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Effectiveness of motor interventions depends not only on learning content but also on the used teaching strategies. However, little is known regarding the application of teaching strategies in clinical practice. This study aimed to develop and assess psychometric properties of a new Dutch observational instrument to document teaching strategies: the Optimizing Performance through Intrinsic Motivation and Attention for Learning (OPTIMAL) Strategies Observational Tool (OSOT). Based on the OPTIMAL theory for motor learning from Wulf and Lewthwaite, the OSOT includes three variables: (a) expectancies, (b) autonomy, and (c) attention. The OSOT's content was created by extracting relevant items from literature and existing instruments. To assess its psychometric properties, a convenience sample of 18 physiotherapy sessions for children with developmental coordination disorder was employed. Video recordings of these sessions were analyzed using Noldus The Observer XT. Relative duration (percentage of session time) was calculated for each item. Intraclass correlations were calculated to examine interrater and intrarater reliability. The design process resulted in 43 items in total. Interrater and intrarater intraclass correlations ranged from 0.48 to 0.99, with 81% (interrater), respectively, 95% (intrarater) of the items scoring above 0.75, indicating excellent agreement. The OSOT enables systematic and reliable observation of Optimizing Performance through Intrinsic Motivation and Attention for Learning teaching strategies used by therapists in Dutch clinical settings.

Sound-augmented toys producing factual knowledge were thought to encourage incidental, playful learning in children with visual impairments (VIs). A group of 15 children with VIs and 22 sighted controls played with a sound-augmented savannah landscape and listened to an informative story in a counterbalanced order. Children's knowledge about savannah animals was assessed at baseline and after each condition in order to quantitatively compare knowledge gains between conditions. Results indicated that children with VIs gained more knowledge than sighted controls from playing with the sound-augmented toy. Furthermore, offering both the augmented toy and the informative story led to higher knowledge gains than a single medium, especially in children with VIs. Sound-augmented toys could therefore be a useful addition to the current curriculum in special education for children with VIs.

Purpose: A large pool of evidence supports the beneficial effect of an external focus of attention on motor skill performance in adults. In children, this effect has been studied less and results are inconclusive. Importantly, individual differences are often not taken into account. We investigated the role of working memory, conscious motor control, and task-specific focus preferences on performance with an internal and external focus of attention in children. Methods: Twenty-five children practiced a golf putting task in both an internal focus condition and external focus condition. Performance was defined as the average distance toward the hole in 3 blocks of 10 trials. Task-specific focus preference was determined by asking how much effort it took to apply the instruction in each condition. In addition, working memory capacity and conscious motor control were assessed. Results: Children improved performance in both the internal focus condition and external focus condition (?[subscript p][superscript 2] = 0.47), with no difference between conditions (?[subscript p][superscript 2] = 0.01). Task-specific focus preference was the only factor moderately related to the difference between performance with an internal focus and performance with an external focus (r = 0.56), indicating better performance for the preferred instruction in Block 3. Conclusion: Children can benefit from instruction with both an internal and external focus of attention to improve short-term motor performance. Individual, task-specific focus preference influenced the effect of the instructions, with children performing better with their preferred focus. The results highlight that individual differences are a key factor in the effectiveness in children's motor performance. The precise mechanisms underpinning this effect warrant further research.

Children with congenital visual impairment have been reported to be delayed in theory of mind development. So far, research focused on first-order theory of mind, and included mainly blind children, whereas the majority of visually impaired children is not totally blind. The present study set out to explore whether children with a broader range of congenital visual impairments have a delay in more advanced theory of mind understanding, in particular second-order theory of mind (i.e. awareness that other people have beliefs about beliefs) and non-literal language (e.g. irony or figure of speech). Twenty-four children with congenital visual impairment and 24 typically developing sighted children aged between 6 and 13 were included. All children were presented with a series of stories involving understanding of theory of mind and non-literal language. When compared with sighted children of similar age and verbal intelligence, performance of children with congenital visual impairment on advanced theory of mind and non-literal stories was alike. The ability to understand the motivations behind non-literal language was associated with age, verbal intelligence and theory of mind skills, but was not associated with visual ability. (Contains 7 tables.)

