Kinaesthetic narratives: Interpretations for children's dance movement therapy process

The present case study was aimed at producing research-based information on developmental dance movement therapy (DMT) in Finland. The hypothesis was that DMT enables non-verbal and verbal expression in children at risk of social displacement and long-term learning disabilities. A dance movement therapist and a preschool teacher co-led a year long, weekly DMT group for six preschool children of whom five had recently immigrated to Finland. The theory and practical methods were founded in DMT, attachment theory and solution focused therapy. The sessions used creative movement, movement observation, kinesthetic attunement and mirroring. The evaluation of the group process was based on participant observation, body memory and children's drawings. Bodily dialogue and supportive holding became integral parts of each session. The themes observed in children's drawings suggested developmental changes and externalisation of emotional experiences. The conclusion was that DMT supported the development of group dynamics and movement as a form of interaction.     

The Ages and Stages Questionnaires: feasibility of use as a screening tool for children in Canada

OBJECTIVE: To determine the accuracy and feasibility of a monitoring tool completed by parents for screening at-risk and community infants and children for developmental problems. METHODS: We assessed 43 children following open-heart surgery and 68 community children (aged 4-36 mo) at prescribed intervals using the Ages and Stages Questionnaires (ASQ). Subjects were followed 3 years later (at age 5-6 yr) via telephone interview with their parents concerning developmental delay identified by physicians. Responses were confirmed by telephone interviews with family physicians. We then compared the results of the ASQ with the physician assessments. RESULTS: Nine at-risk and 9 community children were lost to follow-up. The ASQ identified 4 of the 25 at-risk children as having developmental delay, while 2 of the 6 children assessed by a neurologist were identified as having developmental delay. The ASQ identified 2 of the 59 community children as having developmental delay, 1 of whom was assessed by a neurologist as having developmental delay. The ASQ had sensitivities of 75% in the at-risk group and 100% in the community group, and specificities of 95% and 90%, respectively. The parents were unanimous in their willingness to complete the assessments. CONCLUSION: The ASQ is feasible, inexpensive, easy to use, and was appreciated by the parents. It is a sufficiently sensitive and specific monitoring tool that its use in cardiac follow-up programs and in community programs for healthy children is warranted. Although this tool should not be used to replace clinical assessment, it can be used to rationalize access to specialist developmental assessment services.     

PsyMot: an instrument for psychomotor diagnosis and indications for psychomotor therapy in child psychiatry

Psychomotor therapy is a movement-oriented and body-oriented therapy which resembles dance movement psychotherapy, although some differences remain. Despite historical differences, theoretical backgrounds as well as practical methods of both therapies converge at large. Both fields are in need of assessment development to support diagnosis and treatment. In this article, we present a recently developed systematic tool for psychomotor assessment and diagnosis of children, the PsyMot. The construction of this instrument was inspired by the International Classification of Functioning, children's version, of the World Health Organization. The PsyMot consists of an assessment procedure, guidelines for scoring items and a computer program for converting item scores into scores for clusters of treatment goals. Initial studies suggest that the PsyMot has adequate psychometric qualities, but further research is needed. Possibilities for the use of the PsyMot in different groups are currently being explored.     

The 18‐month early neuropsychologic optimality rating scale (ENORS‐18): A predictive assessment instrument

The development and application of the 15‐item 18‐month Early Neuropsychologic Optimality Rating Scale (ENORS‐18) is described in a sample of 450 children. The ENORS‐18 is scored in an optimal‐nonoptimal fashion and enables assessment of tone, posture, movement, and developmental delay. Comparison of the ENORS‐18 and the 18‐month Bayley developmental indices and a neurologic examination in regard to 36‐month cognitive, motor, and neurologic outcome revealed that ENORS‐18 sensitivity values were 1½ to 10 times greater than the other techniques. Basic neurologic function/intactness items assumed less importance than in the previous 9‐month ENORS; receptive, fine‐motor/oral‐motor expressive, and processing items were more influential. Mental activity variables were equally important on both assessments. This instrument is useful in early assessment due to enhanced detection of dysfunction, decreased time and cost, and greater flexibility with missing data and cutoff scores. Implications of these findings are discussed.     

