Motor skill acquisition in children with poor motor coordination

Physical Activity is essential for growth, development and wellbeing. Children with poor motor coordination are known to have lower levels of participation in physical activity and exercise in comparison to their typically developing peers, at least partly due to the difficulty in acquiring the motor skills they need for participation. Reduced participation in physical activity in childhood increases the risk of developing obesity, cardiovascular disease and psychosocial problems which persist throughout adolescence and adulthood. Poor motor coordination in these children has been largely attributed to their difficulty in acquiring and performing motor skills. However, motor skill acquisition is not yet well understood in this group, in particular whether these children are able to improve the quality of their movement and the pattern of motor skill acquisition. The following thesis aims to investigate the motor skill acquisition in a group of children with motor coordination difficulties and is comprised of two main studies. The first one aims at creating a simple and easy tool for screening coordination in large cohorts of children in mainstream schools in order to identify children with poor motor coordination. The second study is a pilot/feasibility study aimed at informing the implementation of a fully powered follow-up motor learning intervention trial. It involved detection of a sample of children with poor motor coordination using the designed screening tool in 3 mainstream schools and recruiting them into a physical training intervention with an embedded practice of a novel rhythmic stepping task. The characteristics of their performance throughout the training program were investigated by instrumenting the stepping ask and comparing the performance with a group of children with normal motor coordination. Applying a reduction analysis on a large set of motor screening data (which included test items from The Bruininks-Oseretsky Test of Motor Proficiency-Short Form (BOT-SF) as well as Fundamental Movement Skill), we successfully designed a test which has face validity for detection of children with poor coordination. Using this test, we screened a total of 571 students (273 females and 298 males) from 3 main stream schools in Oxfordshire and invited students who scored below the 25th percentile on our screening test (117; 53 girls and 64 boys) to an 11 week training intervention. Thirty-three students attended the intervention (21 girls and 12 boys) with a great difference in recruitment and retention rates between the schools. The learning of the novel motor skill was measured by analysis of the participants’ performance on a novel stepping task, in which they stepped rhythmically in accordance to a sequence of visual stimuli presented on a computer screen. The performance (movement time), measured using accelerometry, was significantly worse in children with coordination problems (p<.001) mean±SD= 1.193±.036. Importantly, children with poor motor coordination were able to improve their performance on the task with no significant differences between the groups. However, we observed a tendency for difference in the pattern of improvement over time (p=.06). Given the nature of the conducted studies, i.e. as feasibility studies, our findings don’t allow of a straightforward generalisation. Still, they entail important implications in clinical and school-based training interventions, directed towards children with poor motor coordination, and it is recommended that a follow-up trial take place which takes into account the suggestions mentioned in this thesis with regards to the involvement of schools, importance of applying successful recruitment strategy and the requirements of successful intervention