity, possibly implicating the parietal-cerebellar cortices.

Online motor control in children with developmental coordination disorder: chronometric analysis of double-step reaching performance

Background
Although there are a number of plausible accounts to explain movement clumsiness in children [or developmental coordination disorder (DCD)], the cause(s) of the disorder remain(s) an issue of debate. One aspect of motor control that is particularly important to the fluid expression of skill is rapid online control (ROC). Data on DCD have been conflicting. While some recent work using double-step reaching suggests no difficulty in online control, others suggest deficits (e.g. based on sequential pointing). To help resolve this debate, we suggest two things: use of recent neuro-computational models as a framework for investigating motor control in DCD, and more rigorous investigation of double-step reaching. Our working assumption here is that ROC is only viable through the seamless integration of predictive (or forward) models of movement and feedback-based mechanisms.

Aim
The aim of this chronometric study was to explore ROC in children with DCD using a double-step reaching paradigm. We predicted slower online adjustments in DCD based on the argument that these children manifest a core difficulty in predictive control.

Methods
Participants were a group of 17 children with DCD and 27 typically developing children aged between 7 and 12 years. Visual targets were presented on a 17-inch LCD touch screen, inclined to an angle of 15° from horizontal. The children were instructed to press each target as it appeared as quickly and accurately as possible. For 80% of the trials, the central target location remained unchanged for the duration of the movement (non-jump trials), while for the remaining 20% of trials, the target jumped at movement onset to one of the two peripheral locations (jump trials). Reaction time (RT), movement time (MT) and reaching errors were recorded.

Results
For both groups, RT did not vary according to trial condition, while children with DCD were slower to initiate movement. Further, the MT of children with DCD was prolonged to a far greater extent on jump trials relative to controls, with a large effect size. As well, children with DCD committed significantly more errors, notably a reduced ability to inhibit central responses on jump trials.

Conclusion
Our findings help reconcile some disparate findings in the literature using similar tasks. The pattern of performance in children with DCD suggests impairment in the ability to make rapid online adjustments that are based on a predictive (or internal) model of the action. These results pave the way for future kinematic investigation.

Coupling online control and inhibitory systems in children with developmental coordination disorder: goal-directed reaching

For children with Developmental Coordination Disorder (DCD), the real-time coupling between frontal executive function and online motor control has not been explored despite reported deficits in each domain. The aim of the present study was to investigate how children with DCD enlist online control under task constraints that compel the need for inhibitory control. A total of 129 school children were sampled from mainstream primary schools. Forty-two children who met research criteria for DCD were compared with 87 typically developing controls on a modified double-jump reaching task. Children within each skill group were divided into three age bands: younger (6-7 years), mid-aged (8-9), and older (10-12). Online control was compared between groups as a function of trial type (non-jump, jump, anti-jump). Overall, results showed that while movement times were similar between skill groups under simple task constraints (non-jump), on perturbation (or jump) trials the DCD group were significantly slower than controls and corrected trajectories later. Critically, the DCD group was further disadvantaged by anti-jump trials where inhibitory control was required; however, this effect reduced with age. While coupling online control and executive systems is not well developed in younger and mid-aged children, there is evidence of age-appropriate coupling in older children. Longitudinal data are needed to clarify this intriguing finding. The theoretical and applied implications of these results are discussed.

A holistic measurement model of movement competency in children

Different countries have different methods for assessing movement competence in children; however, it is unclear whether the test batteries that are used measure the same aspects of movement competence. The aim of this paper was to (1) investigate whether the Test of Gross Motor Development (TGMD-2) and Körperkoordinations Test für Kinder (KTK) measure the same aspects of children’s movement competence and (2) examine the factorial structure of the TGMD-2 and KTK in a sample of Australian children. A total of 158 children participated (M age = 9.5; SD = 2.2). First, confirmatory factor analysis examined the independent factorial structure of the KTK and TGMD-2. Second, it was investigated whether locomotor, object control and body coordination loaded on the latent variable Movement Competency. Confirmatory factor analysis indicated an adequate fit for both the KTK and TGMD-2. An adequate fit was also achieved for the final model. In this model, locomotor (r = .86), object control (r = .71) and body coordination (r = .52) loaded on movement competence. Findings support our hypothesis that the TGMD-2 and KTK measure discrete aspects of movement competence. Future researchers and practitioners should consider using a wider range of test batteries to assess movement competence.

Reduced motor imagery efficiency is associated with online control difficulties in children with probable developmental coordination disorder

Recent evidence indicates that the ability to correct reaching movements in response to unexpected target changes (i.e., online control) is reduced in children with developmental coordination disorder (DCD). Recent computational modeling of human reaching suggests that these inefficiencies may result from difficulties generating and/or monitoring internal representations of movement. This study was the first to test this putative relationship empirically. We did so by investigating the degree to which the capacity to correct reaching mid-flight could be predicted by motor imagery (MI) proficiency in a sample of children with probable DCD (pDCD). Thirty-four children aged 8 to 12 years (17 children with pDCD and 17 age-matched controls) completed the hand rotation task, a well-validated measure of MI, and a double-step reaching task (DSRT), a protocol commonly adopted to infer one's capacity for correcting reaching online. As per previous research, children with pDCD demonstrated inefficiencies in their ability to generate internal action representations and correct their reaching online, demonstrated by inefficient hand rotation performance and slower correction to the reach trajectory following unexpected target perturbation during the DSRT compared to age-matched controls. Critically, hierarchical moderating regression demonstrated that even after general reaching ability was controlled for, MI efficiency was a significant predictor of reaching correction efficiency, a relationship that was constant across groups. Ours is the first study to provide direct pilot evidence in support of the view that a decreased capacity for online control of reaching typical of DCD may be associated with inefficiencies generating and/or using internal representations of action.