The crucial role of the predictability of motor response in visuomotor deficits in very preterm children at school age

Abstract

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...

Kinematic measurement of 12-week head control correlates with 12-month neurodevelopment in preterm infants

“…An infant’s inability to align the head with the body during the pull-to-sit maneuver or stabilize the head in prone could suggest low or high muscle tone, an imbalance between neck flexors and extensors, poor postural stability, or abnormal sensory processing such as abnormal feedback from the vestibular-ocular righting system [11,12]. Recent studies have also noted the significant impact of poor coupling between early motor patterns and vision in preterm infants and later delays in school related motor responses and visuomotor tasks [27,28]. Furthermore, Karch et al [29] found that stereotypy scores of upper limb movements in 3-month-old infants identified cerebral palsy cases with 90% sensitivity and 96% specificity at 2 years of age.…”

National population‐based cohort study found that visual‐motor integration was commonly affected in extremely preterm born children at six‐and‐a‐half years

“…As a larger proportion of children born EPT had mothers born in non-Nordic countries (p < 0.01) and who had lower educational levels (p < 0.01), the analyses were run again adjusting for these factors. The results remained similar, with a mean (standard error) of 88 (AE1) and 99 (AE1) VMI score (p < 0.001), a mean difference of 11 points (95% CI [8][9][10][11][12][13][14] and an effect size of g 2 = 0.06. Mild VMI impairment was detected in 142 of 355 (40%) children born EPT and in 45 of 364 (12%) control children born at term, with an odds ratio of 0.21 (95% CI 0.15-0.31, p < 0.001).…”

“…All of these domains are known to pose difficulties for children born EPT. Several studies have reported lower VMI in preterm‐born children , but few studies have evaluated VMI at school‐age in large cohorts of exclusively EPT children born in the 2000s.…”

Neurofeedback ineffective in paediatric brain tumour survivors: Results of a double-blind randomised placebo-controlled trial

“…Outcome measures 2.6.1. Primary outcomes Well-validated, mostly computerised, (adaptations of) widely used tests were selected to provide a comprehensive assessment of neurocognitive functioning, according to recent recommendations [15]: attention [16], processing speed [16], memory [17e19], executive functioning (EF) [20], visuomotor integration (VMI) [21], and intellectual functioning (Table 1) [17,18]. For a detailed description of the tests, see Appendix.…”