In the present study we tested 13 children with cerebral palsy (CP) and 24 typically developing children (7-12 years old) in a unimanual and bimanual motor planning task. We focused on two research questions: (1) How does motor planning develop in children with and without CP? and (2) Is motor planning facilitated when the task is performed with both hands? Participants had to grasp one or two vertical oriented cylinder(s) and transport it/them to a platform that had different heights. As a measure of motor planning, we registered the height at which participants grasped the cylinder. Here, anticipation of grasp height upon the height of the upcoming target(s) is reflective of proper forward motor planning as it leads to a comfortable posture at the end of the task. In the unimanual task the typically developing children showed a significant grasp height effect, which increased with age. In contrast, no grasp height effect, or age related changes therein were found for the children with CP, suggesting a compromised development of motor planning in these children. Interestingly, when children had to transport one cylinder to a high shelf and one cylinder to a low shelf, the more affected hand of the CP children clearly anticipated the grasp height to the upcoming target height. The less affected hand did not show such anticipation. Taken collectively, these findings suggest a delayed or compromised development of motor planning in children with CP compared to typically developing children. At the same time, the facilitated motor planning of the more affected arm in the bimanual task offers a valuable entry point for intervention to improve motor planning in CP.

Children with developmental coordination disorder (DCD) show deficits in motorcognitive coupling. However, it remains unclear whether such deficits depend on the severity of DCD. The aim of this study was to examine cognitive-motor coupling under different levels of inhibitory control in children with severe (s-DCD) or moderate DCD (m-DCD), compared with typically-developing children (TDC). The performance of 29 primary-school children aged 6-12years with s-DCD (Mage= 9.12± 1.56years), 53 m-DCD (Mage= 8.78± 1.67years), and 201 TDC (Mage= 9.20± 1.50years) was compared on a double jump reaching task (DJRT) paradigm, presented on a large 42-inch touchscreen. The task display had a circular home-base, centred at the bottom of the display, and three target locations at radials of -20°, 0°, and 20°, 40cm above the home-base circle. For the standard double-jump reaching task (DJRT), children moved their index finger from home-base circle to touch the target stimulus as fast as possible; 20% were jump trials where the target shifted left or right at lift-off. For the anti-jump reaching task (AJRT), 20% of trials required an anti-jump movement, touching the contralateral target location. While no group differences were shown on the DJRT, the DCD group were slower to complete reaching movements than the TDC group on AJRT; on the latter, the two DCD sub-groups were not shown to differ. Results confirm the presence of motor inhibition deficits in DCD which may not be dependent on the motor severity of the disorder. [ABSTRACT FROM AUTHOR]

In past comparative studies, children with vision impairment were often shown a developmental delay compared to sighted children in several developmental domains. Medical treatments of vision impairments and societal attitudes toward disabilities changed considerably. Besides, within the rehabilitation practices, a stronger integration of multiple perspectives and increased focus on social inclusion and participation in society is present. The main goal of this scoping review was to investigate what is known about the development in cognition, language and communication, motor, social–emotional, and adaptive skills development of children with vision impairment by longitudinal studies. Besides, the results of the past studies were related to a contemporary view on disability, the participation concept. This was done by applying the family of participation-related constructs (fPRC) framework to examine which factors were covered and which not. A systematic literature search was performed in Web of Science, PsycInfo, ERIC, and Medline. Studies were included if they have been published in peer-reviewed journals between 1994 and 2020 had a longitudinal design and examined the development of children with vision impairment with no additional impairments up to 18 years of age. From the 2698 identified studies, 32 studies were included. The most commonly assessed variables concerned cognition and language and communication development. To a lesser extent, studies examined adaptive skills, motor, and social–emotional development. The majority used vision status as a predictor variable for developmental outcomes. In terms of the fPRC framework, most studies included variables related to the factor activity competences. The factors preferences, sense of self, environment, and involvement were studied far less often. The review suggested a positive impact on developmental outcomes for including variables that can mediate the relation between vision status and developmental outcomes and variables that are related to the fPRC factors environment, sense of self, and preferences. [ABSTRACT FROM AUTHOR]

