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

Mijna  Hadders-Algra

Albert  Gramsbergen

Discussion: Significance and Treatment of Clumsiness in Children

The aim of this paper is to review (i) the
spectrum of neuromotor function at school age in
children who had been born full-term and
presented with neonatal encephalopathy (NE) and
low Apgar scores and (ii) the relation between the
presence/absence of such difficulties and neonatal
brain MRI. Motor outcome appears to be mainly
related to the severity of basal ganglia and
internal capsule involvement. Severe basal ganglia
lesions were always associated with the most
severe outcome, microcephaly, tetraplegia, and
severe global delay, whereas more discrete basal
ganglia lesions were associated with athetoid
cerebral palsy, with normal cognitive development
or minor neuro-motor abnormalities. White
matter lesions were associated with abnormal
motor outcome only if the internal capsule was
involved. Children with moderate white matter
changes but normal internal capsule, had normal
motor outcome at school age.

Eugenio Mercuri

Anna L. Barnett

Neonatal Brain MRI and Motor Outcome at School Age in Children
with Neonatal Encephalopathy: A Review of Personal Experience

The development of action is depicted asconsisting of changes in the task-specificcouplings between perception, movement, andposture. It is argued that this approach mayprovide a much needed basis from whichattempts can be made at theoretically unifyingthe constituents of the clinical continuum (viz.,early detection, diagnosis, prognosis, andintervention). Illustrative examples germane tothis approach are given with regard to howposture serves as a constraint on the emergenceof reaching movements and how corticaldevelopment influences the coordination of legmovements as revealed by a study involvinginfants with white matter lesions. Particularattention is paid to early detection and it isrecommended that further improvements tothis aspect of the clinical continuum can bederived from combining serial qualitative andquantitative (kinematic) assessments withbrain-imaging techniques. It is emphasized thatquantitative assessments should incorporateexperimental manipulations of perception,movement or posture during transitionalperiods in development. Concluding commentsinclude consideration of the timing of earlyintervention.

Brian  Hopkins

Development of Action and the Clinical Continuum

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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

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Papers are published upon acceptance, regardless of the Special Issue publication date.

Neural Plasticity

The Clumsy Child

The Clumsy Child

Articles

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

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