Centre for Educational Neuroscience Online Seminar: “Why do children with DCD trip and fall more than others? Looking around for answers”

The Centre for Educational Neuroscience host a weekly online seminar http://www.educationalneuroscience.org.uk/events/seminars/.  On 3rd December 2020, Prof Mark Hollands (Liverpool John Moore’s University) spoke about understanding developmental coordination disorder. The virtual seminar was attended by our lab members, and the blog below by Afreen Shakur outlines some highlights of the talk.

The speaker began by outlining the importance of motor control in child development, explaining that “how the world works is a function of how we interact with it”. They explained that motor control development is therefore fundamental to perceiving and understanding the properties of our environments. The ability to interact physically and socially is guided by perception and cognition. Since interaction, perception and cognition all employ the same learning processes, cognitive functions rely on movement to occur.

Developmental Coordination Disorder (DCD or dyspraxia) is characterized by below expected motor coordination and the prevalence rate in the population is 5-6%. The speaker outlined how individuals with DCD often behave in a clumsy way, have poor balance and are prone to trips and falls. Additionally, individuals with DCD often have other co-morbidities including ADHD, Dyslexia, and autism. Thus, DCD is often not an independent condition and can be difficult for a clinician to diagnose. Furthermore, Prof. Holland described a high prevalence of anxiety and other mental health problems in DCD individuals. A Dyspraxia Foundation UK survey (2014) found that 40% of the adolescents with DCD felt anxious “all the time”.

In this talk, Prof Hollands presented some of his recent research on DCD. In one study, he investigated whether children with DCD showed altered visuomotor control during walking and, whether stepping problems are linked to anxiety/fear of falling. The study included 20 preadolescents (8-15 years) in each of two groups; typically developing children and children with DCD. Prof Hollands used a motion analysis system to produce 3D pictures of body movement and to quantify the stepping accuracy of the participants. In addition, he used an eye tracker to observe when and where participants looked (relative to a target that they were walking towards). The results indicated, surprisingly, that the DCD group had quite good overall performance, but with a large spread of values in individual performance. There were no differences in eye movement behaviour and levels of anxiety (measured using a fear thermometer) between the DCD and TD groups.

Extending on these findings, Prof Hollands conducted another study which investigated stair negotiation in children with DCD. He used a similar pool of participants as before to compare biomechanical stair walking, anxiety, gaze behaviour and parent’s confidence in their child’s ability. The main differences reported in the results were during stair descent trials (going downstairs). Children with DCD had a slower walking speed compared to typically developing children. Additionally, the DCD group had an elevated heel clearance, which Prof Hollands explains increases the chances of catching your heel at the edge of the stairs and falling. The two groups also showed differences in eye gaze behaviour, the DCD group looked more at the bottom of the stairs that was further ahead, than the TD group. A similar trend is seen in terms of anxiety, children with DCD reported higher anxiety compared to the TD children. Finally, a significant correlation was found in the extent to which individuals looked ahead as they walk (downstairs) and self-reported anxiety.

To conclude, Prof Holland outlined differences in visuomotor control in children with DCD. His results showed a difference in visually guided stepping behaviour both during stepping accuracy and stair negotiation between participants with DCD and typically developing children. Prof Hollands emphasised the need for further research in vision, and how we utilize it. Clinical implications of this include working out an optimal strategy to promote safety for children with DCD and providing solutions for the struggles (and associated anxieties) individuals with DCD face while performing daily activities.

Written by Afreen Shakur