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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.

BackgroundPhysicians are not always comfortable deferring treatment of a stenosis in the left anterior descending (LAD) artery because of the perception that there is a high risk of major adverse cardiac events (MACE). The authors describe, using the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) trial, MACE rates when LAD lesions are deferred, guided by physiological assessment using fractional flow reserve (FFR) or the instantaneous wave-free ratio (iFR).ObjectivesThe purpose of this study was to establish the safety of deferring treatment in the LAD using FFR or iFR within the DEFINE-FLAIR trial.MethodsMACE rates at 1 year were compared between groups (iFR and FFR) in patients whose physiological assessment led to LAD lesions being deferred. MACE was defined as a composite of cardiovascular death, myocardial infarction (MI), and unplanned revascularization at 1 year. Patients, and staff performing follow-up, were blinded to whether the decision was made with FFR or iFR. Outcomes were adjusted for age and sex.ResultsA total of 872 patients had lesions deferred in the LAD (421 guided by FFR, 451 guided by iFR). The event rate with iFR was significantly lower than with FFR (2.44% vs. 5.26%; adjusted HR: 0.46; 95% confidence interval [CI]: 0.22 to 0.95; p = 0.04). This was driven by significantly lower unplanned revascularization with iFR and numerically lower MI (unplanned revascularization: 2.22% iFR vs. 4.99% FFR; adjusted HR: 0.44; 95% CI: 0.21 to 0.93; p = 0.03; MI: 0.44% iFR vs. 2.14% FFR; adjusted HR: 0.23; 95% CI: 0.05 to 1.07; p = 0.06).ConclusionsiFR-guided deferral appears to be safe for patients with LAD lesions. Patients in whom iFR-guided deferral was performed had statistically significantly lower event rates than those with FFR-guided deferral.

Background: The self-concept of children has an impact on later behavioural development and psychopathology; therefore, evidence of the accurate measurement of self-concept is important. Harter and Pike's (1984, "Child Development," 55, 1969) commonly used measure of self-concept, the Pictorial Scale of Perceived Competence and Social Acceptance for Children, has demonstrated varying evidence of its construct validity and reliability, particularly with preschool- or kindergarten-aged participants. Aim: To examine the measurement properties of the Acceptance and Competence measures, and to substantiate the measures' adequacy within the latter participant age range. Sample: One hundred and ninety-seven preschool or kindergarten-aged children (M = 5.40 years, SD = 0.30) provided data as part of the "Animal Fun" study over three measurement periods. Methods: The study conducted a pair of Rasch analyses on the Acceptance and Competence measures described prior, with adherence to the assumptions of univariate measurement, item fit, item invariance, and response category adequacy examined as part of these analyses. Results: While the Acceptance measure demonstrated adequate reliability outside of some potentially misfitting items, the study identified several limitations for the Competence measure, including potential gender-based and verbal IQ-based response biases. Conclusions: Practitioners and research applications of these subscales may benefit from the response recoding recommendations provided in this study for the Acceptance measure, as they improved the measure's properties. The study provides potential solutions to item adequacy concerns, and avenues for future research, involving these measures.

Background: The elaborated environmental stress hypothesis (EESH) provides a framework that describes how motor skills may indirectly cause internalizing problems through various mediating psychosocial factors. While there is evidence to support this framework, little is known about how the proposed relationships may vary across different stages of development. Aims: This study aimed to investigate whether peer problems and perceived self-competence mediated the relationship between motor skills and internalizing problems in pre-primary children, and at 18-month follow up. Sample: A community sample of 197 pre-primary school children (M = 5.40 years, SD = 0.30 years; 102 males, 95 females) participated at Time 1, with 107 completing the Time 2 follow-up. Methods: Standardized instruments were used to measure motor skills and verbal IQ. Perceived self-competence was measured using a self-report measure. Participant peer problems and internalizing problems were measured using teacher report. Age, gender, and verbal IQ were included as covariates. Results: Mediation analysis using PROCESS showed that the relationship between motor skills and internalizing problems was mediated by peer problems at Time 1. At Time 2, the relationship was mediated by peer problems and perceived physical competence. Conclusions: The current results indicate the EESH may function differently across different periods of development. The transition from pre-primary to Grade 1 represents a time of important cognitive and psychosocial development, which has implications for how the relationship between motor skills and internalizing problems can be understood. These findings highlight potential age-appropriate targets for psychomotor interventions aiming to improve the emotional well-being of young children.

