Qualitative age-related changes in fine motor skill performance among 3- to 6-year-old typically developing children.

This study described intra-task fine motor skill components of the Manual Dexterity tasks (Posting Coins; PC, Threading Beads; TB, Drawing Trail; DT) of the Movement Assessment Battery for Children-2 Test for typically developing children and investigated age- and sex-related differences. Three- to six-year-old Dutch children (n = 182, Mage 4.5 ± 1.1 years, 51.1% boys) were observed with regard to intra-task fine motor skill components, and changes in intra-task components of the Manual Dexterity tasks were analyzed across age using of the Kruskal-Wallis test with post-hoc Mann-Whitney U tests, and differences between sexes using the Mann-Whitney U test. The following intra-task components were observed: grip type, manipulation, non-dominant or non-writing hand, grip position, posture, head, coin placement, placement of the bead on the lace tip and joint movement. Results showed that the younger children (3-year-olds) more frequently used a grasp with the full hand (PC, TB), more often put the coin on the container and sliding it in (PC), more often supported the side or top of the container (PC), used more bi-manual manipulation (transferring from hand-to-hand or hand, body or surface assist) (TB, DT), more frequently used primitive, too high grips, predominantly used their proximal joints, and did not support the paper (DT). This in comparison with more frequent use of three-point pinch, direct coin placement, grabbing the front or back of the container, in-hand-manipulation, mature grips and correct height, distal joint use and supporting the paper from the side or below by most 5- and 6-year-olds. Furthermore, most sex-related differences were found in the younger age-groups (3- and 4-year-olds) in the DT tasks with girls outperforming boys. Results from this study add to the knowledge on qualitative fine motor skill performance in a convenience sample of 3- to 6-year-old typically developing children. A limitation of the current study was the relatively small sample size of 6-year-old children. The strength of the current study is its novelty in providing qualitative descriptions of intra-task fine motor skill components in typically developing 3- to 6-year-old children.

The relationship between motor performance and executive functioning in early childhood: A systematic review on motor demands embedded within executive function tasks.

This systematic review examined to what extent response demands of executive functioning (EF) tasks influence the relationship between motor performance and EF in 2- to 6-year-old typically developing (TD) children and children with motor coordination difficulties (MCD). Eighteen of the included articles focused on TD children only and three also on children with MCD. EF tasks were subdivided based on the type of responses (i.e., motor or verbal). EF tasks requiring a motor response were subdivided into two levels (i.e., complex or simple). Results showed that the relationship between motor performance and EF in 2- to 6-year-old TD children and children with MCD was inconclusive with the strength of correlation coefficients for the most part varying from very weak to moderate. The type of EF task response did not influence the relationship between motor performance and EF. The review thus implies that other task demands than the type of EF task response need to be investigated to explain the inconsistent relationship between motor performance and EF, such as the complexity of the motor response of EF tasks, the complexity of the actual motor tasks, and additional processes (e.g., memory, intelligence, language comprehension).

Using Structural Equation Modeling to analyze handwriting of children and youth with Autism Spectrum Disorder.

This study tests a handwriting model for children and youth with Autism Spectrum Disorder (ASD) that displays the relationships between handwriting process and product characteristics, and the predictors of these characteristics. Structural Equation Modelling was used to test the model for children and youth with ASD (n = 50) and typically developing peers (n = 50), ages 10 to 15, for a copying and freestyle handwriting task. Findings suggest a generic handwriting model applying to both groups and both handwriting tasks. Unique effects for children and youth with ASD were identified for: (1) high interdependence of handwriting process characteristics, (2) longer pen stroke in air leading to better legibility, and (3) lower scores for executive functions leading to lower scores for legibility.

Sensory processing in young children with visual impairments: Use and extension of the Sensory Profile.