Assessment of developmental coordination disorder in children born with extremely low birth weights

There is no tool that is considered the "gold" standard for identifying children with developmental coordination disorder (DCD) and various techniques have been reported in the research literature. The aim of this study was to examine the prevalence of DCD in a cohort of extremely low birth weight (ELBW; birth weight ≤ 1,000g) children at age 5 years using various methods including standardized motor assessment measures, an established clinic protocol, and a parent report. We also examined the association between selected neonatal risk factors and severity of the motor impairment. Four methods were used to assess motor functioning: (1) the Movement Assessment Battery for Children (Movement ABC); (2) a motor assessment battery, which included the Movement ABC, the Beery-Buktenica Developmental Test of Visual Motor Integration, and the Developmental Test of Visual Perception-2; (3) a Perinatal Follow-up Clinic protocol, which included the Geometric Design and the Mazes subtests of the Wechsler Preschool and Primary Scale of Intelligence-Revised, the Fine and Gross Motor subscales of the Child Development Inventory, and a pediatric neuromotor exam; and (4) a parent completed questionnaire (i.e., Developmental Coordination Disorder Questionnaire (DCDQ)). The prevalence of motor impairment in ELBW children was 64% on the Movement ABC, 67% on the motor assessment battery, 66% on the Perinatal Follow-up Clinic protocol, and 26% on the DCDQ. Sensitivity ranged from 36% to 100% and specificity from 65% to 92% using the Movement ABC as the reference standard. Neonatal risk factors associated with increased severity of motor impairment were bronchopulmonary dysplasia, postnatal steroids, and increasing gestational age. Children with birth weights ≤ 1,000 g are at considerable risk for motor impairment; therefore, developmental evaluations should include an assessment of motor functions. A standardized motor assessment test such as the Movement ABC appears to be the most effective and efficient means of identifying motor impairment in this high-risk population.     

Mothers' estimates of their children with disorders of language development

The authors' objective in this article was to explore the accuracy of mothers' estimates concerning their children's developmental functioning, especially with respect to vocabulary and gross motor development, by comparing the results of diagnostic tests administered to both the children and their mothers. The authors studied 55 children with disorders of language development (LD) between the ages of 3 and 6 years using several diagnostic scales concerning child development. The authors assessed the mothers' estimates regarding vocabulary and gross motor development by the same scales as those used for their children. These scales were presented as questionnaires and scored like the tests used for the children. There was a significant tendency toward a general overestimation of a child's developmental functioning regarding vocabulary and gross motor skills. Moreover, the accuracy of the mothers' estimates did not seem to be associated with several selected variables. The results did not correspond to those of other studies that have shown that mothers' estimates provide a good indication for the developmental status of a child--at least for the child's developmental status considering vocabulary and gross motor skills in children with LD. The results support the objection regarding the use of maternal estimates as the only source of information concerning the development of a child among scientific studies, especially if they deal with research on the development of vocabulary or gross motor skills.     

Analysis of praxis task demands in the assessment of children with developmental motor deficits

Children with developmental motor deficits and normal control children were evaluated with a battery of praxis tests. Several task demands were examined: representational nature of the gesture, type of limb gesture (transitive vs. intransitive), input modality (command vs. imitation), movement complexity (single gestures vs. sequences of gestures), and movement system (limb vs. orofacial). Performance of the children with developmental motor deficits was significantly lower than that of the normal control children on most of the tasks. Specifically, the children with motor deficits demonstrated impairments in performance of both representational and nonrepresentational gestures relative to the normal controls. Further, they demonstrated impairments in their performance of gestures across different movement systems (i.e., limb, oral) compared to the normal controls. Examination of task demands indicated that, for children with motor deficits, complex gestures were performed less well than single gestures, transitive gestures were performed less well than intransitive gestures, and performance to command was poorer than performance to imitation.     

Effect of unimanual training on contralateral motor overflow in children and adults

Young children and adults performed a rapid unimanual finger‐lifting task. Active hand performance and ipsilateral and contralateral motor overflow were examined using a cross‐hand transfer‐of‐training paradigm. Lateral asymmetries in both the performing hands and overflow hands were investigated. An expected developmental trend was evidenced with children exhibiting more motor overflow than adults. There was also greater overflow evidenced when performing with the left hand than with the right hand in both children and adults. Children evidenced a similar asymmetry in transfer of training, that is, greater transfer of training from the left hand to the right hand than vice versa. The relationship between asymmetries in motor overflow and transfer of training is discussed in terms of cerebral specialization for movement control. Finally, training does seem to influence ipsilateral overflow, suggesting that task efficiency may play a role in the occurrence of motor overflow and that caution be exercised in the use of motor overflow as a diagnostic tool.     

Body identity development: definitions and discussions

As the fields of body psychotherapy and dance/movement therapy mature, they tend to create their own theoretical models. This article articulates a theory of body identity that may provide conceptual resources for these fields, both theoretically and clinically. The historical and developmental roots of body identity are discussed and contextualised, both socioculturally and psychologically. Body identity development is mapped onto a current developmental theory called narrative identity, resulting in a more inclusive discourse of multiple selves and non-conforming identities. The concept of body narrative is introduced, and is seen as the mechanism for the development of body identity. Clinical implications are discussed, though further work is needed to ‘flesh out’ how body identity is navigated in body-centred psychotherapies.     

