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Aims: A computational model aimed to estimate the proportion of visual/motor deficits (first-order defects) and visual-motor abnormal integration (second-order defect) in dyslexic children is described. Study Design: Single-masked case-control study. Place and Duration of Study: Sample: Service of Neuro-Ophthalmology, University of Turin, between December 2017 and November 2018. Methodology: Twenty subjects (age 8-10) were administered a set of tests that recruit the visual and motor domain in different proportions. The score obtained in each trial is weighed by the correspondent share of visuoperceptive and motor recruitment. This way two indexes are obtained: Eta (h) and Mu (m), that quantify the expected and estimated damage of the two functions across the range of average performance. The difference between the expected and estimated level of damage in the two domains represents the quota of selective visuoperceptive / motor impairment of the subject. In turn, no or negligible difference in the presence of abnormal z-score would reveal impaired visual-motor integration with no evident visual or motor damage. Results: The model detected a prevalent first-order defect in the visuo perceptive or motor domain in 58% of the cases (visuo perceptive alteration: 27%, motor alteration: 73%), and a prevalent second-order defect in the remaining 42% of the subjects. Internal consistency was adequate for research and screening purpose (Cronbach’s coefficient alpha: from 0.77 to 0.84). Conclusion: The Eta/Mu model seems a promising tool to detect cases of visual and motor alteration as well as the level of visual-motor integration in dyslexic children. Further effort is needed to improve test-retest reliability by examining larger samples, so as to make it suitable to customize the rehabilitation program of children suffering from learning disabilities.

Repeated subconcussive blows to the head during sports or other contact activities may have a cumulative and long lasting effect on cognitive functioning. Unobtrusive measurement and tracking of cognitive functioning is needed to enable preventative interventions for people at elevated risk of concussive injury. The focus of the present study is to investigate the potential for using passive measurements of fine motor movements (smooth pursuit eye tracking and read speech) and resting state brain activity (measured using fMRI) to complement existing diagnostic tools, such as the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), that are used for this purpose. Thirty-one high school American football and soccer athletes were tracked through the course of a sports season. Hypotheses were that (1) measures of complexity of fine motor coordination and of resting state brain activity are predictive of cognitive functioning measured by the ImPACT test, and (2) within-subject changes in these measures over the course of a sports season are predictive of changes in ImPACT scores. The first principal component of the six ImPACT composite scores was used as a latent factor that represents cognitive functioning. This latent factor was positively correlated with four of the ImPACT composites: verbal memory, visual memory, visual motor speed and reaction speed. Strong correlations, ranging betweenr= 0.26 andr= 0.49, were found between this latent factor and complexity features derived from each sensor modality. Based on a regression model, the complexity features were combined across sensor modalities and used to predict the latent factor on out-of-sample subjects. The predictions correlated with the true latent factor withr= 0.71. Within-subject changes over time were predicted withr= 0.34. These results indicate the potential to predict cognitive performance from passive monitoring of fine motor movements and brain activity, offering initial support for future application in detection of performance deficits associated with subconcussive events.

We conducted a case-control study using the Eyesi simulator to assess the surgical performance of 24 chronic cocaine users (CCUs) and 24 sex-/age-matched controls to numerically quantify ophthalmic microsurgical simulator performance and fine motor deficiencies. The inclusion criteria were no exposure to illicit drugs other than cocaine, marijuana, or alcohol within the previous month and no health conditions that could impact manual task performance. The outcomes included surgical scores (0–100, worst-best) and task completion time (minutes). Fisher's exact test, analysis of variance, Mann-Whitney U test, and Kruskal-Wallis test followed by Dunn-Bonferroni post-hoc were conducted for statistical analysis. The Eyesi scores were lower among CCUs compared to controls for bimanual tasks (4.50 ± 14.30 vs. 18.46 ± 26.64, p = 0.012), for exercises demanding upper and lower limb coordination (both hands and two foot pedals, respectively) (74.13 ± 35.01 vs. 85.21 ± 24.1, p = 0.045), and in the overall score for all three tasks (27.38 ± 15.06 vs. 39.5 ± 18.66, p = 0.021). CCUs took longer to complete tasks when performing exercises demanding upper and lower limb coordination compared to controls (1.26 ± 0.38 vs. 1.02 ± 0.44 min, p = 0.006). Individuals who used cocaine during the previous month had an independent lower bimanual score compared to controls (1.42 ± 4.91 vs. 18.46 ± 26.64, p = 0.018). No differences in performance among the CCUs were attributable to sporadic cannabis or alcohol use. Chronic use of cocaine negatively impacted fine dexterity as measured by bimanual tasks or maneuvers that required simultaneous coordination of the upper and lower limbs. This was most notable among individuals who used cocaine during the 1-month period before the simulation.