BACKGROUND: Children with visual impairments (VI) are at risk for sensory processing difficulties. A widely used measure for sensory processing is the Sensory Profile (SP). However, the SP requires adaptation to accommodate for how children with VI experience sensory information. AIMS: (1) To examine sensory processing patterns in young children with VI, (2) to develop VI-specific items to use in conjunction with the SP and to determine internal consistency and construct validity of these newly developed items, and (3) to examine the association between sensory processing and and emotional and behavioral problems. METHODS: Twenty-six VI-specific items were added to the SP. The SP and these items were completed by caregivers of 90 children with VI between 3 and 8 years old. The Child Behavior Checklist (CBCL) was used to assess emotional and behavioral problems. RESULTS: Three- to five-year-old children with VI have significantly more difficulties in three quadrants of the SP as compared to the norm group. Six- to eight-year-old children with VI have more difficulties in all quadrants. A reliable and valid VI-specific set of 15 items was established following psychometric evaluation. Age-related differences were found in the associations between the SP and CBCL. CONCLUSION: Although further validation is recommended, this evaluation of the VI-specific item set suggests it has the potential to be a useful measure for children with VI.

Balancing Text Generative and Text Transcriptive Demands: Written Content and Handwriting Legibility and Speed of Children and Youth with Autism Spectrum Disorder.

The aim of this study was to assess text generation and text transcription of children and youth with Autism Spectrum Disorder (ASD, n = 67) and Typically Developing (TD) peers (n = 67). Participants (80.6% male, ages 9-14) produced a free-style handwriting task analysed for written content and handwriting legibility and speed. Findings showed children and youth with ASD perform significantly poorer than TD peers for written content and handwriting legibility and speed. For children and youth with ASD, poor handwriting legibility predicted poor written content. For TD peers, fast handwriting predicted good written content. Collapsing both groups, ASD group membership negatively predicted written content, after controlling for handwriting legibility and speed. Practical implementations for the educational context are provided.

The Relationship between Social Environmental Factors and Motor Performance in 3- to 12-Year-Old Typically Developing Children: A Systematic Review.

Motor performance during childhood is important for prosperity in life, and the social environment may contain potentially important and modifiable factors associated with motor performance. Therefore, the aim of this systematic review was to identify social environmental factors associated with motor performance in 3- to 12-year-old typically developing children. Four electronic databases were searched, which resulted in 31 included studies. The methodological quality was determined using the Quality of Prognosis Studies in Systematic Reviews tool. Most studies were conducted in 3-6-year-old children. In the home environment, parental beliefs in the importance of physical activity and parental behaviors matching these beliefs were related to better motor performance of children, although these relationships were often sex-dependent. The school and sports environments were investigated much less, but some preliminary evidence was found that being better liked by peers, attending a classroom with a smaller age range, having more interaction with the teacher and classmates, and having a higher educated teacher was related to better motor performance. Further research is required to further unravel the relationship between the social environment and motor skills, with a specific focus on 6-12-year-old children and environments outside of the home environment.

Assessing Motor Performance in Preschool Children: The Zurich Neuromotor Assessment-2 and the Movement Assessment Battery for Children-2.

Comparing motor assessment tools that are available for young children is important in order to select the most appropriate clinical and research tools. Hence, this study compared motor performance assessed with the Zurich Neuromotor Assessment-2 (ZNA-2) to the Movement Assessment Battery for Children-2 (MABC-2). The sample consisted of 169 children, aged 3-5 years (87 boys; 51%). We used Pearson correlations to examine relationships between the ZNA-2 and MABC-2 component and total scores. In addition, Pearson correlations were performed between individual fine motor and balance items of the ZNA-2 and MABC-2. Results were that the total scores of the ZNA-2 and MABC-2 correlated moderately (r = .40, p < .001). Non-significant to moderate correlations were found between components (r = -.00 to .47) and between individual items of fine motor skills (r = .04 to .38) and balance (r = -.12 to .38). Thus, the ZNA-2 and MABC-2 measure partly similar and partly different aspects of motor performance.

The degree of stability in motor performance in preschool children and its association with child-related variables.