Poor motor skills have been associated with a range of interpersonal and intrapersonal difficulties, including poor self-competence, peer problems, and internalizing problems such as anxiety and depression. The Elaborated Environmental Stress Hypothesis provides a theoretical framework for understating these relationships. Studies have recently begun to evaluate this framework; however, ongoing empirical investigation is required. Currently, the extent to which these relationships may differ across factors such as gender remains unclear. The current study tests an indirect effect of motor skills on internalizing problems via peer problems and perceived self-competence in a community sample of 164 children (81 males; 83 females) aged 7 to 12 years. A combination of clinician-administered, self-report, and parent-rated measures were used. Regression analysis using PROCESS indicated that the relationship between motor skills and internalizing problems was not moderated by gender. Motor skills did have an indirect effect on internalizing problems via perceived scholastic competence and peer problems. Results provide partial support for part of the Elaborated Environmental Stress Hypothesis; perceived scholastic competence and peer problems are mechanisms through which motor skills are related to internalizing problems in school-aged children. This study highlights potentially important targets for psychomotor interventions for this age group.

A mixed methods design was applied to evaluate the application of the Perceived Locus of Causality scale (PLOC) to preadolescent samples in physical education settings. Subsequent to minor item adaptations to accommodate the assessment of younger samples, qualitative pilot tests were performed (N = 15). Children's reports indicated the need for further revisions to the items, resulting in the Children's PLOC (C-PLOC). In a second study involving a larger sample of 9-12 year old children (N = 429), the questionnaire was evaluated using quantitative methods. The five factor structure hypothesized based on self-determination theory was confirmed. Discriminant validity and reliability of the subscales was largely supported, but require confirmation in future research. Age was not found to be significantly related to children's motivational styles. Taken together, initial results provide support for the suitability of the C-PLOC for the assessment of motivation in 9-12 year old children in physical education.

Aim: Research suggests important links between motor coordination and executive functions. The current study examined whether motor coordination predicts working memory, inhibition, and switching performance, extending previous research by accounting for attention-deficit-hyperactivity disorder (ADHD) symptomatology and other confounding factors, in an adolescent normative sample. Method: Ninety-three adolescents (38 females, 55 males) aged 12 to 16 years (mean age 4y 2mo, SD 1y 1mo) were assessed on the Movement Assessment Battery for Children-2 (MABC-2), Wechsler Intelligence Scale for Children-IV, N-back task, the inhibition subtest from the NEPSY-II: A Developmental Neuropsychological Assessment, second edition, and the parent-rated Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour Questionnaire. Results: The MABC-2 total score accounted for a significant proportion of the variance in visuospatial working memory (p=0.041) but not for verbal working memory. The MABC-2 aiming and catching component, however, was found to account for unique variance in both verbal (p=0.019) and visuospatial working memory (p=0.016). The MABC-2 total score was found to account for a significant proportion of the variance in inhibition total completion time (p=0.017). Finally, balance skills accounted for unique variance in a NEPSY-II inhibition total errors variable (p=0.020). Interpretation: The results provide support for an overlap between motor coordination and executive functions, which has important practical implications. The study also suggests shared mechanisms underpinning the relationship between these areas, including possible cerebellar involvement. (Contains 4 tables.)

The parent-rated Developmental Coordination Disorder Questionnaire (DCDQ) has been revised to incorporate a wider age range, including adolescence. In this exploratory study, internal consistency and validity of the DCDQ-2007 was assessed using a community-based sample of 87 adolescents. Psychometric properties of the DCDQ-2007 were investigated and concurrent validity, sensitivity, and specificity were assessed with the MABC-2 as a criterion standard. The results demonstrated high internal consistency for the DCDQ-2007 and a relationship with the MABC-2 was found. The DCDQ-2007 met the recommended standard for sensitivity, although the confidence interval was large; however, it failed to meet the recommended standard for specificity. This has important implications concerning the suitability of the DCDQ-2007. Although promising psychometric properties were found within the current study, the applicability of the DCDQ-2007 as a screening measure for motor difficulties requires careful consideration. (Contains 6 tables.)

