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

BackgroundEarly 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.AimsTo investigate the age-related validity and reliability of the Dutch version of the Little Developmental Coordination Disorder Questionnaire (LDCDQ-NL).Methods and proceduresTwo 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 resultsInternal 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 implicationsThe 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.     

Motor skills,visual perception,and visual-motor integration in children and youth with Autism Spectrum Disorder

BackgroundMotor skill deficits are prevalent among children with Autism Spectrum Disorder (ASD) however, little is known about the underlying mechanism of these deficits. In response to this gap, this study investigated how visual perception (VP) and visual-motor integration (VMI) are associated with motor skills among children and youth with ASD.MethodsSixty-seven individuals with ASD and sixty-seven age- and gender-matched individuals without ASD (age range: 9.83–15.13 years) participated. Motor skills were assessed with the Movement Assessment Battery for Children-2 (MABC-2) and VP and VMI with the respective components of the Beery-Buktenica Developmental Test of Visual-Motor Integration-6 (Beery VMI-6).ResultsSignificantly more children and youth with ASD were in the red and orange zone of the MABC-2 traffic-lighting system for the total MABC-2 and the Aiming and Catching and Balance components compared to the children and youth without ASD. Both groups did not differ on the VP and VMI components of the Beery VMI-6. Pearson correlations between VP and VMI, and motor skills were weak but significant for the individuals without ASD, but not for the ASD group.ConclusionThe current study added to the evidence about motor skill deficits among children and youth with ASD. VP and VMI were not related to motor skills, suggesting that these functions – as measured in the current study – are no underlying mechanisms of motor skill deficits of children with ASD and average intelligence. Diagnostic implications are provided for the evidence of motor skill deficits among children and youth with ASD.     

Does the Movement Assessment Battery for Children-2 at 3 years of age predict developmental coordination disorder at 4.5 years of age in children born very preterm?

BackgroundVery preterm children (VPT) are at high risk for developmental coordination disorder (DCD). The Movement Assessment Battery for Children-2 (MABC-2) Test is commonly used to identify children with DCD, but little is known about the predictive validity of this assessment in this population.AimsThe aims of this study were to determine if MABC-2 scores at 3 years can predict DCD at 4.5 years and if DCD can be reliably identified in VPT children at 3 years.Methods and proceduresIn a retrospective sample of 165 VPT children, logistic regression was used to determine if the MABC-2 score at 3 years is predictive of DCD at 4.5 years. Cross-tabulations were used to determine the relationship between scores at 3 years and DCD at 4.5 years.Outcomes and resultsMABC-2 scores at age 3 were a significant predictor (OR = 0.82, p = 0.001) of DCD diagnosis at 4.5 years. The MABC-2 has excellent sensitivity (90%), moderate specificity (69%), small to moderate positive predictive value (38%) and high negative predictive value (97%).Conclusions and implicationsThe MABC-2 is highly sensitive in identifying VPT children with DCD, but also has many false positives. MABC-2 scores can reliably predict VPT children who are not at risk of DCD.     

Modulation effects of the intact motor skills on the relationship between social skills and motion perceptions in children with autism spectrum disorder: A pilot study

BackgroundAn individual with autism spectrum disorder (ASD) has social skill, motor skill, and motion perception deficits. However, the relationship among them was not clarified. Therefore, this study aimed to evaluate the effects of motor skills on social skills and motion perception.MethodsFive typically developed children and fourteen children with ASD participated in our study. The N200 component, a brain activity indicating motion perception, was induced in mid-temporal (MT/V5) brain area by watching a random dot kinematograph, and was recorded using a scalp electroencephalogram. Furthermore, the social responsiveness scale (SRS) indicating the social skill deficit, the developmental coordination disorder questionnaire (DCDQ) estimating the developmental coordination disorder (DCD), and the movement assessment battery for children second edition (MABC-2) indicating motor skills were recorded in the children with ASD. A hierarchical multiple regression analysis was conducted to examine the modulation effects of motor skills on the relationship between social skills and motion perception. The dependent variable was the N200 latency, and the independent variables were SRS, MABC-2, and combined MABC-2 and SRS.ResultsThe N200 latency was more delayed in children with ASD relative that in typically developed children. Intact balance ability modulated the relationship between social skills and N200 latency in children with ASD. Within the high balance ability, when the social skills worsened, the N200 latency was shortened.ConclusionsThis is the first report that intact motor skills could modulate the relationship between social skills and motion perception.     