A study looking at the effectiveness of developmental screening in identifying learning disabilities in early childhood

This is a retrospective study of children under six years of age referred to the Brothers of Charity Early Intervention Services in County Galway, a service that caters for children under 6 years with learning disabilities. The aim in doing this study was to assess the value of routine developmental screening in identifying children with learning difficulties. This study also investigates the patterns and sources of referral to the remedial services provided by the Brothers of Charity and highlights possible avoidable delays in referral. The results showed that many children were referred for remedial services late. The reasons for late referral included late identification of some children with problems, insufficient co-ordination of community-based services and a lack of awareness of the importance of early intervention in some cases. As some communication disorders such as autism, autistic spectrum disorders and specific language delay may not express themselves until the later part of the second year of life, the 18-24 month developmental assessment is of vital importance. However identification of these disorders can present difficulties and may call for additional training for professionals involved in the developmental screening of children in that age group. The interval between initial identification and referral for remedial care in many cases was more than twelve months. We propose that, in order to minimize this time, children requiring a more in-depth assessment should be assessed by a community-based multidisciplinary team, enabling integrated assessment by the different disciplines and thus speedier referral to remedial services.     

Development of speed of repetitive movements in children is determined by structural changes in corticospinal efferents.

This study was aimed to determine the relationship between the maturation of corticospinal efferents, determined by transcranial stimulation of motor cortex, and the development of fastest repetitive voluntary motor activity in children. The development of fastest repetitive voluntary motor activity was assessed for 3 different types of movements including fastest repetitive tapping movements, aiming movements and a pegboard transportation task. These 3 motor activities were chosen as they were different as to their dependence on detailed sensory guidance. Despite these differences the speed of all 3 movements showed a very similar developmental profile, which was matched, however, by the developmental slope of the fastest cortico-motoneuronal efferents. Hence the development of central conduction times determines the speed of repetitive movements in children. In contrast, we could not observe significant effects of repetitive training on speed of these movements. We show for the first time that the development of fastest voluntary movements is a structure-bound phenomenon, being independent from learning.     

Dendritic and Synaptic Variety in the Neocortex

In a multisite study of 351 children with autism spectrum disorders, 21 children with developmental delays, and 31 children with typical development, this study used caregiver interviews (i.e., the Autism Diagnostic Interview-Revised) at the time of entry into other research projects and follow-up telephone interviews designed for this project to describe the children's early acquisition and loss of social-communication milestones. Children who had used words spontaneously and meaningfully and then stopped talking were described by their caregivers as showing more gestures, greater participation in social games, and better receptive language before the loss and fewer of these skills after the loss than other children with autism spectrum disorders. A significant minority of children with autism without word loss showed a very similar pattern of loss of social-communication skills, a pattern not observed in the children with developmental delays or typical development.     

Early regression in social communication in autism spectrum disorders: a CPEA Study

In a multisite study of 351 children with autism spectrum disorders, 21 children with developmental delays, and 31 children with typical development, this study used caregiver interviews (i.e., the Autism Diagnostic Interview-Revised) at the time of entry into other research projects and follow-up telephone interviews designed for this project to describe the children's early acquisition and loss of social-communication milestones. Children who had used words spontaneously and meaningfully and then stopped talking were described by their caregivers as showing more gestures, greater participation in social games, and better receptive language before the loss and fewer of these skills after the loss than other children with autism spectrum disorders. A significant minority of children with autism without word loss showed a very similar pattern of loss of social-communication skills, a pattern not observed in the children with developmental delays or typical development.     

Neuromotor noise limits motor performance,but not motor adaptation,in children

Children do not typically appear to move with the same skill and dexterity as adults, although they can still improve their motor performance in specific tasks with practice. One possible explanation is that their motor performance is limited by an inherently higher level of movement variability, but that their motor adaptive ability is robust to this variability. To test this hypothesis, we examined motor adaptation of 43 children (ages 6-17) and 12 adults as they reached while holding the tip of a lightweight robot. The robot applied either a predictable, velocity-dependent field (the "mean field") or a similar field that incorporated stochastic variation (the "noise field"), thereby further enhancing the variability of the subjects' movements. We found that children exhibited greater initial trial-to-trial variability in their unperturbed movements but were still able to adapt comparably to adults in both the mean and noise fields. Furthermore, the youngest children (ages 6-8) were able to reduce their variability with practice to levels comparable to the remaining children groups although not as low as adults. These results indicate that children as young as age 6 possess adult-like neural systems for motor adaptation and internal model formation that allow them to adapt to novel dynamic environments as well as adults on average despite increased neuromotor or environmental noise. Performance after adaptation is still more variable than adults, however, indicating that movement inconsistency, not motor adaptation inability, ultimately limits motor performance by children and may thus account for their appearance of incoordination and more frequent motor accidents (e.g., spilling, tripping). The results of this study also suggest that movement variability in young children may arise from two sources--a relatively constant, intrinsic source related to fundamental physiological constraints of the developing motor system and a more rapidly modifiable source that is modulated depending on the current motor context.     