We tested whether developmental coordination disorder (DCD) and mixed receptive expressive language disorder (RELD) are valid diagnoses by assessing whether they are separated from each other, from other childhood disorders, and from normality by natural boundaries termed zones of rarity. Standardized measures of intelligence, language, motor skills, social cognition, and executive functioning were administered to children with DCD (n = 22), RELD (n = 30), autistic disorder (n = 30), mental retardation (n = 24), attention deficit/hyperactivity disorder (n = 53) and to a representative sample of children (n = 449). Discriminant function scores were used to test whether there were zones of rarity between the DCD, RELD, and other groups. DCD and RELD were reliably distinguishable only from the mental retardation group. Cluster and latent class analyses both resulted in only two clusters or classes being identified, one consisting mainly of typical children and the other of children with a disorder. Fifty percent of children in the DCD group and 20% in the RELD group were clustered with typical children. There was no evidence of zones of rarity between disorders. Rather, with the exception of mental retardation, the results imply there are no natural boundaries between disorders or between disorders and normality. (Contains 1 figure and 4 tables.)

This study explored the cognitive performance of children with Attention Deficit/Hyperactivity Disorder (ADHD) and/or Developmental Coordination Disorder (DCD) using the Wechsler Intelligence Scale for Children-IV. Participants were 62 children with ages between 9 years 8 months and 12 years 7 months. These children were placed into one of the four groups: "Comparison" (n = 26), "ADHD" (n = 14), "DCD" (n = 11), and "ADHD + DCD" (n = 11) groups. The ADHD symptoms were assessed using the Australian Disruptive Behaviours Scale, and motor ability was assessed using the McCarron Assessment of Neuromuscular Development (MAND). Significantly poorer perceptual reasoning ability was seen in "DCD" and "ADHD + DCD" groups but not in the "ADHD" group. The findings provide evidence that a deficit in visuo-spatial ability may underlie DCD but not ADHD. These findings revealed different cognitive profiles for ADHD and/or DCD, thus the current study does not lend support to the common aetiology hypothesis in understanding the basis of ADHD and DCD comorbidity. (Contains 2 tables.)

The aim of this study was to investigate the relationship between poor motor ability and anxious and depressive symptomatology in child and adolescent monozygotic twins. The co-twin control design was used to explore these mental health issues in MZ twins concordant and discordant for a motor disorder, and controls. This methodology offers the unique opportunity to control for genetic effects and shared environmental influences, and permits the investigation of non-shared environmental influences. The Developmental Coordination Disorder Questionnaire was used to identify 23 sets of twins discordant for a motor disorder, 23 sets concordant for a motor disorder, and 773 sets of twins with no motor disorder from a total sample of 2122 Australian sets of twins. The Strengths and Weaknesses of ADHD Symptoms and Normal Behaviour questionnaire was used to exclude participants with high Attention Deficit Hyperactivity Disorder symptomatology. Anxious and depressive symptomatology were assessed using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) based questionnaires on Generalised Anxiety Disorder and Sad Affect. Results indicated significantly higher levels of anxious and depressive symptomatology in twins with a motor disorder in discordant pairs compared to their co-twins without a motor disorder, and controls. There were significantly higher levels of anxious symptomatology in twins with a motor disorder in discordant sets than in sets of twins concordant for a motor disorder. There were significantly higher levels of anxious symptomatology in concordant twins than in controls. Implications of these findings are discussed with emphasis on understanding and recognising the relationship between a motor disorder and anxious and depressive symptomatology in clinical practice for children and adolescents with these disorders. (Contains 4 tables.)

Aim: It has been suggested that one approach to identifying motor impairment in children is to use the Child Behavior Checklist (CBCL) as a screening tool. The current study examined the validity of the CBCL in identifying motor impairment. Method: A total of 398 children, 206 females and 192 males, aged from 3 years 9 months to 14 years 10 months were assessed on the McCarron Assessment of Neuromuscular Development to determine their motor ability. Parents completed the CBCL. Results: The "Clumsy" item on the CBCL was found to predict motor ability independent of the child's age, sex, and scores on other items of the CBCL. However, the sensitivity of the "Clumsy" item in terms of identifying motor impairment was found to be a low 16.7% compared with specificity of 93.2%. The item "Not liked" was also found to be a significant predictor of motor impairment. Interpretation: Although the "Clumsy" and "Not liked" items were found to have a relationship with motor ability, they should not be relied upon to categorize children as motor impaired versus not impaired. It is possible that these items may be better indicators of motor impairment in children with developmental disorders such as attention-deficit-hyperactivity disorder, but clinical samples are needed to address this.