Reduced relative volume in motor and attention regions in developmental coordination disorder: A voxel-based morphometry study

Background and objectivesDevelopmental coordination disorder (DCD) is a prevalent childhood movement disorder, impacting the ability to perform movement skills at an age appropriate level. Although differences in grey matter (GM) volumes have been found in related developmental disorders, no such evidence has been linked with DCD to date. This cross-sectional study assessed structural brain differences in children with and without DCD.MethodsHigh-resolution structural images were acquired from 44 children aged 7.8–12 years, including 22 children with DCD (≤16th percentile on MABC-2; no ADHD/ASD), and 22 typically developing controls (≥20th percentile on MABC-2). Structural voxel-based morphology analysis was performed to determine group differences in focal GM volumes.ResultsChildren with DCD were found to have significant, large, right lateralised reductions in grey matter volume in the medial and middle frontal, and superior frontal gyri compared to controls. The addition of motor proficiency as a covariate explained the between-group GM volume differences, suggesting that GM volumes in motor regions are reflective of the level of motor proficiency. A positive correlation between motor proficiency and relative GM volume was also identified in the left posterior cingulate and precuneus.ConclusionsGM volume reductions in premotor frontal regions may underlie the motor difficulties characteristic of DCD. It is possible that intervention approaches targeting motor planning, attention, and executive functioning processes associated with the regions of reduced GM volume may result in functional improvements in children with DCD.     

Factors influencing the motor development of prematurely born school-aged children in Brazil

Despite technological advances in neonatology, premature children are still susceptible to disruptions in neurological development. The current study aimed to analyze the factors that influence motor development in prematurely born school-aged children in Brazil. This cross-sectional study involved 100 “apparently normal” children, aged 8–10 years, born at less than 35 weeks of gestation or with birth weight < 1500 g. Their motor development was assessed using the Movement Assessment Battery for Children (MABC-2). The children's neuropsychological and academic performance was assessed with the Token Test (TT) and Teste de Desempenho Escolar (TDE), respectively. Parents answered questions regarding the child's clinical history and behavior using the Strengths and Difficulties Questionnaire (SDQ) and family environment resources (RAF). Hierarchical multivariate analyses revealed that 39% of the children scored lower on the MABC-2, as compared to that expected for their age (manual dexterity: 49%; balance: 35%; throwing/catching a ball: 26%). Multivariate analysis indicated that the lower the birth weight, the maternal age at childbirth, and the RAF score, the greater was the chance of impairment on the MABC-2 scores. The probability of having an impairment MABC-2 scores was four times higher when the mother was not employed. We also found associations between MABC-2 scores and the tasks of tying shoes and opening/closing zippers and buttons. Factors related to children's home environments and birth weight are associated with deficient motor performance in prematurely born Brazilian school-aged children. Deficient motor skills were also associated with difficulty in performing functional tasks requiring greater manual dexterity.     

Reliability and validity of age band 1 of the Movement Assessment Battery for Children--second edition

The purpose of this study was to examine specific aspects of the reliability and validity of age band 1 of the Movement Assessment Battery for Children - Second Edition (MABC-2) (Henderson, Sugden, & Barnett, 2007) in Greek preschool children. One hundred and eighty-three children participated in the study; the children ranged in age from 36 to 64 months old (M = 50 months, SD = 9 months). Test-retest reliability of the MABC-2 was evaluated using intraclass correlation coefficient (ICC). Cronbach's alpha for the items of each motor domain was estimated to determine internal consistency. Confirmatory factor analysis was used to examine the factorial validity of the MABC-2 test. Correlation coefficients among individual item scores and the total score were also calculated to further examine validity. The ICC for all test items was good, except for the drawing trail task, which was moderate. Cronbach's alpha coefficient values were .51, .70 and .66 for manual dexterity, aiming and catching, and balance, respectively. In the confirmatory factor analysis, goodness-of-fit indices suggested a satisfactory fit of the data to the model. The correlation coefficients between each test item and the total score were moderate. The results suggest that the MABC-2 can be a reliable and valid tool for the assessment of movement difficulties among 3-5-year-old children.     