Understanding the stability of individual differences in motor performance during the early years of life, despite normative age-related growth in motor performance, has important implications for identification of motor coordination difficulties and subsequently, early remediation. Therefore, the aims of the present study were to examine the degree of rank-order and individual-level stability in motor performance in young children with different levels of motor skill proficiency. Subsequently, we explored the influence of child variables (i.e., age, gender, and behavioural self-regulation) on different aspects of stability. In this longitudinal study, a community sample of 68 participants (49% girls) with a mean age of 3 years and 11 months (SD = 7 months) were assesses in three six-monthly waves. The total standard score of the Movement Assessment Battery for Children-2 (MABC-2) was used as the measure of motor performance. Rank-order stability was examined with zero-order Pearson correlations. Individual-level stability was examined by means of stability in classifications (at risk for motor coordination difficulties versus typically developing). In addition to examining stability in group classification, the Reliable Change Index (RCI) was calculated to examine if the difference in a child's scores over time exceeded (increased or decreased relative to) the expected change. The results showed moderate to high rank-order stability between time points. No significant differences in degree of rank-order stability were found between boys and girls and between 3-year old and 4-year old children. In terms of stability of classification, it was shown that for ~50% of the children with motor coordination difficulties and ~ 90% of typically developing the classification based on the cut-off score on the MABC-2 was stable. Based on the RCI, over 90% showed individual-level stability. The level of behavioural self-regulation at T1 (as measured with the Head-Toes-Knees-Shoulders task) was not significantly related to individual-level stability in motor performance. In conclusion, our findings highlight the importance of a careful choice of stability measures and a reflection on the implications of their results. More research is needed to understand which child and environmental variables impact on stability.

Emerging School Readiness Profiles: Motor Skills Matter for Cognitive- and Non-cognitive First Grade School Outcomes.

A promising approach for studying school readiness involves a person-centered approach, aimed at exploring how functioning in diverse developmental domains conjointly affects children's school outcomes. Currently, however, a systematic understanding lacks of how motor skills, in conjunction with other school readiness skills, affect a child's school outcomes. Additionally, little is known about longitudinal associations of school readiness with non-academic (e.g., socioemotional) school outcomes. Therefore, we examined the school readiness skills of a sample of Dutch children (N = 91) with a mean age of 3 years and 4 months (46% girls). We used a multi-informant test battery to assess children's school readiness in terms of executive functions (EFs), language and emergent literacy, motor skills, and socioemotional behavior. During the spring term of a child's first grade year, we collected academic and non-academic (i.e., EFs, motor skills, socioemotional- and classroom behavior, and creative thinking) school outcomes. A latent profile analysis revealed four distinct profiles. Children in the "Parent Positive" (29%) profile were rated positively by their parents, and performed variably on motor and language/emergent literacy skills tests. The second profile-"Multiple Strengths" (13%)-consisted of children showing strengths in multiple domains, especially with respect to motor skills. Children from the third profile-"Average Performers" (50%)-did not show any distinct strengths or weaknesses, rather displayed school readiness skill levels close to, or just below the sample mean. Finally, the "Parental Concern" (8%) profile was characterized by high levels of parental concerns, while displaying slightly above average performance on specific motor and language skills. Motor skills clearly distinguished between profiles, next to parent-rated EFs and socioemotional behavior, and to a lesser extent emergent literacy skills. School readiness profiles were found to differ in mean scores on first grade academic achievement, parent- and teacher-rated EFs, motor skills, parent-rated socioemotional functioning, and pre-requisite learning skills. The pattern of mean differences was complex, suggesting that profiles could not be ranked from low to high in terms of school outcomes. Longitudinal studies are needed to disentangle the interaction between emerging school readiness of the child and the surrounding context.

The Relationships between Sibling Characteristics and Motor Performance in 3- to 5-Year-Old Typically Developing Children.

Siblings have been hypothesized to positively impact the motor performance of children by acting as examples and by providing a safe environment, but they may also negatively impact motor performance because they could compete for the parent's time and care. Therefore, this study investigates the relationship between several sibling characteristics and motor performance in 3- to 5-year-old children. The sample consisted of 205 3- to 5-year-old children (mean age 50.9 ± 10.0 months, 52.2% boys). The Movement Assessment Battery for Children-2 was used to measure motor performance. The sibling variable was operationalized as the number of siblings present, the age difference between a child and its siblings, and the birth order position of a child. The confounding variables that were taken into account were the age, sex, and behavioral problems of the child and maternal education level. None of the investigated sibling variables were related to the total motor performance of a child after controlling for possible confounding variables. The absence of any associations between the sibling variables and motor performance might be explained by the characteristics of the study sample, the possibility that there is no linear relationship, or the presence of still unknown moderating or mediating factors.