Objective Deficits in fine motor coordination have been suggested to be associated with Attention-Deficit/Hyperactivity Disorder (ADHD). However, despite the negative impact of poor fine motor skills on academic achievement, researchers have paid little attention to this problem. The aim of this study was to explore the relationship between ADHD dimensions and fine motor performance. Method Participants were 43 children with a diagnosis of ADHD aged between 7 and 14 years ( M = 9.61; 81% male) and 42 typically developing (TP) children in the same age range ( M = 10.76; 75.2% male). Results Children with ADHD performed worse than TP on all tasks ( δ Fine_motor_tasks, −0.19 to −0.44). After controlling for age and ADHD-HY (hyperactivity/impulsivity), higher scores on ADHD-IN (inattentiveness) predicted a larger number of mistakes among all psychomotricity tasks and conditions ( β 0.39–0.58, p s Conclusion The ADHD group showed poorer fine motor performance than controls across all fine motor coordination tasks. However, lower performance (more mistakes), was related to the inattention dimension but not to the hyperactivity/impulsivity dimensions. Authors recommend including training and enhancement of the fine motor skills for more comprehensive ADHD treatment.

Hand function is critical for independence in activities of daily living for older adults. The purpose of this study was to examine how grip strength, arm curl strength, and manual dexterous coordination contributed to time-based versus self-report assessment of hand function in community-dwelling older adults. Adults aged ≥60 years without low vision or neurological disorders were recruited. Purdue Pegboard Test, Jamar hand dynamometer, 30-second arm curl test, Jebsen-Taylor Hand Function Test, and the Late-Life Function and Disability Instrument were administered to assess manual dexterous coordination, grip strength, arm curl strength, time-based hand function, and self-report of hand function, respectively. Eighty-four adults (mean age = 72 years) completed the study. Hierarchical multiple regressions show that older adults with better arm curl strength (β = −.25, p

Aim: The current study examined the relationship between cognitive performances (executive function, selective attention and reaction time), fine motor coordination skills and perceived difficulty after active transport to school. Method: Fifteen right-handed children’s underwent session, 15-min walking session at 30% (WS1) and 15-min walking session (WS2) at 50% of maximal aerobic speed. Subjects performed tests to evaluate executive function, reaction time and selective attention. After each trial, a questionnaire of perceived difficulty (PD) was completed. Results: Average time in TMT part A (F(2,22) = 4.44; p = 0.024; η2= 0.288) and TMT part B (F(2,22) = 4.54; p = 0.022; η2= 0.292), and committed errors (F(2,22) = 7.78; p = 0.003; η2= 0.414) was improved after walking sessions in comparison by CS. The mean scores were significantly higher after walking sessions for both long and short-distance throws (p < 0.05). Moreover, a significant negative correlation was found between committed errors (TMT part B) and both dart throwing consistency and accuracy (r = - 0.6; r = - 0.64; p < 0.05) (respectively). Post-hoc analysis showed that PD was better after walking sessions with low intensity for both short and long throwing distance. However, it seems that walking session with sustained intensity allows speed and accuracy improvement of cognitive processing. Conclusion: Thus, active walking to school with low intensity was sufficient to produce positives changes in psychomotor performance and decrease in perceived difficulty scores. By including individual differences in gross motor coordination as well as physical activity level, the exact nature of the link between psychomotor skills and cognitive performance could be more addressed.

Present study is focused on highlighting the effects of fine motor coordination errors in multiple reactions tasks to stimuli measured as correct, incorrect and omitted audio-visual stimuli. The hypotheses assume possible statistically differences in the stimuli reactivity between the group with less fine motor errors and the group with high number of errors (left and right hand and total errors). The instruments were the Labyrinth test B19 and the Determination test (Dt test), both from Vienna Tests System (2012). The results confirm only the hypotheses regarding the differences in stimuli reactivity by the influence of total number of errors.

When children are not ready to write, assessment of fine motor coordination may be indicated. The purpose of this study was to evaluate which fine motor test, the Nine-Hole Peg Test (9-HPT) or the newly developed Timed Test of In-Hand Manipulation (Timed-TIHM), correlates best with handwriting readiness as measured by the Writing Readiness Inventory Tool In Context-Task Performance (WRITIC-TP). From the 119 participating children, 43 were poor performers. Convergent validity of the 9-HPT and Timed-TIHM with WRITIC-TP was determined, and test-retest reliability of the Timed-TIHM was examined in 59 children. The results showed that correlations of the 9-HPT and Timed-TIHM with the WRITIC-TP were similar (rs = -0.40). The 9-HPT and the complex rotation subtask of the Timed-TIHM had a low correlation with the WRITIC-TP in poor performers (rs = -0.30 and -0.32 respectively). Test-retest reliability of the Timed-TIHM was significant (Intraclass Correlation Coefficient = 0.71). Neither of these two fine motor tests is appeared superior. They both relate to different aspects of fine motor performance. One of the limitations of the methodology was unequal numbers of children in subgroups. It is recommended that further research is indicated to evaluate the relation between development of fine motor coordination and handwriting proficiency, on the Timed-TIHM in different age groups.