The efficacy of two task-orientated interventions for children with Developmental Coordination Disorder: Neuromotor Task Training and Nintendo Wii Fit training

Neuromotor Task Training (NTT) and Nintendo Wii Fit Training (Wii training) are both task-based interventions used to improve performance in children with motor coordination problems. The aim of this study was to compare the efficacy of these two interventions on the motor performance, isometric strength and cardiorespiratory fitness (aerobic and anaerobic capacity) of children with Developmental Coordination Disorder (DCD) attending mainstream schools in a low-income setting. A pragmatic, quasi-experimental study design was utilized. Children between the ages of 6–10 years, who scored at or below the 16th percentile on the Movement Assessment Battery for Children-2 (MABC-2) and whose teacher reported a functional motor problem, were allocated to either NTT (n = 37) or Wii training (n = 19) groups depending on school of attendance. The MABC-2, a hand-held dynamometer, the Functional Strength Measure, the Muscle Power Sprint Test and the 20 m Shuttle Run Test were used to assess performance at baseline and after the intervention. The main findings show that the mean motor performance scores of both groups improved over the study period. However, significant differences in improvement were detected between groups, with the NTT group showing greater improvement in motor performance, functional strength and cardiorespiratory fitness. No improvements in isometric strength were seen in either group. The Wii training group showed significant improvement in anaerobic performance. This study provides evidence to support the use of both the Wii Training and NTT for children with DCD. However, in comparison to Wii training, the NTT approach yields superior results across measures of motor proficiency, cardiorespiratory fitness and functional strength. The decision to use either approach may be influenced by resources and time constraints.     

Motor impairments screened by the Movement Assessment Battery for Children-2 are related to the visual-perceptual deficits in children with Developmental Coordination Disorder

This study was to examine to what extent the motor deficits of children with Developmental Coordination Disorder (DCD) verified by the Movement Assessment Battery for Children-2 (MABC-2) are linked to their visual-perceptual abilities. Seventeen children with DCD and seventeen typically developing children (TD) aged 5–10 years screened from a total of 250 children were recruited. The assessments included MABC-2, traditional test of visual perceptual skills (TVPS-R), and computerized test for sequential coupling of eye and hand as well as motion coherence. The results indicated that children with DCD scored lower than TD in MABC-2, and their total scores were highly correlated with manual dexterity component scores. DCD group also showed poor visual-perceptual abilities in various aspects. The visual discrimination and visual sequential memory from the TVPS-R, the sequential coupling of eye and hand, and the motion coherence demonstrated a moderate or strong correlation with the MABC-2 in the DCD rather than the TD group. It was concluded that the motor problems screened by MABC-2 were significantly related to the visual-perceptual deficits of children with DCD. MABC-2 is suggested to be a prescreening tool to identify the visual-perceptual related motor deficits.     

Activity participation intensity is associated with skeletal development in pre-pubertal children with developmental coordination disorder

PurposeThis study aimed (1) to compare the skeletal maturity and activity participation pattern between children with and without developmental coordination disorder (DCD); and (2) to determine whether activity participation pattern was associated with the skeletal development among children with DCD.Materials and methodsThirty-three children with DCD (mean age: 7.76 years) and 30 typically developing children (mean age: 7.60 years) were recruited. Skeletal maturity was assessed with the Sunlight BonAge system. Motor ability was evaluated by the Movement assessment battery for Children-2 (MABC-2). Participation patterns were evaluated using the Children Assessment of Participation and Enjoyment assessment. Analysis of variance was used to compare the outcome variables between the two groups. Multiple regression analysis was performed to examine the relationship between skeletal development, motor performance and activity participation intensity in children with DCD.ResultsThe DCD group had significantly delayed skeletal development, lower MABC-2 derived scores, and participated less intensely in various types of physical activities than their typically developing peers. After accounting for the effects of age and sex, activity participation intensity score remained significantly associated with delay in skeletal development, explaining 28.0% of the variance (F_{change1, 29} = 11.341, p = 0.002).ConclusionSkeletal development is delayed in pre-pubertal children with DCD. Limited activity participation intensity appears to be one of the contributing factors.     

