Hilde Van Waelvelde

Background: Postural control deficits are common among children with and without disabilities. Performance-based postural control tests provide both quantitative and qualitative insights into the severity of these deficits but are underutilized in clinical practice. Digitizing existing postural control tests could increase their overall implementation. Purpose: This study examined the feasibility and validity of ‘Matti’, a pressure-sensitive device, as a tool for recording simple continuous data for two performance-based postural control subtests: the time in seconds during the One-Board Balance Test (OBBT) and the number of jumps during the Lateral Jump Test (LJT), in typically developing children. Study Design: Cross-sectional study Methods: Both conventional and digitized versions of both the OBBT and LJT were administered. The conventional test condition was rated by an observer, while the digitized version was scored by both an observer and analysis software using Matti’s sensor data. Correlation analyses, comparisons of the mean or median, and Bland-Altman plots were used to assess concurrent validity and level of agreement between conventional and digitized test conditions, as well as between observed and digital outcomes of the digitized test condition. The level of enjoyment between conventional and digital testing was evaluated using a Smiley-o-Meter. Results: Forty-six children (average age 8.98 (±1.04) years, 10 female) participated in this study. Digitized testing showed strong correlations between digital and observer-based outcomes for both the digital OBBT (rs=.991, p<0.001) and LJT (r=.962, p<0.001). However, differences were noted between conventional and digitized conditions. Participants reported significantly higher levels of enjoyment during digital testing (Z=-2.530; p = 0.011). Conclusion: The Matti demonstrates good feasibility for a simple digitized performance-based postural control test. However, differences between the scores of conventional and digitized test conditions indicate a lack of concurrent validity with conventional clinical tests. The higher perceived enjoyment reported during digital testing suggests its potential as a valuable tool in pediatric postural control assessment and rehabilitation.

Aim: To compare the motor, physical, and behavioural performance of children at risk of developmental coordination disorder (rDCD) and typically developing children at 3, 4, and 5 years of age. Method: Following a longitudinal design, 35 mainly high‐risk children identified as rDCD by a multidisciplinary team at a centre for developmental disabilities and 34 typically developing children participated. Children were assessed with the Movement Assessment Battery for Children, Second Edition, Dutch/Belgian version (MABC‐2‐NL), Beery‐Buktenica Test of Visual‐Motor Integration (Beery VMI‐6), Little Developmental Coordination Disorder Questionnaire – Belgian version (LDCDQ‐BE), Motor Skill Checklist, Functional Strength Measurement, body mass index, and Child Behavior Checklist. Linear mixed‐model analyses compared performance between groups (rDCD and typically developing) and subgroups (confirmed and cleared DCD at 5 years). Results: Children with rDCD scored significantly worse on all outcomes at every time point compared with typically developing children, except for visual perception. Performance on the MABC‐2‐NL, Beery VMI‐6 subtest motor coordination, and LDCDQ‐BE was also consistently below average for those in the rDCD group. Performance across time points was stable in the rDCD group, with only a significant improvement in LDCDQ‐BE. Children not diagnosed with DCD ( n = 5) were mostly similar in performance to the typically developing group. Interpretation: Performance differences are present at 3 years in high‐risk children at rDCD and tend to persist between 3 and 5 years.

Developmental Coordination Disorder (DCD) is a neurodevelopmental condition affecting coordinated motor skill acquisition usually diagnosed after 5y. However, parents and clinicians report poorer movement quality at earlier ages. Using the ‘Observable Movement Quality’ scale (OMQ), we compared movement quality between children with typical development (TD), with DCD, and with DCD and Autism Spectrum Disorder (ASD). Using blinded retrospective video analysis, a trained physical therapist observed 5-min compilations of home videos at 6-12 m (n = 53), 12-18 m (n = 54), and 18-24 m (n = 47) followed by OMQ-scoring and a three-point scale for clinical judgement (will/might/will not develop DCD). A 15% sample was re-evaluated to assess intra-rater reliability using Spearman coefficients. OMQ group performance was assessed using Kruskal–Wallis tests, while dichotomized (good/poor quality) data were examined with Fisher exact tests. OMQ scores’ association with later motor performance (MABC-2 and DCDQ) was analysed via Spearman coefficients. Cramer’s V determined the strength of association between clinical judgment and diagnostic outcome. Intra-rater reliability for total OMQ score was strong (r_s = 0.79, p ≤ 0.001). Reduced movement quality was found at 18-24 m in children with DCD (median 69, interquartile range [IQR] 10) and DCD+ASD (median 69, IQR 14) compared to TD children (median 74, IQR 2) (p ≤ 0.001). Five times more compilations in the DCD groups demonstrated poor overall movement quality at 18-24 m. At 18-24 m, movement quality correlated strongly with MABC-2 (r_s = 0.66) and DCDQ (r_s = 0.67). The therapist correctly identified 63–67% of DCD and DCD+ASD children respectively (Cramer's V = 0.62, p ≤ 0.001). These findings underscore the importance of investigating movement quality as a potential early feature of DCD.