The scientific literature shows that the acquisition of literacy is a basic and indispensable to consolidate school learning other instrumental learning. The processes involved in the acquisition of the reading and writing require sensory integration within a set sequential maturation process that must be programmed interconnection information to the brain as a result of the different and multiple connections occur between functional parts. At this point, the driving factors of the environment and stimulation are key, regardless of the presence or absence of learning difficulties during childhood. Thus, the development of motor patterns contributes to automatic movements that help decrease the burden of care for subjects increased: muscle tone (essential to consolidate the stroke) ; graphomotor balance, and General motor coordination as well as fine motor coordination (eye-hand, essentially). Often, because of the discrepancy of different maturation levels in relation to the acquisition of motor patterns in the early years, it might appear associated learning disabilities. In this paper the different motor patterns are identified and associated with the bases of the nervous system for understanding brain functionality and complexity associated with reading-writing processes. For this, attends a review of studies in which the incidence of these other variables is observed. Finally, recognizing the principle of prevention in education, it is considered that many of the difficulties related to reading and writing can be prevented with proper educational intervention in the early school years.Keywords: motor patterns, reading, writing, neuroscience, brain.Resumen.La literatura científica evidencia que la adquisición de la lectoescritura constituye un aprendizaje instrumental básico e indispensable para consolidar otros aprendizajes escolares. Los procesos que intervienen en la adquisición de la lectura y la escritura requieren de una integración sensorial dentro de un conjunto proceso madurativo secuencial en el que se ha de programar la interconexión de la información que llega al cerebro como efecto de las diferentes y múltiples conexiones que entre sus partes funcionales ocurren. En este punto, los factores motrices y la estimulación del entorno resultan claves, independientemente de la presencia o ausencia de dificultades de aprendizaje durante la niñez. De tal manera, el desarrollo de los patrones motores contribuye a generar automatismos en los movimientos que permiten disminuir la carga de atención de los sujetos por un aumento de: el tono muscular (indispensable para consolidar el trazo); el equilibrio grafomotor; y de la coordinación motriz general, así como de coordinaciones motoras específicas (óculomanual, esencialmente). Con frecuencia, como consecuencia de la discrepancia de diferentes niveles madurativos en relación a la adquisición de los patrones motores en los primeros años, puede ser que aparezcan dificultades de aprendizaje asociadas. En este trabajo se identifican los diferentes patrones motores y se asocian a las bases del sistema nervioso que permiten entender la funcionalidad del cerebro y su complejidad relacionada con los procesos lecto-escritores. Para ello, se atiende a una revisión de trabajos en los que se observa la incidencia de estas variables en otras. Finalmente, reconociendo al principio de prevención en educación, se considera que muchas de las dificultades relacionadas con la lectura y la escritura se pueden prevenir con una adecuada intervención educativa en los primeros años escolares.Palabras clave: patrones motores, lectura, escritura, neurociencia, cerebro.

Irregularities in force output are present throughout human movement and can impair task performance. We investigated the presence of a large force discontinuity (after-peak reduction, APR) that appeared immediately following peak in maximal effort ramp contractions performed with the thumb adductor and ankle dorsiflexor muscles in 25 young adult participants (76% males, 24% females; M age 24.4 years, SD = 7.1). The after-peak reduction displayed similar parameters in both muscle groups with comparable drops in force during the after-peak reduction minima (thumb adductor: 27.5 ± 7.5% maximal voluntary contraction; ankle dorsiflexor: 25.8 ± 6.2% maximal voluntary contraction). A trend for the presence of fewer after-peak reductions with successive ramp trials was observed, suggesting a learning effect. Further investigation should explore underlying neural mechanisms contributing to the after-peak reduction.

The authors report improved fine motor coordination when using Dexteria with a healthy population. Technology may improve patient engagement and participation when incorporated into treatment programs. - Kristin Valdes, OTD, OT, CHT, Practice Forum Editor, Journal of Hand Therapy.