Background & Aims: We tested the Diagnostic and Statistical Manual of Mental Disorders (DSM) hypothesis that so-called specific developmental disorders are marked by a pattern of specific discrepant achievement, and an alternative hypothesis that children with these disorders show a pattern of relatively pervasive low achievement. Methods & Procedures: Children with a diagnosis of Mixed Receptive Expressive Language Disorder (RELD; n = 21) were compared with children with no previously suspected disorder but low standard language scores (less than 80; n = 22) selected from a representative sample, and children with Developmental Coordination Disorder (DCD; n = 20) were compared with children with no previously suspected disorder but low standard motor skills scores (n = 28) selected from a representative sample. Outcomes & Results: Children with diagnosed disorders were more pervasive underachievers. The RELD group obtained lower scores on measures of verbal comprehension, emotion understanding, theory of mind, working memory and response inhibition; the DCD group obtained lower scores on measures of perceptual organization, verbal comprehension, receptive and expressive language, and visual inspection time. Conclusions & Implications: We conclude that relatively pervasive underachievement distinguishes disordered from normal low achievers. (Contains 1 table.)

The concurrent validity of the Developmental Coordination Disorder Questionnaire (DCDQ) and the McCarron Assessment of Neuromuscular Development (MAND) was investigated in an Australian sample of 38 girls and 91 boys aged 9-12 years (M = 11.15, SD = 0.81). The MAND identified 44 children with motor impairment (MI) and 85 children without MI. The overall decision agreement between the two measures in identifying MI was 0.64. The DCDQ had a sensitivity of 0.55 and a specificity of 0.74. The DCDQ was accurate in identifying children with moderate or severe MI but identified less than half of the children with mild MI. (Contains 4 tables.)

School-age children with movement problems such as Developmental Coordination Disorder (DCD) are known to have social and emotional difficulties. However, little research has investigated younger children to determine whether these problems emerge at school age or are present earlier. The aim of the current study was to investigate the relationship between motor coordination, emotional recognition and internalising behaviours in young preschool children. Forty-one kindergarten children (M = 4 years, 4 months), 22 boys and 19 girls, were assessed on the McCarron Assessment of Neuromuscular Development, the Emotional Recognition Scales, the Wechsler Preschool and Primary Scale of Intelligence, and the Child Behavior Checklist. Motor ability was positively related to a child's emotion comprehension. However, once age, sex, Performance IQ and Verbal IQ were controlled for, it was no longer a significant predictor, which contrasts with previous findings in school-age children. However, the expected correlation between motor ability and anxiety/depression was significant with a moderate effect size. The results indicate that further investigation is required on the relationship between motor ability and social-emotional development in preschool-age children. (Contains 3 tables.)

It has been suggested that the high levels of comorbidity between attention-deficit-hyperactivity disorder (ADHD) and developmental coordination disorder (DCD) may be attributed to a common underlying neurocognitive mechanism. This study assessed whether children with DCD and ADHD share deficits on tasks measuring working memory, set-shifting, and processing speed. A total of 195 children aged between 6 years 6 months and 14 years 1 month (mean 10y 4mo [SD 2y 2mo]) were included in this study. A control group (59 males, 79 females), a DCD group (12 males, six females), an ADHD-predominantly inattentive group (16 males, four females), and an ADHD-combined group (15 males, four females), were tested on three executive functioning tasks. Children with DCD were significantly slower on all tasks, supporting past evidence of a timing deficit in these children. With few exceptions, children with ADHD did not perform more poorly than control children. These findings demonstrate the importance of identifying children with motor deficits when examining tasks involving a timing component.

We propose that stronger than usual correlations between abilities indicate which cognitive processes are impaired in autism. Study 1 compared partial correlations (controlling age) between intelligence and social cognition in children with autism (n = 18), mental retardation (MR; n = 34), or no psychological disorder (n = 37). Correlations were stronger in the autism group. Study 2 compared correlations between measures of perceptual organization and verbal comprehension, receptive and expressive language, fine and gross motor coordination, and theory of mind, emotion recognition, and emotion understanding abilities in children with autism (n = 30) or MR (n = 24) and in a large representative sample of children (n = 449). Results indicate that autism is marked by stronger correlations between all ability domains, and MR is marked by stronger correlations between motor coordination tasks and other ability measures.