High Gamma Oscillations of Sensorimotor Cortex During Unilateral Movement in the Developing Brain: a MEG Study

Recent studies in adults have found consistent contralateral high gamma activities in the sensorimotor cortex during unilateral finger movement. However, no study has reported on this same phenomenon in children. We hypothesized that contralateral high gamma activities also exist in children during unilateral finger movement. Sixty normal children (6–17 years old) were studied with a 275-channel MEG system combined with synthetic aperture magnetometry (SAM). Sixty participants displayed consistently contralateral event-related synchronization (C-ERS) within high gamma band (65–150 Hz) in the primary motor cortices (M1) of both hemispheres. Interestingly, nineteen younger children displayed ipsilateral event-related synchronization (I-ERS) within the high gamma band (65–150 Hz) just during their left finger movement. Both I-ERS and C-ERS were localized in M1. The incidence of I-ERS showed a significant decrease with age. Males had significantly higher odds of having ipsilateral activity compared to females. Noteworthy, high gamma C-ERS appeared consistently, while high gamma I-ERS changed with age. The asymmetrical patterns of neuromagnetic activities in the children’s brain might represent the maturational lateralization and/or specialization of motor function. In conclusion, the present results have demonstrated that contralateral high-gamma neuromagnetic activities are potential biomarkers for the accurate localization of the primary motor cortex in children. In addition, the interesting finding of the ipsilateral high-gamma neuromagnetic activities opens a new window for us to understand the developmental changes of the hemispherical functional lateralization in the motor system.     

Implications of large WISC/WISC-R Verbal-Performance IQ discrepancies

Forty children with Verbal-Performance IQ discrepancies on the WISC/WISC-R were studied in regard to clinical findings on psychological, educational, speech-language, and medical evaluations. Significant delays in the development of verbal when compared to performance skills were observed frequently in this referred sample. The verbal deficits were mostly developmental in nature, rather than secondary to emotional or family background factors. These children's developmental difficulties were frequently complex ones that benefitted from multidisciplinary assessment and treatment planning. It was emphasized that future research in regard to these intellectual patterns should be conducted within the confines of more neuropsychologically oriented approaches.     

Developmental study of visual perception of handwriting movement: Influence of motor competencies?

This paper investigates the influence of motor competencies for the visual perception of human movements in 6-10 years old children. To this end, we compared the kinematics of actual performed and perceptual preferred handwriting movements. The two children's tasks were (1) to write the letter e on a digitizer (handwriting task) and (2) to adjust the velocity of an e displayed on a screen so that it would correspond to "their preferred velocity" (perceptive task). In both tasks, the size of the letter (from 3.4 to 54.02 cm) was different on each trial. Results showed that irrespective of age and task, total movement time conforms to the isochrony principle, i.e., the tendency to maintain constant the duration of movement across changes of amplitude. However, concerning movement speed, there is no developmental correspondence between results obtained in the motor and the perceptive tasks. In handwriting task, movement time decreased with age but no effect of age was observed in the perceptive task. Therefore, perceptual preference of handwriting movement in children could not be strictly interpreted in terms of motor-perceptual coupling.     

To throw or to place: does onward intention affect how a child reaches for an object?

Picking up an object is a seemingly simple and isolated task; however, research has demonstrated that adults plan a reach-to-grasp movement on the basis of forthcoming actions. For example a greater deceleration period is seen in an initial reach movement which precedes a place movement compared to a throw movement. This task-specific or second-order motor planning is also seen in infants and toddlers; however, the developmental progression is unclear. Reach-to-grasp movements of 48 children, split into four age groups (4–5, 6–7, 8–9 and 10–11 years) were recorded. These movements preceded a tight place, a loose place or a throw action. All the children showed some degree of tailoring kinematics to the onward action. In the 4–5 year-old group, this was demonstrated by a longer movement duration in the place actions compared to the throw action. In the older children the proportion of time spent decelerating increased as the precision requirements of the task increased. These results demonstrate that all children are able to use second-order planning to integrate onward task demands into their movements. The capacity for this increases with age but is not fully mature at 11 years. These developmental effects may be explained by the relative weighting of costs involved in tailoring a reach action compared to the benefits of producing a more efficient onward action.