This article describes the development of a teacher rating scale that is sensitive to a select group of behavior disorders exhibited by children in the classroom. The scale, the Illinois Classroom Assessment Profile (ICAP), was developed to distinguish among behavioral dimensions representing sustained attention, impulsivity, conduct, fine motor coordination, and evaluative anxiety. The fact that disorders in these behaviors are observed in children diagnosed as hyperactive has served as the impetus for this research. The ICAP is intended to facilitate research investigating the effects of specific treatments on each of these behavioral dimensions.

As a part of a large multidisciplinary clinical and research follow-up study, 47 Williams syndrome patients underwent detailed neurologic testing. Because previous studies have documented the absence of major neurologic signs in Williams syndrome, the neurologic testing focused on soft signs. Previous findings of impairment of both gross and fine motor coordination were confirmed, and the presence of mild cerebellar and extrapyramidal signs was documented. In a 4-year follow-up study, an age-related pattern was revealed: soft extrapyramidal signs became more evident from 8 years of age and increased in the 14+ age group. The results are discussed according to a hypothesis related to the dopaminergic system involvement in Williams syndrome: anomalous organization or accelerated ageing process.

Long term alcohol abuse causes physical, cognitive, psychological and neuropsychological deficit in alcoholic individual. Current study intends assess and rehabilitate fine motor coordination of chronic alcohol dependent cases. Seven chronic cases of alcohol dependence were selected from de-addiction ward of Ranchi Institute of Neuropsychiatry and Allied Sciences, Kanke. All the cases were assessed on LNNB & AIIMS Motor function scale. Each patient was individually given one month rehabilitation training with Talking Pen. All the cases were assessed in pre and post test condition. Result was analyzed using Wilcoxin Sign Rank Test. Result reveals there was significant difference between patient’s pre and post intervention performance which suggests improved fine motor functioning of the alcohol dependent individuals.

Background Visual-motor integration (VMI) skills are essential for successful academic performance, but to date no studies have assessed these skills in a population-based cohort of Australian Aboriginal children who, like many children in other remote, disadvantaged communities, consistently underperform academically. Furthermore, many children in remote areas of Australia have prenatal alcohol exposure (PAE) and Fetal Alcohol Spectrum Disorder (FASD), which are often associated with VMI deficits. Methods VMI, visual perception, and fine motor coordination were assessed using The Beery-Buktenica Developmental Test of Visual-Motor Integration, including its associated subtests of Visual Perception and Fine Motor Coordination, in a cohort of predominantly Australian Aboriginal children (7.5–9.6 years, n = 108) in remote Western Australia to explore whether PAE adversely affected test performance. Cohort results were reported, and comparisons made between children i) without PAE; ii) with PAE (no FASD); and iii) FASD. The prevalence of moderate (≤16th percentile) and severe (≤2nd percentile) impairment was established. Results Mean VMI scores were ‘below average’ (M = 87.8 ± 9.6), and visual perception scores were ‘average’ (M = 97.6 ± 12.5), with no differences between groups. Few children had severe VMI impairment (1.9%), but moderate impairment rates were high (47.2%). Children with FASD had significantly lower fine motor coordination scores and higher moderate impairment rates (M = 87.9 ± 12.5; 66.7%) than children without PAE (M = 95.1 ± 10.7; 23.3%) and PAE (no FASD) (M = 96.1 ± 10.9; 15.4%). Conclusions Aboriginal children living in remote Western Australia have poor VMI skills regardless of PAE or FASD. Children with FASD additionally had fine motor coordination problems. VMI and fine motor coordination should be assessed in children with PAE, and included in FASD diagnostic assessments.

The present study measured the short-term effect of special stimulating music on motor coordination in Parkinson patients. Eleven patients with a dominant akinetic Parkinson syndrome as well as ten healthy persons (age-matched control group) participated in this study. In the Parkinson group, the measurement of fine motor coordination with the 'Vienna Test System' showed an improvement in two (aiming, line tracking) of the four subtests after listening to the music. The patients improved their performance with the right arm significantly in the subtest aiming-error-time. No statistical differences were found in the other two subtests (steadiness, tapping) in both groups. There was also no improvement in frequency of tapping movement on the power-force-working-plate. Accordingly, music effects more the precision of a movement than the speediness. The measurements on the power-force-working-plate showed a significant improvement in two of five measured parameters: contact time, variability coefficient for total step and impact maximum changed significantly. This study gives evidence that specific music can improve the precision of arm and finger movements.

Motor coordination problems are common in different developmental disorders including autism and dyspraxia. Gross and fine motor coordination skills are critical to the appropriate motor coordination development that is relevant to support individuals' independence. Exergames are a good tool to help children practice motor skills as they find them engaging. In this work, we present how FroggyBobby an exergame designed for practicing gross motor coordination skills, can be extended to combine gross and fine motor exercises for supporting children with motor problems to practice self-care activities that require motor coordination.