This longitudinal study modeled children's complex executive function (EF) development using the Groton Maze Learning Task (GMLT). Using a cohort‐sequential design, 147 children (61 males, 5.5–11 years) were recruited from six multicultural primary schools in Melbourne and Perth, Australia. Race/ethnicity data were not available. Children were assessed on the GMLT at 6‐month intervals over 2‐years between 2010 and 2012. Growth curve models describe age‐related change from 5.5 to 12.5 years old. Results showed a quadratic growth trajectory on each measure of error—that is, those that reflect visuospatial memory, executive control (or the ability to apply rules for action), and complex EF. The ability to apply rules for action, while a rate‐limiting factor in complex EF, develops rapidly over early‐to‐mid childhood. [ABSTRACT FROM AUTHOR]

Motor learning interventions for children with cerebral palsy (CP) that elicit relatively permanent and transferable improvements in motor skill capability are essential. Knowledge is needed about the augmented feedback forms that most effectively promote this. This review aims to collect and analyze the current evidence for the effectiveness of different forms of feedback for motor learning in children with CP to improve motor task performance. PubMed, PsycInfo, and Cochrane Library were searched to identify relevant studies. Studies were included if (1) they were conducted in children with CP or compared children with CP to TD children and (2) a form of augmented feedback related to a motor task was administered. Initially, 401 records were identified for screening. Ultimately, 12 articles were included in the review. The evidence thus far supports the expectancy that children with CP generally benefit from feedback provided during or after performing a movement task. Due to the heterogeneity of existing studies, it is difficult to draw firm conclusions regarding relative effectiveness of feedback forms. This review showed that more high-quality research is warranted on the effectiveness of specific feedback forms on motor learning in children with CP. Children with CP benefit from several forms of knowledge of performance or knowledge of results feedback provided during or after performing a movement task. Feedback should not be provided with every performed trial. Feedback frequency can best be reduced by letting children determine after which trials they want feedback. Learning curves under similar feedback conditions varied largely between children, warranting tailor-made forms of feedback to be applied during motor learning and rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose. The present study focused on the impact of an adapted Cognitive Orientation to daily Occupational Performance (CO-OP) five-day intervention program for children with developmental coordination disorder (DCD). Important adaptations were the new combination of individual CO-OP sessions and group activities, the short and intensive program that was followed by a training and coaching trajectory, and the use of video logs. Materials and Methods. Eighteen children with DCD (aged 8-16 years) participated in the five-day intervention during which they worked on three intervention goals. After the intervention, during an eight-week training and coaching trajectory for parents and children, children worked on a transfer goal. Assessment took place at four moments in time: two pretest measures, a posttest measure, and a 3-month follow-up measure. Primary outcome measures focused on changes in performance and satisfaction of self-chosen intervention and transfer goals. The secondary outcome measure explored changes in children's attitude, motivation, and confidence in relation to motor skill activities, social skills, and level of participation. Results. Significant improvements were found with regard to the performance and satisfaction of intervention goals. For the transfer goal, only parents reported significant improvements. Finally, parents indicated potential improvements with regard to the attitude, motivation, and confidence of their children, but not for their social skills or level of participation. Conclusion. The findings are promising with regard to the efficacy of this adapted CO-OP intervention for improving intervention goals, but less effective for transfer of learned skills to other goals after the intervention. Future research should focus on how postintervention parental coaching can be improved in order to increase generalization and transfer. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the current state of evidence and methodological quality of studies on implicit and explicit motor learning in both typically developing children and children with developmental disorders. A systematic literature review was conducted on the experimental literature published up to April 2020. A total of 25 studies were included. Studies were evaluated on methodological quality, paradigm used, and level of evidence. The results showed that implicit paradigms are as effective as explicit paradigms in both groups of children. Studies are predominantly experimental in nature involving mostly upper limb aiming tasks. The few studies that were performed outside the lab (n = 5) suggest superior efficacy of the implicit paradigm. Methodological quality varied between studies and was not always of sufficient standard to allow conclusions. In particular, manipulation checks were only performed in 13 studies (52% of all studies), limiting conclusions. Further progress can be made by focussing on improving methodological quality through retention testing by the inclusion of a control group, by the inclusion of a manipulation check, and via assessment of relevant co-variables, such as working memory, age, and motor competence. [ABSTRACT FROM AUTHOR]