This study aimed to assess if children with a vestibular impairment (VI) are more prone to have neurocognitive deficits compared to typically developing (TD) peers, taking into account important confounding factors with hearing loss being the most important. The neurocognitive performance of fifteen VI children (6–13 years old) was compared to that of an age-, handedness- and sex-weighted group of TD peers (n = 60). Secondly, their performance was also compared to matched groups of TD and hearing impaired (HI) children to evaluate the involvement of HI. The protocol comprises cognitive tests assessing response inhibition, emotion recognition, visuospatial memory, selective and sustained attention, visual memory and visual-motor integration. Based on the results, the VI group had significantly reduced scores on ‘social cognition’ (p = 0.018), ‘executive functions’ (p < 0.01), and ‘perceptual-motor functioning’ (p = 0.020) compared to their TD and HI peers. For the categories ‘complex attention’ and ‘learning and memory’ no differences could be observed. Analogous to the findings of previous literature, the symptoms of a VI are often not limited to the primary functions of the system, but also comprise an impact on emotional and cognitive performance. Therefore, more holistic rehabilitation approaches should be encouraged, with a screening and attention for cognitive, emotional and behavioral dysfunctions in the vestibular population. Since this is one of the first studies to investigate the involvement of a VI in a child’s cognitive development, these findings support the need for studies further characterizing the impact of a VI, the underlying pathophysiology and the effect of different rehabilitation procedures.

Concepts such as participation and environment may differ across cultures. Consequently, to use a measure like the Young Children’s Participation and Environment Measure (YC-PEM) in other than the original English-speaking contexts, cultural adaptation needs to be assured. The objective is to cross-culturally translate, adapt, and pilot test the YC-PEM into the Dutch language and culture. In total 3 cognitive interviews with caregivers and one focus group with Occupational Therapists (N = 5) working in early intervention were conducted to evaluate the cultural relevance of the YC-PEM content for use in a Dutch context. Data was analyzed by content analysis using semantic, idiomatic, content, and conceptual equivalence. The YC-PEM was pilot tested with 31 caregivers of children with and without disabilities. Setting specific estimates of internal consistency and test–retest reliability were obtained. Results show adaptations mainly focused on content and conceptual equivalence, with conceptual equivalence being the most challenging to reach. Internal consistency estimates varied from .42 to .93 for the participation scales and from .74 to .83 for the environmental scale. This study gives preliminary evidence for the use of a culturally adapted YC-PEM in Belgium and the Netherlands. Further validation in a larger sample is indicated to evaluate its psychometric properties.

Physical activity (PA) can improve children’s executive functioning (EF), which might be caused by increased levels of brain-derived neurotrophic factor (BDNF). This study investigated whether acute and/or chronic PA leads to increased BDNF levels and enhanced EF in children. Methods: In total, 47 children (mean age 9.69 ± 0.60; 46.8% boys) participated. Children performed a maximal exercise test to measure acute PA. Before and after, BDNF was collected and EF was measured. Chronic PA was proxy-reported. Repeated Measures ANOVAs were performed to study the effect of acute PA on BDNF and EF. Mediation analyses were performed to investigate the mediation effect of BDNF on the association between chronic PA and BDNF. Results: A borderline significant effect of acute PA on BDNF was found (F = 3.32, p = 0.075) with an increase in BDNF (+29.58 pg/mL) after acute PA. A significant effect was found for performance on inhibition tasks (Flanker (accuracy +5.67%, p = 0.034) and Go/No-Go (+0.15%, p = 0.022)). No effect of acute PA was found on the EF outcomes. No significant correlation between chronic PA and EFs nor BDNF was found. Conclusions: Acute PA might increase BDNF and improve some EFs (i.e., inhibition) in children. Chronic PA was not associated with EF nor BDNF. Trial Registration Number: NCT02503579.

This study aimed to explore the association between developmental coordination disorder (DCD) diagnosed after the age of three and both a standardized motor test—the Alberta Infant Motor Scale (AIMS)—and non-standardized observation of movement quality carried out before the age of three. Children at risk or with developmental concerns were studied retrospectively. Children were excluded in case of a diagnosis, excluding DCD, e.g., cerebral palsy, or IQ < 70. Of the 503 included children, 246 were diagnosed with (at-risk) DCD. Multivariate binary logistic regression revealed a significant association between DCD diagnosis after the age of three and male gender and with different aspects of poor movement quality in different age groups before the age three. Univariate analyses revealed an association between DCD diagnosis and the number of poor movement-quality descriptions at 0–6 months, 6–12 months, and 18 months–3 years but not with the AIMS scores. The MABC-2 scores after the age of three were significantly correlated with the number of poor movement-quality descriptions in age groups 0–6 months and 18 months–3 years and with the AIMS scores in age groups 6–12 months and 12–18 months. The results suggest that DCD can be associated with poor movement quality before the age of three.