Poor fine motor coordination including unestablished hand preference, poor bimanual coordination and avoidance of crossing the body midline in children are common reasons for referral to occupational therapy. Clinical observations suggest a possible correlation between these variables in children with learning disabilities (Ayres, 1973). Several occupational therapy intervention sources for children suggest that unestablished hand preference may be treated by employing exercises in bimanual coordination and crossing of the midline. However, there is little empirical evidence that a significant correlation exists between hand preference, bimanual coordination and crossing of the body midline. Specific investigation of the relationship between the three variables should provide a stronger basis for treatment of children presenting with problems in bilateral integration, crossing of the midline and poorly established hand preference. The nature of this relationship may shape the foundations for a spe...

The hemispheric lateralization of certain faculties in the human brain has long been held to be beneficial for functioning. However, quantitative relationships between the degree of lateralization in particular brain regions and the level of functioning have yet to be established. Here we demonstrate that two distinct forms of functional lateralization are present in the left vs. the right cerebral hemisphere, with the left hemisphere showing a preference to interact more exclusively with itself, particularly for cortical regions involved in language and fine motor coordination. In contrast, right-hemisphere cortical regions involved in visuospatial and attentional processing interact in a more integrative fashion with both hemispheres. The degree of lateralization present in these distinct systems selectively predicted behavioral measures of verbal and visuospatial ability, providing direct evidence that lateralization is associated with enhanced cognitive ability.

The role of glial cells and their interaction with neurons in normal behavior is unclear. To address this question, Saab et al. studied a special type of glial cell in the cerebellum. Conditional mutant mice were produced in which the two glutamate receptor subunits normally present in Bergmann glial cells were efficiently ablated in a temporally controlled manner. Glutamate signaling of the glial cells contributed to the structural and functional integrity of the cerebellar network. Bergmann glial cells also played a role in the “fine-tuning” of neuronal processing, which is crucial for the fast and precise control of complex motor behavior. A. S. Saab, A. Neumeyer, H. M. Jahn, A. Cupido, A. A. M. Simek, H.-J. Boele, A. Scheller, K. Le Meur, M. Gotz, H. Monyer, R. Sprengel, M. E. Rubio, J. W. Deitmer, C. I. De Zeeuw, F. Kirchhoff, Bergmann glial AMPA receptors are required for fine motor coordination. Science 337 , 749–753 (2012). [Abstract][Full Text]

Children with developmental coordination disorder are most frequently evaluated for deficits in fine and gross motor skills. Several studies have assessed the relationship between motor incoordination and gross measures of cognition, although there has been minimal research investigating the relationship between coordination deficits, comprehensive cognitive abilities, and academic performance. We present a case study of an 8‐year‐old White boy with developmental coordination disorder who was reported to have significant academic problems, primarily in handwriting and timely completion of his work secondary to his motor deficits. Neurologic, occupational, and physical therapy evaluations reported gross and primarily fine motor coordination deficits with recommendations for standard occupational therapy services. A neuropsychological evaluation revealed generally average abilities on verbal measures and visuospatial measures not requiring motor skills but generally deficient abilities on all visuospatial m...

Brain injury, genetic manipulations, and pharmacological treatments can result in alterations of motor skills in mice. Fine motor coordination and balance can be assessed by the beam walking assay. The goal of this test is for the mouse to stay upright and walk across an elevated narrow beam to a safe platform. This test takes place over 3 consecutive days: 2 days of training and 1 day of testing. Performance on the beam is quantified by measuring the time it takes for the mouse to traverse the beam and the number of paw slips that occur in the process. Here we report the protocol used in our laboratory, and representative results from a cohort of C57BL/6 mice. This task is particularly useful for detecting subtle deficits in motor skills and balance that may not be detected by other motor tests, such as the Rotarod.

The purpose of this study was to evaluate the effect of acute sleep deprivation on the fine motor coordination in obstetrics and gynecology residents.Twenty-eight obstetrics and gynecology residents completed a series of tasks using the Purdue pegboard standardized protocol for testing fine motor coordination both before and after a 24-hour call.Twenty-three participants were women and 5 were men. There was a learning curve demonstrated for performance of the tasks. There was a statistically significant decline in performance of residents after overnight call. When adjusting for the learning curve, effects of sleep deprivation were magnified for all tasks: right (dominant) hand (P = .0005), left hand (P = .0020), both hands (P.0001), and assembly (P.0001). There were significant differences in performance when segregated by year of training and sex; female residents appeared to tolerate better lack of sleep.Acute sleep deprivation has a deleterious effect on fine motor coordination in this group of obstetrics and gynecology residents.