Do children with ASD have difficulty handwriting under time pressure?

BackgroundChildren with autism spectrum disorder (ASD) often experience significant handwriting impairment, however the influence of time pressure on overall performance is unclear. The aim of the current study was to characterise the handwriting profile of children with ASD across both non-speeded and speeded conditions, with particular focus given to spacing difficulties and handwriting errors. A further aim was to explore the relationships between handwriting and both intellectual and motor skills under different task conditions.MethodBoys with ASD (n = 23) and matched controls (n = 20) aged 8–12 years completed a modified version of the speed subtest of the Handwriting Performance Test, which allowed for both an ecologically valid and relatively simple motoric task. Participants wrote a simple phrase (cat and dog) five times in each condition.ResultsNo significant group differences were identified for handwriting errors or spacing between words in either condition, however the ASD group demonstrated greater variability relative to controls, particularly in the speeded condition. Significant negative associations were identified between motor proficiency and handwriting errors in the non-speeded condition.ConclusionsWhile motor processes are shown to have a significant role in overall handwriting proficiency, it appears that motor ability may influence the handwriting process to different degrees, depending on the nature of the task employed. A lack of group differences with respect to handwriting errors and spacing between words may suggest that children with ASD have the ability to compensate for underlying motor impairment when completing a well-practiced writing task.     

Movement Assessment Battery for Children-2: Translation,reliability, and validity for Brazilian children

The Movement Assessment Battery for Children 2nd edition (MABC-2) is a well-recognized assessment used to identify children with Developmental Coordination Disorder (DCD). Although researchers and practitioners across Brazil have used the MABC-2 to identify children with motor deficits, its validation for this particular population has yet to be investigated. In this study, we translated all MABC-2 items and validated them with respect to content, construct and criteria validity. The validation process involved 13 experts in Motor Development and a total of 844 children (3–13 years old) from two different states in Brazil. A cross-cultural translation method yielded a Brazilian–Portuguese version of the battery. The expert panel confirmed language clarity and pertinence of the items. High intra- and inter-rater reliability and internal consistency for the MABC-2 was established for Brazilian children. A discriminant analysis confirmed the MABC-2 power (.80) to differentiate children with DCD and those at risk for DCD from typically developing children. Predictive validity was observed for the impairment scores and a percentile main effect was found in the repeated measures ANOVA (ICC: .93 and .73, respectively). Although our data are not representative of the entire country, this study is the first to confirm that the original standardized scores established for the MABC-2 are valid in Brazilian children.     

Age band 1 of the Movement Assessment Battery for Children-Second Edition: Exploring its usefulness in mainland China

The aim of this paper was to examine the validity and reliability of age band 1 of the Movement Assessment Battery for Children-Second Edition (MABC-2) in preparation for its standardization in mainland China. Interrater and test–retest reliability of the MABC-2 was estimated using Intraclass Correlation Coefficient (ICC). Cronbach's alpha for each item and Item-total correlation were used to determine internal consistency. The content validity was determined by the Item-level content validity index (I-CVI). Confirmatory factor analysis was used to examine the factorial validity of the MABC-2 test. The correlation coefficients between the MABC-2 and the Peabody Developmental Motor Scales-2 (PDMS-2) were used to assess the criteria-related validity. The Cronbach's alpha values of all eight items together were moderate but acceptable. The correlation coefficients between each test item and the total score were moderate except for two items. The ICC of interrater and test–retest reliability for each test items was good. The I-CVI of each item was excellent (each above 0.78). The result of confirmatory factor analysis showed that the goodness-of-fit indices of the adjusted model were good (each above 0.9), indicating a satisfactory fit of the data to the model. The total score on MABC-2 and PDMS-2 was correlated well (r = 0.631). It is concluded that the reliability and validity of age band 1 of MABC-2 were fair in this study based on a large sample. However, there was a need to adjust part of items to improve the test's psychometric properties when it is used in Chinese children.     