A Narrative Review of Motor Competence in Children and Adolescents: What We Know and What We Need to Find Out.

Lack of physical activity is a global public health problem causing not only morbidity and premature mortality, but it is also a major economic burden worldwide. One of the cornerstones of a physically active lifestyle is Motor Competence (MC). MC is a complex biocultural attribute and therefore, its study requires a multi-sectoral, multi-, inter- and transdisciplinary approach. MC is a growing area of research, especially in children and adolescents due to its positive association with a plethora of health and developmental outcomes. Many questions, however, remain to be answered in this field of research, with regard to: (i) Health and Developmental-related Associations of MC; (ii) Assessment of MC; (iii) Prevalence and Trends of MC; (iv) Correlates and Determinants of MC; (v) MC Interventions, and (vi) Translating MC Research into Practice and Policy. This paper presents a narrative review of the literature, summarizing current knowledge, identifying key research gaps and presenting questions for future investigation on MC in children and adolescents. This is a collaborative effort from the International Motor Competence Network (IMCNetwork) a network of academics and researchers aiming to promote international collaborative research and knowledge translation in the expansive field of MC. The knowledge and deliverables generated by addressing and answering the aforementioned research questions on MC presented in this review have the potential to shape the ways in which researchers and practitioners promote MC and physical activity in children and adolescents across the world.

Task-Specific and Latent Relationships Between Motor Skills and Executive Functions in Preschool Children.

There has been an increasing interest in the relationship between motor skills and executive functions (EFs) in young children over the years. However, no clear picture on the relationship between both domains has emerged from these studies. We have extended previous findings by conducting a comprehensive examination of task-specific and latent relationships between a range of motor skills and EFs in preschool children. The sample consisted of 198 3- to 5-year-old children (102 boys; 51.5%). Motor skills were assessed using the Movement Assessment Battery for Children Second Edition. EFs were assessed with the performance-based tasks 'Day/Night,' 'Hand Tapping,' 'Forward Corsi Block,' 'Forward Digit Recall,' and 'Conflict Task,' and a rating-based EF measure (i.e., the Behavior Rating Inventory of Executive Functioning - Preschool version). Task-specific relationships were examined using zero-order Pearson correlations. Latent factors of motor skills and EFs were examined using confirmatory factor analysis and exploratory structural equation modeling. Structural equation modeling (SEM) was used to examine latent relationships. The results of the Pearson correlation analyses showed statistically significant albeit weak correlations between specific motor and EF items (r = 0.15 to r = 0.23). SEM showed non-significant weak relationships between a general motor factor (as a unitary latent construct) on the one hand, and performance-based EFs and rating-based EFs (as latent EF components) on the other hand. In conclusion, this study suggested only weak relationships between motor skills and EFs in preschool children with no clear differences between their task-specific and latent relationships.

Identifying patterns of motor performance, executive functioning, and verbal ability in preschool children: A latent profile analysis.