A study was made of the oral diadochokinetic rates, non-linguistic rhythmic skills and auditory sequential memory of 60 normal and 30 severely speech-disordered children aged 3-5 years. Results were analysed and the speech-disordered children showed a wide range of difficulties. All age groups of the speech-disordered children scored significantly less well than the normal children on the three tasks. Their diadochokinetic rates showed a particular problem with the sequencing of different sounds rather than with repetitions of the same sound. Their rhythmic skills showed greatest difficulty with the stress component of the task. Their auditory sequential memory was significantly poorer than the normal children. These difficulties are interpreted as a sign of a deficit of fine motor coordination and timing in the speech-disordered children. Diadochokinetic rates and non-linguistic rhythmic skills are shown to be developmentally age-related abilities in normal children.

In an attempt to achieve functional grasp and release, the intrinsic muscles are frequently a secondary goal or completely over looked. Their importance in fine motor coordination is significant for performing daily tasks. Very few therapy tools are designed to help in this area. This group of therapists has nicely designed a tool to assist in strengthening the intrinsics.

Objectives The DSM-IV-TR criteria for Developmental Coordination Disorder (DCD) involve a marked impairment in the development of motor coordination although visuo-spatial, digital and visuo-motor perception, neuromuscular tone, qualitative and quantitative measures of gross and fine motor coordination related impairments might be used to isolate three main subtypes of DCD/dyspraxia: ideo-motor, visuo-spatial and constructional, and a mix group sharing common impairments with additional comorbidities. This study focus on isolating specific markers of coordination disorder and their interactions in mix vs. pure form of dyspraxia. Methods Tree-based bagged classifiers were used to highlight relevant markers among 49 pass/fail tests that best discriminate two clinical subgroups based on a sample (N = 63) of 5–15 years old children having IQ in the expected range (40% mix dyspraxia). Model calibration was done on a training sample through nested repeated 5-fold cross-validation while predictive performance were assessed on a held-out validation sample, using a split ratio of 0.7/0.3. Results We found that digital praxia, imitation of gestures, manual dexterity, digital perception, lego blocks, and visual motor integration were among the top most important impairments when predicting subtypes. Specific interactions among those predictors and other impairments (motor pathway, visual evoked potential, language) were shown to provide additional insights into DCD subtyping. Conclusions Taylored follow-up of patients presenting with DCD should consider the specificity of visuo-spatial, neuromotor and neuropsychological impairments whose co-occurrence allow to define different subtypes of DCD.

The effect of severe trauma on handedness was studied through patient responses from 146 questionnaires that were correlated with individual chart review. Subjects were asked to designate their hand use preference, before and after injury, when performing 16 activities. The incidence of change in hand use was determined within four diagnostic types and five designated anatomical levels of injury. Results indicated a significant difference in the way subjects in different diagnostic types and anatomical levels of injury performed. Simple, short activities that did not require sustained fine motor coordination were reported as being performed more easily with a different hand after injury than complex, continuous activities that required sustained fine motor coordination. Significant differences in job duties and place of employment were found for the anatomical level of an injury but not for diagnostic type. Findings suggest that the diagnostic type, the anatomical level of an injury, and the complexity of a task should be considered before changes in hand use are recommended.

An auditory and acoustic analysis was performed of the voice production of 24 children between 5 and 8 years of age with unintelligible speech and 24 children without speech or language deficits matched for age. Two aspects of voice production were assessed, prephonatory tuning and phonatory modulation. The categories used for the auditory assessment were preutterance vocalizations, abnormal initiation, rough voice, breathy voice, tense voice, voice tremor, intraphonemic disruption and pitch break. The acoustic analysis consisted of calculation of the mean fundamental frequency and the pitch perturbation factor in repetitions of the series of syllables /pa/, /ta/, /ka/. Intrasyllabic pitch breaks were also noted. The children with unintelligible speech had significantly more signs of abnormal prephonatory tuning and abnormal phonatory modulation than the control children. The findings suggest that voice production in unintelligible children has not yet become automatized. This possibility is discussed in relation to the central control of phonation.

A controlled retrospective study of some short-term and long-term effects of elective induction of labour was conducted. There did not appear to be any increase in the incidence of maternal complications during labour, or of neonatal problems in the induced-labour group compared with the remainder of the mothers in the hospital. In the follow-up phase of the study, two treatment groups of children who were delivered after amniotomy and amniotomy plus the administration of oxytocin were compared with each other, and with a control group of children born after spontaneous labour. The children were assessed at the age of five years on verbal and non-verbal subtests of a standardized intelligence scale, tests of gross motor and fine motor coordination, and auditory and visual tests. A full physical examination was also performed. No statistically significant differences nor trends of clinical interest were found between the groups on any measure.