Does relative body fat influence the Movement ABC-2 assessment in children with and without developmental coordination disorder?

Developmental coordination disorder (DCD) is a condition that results in an impairment of gross and/or fine motor coordination. Compromised motor coordination contributes to lower levels of physical activity, which is associated with elevated body fat. The impact of elevated body fat on motor coordination diagnostic assessments in children with DCD has not been established. The purpose of this study was to determine if relative body fat influences performance on the Movement Assessment Battery for Children, 2nd Edition (MABC-2) test items in children with and without DCD. A nested case–control, design was conducted within the Physical Health Activity Study Team longitudinal cohort study. The MABC-2 was used to assess motor coordination to categorize cases and matched controls. Relative body fat was assessed using whole body air displacement plethysmography. Relative body fat was negatively associated with the MABC-2 “balance” subcategory after adjusting for physical activity and DCD status. Relative body fat did not influence the subcategories of “manual dexterity” or “aiming and catching”. Item analysis of the three balance tasks indicated that relative body fat significantly influences both “2-board balance” and “zig-zag hopping”, but not “walking heel-toe backwards”. Children with higher levels of relative body fat do not perform as well on the MABC-2, regardless of whether the have DCD or not. Dynamic balance test items are most negatively influenced by body fat. Health practitioners and researchers should be aware that body fat can influence results when interpreting MABC-2 test scores.     

Short-term motor learning of dynamic balance control in children with probable Developmental Coordination Disorder

PurposeTo explore the differences in learning a dynamic balance task between children with and without probable Developmental Coordination Disorder (p-DCD) from different cultural backgrounds.ParticipantsTwenty-eight Dutch children with DCD (p-DCD-NL), a similar group of 17 South African children (p-DCD-SA) and 21 Dutch typically developing children (TD-NL) participated in the study.MethodsAll children performed the Wii Fit protocol. The slope of the learning curve was used to estimate motor learning for each group. The protocol was repeated after six weeks. Level of motor skill was assessed with the Movement ABC-2.ResultsNo significant difference in motor learning rate was found between p-DCD-NL and p-DCD-SA, but the learning rate of children with p-DCD was slower than the learning rate of TD children. Speed–accuracy trade off, as a way to improve performance by slowing down in the beginning was only seen in the TD children, indicating that TD children and p-DCD children used different strategies. Retention of the level of learned control of the game after six weeks was found in all three groups after six weeks. The learning slope was associated with the level of balance skill for all children. This study provides evidence that children with p-DCD have limitations in motor learning on a complex balance task. In addition, the data do not support the contention that learning in DCD differs depending on cultural background.     

Adapting the rivermead behavioural memory test for use with children aged 5 to 10 years

Abstract

We describe modifications made to the Rivermead Behavioural Memory Test (RBMT) to make it appropriate for use with children. Results of a sample of 335 children aged 5 to 10 years, attending mainstream schools, are reported. Each child was given two of the four versions of the modified test for children together with a number of tests of memory and achievement from the Wechsler Intelligence Test for Children (Revised WISC-R), and the British Ability Scales (BAS). The children's version of the behavioural memory test (RBMTC) has good interrater and parallel form reliability. The validity of the RBMTC was established in two ways. First, with other tests of memory from the WISC and BAS. Second, a small (n = 36) group of children with severe epilepsy and memory difficulties, attending a residential school, were tested. The houseparents of these children were asked to complete rating scales on everyday memory performance. There was significant agreement between houseparents' observations and scores on the RBMTC (Spearman rank correlation = .71, p > 001), indicating that the test is indeed assessing everyday memory.     

