Date of Degree
Physical Therapy | Psychology
Attention; Developmental Coordination Disorder; Dual Task Paradigm; Gait
The aim of this research was to evaluate how increased levels of challenge to attentional capacity would affect the motor planning and coordination in the gait of children at risk of Developmental Coordination Disorder (DCD) across developmental ages. The study incorporated a dual task paradigm requiring both motor and attention performance, with the primary hypothesis that children who are at risk of DCD across different ages (3- to 8 yrs.-of-age) would demonstrate an alteration in their motor strategies if they were simultaneously engaging in an attention task. A secondary hypothesis of this study was that there is an underlying deficit in the attention regulation systems in children with DCD that manifests itself in diminished motor performance. It was postulated that these children would have behaved differentially when tested for other behaviors requiring attention regulation in their neonatal and toddler stages. Children (n=27) ages 3-8-years-old who were part of a longitudinal study at the NYS Institute for Basic Research in Developmental Disabilities were recruited for this study. Selective, age appropriate standardized questionnaires related to motor performance, participation, and behavior, were completed by the children's parents. Clinical and non-clinical groups were determined by performance on the Movement Assessment Battery for Children - Second Edition (score <= 16th %). Each child participated in experimental motor tasks with increasing attentional complexity, using a) a computer-based attention task (CAT), requiring response by voice or button press, and b) an assessment of each child’s gait in a fully instrumented gait lab requiring the participant to simply walk, or respond to an image projected at the end of a walkway, with or without the need to move around a barrier (increasing demands of Dual Task). Correlation analyses were performed between the categorical risk variable (risk/no risk) and select variables related to the participants’ qualitative performance during the barrier task, and archival data associated with these participants, including neonatal physiological measures of brain insult and neonatal, infant and toddler behavioral measures of attention, neurobehavioral organization and cognition. Single Task: CAT. Across task types, faster reaction times were observed for the older children, with the clinical group demonstrating faster reaction times for the voice response task and slower reaction times for the button press response task. Single Task: Walking. There were no differences between age or clinical groups for variables related to balance strategies. Dual Task: Walking. Across tasks, faster reaction times were observed across all older children, with a developmental trend of improved reaction time over age for the no-risk group only. Developmental trends were identified related to use of perceptual information and implementation of balance strategies during the varied task types. Across task types, differential compensatory strategies in balance and smoothness of movement were seen between the risk and no-risk groups, with the risk group demonstrating a greater reliance on perceptual information to initiate response to stimulus, as well as implementation of more exaggerated trunkal deviation, jerk, and effort during the barrier task. Exploratory Study: Archival Data. Although no relationship was found between physiological measures of brain insult and categorical risk or experimental variables, the children in the risk group demonstrated trends of performance on early behavioral measures similar to children who have sustained brain insult during the neonatal period. The findings indicate that there were no group differences during the well - practiced motor behavior of walking. However, noticeable differences emerged with the increasing demands of a dual task paradigm for children at risk for DCD. These children have decreased attentional capacity as compared to the children in the non-risk group, and this impacts their postural strategies during dual tasks. Additionally, early behavioral measures of attention, neurobehavioral organization and cognition may potentially serve as indicators of risk of DCD at early ages. Currently, DCD is diagnosed at 6-8-years-of-age, and is assessed using standardized measures in a decontextualized environment. Furthermore, typical care intervention involves a single task oriented approach. Considering that the goal individuals for participation in rich contexts, it is suggested that new models of evaluation and intervention be considered at earlier age of evaluation and intervention is to better prepare individuals for participation in rich contexts, it is suggested that new models of evaluation and intervention be considered at earlier ages.
Bensinger-Brody, Yocheved, "Developmental Coordination Disorder: The Relationship Between Gait And Attention With Possible Implications For Early Identification And Intervention" (2015). CUNY Academic Works.