Twenty young Naval enlisted male volunteers were first rehearsed and then tested before, during, and after vertical (z-axis) whole-body vibration. Fourteen were tested only at 8 Hz, and six were tested at 8 Hz/0.21 gz rms, 16 Hz/0.43 gz rms and 32 Hz/0.85 gz rms, using three paper-and-pencil tasks involving visual, motor, and cognitive skills. The tasks were ‘Spoke’, a speed of tapping test; “Aiming”, a test of fine motor coordination; and “Coding”, involving mental computation. Results showed an approximately equal decrement across conditions in the Spoke and Coding (but not Aiming) tests that conforms with the frequency function embodied in the current international standard (ISO 2631–1978) on human exposure to vibration. In addition, it was found that a modicum of vibration experience may be necessary before reliable data are obtained in this kind of testing. Implications for methodology and for the application of the current standard are briefly discussed.

The recognition and evaluation of deficits and abnormalities related to the development of feeding require comprehensive and systematic observation. This article describes both gross and fine motor coordination, as well as primitive reflexive movement, which influence eating. Oral-pharyngeal reflexes, the function of the tongue, oral hygiene, and the condition of the teeth are described relative to their influence on the feeding process. The development of eating behaviors of children are briefly outlined.

The Purdue Pegboard provides an excellent test of fine motor coordination. Unfortunately, extensive data have not been collected from children. Accordingly, most examiners use the instrument subjectively ‐ relying on their impressions and experience regarding normal and abnormal performance. To enhance the efficacy of this valuable instrument, the author and his assistants collected data from 1334 normal school children (663 boys and 671 girls) ages 5–16. The group was divided into half‐year age groups. For each half‐year group means, standard deviations, and percentile ranks are provided, enabling the examiner to quantify a patient's score on this valuable test of fine motor coordination. In order to ascertain whether the instrument's use in the MBD diagnostic battery is justified, the scores of the normal children were compared with those of 212 children (145 boys and 67 girls) with well‐diagnosed neurologically based learning disabilities (MBD)

Two 16-member groups of 5- and 6-year-old children, one group with a history of chronic otitis media and one without such a history, were tested on three measures of motor performance. These were the Motor Accuracy Test–Revised, the Stott Test of Motor Impairment, and measures of duration of standing balance. These instruments assess, respectively, fine motor coordination, overall motor skills, and balance. On each of these measures, children with a history of chronic otitis media scored lower than children without such a history. However, when these scores were compared statistically, no significant differences were found between the two groups. Because the results of this study were inconclusive, routine motor performance evaluation of children with a history of chronic otitis media is not advocated at this time.

Pregnant rats were administered a teratogenic dose of vitamin A excess on Days 17 and 18 of gestation. Intubation controls received the vehicle alone and nontreated mothers were left undisturbed. All groups were fostered to other nontreated mothers at birth. During adulthood, offspring were lever-trained to obtain a water reward on an intermittent reinforcement schedule and on an S+, S− auditory discrimination. Unlike animals treated with vitamin A excess on Days 14 and 15 of gestation, these animals revealed no retardation in growth and development nor in brain size. Throughout the VI-40 sessions and the S+ trials of discrimination training, the vitamin A animals had consistently slower rates of response compared to the controls. However, they did not evidence any impaired learning ability; like the nontreated, they extinguished S− responding, acquired long S− latencies, and maintained short S+ latencies. Possibly, the treatment may have produced a subtle motor deficit affecting fine motor coordination.

Factor analyses were accomplished on the de Hirsch Test Battery scores generated by 50 5½-yr.-old youngsters. The investigator attempted to replicate sampling and screening measures used by de Hirsch in her original work. Results were interpreted in terms of Buktencia's task-analysis approach and also Satz's theoretical model of learning disability. The de Hirsch Index taps a major visual discriminatory component which is interlocked with progressively more complex processes ranging from fine motor coordination productions to immediate memory for complex visual symbols.

There is wide variation in the length of the Y chromosome. In the same individual the length varies continuously and is normally distributed. We describe a boy with borderline mental retardation, gross and fine motor coordination difficulty, muscle rigidity, ptosis, clinodactyly, and a Y chromosome of different lengths in two separate cell populations. The most probable explanation of the cytogenetic finding is a mitotic unequal sister chromatid exchange of the Y chromosome.

