Children presenting with DevelopmentalCoordination Disorder or clumsiness oftenexhibit signs of minor neurological dysfunction(MND). The data of the Groningen PerinatalProject, a long-term follow-up project .on therelations between prenatal and perinataladversities and neurological, behavioral, andcognitive development revealed that two basicforms of MND can be distinguished: simple andcomplex MND. During school age children withsimple MND are characterized by the presenceof one or two dysfunctional clusters of MND, inadolescence by the presence of choreiformdyskinesia or hypotonia. Probably the majorsources of origin of simple MND are geneticconstitution and stress during early life. SimpleMND might reflect the lower tail of the normaldistribution of the quality of non-pathologicalbrain function. In line with this hypothesis isthe finding that simple MND is associated withonly a moderately increased risk for learning andbehavioral problems. Children withcomplex MND present at school age with atleast three dysfunctional clusters of MND, inadolescence with problems in fine manipulationor coordination. Perinatal adversities play anevident etiological role in the development ofcomplex MND, suggesting that it might beattributed to a lesion of the brain at early age.In line with this idea is the finding that complexMND shows .a strong correlation with attentionand learning problems.

Mijna  Hadders-Algra

Developmental Coordination Disorder: Is Clumsy Motor Behavior Caused by a Lesion of the Brain at Early Age&#0063;

Developmental coordination disorder (DCD)
is a common motor problem affecting—even in
rather severe form—several percent of school
age children. In the past, DCD has usually been
called ‘clumsy child syndrome’ or ‘non-cerebralpalsy
motor-perception dysfunction’. This
disorder is more common in boys than in girls
and is very often associated with psychopathology,
particularly with attention-deficit/hyperactivity
disorder (ADHD) and autism spectrum disorders/
autistic-type problems. Conversely, children
with ADHD and autism spectrum problems,
particularly those given a diagnosis of Asperger
syndrome, have a very high rate of comorbid
DCD. Psychiatrists appear to be unaware of this
type of comorbidity in their young patients.
Neurologists, on the other hand, usually pay
little attention to the striking behavioral and
emotional problems shown by so many of their
‘clumsy’ patients. A need exists for a much
clearer focus on DCD—in child psychiatry and
in child neurology—both in research and in
clinical practice.

Christopher Gillberg

Bj&#xf6;rn Kadesj&#xf6;

Why Bother About Clumsiness? The Implications of Having Developmental Coordination Disorder (DCD)

Mijna Hadders-Algra

Albert Gramsbergen

The Clusmy Child: Where Are We and Where Are We Going&#x3F;

Awareness of children who experienceunexpected difficulty in the acquisition ofmotor skills has increased dramatically over thelast twenty years. Although the positing of adistinct syndrome has proven seminal inprovoking further questions, several basicterminological problems remain unresolved. Inthis paper, we conduct a component analysis ofthe three, principal competing labels for thisdisorder, two of them being elements derivedfrom systematic diagnostic frameworks. Ourpreference for the DSM IV term DevelopmentalCoordination Disorder (DCD) is stated findjustified. Problems in diagnosis are discussed,especially in relation to the etiology-dominatedmedical model. We argue that an attempt shouldbe made to identify (pathological) positive signsthat can reliably be detected rather than relyingentirely on normative evidence of a lack ofskills exhibited by other children of the sameage. The high degree of overlap between DCDand other developmental disorders suggeststhat DCD might not constitute a distinctsyndrome. In this context, we emphasize theneed to determine whether incoordination takesa different form when it occurs alone orwhether it is combined with generaldevelopmental delay or with other specificdisorders in children of normal intelligence.

Sheila E. Henderson

Leslie  Henderson

Toward An Understanding of Developmental Coordination Disorder:Terminological and Diagnostic Issues

A brief survey is given of how motoneuronsand motor units are used for the gradation Ofmuscle force during motor behavior. Basicproperties of motoneurons and muscle fibers,including major kinds of functional specializationalong the axis of &#8216;fast&#8217; vs. &#8216;slow&#8217;, are reviewed.The principles underlying the rate and recruitmentgradation of force are described, stressingthat the properties of motoneurons and musclefibers are matched to automate importantaspects of the gradation procedure. Recentinvestigations concerning synaptically evokedchanges in the discharge properties of motoneuronsreceive special attention, including&#8216;plateau&#8217; currents and, under appropriateconditions, self-sustained &#8216;plateau&#8217; discharges.