The end-state comfort (ESC) effect refers to the consistent tendency of healthy adults to end their movements in a comfortable end posture. In children with and without developmental coordination disorder (DCD), the results of studies focusing on ESC planning have been inconclusive, which is likely to be due to differences in task constraints. The present pilot study focused on the question whether children with and without DCD were able to change their planning strategy and were more likely to plan for ESC when demanded by complex object manipulations at the end of a task. To this end, we examined ESC planning in 18 children with and without DCD (aged 5–11years) using the previously used sword-task and the newly developed hammer-task. In the sword-task, children had to insert a sword in a wooden block, which could be relatively easily completed with an uncomfortable end-posture. In the hammer-task, children had to strike down a nail in a wooden pounding bench, which required additional force and speed demands, making it relatively difficult to complete the movement with an uncomfortable end-posture. In line with our hypothesis, the results demonstrated that children with and without DCD were more likely to plan for ESC on the hammer-task compared with the sword-task. Thus, while children with and without DCD show inconsistent ESC planning on many previously used tasks, the present pilot study shows that many of them are able to take into account the end-state of their movements if demanded by task constraints. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate in children with developmental coordination disorder (DCD) the effects of Wii-training compared with task-specific matched training (TST). Material and methods: A randomized controlled trial (RCT) was conducted with 32 children having DCD, aged 7–10 years. Children were randomly assigned to the Wii or task-specific training. Both interventions consisted of 16, 60-min sessions over an 8-week period. The primary outcome measure of movement skill was the Movement Assessment Battery for Children-2 (MABC-2), administered by blinded assessors. Measures included total standard scores (TSS), manual dexterity, aiming/catching, and balance component scores. Results: From pre- to post-test, both groups improved significantly on TSS and balance after intervention. The Wii intervention group also improved on manual dexterity. Neither group improved significantly on aiming/catching. Conclusions: Both the Wii and task-specific training improved overall motor performance and balance. On other MABC-2 component scores, treatment effects differed between groups: Task-specific training had more pronounced effects on balance skills, while Wii training had slightly stronger treatment effects than task-specific training on manual dexterity. It was concluded that task-specific training affords stronger benefits for general motor skill than Wii-based training. Whether Wii training can promote clinically significant benefits for upper-limb function remains to be seen. Trial Registration: This study is registered in a clinical trials registry platform (Protocol: RBR-89YDGJ). Available on the Brazilian Clinical Trials Registry <> Wii-training and task-specific matched training programs afforded gains in motor performance in children with developmental coordination disorder, similarly; The selected Wii tasks were able to improve the motor performance in children with developmental coordination disorder, but should not be used as an exclusive strategy for these children; Our findings suggest caution in recommending Wii-based training as a viable alternative to more task-specific matched training for children with developmental coordination disorder. [ABSTRACT FROM AUTHOR]

Converging evidence indicates that motor deficits in cerebral palsy (CP) are related not only to problems with execution, but also to impaired motor planning. Current rehabilitation mainly focuses on alleviating compromised motor execution. Motor imagery is a promising method of training the more ‘cognitive’ aspects of motor behaviour, and may, therefore, be effective in facilitating motor planning in patients with CP. In this review first we present the specific motor planning problems in CP followed by a discussion of motor imagery and its use in clinical practice. Second, we present the steps to be taken before motor imagery can be used for rehabilitation of upper limb functioning in CP. Motor imagery training has been shown to be a useful addition to existing rehabilitation protocols for poststroke rehabilitation. No such study has been conducted in CP. The age at which children can reliably use motor imagery, as well as the specific way in which motor imagery training needs to be implemented, must be researched before motor imagery training can be employed in children with CP. Based on the positive results for poststroke rehabilitation, and in light of the motor problems in CP, motor imagery training may be a valuable additional tool for rehabilitation in CP. [ABSTRACT FROM AUTHOR]