BACKGROUND: A relationship between motor performance and cognitive functioning is increasingly being recognized. Yet, little is known about the precise nature of the relationship between both domains, especially in early childhood. AIMS: To identify distinct constellations of motor performance, executive functioning (EF), and verbal ability in preschool aged children; and to explore how individual and contextual variables are related to profile membership. METHODS AND PROCEDURES: The sample consisted of 119 3- to 4-year old children (62 boys; 52%). The home based assessments consisted of a standardized motor test (Movement Assessment Battery for Children - 2), five performance-based EF tasks measuring inhibition and working memory, and the Receptive Vocabulary subtest from the Wechsler Preschool and Primary Scale of Intelligence Third Edition. Parents filled out the Behavior Rating Inventory of Executive Function - Preschool version. Latent profile analysis (LPA) was used to delineate profiles of motor performance, EF, and verbal ability. Chi-square statistics and multinomial logistic regression analysis were used to examine whether profile membership was predicted by age, gender, risk of motor coordination difficulties, ADHD symptomatology, language problems, and socioeconomic status (SES). OUTCOMES AND RESULTS: LPA yielded three profiles with qualitatively distinct response patterns of motor performance, EF, and verbal ability. Quantitatively, the profiles showed most pronounced differences with regard to parent ratings and performance-based tests of EF, as well as verbal ability. Risk of motor coordination difficulties and ADHD symptomatology were associated with profile membership, whereas age, gender, language problems, and SES were not. CONCLUSIONS AND IMPLICATIONS: Our results indicate that there are distinct subpopulations of children who show differential relations with regard to motor performance, EF, and verbal ability. The fact that we found both quantitative as well as qualitative differences between the three patterns of profiles underscores the need for a person-centered approach with a focus on patterns of individual characteristics.

Age-related validity and reliability of the Dutch Little Developmental Coordination Disorder Questionnaire (LDCDQ-NL).

BACKGROUND: Early recognition of children at risk of Developmental Coordination Disorder (DCD) is important, but variability in motor development in preschool children affects the validity of instruments to reliably detect children at risk of DCD. AIMS: To investigate the age-related validity and reliability of the Dutch version of the Little Developmental Coordination Disorder Questionnaire (LDCDQ-NL). METHODS AND PROCEDURES: Two hundred and sixty 3- to 5-year old children were recruited in the Netherlands. Parents filled out the LDCDQ-NL and children were assessed with the Movement Assessment Battery for Children-2 Test (MABC-2 Test). Internal consistency of the LDCDQ-NL was determined by Cronbach's alpha. Construct validity was investigated using factor analysis. Concurrent validity was measured by calculating correlations between the LDCDQ-NL and MABC-2. Receiver Operating Characteristics (ROC) were calculated to assess discriminant validity. OUTCOMES AND RESULTS: Internal consistency of the LDCDQ-NL was 0.91. Factor analysis resulted in three factors (Fine motor skills, Locomotor skills, Ball skills). Correlation between the LDCDQ-NL and MABC-2 Test increased with increasing age. With a sensitivity of 80%, specificity increased with age. CONCLUSIONS AND IMPLICATIONS: The LDCDQ-NL is a reliable and valid screening instrument for 4- and 5-year old Dutch children; concurrent and discriminant validity are low for 3-year olds.

Skill-related physical fitness versus aerobic fitness as a predictor of executive functioning in children with intellectual disabilities or borderline intellectual functioning.

Children with intellectual disabilities (ID) or borderline intellectual disabilities (BIF) often demonstrate impairments in executive functioning (EF). Studies in typically developing children show that aerobic fitness (AF) is positively related with EF. Skill-related physical fitness (SF) might, however, be a stronger predictor of EF than AF, as cognitive challenges are inherent in application of these skills. In this study, AF and SF were examined simultaneously in relationship with domains of EF in children with ID or BIF. Seventy-three children (age range 8-11; 51 boys) with ID (IQ range 56-79) or BIF (IQ range 71-79) were measured annually over a period of 4 years on AF (20-m endurance shuttle run test) and SF (plate tapping and 10×5m run). EF was measured with the Stroop Color-Word test (inhibition), Trailmaking and Fluency test (cognitive flexibility), Self-ordered pointing task (working memory) and the Tower of London (planning). Multilevel models showed that SF was significantly associated with inhibition and both measures of cognitive flexibility, but in the same models no significant associations between AF and EF were found. In addition, age was significantly related to working memory and cognitive flexibility, favouring the older children. In children with ID or BIF, SF is of greater importance than AF in relationship with core domains of EF.

The relationship between motor performance and parent-rated executive functioning in 3- to 5-year-old children: What is the role of confounding variables?

