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      A randomized controlled trial of a group-based gaze training intervention for children with Developmental Coordination Disorder

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          Abstract

          The aim of this study was to integrate a gaze training intervention (i.e., quiet eye training; QET) that has been shown to improve the throwing and catching skill of children with Developmental Coordination Disorder (DCD), within an approach (i.e., group therapy) that might alleviate the negative psychosocial impact of these motor skill deficits. Twenty-one children with DCD were split into either QET (8 male 3 female, mean age of 8.6 years ( SD = 1.04) or technical training (TT) groups (7 male 3 female, mean age of 8.6 years ( SD = 1.84). The TT group were given movement-related instructions via video, relating to the throw and catch phases, while the QET group were also taught to fixate a target location on the wall prior to the throw (QE1) and to track the ball prior to the catch (QE2). Each group partook in a 4-week, group therapy intervention and measurements of QE duration and catching performance were taken before and after training, and at a 6-week delayed retention test. Parental feedback on psychosocial and motor skill outcomes was provided at delayed retention. Children improved their gaze control and catching coordination following QET, compared to TT. Mediation analysis showed that a longer QE aiming duration (QE1) predicted an earlier onset of tracking the ball prior to catching (QE2) which predicted catching success. Parents reported enhanced perceptions of their child’s catching ability and general coordination in the QET group compared to the TT group. All parents reported improvements in their child’s confidence, social skills and predilection for physical activity following the trial. The findings offer initial support for an intervention that practitioners could apply to address deficits in the motor and psychosocial skills of children with DCD.

          Trial registration: ClinicalTrials.gov NCT02904980

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          Most cited references12

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          Understanding performance deficits in developmental coordination disorder: a meta-analysis of recent research.

          Developmental coordination disorder (DCD) is a significant disorder of childhood, characterized by core difficulties in learning fine and/or gross motor skills, and the attendant psychosocial problems. The aim of the meta-analysis presented here (the first on DCD since 1998) was to summarize trends in the literature over the past 14 years and to identify and describe the main motor control and cognitive deficits that best discriminate children with DCD from those without.
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            Visual control when aiming at a far target.

            Gaze behavior of elite basketball athletes was determined as they performed 10 accurate and 10 inaccurate free throws (FTs) to a regulation basket wearing an eye tracker that permitted normal accuracy. Experts (mean FT = 78%) differed significantly from near experts (mean FT = 56%) in having a longer fixation on the target combined with an earlier fixation offset during the shooting action. These results, which depart from current models of near aiming, are tentatively explained using a location-suppression hypothesis. During the early phases of the aiming action, a fixation of long duration is needed on a specific target location. As the aiming action is then performed, vision appears to be a liability and is suppressed.
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              Neural underpinnings of impaired predictive motor timing in children with Developmental Coordination Disorder.

              A dysfunction in predictive motor timing is put forward to underlie DCD-related motor problems. Predictive timing allows for the pre-selection of motor programmes (except 'program' in computers) in order to decrease processing load and facilitate reactions. Using functional magnetic resonance imaging (fMRI), this study investigated the neural correlates of motor timing in DCD (n=17) and typically developing children (n=17). The task involved motor responses to sequences of visual stimuli with predictive or unpredictive interstimulus intervals (ISIs). DCD children responded with a smaller reaction time (RT) advantage to predictive ISIs compared to typically developing children. Typically developing children exhibited higher activation in the right dorsolateral prefrontal cortex (DLPFC) and right inferior frontal gyrus (IFG) for responses at unpredictive as opposed to predictive ISIs, whereas activations in DCD children were non-differentiable. Moreover, DCD children showed less activation than typically developing children in the right DLPFC, the left posterior cerebellum (crus I) and the right temporo-parietal junction (TPJ) for this contrast. Notably, activation in the right temporo-parietal junction (TPJ) positively correlated with RT as an indicator of processing load in both groups. These data indicate that motor performance in DCD children requires extra processing demands due to impaired predictive encoding.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                10 February 2017
                2017
                : 12
                : 2
                : e0171782
                Affiliations
                [1 ]Centre for Health, Exercise and Active Living, Manchester Metropolitan University, Crewe, United Kingdom
                [2 ]Department of Health Sciences, Liverpool Hope University, Liverpool, United Kingdom
                [3 ]College of Life & Environmental Sciences, University of Exeter, Exeter, United Kingdom
                [4 ]Faculty of Kinesiology, University of Calgary, Calgary, Canada
                TNO, NETHERLANDS
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: GW CM OA MW.

                • Formal analysis: GW MW CM SV JV.

                • Funding acquisition: GW OA MW.

                • Investigation: GW GC CM.

                • Methodology: GW MW CM.

                • Project administration: OA GW.

                • Resources: GW OA.

                • Supervision: GW OA.

                • Validation: GW CM MW OA.

                • Visualization: GW.

                • Writing – original draft: GW MW.

                • Writing – review & editing: SV JV GW GC MW.

                Author information
                http://orcid.org/0000-0003-0851-7090
                Article
                PONE-D-16-35070
                10.1371/journal.pone.0171782
                5302797
                28187138
                f0abac19-6aba-4d37-a5db-39c855d4d5f8
                © 2017 Wood et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 5 October 2016
                : 23 January 2017
                Page count
                Figures: 3, Tables: 4, Pages: 16
                Funding
                Funded by: The Waterloo Foundation
                Award ID: 1119/1603
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100010030, Liverpool Hope University;
                Award ID: HEIF5 Programme 2011-2015
                Award Recipient :
                This research was funded by grants from Liverpool Hope University (HEIF5 Programme 2011-2015) and The Waterloo Foundation (1119/1603). The funders were not involved in the study design, data collection, data analysis, manuscript preparation, nor publication decisions. The authors have stated that they had no interests that might be perceived as posing a conflict or bias.
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                Data for this publication are freely availabe via this link: http://researchdata.mmu.ac.uk/24/.

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