Eight patients with Williams syndrome and 6 with Down syndrome, matched for age and full-scale IQ, underwent detailed neurologic testing as part of a large multidisciplinary research center study. Williams syndrome patients were small for gestational age and often had histories of failure-to-thrive and feeding problems as infants. Half of the Williams syndrome patients had epilepsy. On neurologic testing, Williams syndrome patients had greater difficulty with gross and fine motor coordination, oromotor skills, and cerebellar function than did those with Down syndrome. The neurologic distinctions between these 2 groups may reflect an underlying, as yet undefined, metabolic defect in Williams syndrome.

The performance on the Illingworth of 32 3-mo.-old home-reared Greek infants was compared to that of 22 infants reared in a modern institution. Home-reared infants were superior to institutional infants in every aspect of development except on Manipulations (fine motor coordination). It is speculated that the superiority of the home infants is attributed to the quality of the mother/caretaker-infant relationship.

Fifty children with minimal brain dysfunction who had handwriting deficits received methylphenidate or placebo under double-blind conditions. Twenty-six children (52%) showed improvement in hand-writing following treatment with methylphenidate for four weeks. One child receiving placebo had improvement in handwriting, but his handwriting improved further after he was switched to methylphenidate. In general, handwriting tended to deteriorate promptly when drug treatment was discontinued. Thirty-six patients (72%) receiving methylphenidate for four weeks were rated behaviorally improved by teachers; in contrast, seven children (14%) showed behavioral improvement following treatment with placebo. Improvement in attention and behavior, which was ascertained by the use of Conner's Abbreviated Teacher Rating Scale, did not always correspond with improvement in handwriting. Advances in handwriting skills following treatment with methylphenidate may have been directly related to improvement in fine motor coordination. Gains in handwriting were maintained for up to 26 months of follow-up in 21 children who received methylphenidate on a long-term basis.

To test the hypothesis that iron deficiency in infants and children is associated with behavioral alterations, 24 infants with iron deficiency anemia, ages 9 to 26 months, were randomly assigned to a treatment and control group. Bayley Scales of Infant Development were administered before treatment with intramuscular iron or placebo; the test was readministered in five to eight days. Children treated with iron showed a significant increase in their scores on the Mental Development Index averaging a mean gain of 13.6 points in a mean time of 6.8 days. The treated group was also found to become more alert and responsive and demonstrated improvement in tests of gross and fine motor coordination. These findings support the hypothesis that iron deficiency in infants produces developmental alterations and that these changes are rapidly reversible with iron therapy.

Children with average intelligence and without any auditory defects are expected to have a small vocabulary of 15–20 meaningful words by 18–20 months of age. By 2 years, most normal children can and do communicate their needs and wants. Speech development occurs earlier in girls than in boys, although boys show a greater rate of progress later on and catch up with the girls. Physical maturation influences language development by providing the child with a variety of experiences that stimulate his desire and ability to talk. Furthermore, fine motor coordination of the muscles of articulation is a prerequisite for speech development. The emotional atmosphere of the home and the amount of verbal interaction between the parents and the child and the child and his sibs are all instrumental in the child’s rate of language acquisition and ability to communicate. The impersonal exposure to the language emanating from communications media such as television and radio has not proved to be a helpful model for language enrichment, although television sets and/or radios are found in the majority of American homes. The failure to acquire speech by 2–21/2 years of age calls for an investigation into etiology and the initiation of a treatment program for the child.

A seven-generation pedigree of apparent X-linked, nonspecific mental retardation is reported. There are 19 known affected males who appear to have received the gene through normal mothers. Retardation, lack of fine motor coordination, hyperactivity and a speech defect are the characteristics of affected individuals studied.

experiments were conducted to determine the effects of induced hypnotic anesthesia in S's dominant arm upon the performance of various motor coordination tasks. Experiment 1 assessed the ability of Ss to tap a pencil within a 20 mm diameter circle while the limb performing the task was or was not anesthetized. Experiment 2 determined the effect of hypnotic anesthesia upon the ability to perform a hand-turn task. Experiment 3 considered the effects of hypnotic anesthesia on the ability to draw and duplicate a sine-wave pattern. In all 3 experiments, hypnotic anesthesia adversely affected task performance. The results were interpreted as indicating a possible relationship between induced hypnotic anesthesia and mimicked cerebellar dysfunction.

This study investigated specific aspects of neurodevelopmental functioning in good and poor readers entering second grade and followed their neurodevelopmental course and reading progress over a three-year period. Poor readers at age seven performed significantly worse than good readers on assessment of gross and fine motor coordination and corticosensory functioning. Furthermore, the presence of soft signs at age seven was significantly predictive of reading achievement at age ten. Group differences in neurodevelopmental functioning disappeared by age ten, and the presence of soft signs at ages eight and nine no longer was predictive of reading achievement. These findings have implications for pediatricians, educators, and researchers exploring brain-behavior relationships.