Fine and gross motor skills differ between healthy-weight and obese children

Within the obesity literature, focus is put on the link between weight status and gross motor skills. However, research on fine motor skills in the obese (OB) childhood population is limited. Therefore, the present study focused on possible weight related differences in gross as well as fine motor skill tasks. Thirty-four OB children (12 ♀ and 22 ♂, aged 7–13 years) were recruited prior to participating in a multidisciplinary treatment program at the Zeepreventorium (De Haan, Belgium). Additionally, a control group of 34 age and gender-matched healthy-weight (HW) children was included in the study. Anthropometric measures were recorded and gross and fine motor skills were assessed using the Bruininks–Oseretsky Test of Motor Proficiency, second edition (BOT-2). Results were analyzed by independent samples t-tests, multivariate analysis of variance, and a chi-squared test. Being OB was detrimental for all subtests evaluating gross motor skill performance (i.e., upper-limb coordination, bilateral coordination, balance, running speed and agility, and strength). Furthermore, OB children performed worse in fine motor precision and a manual dexterity task, when compared to their HW peers. No group differences existed for the fine motor integration task. Our study provides evidence that lower motor competence in OB children is not limited to gross motor skills alone; OB children are also affected by fine motor skill problems. Further investigation is warranted to provide possible explanations for these differences. It is tentatively suggested that OB children experience difficulties with the integration and processing of sensory information. Future research is needed to explore whether this assumption is correct and what the underlying mechanism(s) could be.     

Cognitive-motor interference during fine and gross motor tasks in children with Developmental Coordination Disorder (DCD)

BackgroundWhile typically developing children produce relatively automatized postural control processes, children with DCD seem to exhibit an automatization deficit. Dual tasks with various cognitive loads seem to be an effective way to assess the automatic deficit hypothesis.AimsThe aims of the study were: (1) to examine the effect of a concurrent cognitive task on fine and gross motor tasks in children with DCD, and (2) to determine whether the effect varied with different difficulty levels of the concurrent task.Methods and proceduresWe examined dual-task performance (Trail-Making-Test, Trail-Walking-Test) in 20 children with DCD and 39 typically developing children. Based on the idea of the Trail-Making-Test, participants walked along a fixed pathway, following a prescribed path, delineated by target markers of (1) increasing sequential numbers, and (2) increasing sequential numbers and letters. The motor and cognitive dual-task effects (DTE) were calculated for each task.ResultsRegardless of the cognitive task, children with DCD performed equally well in fine and gross motor tasks, and were slower in the dual task conditions than under single task-conditions, compared with children without DCD. Increased cognitive task complexity resulted in slow trail walking as well as slower trail tracing. The motor interference for the gross motor tasks was least for the simplest conditions and greatest for the complex conditions and was more pronounced in children with DCD. Cognitive interference was low irrespective of the motor task.Conclusions and implicationsChildren with DCD show a different approach to allocation of cognitive resources, and have difficulties making motor skills automatic. The latter notion is consistent with impaired cerebellar function and the “automatization deficit hypothesis”, suggesting that any deficit in the automatization process will appear if conscious monitoring of the motor skill is made more difficult by integrating another task requiring attentional resources.     

An articulatory-based disyllabic and trisyllabic Non-Word Repetition test: reliability and validity in Italian 3- to 7-year-old children

The contribution of the phonological working memory to the Non-Word Repetition (NWR) task is well established, but growing evidence also suggests a valuable underlying role of oro-motor abilities. Assuming that NWR involves output implementation mediated by the speech motor system, the study aimed to develop a novel Italian NWR task of disyllabic and trisyllabic items. The task, for the first time, was composed using each Italian speech sound.

The study also aimed to investigate the reliability proprieties of the task (test–retest, intra-rater, inter-rater), internal consistency, concurrent and construct validity, and to collect normative data for pre-school children. An observational cross-sectional study was conducted and 375 Italian-speaking typically developing children aged 3.0–6.11 years were assessed with the novel test. Two raters assessed inter-rater reliability in a random sub-sample; test–retest reliability was examined through a repeated administration of the task two weeks apart; intra-rater reliability was investigated by two evaluations of the same audio-recordings. To evaluate concurrent validity children were also assessed through a pre-existing NWR test, and to estimate construct validity, scores from children of different age groups were compared.

Results indicated excellent test–retest, intra-rater, inter-rater reliability agreement, high internal consistency and good concurrent validity. Normative data suggested that successful performance on NWR increases with age and declines with an increase in stimuli length. Despite the low working memory load in the disyllabic and trisyllabic items, a saturation of the task was not observed for any age group.

The novel NWR test is a reliable and valid instrument, and it can be applied in clinical practice to assess how the child retains, plans and articulates a phonological and motor programme of unknown verbal material.