In the present study we examined unimanual and bimanual fingertip force control during grasping in children with hemiplegic cerebral palsy (CP). Participants lifted, transported and released an object with one hand or both hands together in order to examine the effect on fingertip force control for each hand separately and to determine whether any benefit exists for the affected hand when it performed the task concurrently with the less-affected hand. Seven children with hemiplegic CP performed the task while their movement and fingertip force control were measured. In the bimanual conditions, the weight of the instrumented objects was equal or unequal. The durations of the all temporal phases for the less-affected hand were prolonged during bimanual control compared to unimanual control. We observed close synchrony of both hands when the task was performed with both hands, despite large differences in duration between both hands when they performed separately. There was a marginal benefit for two of the five force related variables for the affected hand (grip force at onset of load force, and peak grip force) when it transported the object simultaneously with the less-affected hand. Collectively, these results corroborate earlier findings of reaching studies that showed slowing down of the less-affected hand when it moved together with the affected hand. A new finding that extends these studies is that bimanual tasks may have the potential to facilitate force control of the affected hand. The implications of these findings for recent rehabilitative therapies in children with CP that make use of bimanual training are discussed. [ABSTRACT FROM AUTHOR]

It has been suggested that motor imagery ability develops gradually between 5 and 12 years of age, but ambiguity remains over the precise developmental course before 9 years. Hence, we determined the age-related differences in the use of motor imagery by children on the mental chronometry paradigm. In addition, we examined whether the use of motor imagery is related to cognitive and hand abilities. To this end, we compared duration of actual pointing and imagined pointing on a radial Fitts’ task in 82 children (three age groups; 6-, 7-, and 8-year-olds). In line with previous studies, we found an age-related increase in temporal congruence between actual and imagined pointing and compliance with Fitts’ law. Importantly, however, we showed that only a limited number of 7- and 8-year-olds were actually using motor imagery to perform the imagined pointing task, whereas the 6-year-olds did not employ motor imagery to perform the task. The current results extend previous research by establishing that the age of onset to use motor imagery in the mental chronometry paradigm is not prior to 7 years. [ABSTRACT FROM AUTHOR]

Visual impairment in childhood often has life-long implications. To aim for the highest levels of functioning, participation, and quality of life and to ensure children's well-being, children should be entitled to the most effective rehabilitation programs. We review evidence for the effectiveness of rehabilitation interventions for children with visual impairment to improve skills and behavior, thereby improving participation and quality of life as an ultimate goal. Of the 441 potentially relevant articles identified, 66 studies met our inclusion criteria (i.e., 28 randomized controlled trials, 18 nonrandomized controlled trials, and 20 before-after comparisons). The results suggest that sports camps, prescription and training in the use of low vision devices, and oral hygiene programs might be effective in improving functioning and elements of participation and quality of life in children with visual impairment. Other interventions showed mixed or negative results. The results should be interpreted with caution because of moderate to high risk of bias and suboptimal reporting. Heterogeneity of results and the use of over 50 different outcome measures prevented a meta-analysis. Future studies should focus on promising interventions for which effectiveness is still unclear (e.g., mobility, social skills), with adequately designed methodology. [ABSTRACT FROM AUTHOR]

When completing grip-selection tasks, healthy adults generally plan for the most comfortable end-posture which is termed the end-state comfort (ESC) effect. Children with and without developmental coordination disorder (DCD) are less likely to plan for ESC which begs the question as to whether they are not able to perform this type of planning or whether they prioritize other aspects of the task. (1) Examine if children with and without probable DCD (pDCD) are able to plan for ESC if they are explicitly instructed to and (2) if this transfers to another similar task. (3) Examine if children with and without pDCD perceive the level of comfort of the grips that they use differently and if this relates to ESC planning. Twelve children with and 12 children without probable DCD (pDCD) (aged 5–9 years) received a 10-min training session in which children were explicitly instructed to end their movement in ESC, after which they formulated their own plan to reach this goal. The study consisted of a pre-post-test design in which changes in the proportion of ESC were analyzed on the task that was trained as well as on an untrained transfer-task. Furthermore, the perceived level of comfort was examined. Both groups of children showed a higher proportion of ESC on the post-test compared with the pre-test, on the task that was trained as well as on the transfer-task. There were no group differences regarding the perceived level of comfort of the different grip postures. The majority of the children with and without pDCD seems to be able to adjust their planning strategy and prioritize ESC if they are explicitly instructed to. • Children with and without pDCD were explicitly instructed to plan for ESC. • Using the CO-OP approach children adjusted their planning strategy and prioritized ESC. • There were no differences between the groups in their perceived level of comfort. • Children perceived an "uncomfortable" start-posture as uncomfortable. • While an "uncomfortable" end-posture was not necessarily perceived as uncomfortable. [ABSTRACT FROM AUTHOR]