It is generally agreed that motor performance and executive functioning (EF) are intertwined. As the literature on this issue concerning preschool children is scarce, we examined the relationship between motor performance and parent-rated EF in a sample of 3- to 5-year-old children with different levels of motor skill proficiency, while controlling for age, gender, socio-economic status (SES), and attention-deficit-hyperactivity disorder (ADHD) symptomatology. EF was reported by parents of 153 children (mean age 4years 1months, SD 8months; 75 male) by means of the Behaviour Rating Inventory of Executive Function-Preschool version (BRIEF-P). Parent-reported ADHD symptoms were assessed using the Hyperactivity-Inattention subscale of the Strengths and Difficulties Questionnaire3-4. In addition, the children performed the Movement Assessment Battery for Children-2 (MABC-2). Several weak to moderate relationships were found between the MABC-2 Total Score and the EF subscales. Once other variables such as age, gender, SES, and ADHD symptomatology were taken into account, the only BRIEF-P subscale that was associated with the MABC-2 Total Score was the Working Memory subscale. Compared to their typically developing peers, children who are at risk for motor coordination difficulties (⩽the 16th percentile on the MABC-2) performed poorly on the Working Memory subscale, which confirms the results of the regression analyses. The at risk group also performed significantly worse on the Planning/Organize subscale, however. This is one of the first studies investigating the relationship between motor performance and parent-rated EF in such a young age group. It shows that the relationship between motor performance and EF in young children is complex and may be influenced by the presence of confounding variables such as ADHD symptomatology.

The interrelationships between motor, cognitive, and language development in children with and without intellectual and developmental disabilities.

It is generally agreed that cognitive and language development are dependent on the emergence of motor skills. As the literature on this issue concerning children with developmental disabilities is scarce, we examined the interrelationships between motor, cognitive, and language development in children with intellectual and developmental disabilities (IDD) and compared them to those in children without IDD. In addition, we investigated whether these relationships differ between children with different levels of cognitive delay. Seventy-seven children with IDD (calendar age between 1;0 and 9;10 years; mean developmental age: 1;8 years) and 130 typically developing children (calendar age between 0;3 and 3;6 years; mean developmental age: 1;10 years) were tested with the Dutch Bayley Scales of Infant and Toddler Development, Third Edition, which assesses development across three domains using five subscales: fine motor development, gross motor development (motor), cognition (cognitive), receptive communication, and expressive communication (language). Results showed that correlations between the motor, cognitive, and language domains were strong, namely .61 to .94 in children with IDD and weak to strong, namely .24 to .56 in children without IDD. Furthermore, the correlations showed a tendency to increase with the severity of IDD. It can be concluded that both fine and gross motor development are more strongly associated with cognition, and consequently language, in children with IDD than in children without IDD. The findings of this study emphasize the importance of early interventions that boost both motor and cognitive development, and suggest that such interventions will also enhance language development.

A systematic review of the effects of motor interventions to improve motor, cognitive, and/or social functioning in people with severe or profound intellectual disabilities.

While it is generally agreed that motor activity promotes motor, cognitive, and social development, the specific benefits in people with severe or profound intellectual disabilities (S-PID) are as yet unknown. The aim of this study was to systematically review the evidence related to motor interventions designed to improve motor, cognitive, and/or social outcomes in people with S-PID. A systematic review of empirical studies published between 1982 and 2012 was conducted using four databases (MEDLINE, PsycINFO, ERIC, and CINAHL). Data were extracted regarding the aim of the study, study design, sample characteristics, theoretical framework, intervention, the measurement tools utilized, and outcomes. Of 295 articles reviewed, 46 met our inclusion criteria and covered 45 different studies. Forty articles used single-subject designs and five used a group design. The majority of the articles focused on behavioural techniques with (n=21) or without (n=15) assistive technology. Theoretical frameworks were explicitly reported in nine (20%) of the 45 articles. Thirty-eight articles reported improvement in basic motor skills and eight articles reported improvement in recreational or more specialist motor skills. None of the articles reported negative effects due to motor interventions. Further research is required to determine which motor interventions are the most effective in improving motor outcomes and/or cognitive and social outcomes, and on the longer term effects of these interventions in people with S-PID.