DCDDevelopmental No group difference in visuomotor performance was present for the structured condition. In the non-structured condition, children born very preterm with and without a research diagnosis of DCD had poorer visuomotor performance than those born at term.
INTERPRETATIONThe predictability of the required motor response plays a crucial role in visuomotor deficits in very preterm children, regardless of DCD status.Children born very preterm (<32wks' gestation) are vulnerable to poor visuomotor development throughout childhood and adolescence. 1 This plays a key role in their exploration of the world, academic performance, sporting abilities, involvement in social activities, and self-efficacy. 2,3 In recent literature, visuomotor performance of very preterm children has been commonly described with the widely used Beery-Buktenica Developmental Test of Visual-Motor Integration, 4 indicating widespread visuomotor integration deficits closely interrelated with poor motor performance.5 Although these outcomes clearly illustrate the negative impact of very preterm birth on visuomotor skills and related motor performance, there is a lack of understanding of the underlying mechanisms of visuomotor problems in very preterm children, which hampers opportunities for efficient treatment.Several studies have described the crucial role of internal models of motor planning and continuous motor control in visuomotor performance of typically developing children.6,7 During a visuomotor task, the nervous system has to predict the future location of a moving limb, thereby integrating efferent and afferent signals, eventually altering responses to any changes in the environment during the course of movement. By having internal models or representations of intended actions, predicting the outcome of movements can be processed much quicker in the brain than when a person has to rely on relatively slow sensory-feedback information, thereby providing efficiency to the brain's motor system. 8 Recent studies suggest that visuomotor problems in children with developmental coordination disorder (DCD) are related to specific 'internal modelling deficits', 9,10 which limit their ability to generate accurately and use internal models of motor planning and continuous motor control. Interestingly, the incidence of DCD in very preterm children is on average more than six times higher than in term peers.11 However, it is unclear whether deficits in internal models of motor planning and continuous motor control also underpin the widespread visuomotor problems of very preterm children.In this study, we first assessed the severity of motor deficits in a cohort of 58 very preterm children and 64 age-matched comparison children born at term using the Movement Assessment Battery for Children (M-ABC) as a comprehensive measure of motor functioning. 12 Secondly, the underpinnings of visuomotor problems in very preterm children were investigated using a novel visuomotor task, which tested visuomotor performance under a systematic increase in wor...