In everyday life, tasks are often performed simultaneously, which may be more difficult for children with developmental coordination disorder (DCD) than their peers. To examine (1) the effects of task complexity and type of concurrent task on dual-task performance in children with and without DCD; and (2) if the amount of effort that children put into the task performance differs between the groups. Participants were 64 children with and without DCD (aged 7–14 years). The dual-task paradigm consisted of a manual dexterity task of relatively low complexity (box and block test) or relatively high complexity (pegboard task), and a concurrent motor task (cycling task) or a concurrent cognitive task (word-listening task). To assess mental effort, children were asked how tired they felt before and after the experiment. Dual-task interference was highest when the manual dexterity task of relatively high complexity was combined with the concurrent motor task. There were no group differences in dual-task interference, but children with DCD reported a larger increase in the level of tiredness after the experiment indicative of greater mental effort. Depending on task demands, children with DCD are able to perform dual-tasks at the same level as their peers, but performance may take children with DCD more mental effort. • Manual dexterity tasks of varying complexity were combined with a cognitive and motor task. • Dual-task interference was highest for the complex task with a concurrent motor task. • No group differences were found in dual-task interference. • It seems that it took children with DCD more mental effort to perform the tasks. [ABSTRACT FROM AUTHOR]

Abstract: In the present study, we investigated the development of action planning in children with unilateral Cerebral Palsy (CP, aged 3–6 years, n =24) and an age matched control group. To investigate action planning, participants performed a sequential movement task. They had to grasp an object (a wooden play sword) and place the sword in a hole in a wooden block. Our main dependent variable was the grip type that participants used, i.e., did they adapt their initial grip choice such that they would reach a comfortable posture at the end of the action? This end-state comfort effect has been abundantly shown in research on action planning, and is taken as evidence for anticipatory planning. The first aim of the study was to investigate the development of action planning in the unilateral CP group and the control group. Our hypothesis was that action planning improves with age in the control group, but not in the unilateral CP group. The results showed that planning was impaired in the unilateral CP group compared with the control group. Consistent with our hypothesis, we found an age effect in the control group, but not in the unilateral CP group. In the control group 5 and 6 years olds showed more anticipatory planning compared with the 3 and 4 years olds. The second aim of this study was to examine whether an intervention for children with unilateral CP (i.e., constrained induced movement therapy combined with bimanual training) affected action planning. The children with unilateral CP were therefore measured on the experimental task before and after an 8-week intervention period. The results showed that planning improved after the intervention. This finding suggests that action planning ability in young children with unilateral CP may be sensitive to improvement. These findings are discussed within the context of typical and atypical development of action planning and further guidelines for intervention in children with unilateral CP are given. [Copyright &y& Elsevier]

This study investigated the role of working memory capacity on implicit and explicit motor sequence learning in young children. To this end, a task was utilized that required a gross motor response (flexing the elbow) and that could differentiate between movement speed (i.e., reaction time and movement time) and movement accuracy. Children aged 7-9 years practiced a serial reaction time task that involved the production of a fixed sequence of elbow flexions of prescribed magnitude across two consecutive days. Children in the explicit group were informed about the presence of the sequence and were shown this sequence, while children in the implicit group were not made aware of the sequence. Additionally, children's verbal and visuospatial working memory capacity was assessed. Results of day 1 regarding movement speed revealed no evidence of sequence learning for either group, but movement accuracy results suggested that sequence learning occurred for the implicit group. For both groups, only improvements in movement accuracy were consolidated on day 2, indicating both general and sequence specific learning. Working memory capacity did not correlate with learning in either of the groups. Children in the explicit group accumulated more sequence knowledge compared to children in the implicit group, but this knowledge did not translate to more or better sequence learning. The minimal differences found between the implicit and explicit condition and the absence of a role for working memory capacity add to the increasing evidence that the observed differences between implicit and explicit sequence learning in adults may be less distinct in children. [ABSTRACT FROM AUTHOR]

A correction to the article "Anticipatory action planning increases from 3 to 10 years of age in typically developing children”" that was published in the 114 (2013) issue is presented.