D.  Kernell

Principles of Force Gradation in Skeletal Muscles

J. A. Eyre

Development and Plasticity of the Corticospinal System in Man

The aim of this pilot study was to evaluatethe effectiveness of a Neuromotor TaskTraining (NTT), recently developed for thetreatment of children with DevelopmentalCoordination Disorder (DCD) by pediatricphysical therapists in the Netherlands. NTT isa task-oriented treatment program basedupon recent insights from motor control andmotor learning research. Ten children withDCD (intervention group) were tested beforeand after 9 and 18 treatment sessions on theMovement ABC and a dysgraphia scale inorder to measure the effectiveness oftreatment on gross and fine motor skills ingeneral and handwriting in particular. Fivechildren (no-treatment control group) weretested twice with a time lag of nine weeks onthe Movement ABC in order to measurespontaneous improvement. No improvementwas measured for the children in the notreatmentcontrol group, whereas a significantimprovement was found for children in theintervention group for both quality ofhandwriting and performance on theMovement ABC after 18 treatment sessions.

M. M. Schoemaker

A. S. Niemeijer

K.  Reynders

B. C. M. Smits-Engelsman

Effectiveness of Neuromotor Task Training for Children with Developmental Coordination Disorder: A Pilot Study

Little is known about prenatal and perinatalbrain injury resulting in subsequent clumsybehavior in children. One candidate motor systemis the pyramidal tract. The tract traverses theentire central nervous system and, through directand indirect connections to the brainstem andspinal cord sensory and motor nuclei, is involvedin the learning and execution of skilled movements.Here, rats, either naive or pretrained on anumber of motor tasks, were assessed for acuteand chronic impairments following complete orincomplete pyramidal tract lesions. Postsurgeryrats with complete lesions were impaired on thequalitative measures of limb aiming, supination,and posture. Impaired movements requirefixations, complementary movements in differentbody segments. The impairment in fixations wasmanifest acutely and underwent no improvementwith subsequent training/testing. The finding thatcomplete and partial pyramidal tract lesionsproduce chronic impairment in fixations providesinsight for understanding clumsy behavior inhumans and its potential remediation via specifictraining in making fixations.

Ian Q. Whishaw

Dionne M. Piecharka

Felicia R. Drever

Complete and Partial Lesions of the Pyramidal Tract in theRat Affect Qualitative Measures of Skilled Movements:Impairment in Fixations as a Model for Clumsy Behavior

This paper briefly reviews the functional
anatomy of the basal ganglia and their
relationships with the thalamocortical system.
The basal ganglia, including the striatum,
pallidum, subthalamic nucleus, and substantia
nigra, are involved in a number of parallel,
functionally segregated cortical-subcortical
circuits. These circuits support a wide range of
sensorimotor, cognitive and emotional-motivational brain functions. A main role of the
basal ganglia is the learning and selection of the
most appropriate motor or behavioral
programs. The internal functional organization
of the basal ganglia is very well suited for such
selection mechanisms, both in development and
in adulthood. The question of whether
clumsiness may be, at least in part, attributed
to dysfunction of the basal ganglia is discussed
in the context of the differential, complementary,
or interactive roles of the basal
ganglia and the cerebellum in the development
of motor control.

Henk J. Groenewegen

The Basal Ganglia and Motor Control

Albert  Gramsbergen

Discussion: Significance and Treatment of Clumsiness in Children

About this journal

Neural Plasticity is an interdisciplinary journal dedicated to the publication of articles related to all aspects of neural plasticity, with special emphasis on its functional significance as reflected in behavior and in psychopathology.

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Chief Editor, Professor Baudry, is currently University Professor at Western University of Health Sciences in Pomona, CA. His research focuses on understanding the molecular/cellular mechanisms of learning and memory and neurodegeneration.

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Neural Plasticity

This Issue is now open for submissions.
Papers are published upon acceptance, regardless of the Special Issue publication date.

Neural Plasticity

The Clumsy Child

The Clumsy Child

Articles

Developmental Coordination Disorder: Is Clumsy Motor Behavior Caused by a Lesion of the Brain at Early Age?

Why Bother About Clumsiness? The Implications of Having Developmental Coordination Disorder (DCD)

The Clusmy Child: Where Are We and Where Are We Going?

Toward An Understanding of Developmental Coordination Disorder: Terminological and Diagnostic Issues

Principles of Force Gradation in Skeletal Muscles

Development and Plasticity of the Corticospinal System in Man

Effectiveness of Neuromotor Task Training for Children with Developmental Coordination Disorder: A Pilot Study

Complete and Partial Lesions of the Pyramidal Tract in the Rat Affect Qualitative Measures of Skilled Movements: Impairment in Fixations as a Model for Clumsy Behavior

The Basal Ganglia and Motor Control

Discussion: Significance and Treatment of Clumsiness in Children