Alice Gomez

Research Objectives in Motor Coordination Disorders

Introduction to the Presentation

• Alice Gomez, Deputy Director for Research at INSP and CRNL, expresses gratitude for the invitation and excitement to present her current work.

• She aims to discuss the role of the body in developmental coordination disorders (TDC) and will address cognitive aspects if time permits.

Overview of the Program "Encore"

• The "Encore" program is a universal intervention designed for all preschool children to enhance their body representation.

• This research project was developed collaboratively with professionals including psychomotor therapists, preschool teachers, and occupational therapists.

Understanding Developmental Coordination Disorder (TDC)

• TDC is defined as a disorder affecting motor coordination development, evaluated through standardized tests like MABC2.

• Children with dyspraxia struggle with daily tasks such as dressing or writing, impacting their academic performance and participation in sports or arts.

Prevalence and Risk Factors

• Although prevalence studies are lacking in France, it is estimated that one child per class may be affected by TDC.

• Genetic influences and environmental factors contribute to TDC; prematurity is identified as a significant risk factor.

Case Study: Louis's Challenges

• A video illustrates Louis's difficulties with motor skills, particularly when tying his shoes, highlighting his struggles with body coordination.

• The presentation transitions into discussing how these motor challenges relate to difficulties in accurately constructing a body representation.

Understanding Body Representation in Children with Dyspraxia

The Complexity of Body Representation

• The concept of body representation is complex, involving the integration of multiple sensory inputs such as balance, proprioception, vision, and somesthesia.

• Different forms of brain representations exist; these are well-studied and will be elaborated on later in the presentation.

• Early construction of body representation begins at birth and continues to refine throughout childhood into adolescence.

Importance for Children with Dyspraxia

• Professionals report that children with dyspraxia struggle with tasks requiring knowledge of specific body parts (e.g., fingers, eyes, mouth).

• This impaired body representation can hinder children's participation in daily activities.

• Current research indicates that sensory information may be altered in dyspraxic children, affecting their body representation.

Proprioceptive Deficits

• Recent studies by Marion Nafréchou show deficits in proprioception among dyspraxic children—specifically their ability to perceive bodily position without visual input.

• In a study involving 9 to 12-year-olds, dyspraxic children demonstrated less precision in reproducing perceived angles compared to neurotypical peers.

Sensory and Motor Representations

• Observations suggest that sensory deficits may disrupt accurate body representation development.

• The brain organizes sensory signals from specific body parts (e.g., fingers), which helps construct a refined mental map over time.

Evaluating Body Representation Accuracy

• Researchers aim to compare the accuracy of body representations between dyspraxic children and neurotypical individuals through tactile localization tasks.

• Participants will identify touched fingers while blindfolded to assess their awareness of different body parts' positions.

This structured overview captures key insights from the transcript regarding the complexities surrounding body representation in children with dyspraxia. Each point is linked directly to its corresponding timestamp for easy reference.

Understanding Sensory and Motor Representation in Dyspraxia

Results of the Sensory Task

• Participants perceive a colored sticker that lights up, measuring whether they accurately raise their finger or confuse it with others. The results are presented as confusion matrices.

• Confusion matrices are created for neurotypical adults, neurotypical children, and children with dyspraxia, showing cumulative responses from participants during trials for each finger.

• For neurotypical adults, when stimulating the thumb, responses are consistently accurate, resulting in a dark square on the matrix indicating high precision in body part differentiation.

• Neurotypical children's diagonal accuracy is less precise than adults', reflecting ongoing development; dyspraxic children's accuracy is significantly lower compared to age-matched peers.

• Dyspraxic children's foot representation confusion parallels neurotypical children's confusion regarding their feet, suggesting a tactile precision similar to using their feet rather than hands.

Implications of Findings

• Results indicate that dyspraxic children may have a more confused sensory representation of their bodies compared to neurotypical peers.

Observations from Action Tasks

• In action tasks, children can raise the correct finger but often lift nearly all fingers due to involuntary movements known as synkinesis—associated movements occurring spatially close in the brain.

• These synkinetic movements are evident both contralaterally and proximally among participants during finger-lifting tasks.

Differentiation Across Age Groups

• The study questions whether poor body part differentiation persists into adulthood or if it's merely developmental delay. This distinction is crucial for understanding motor coordination disorders.

• Evaluating both neurotypical adults and those with TDC reveals refined body representations in dyspraxics compared to childhood levels but still significant difficulties relative to age-matched controls.

Conclusions on Body Representations

• Although dyspraxic individuals show some improvement in sensory and motor representations over time, these remain generally more confused than those of their peers.

• Persistent challenges suggest potential underlying issues beyond mere lack of experience or learning deficits related to motor coordination disorders.

• Future research aims to explore somatosensory mapping differences between children and adults with dyspraxia through functional imaging studies led by researchers mentioned earlier.

Importance of Body Representation in Children

Overview of Dyspraxia and Body Representation

• The discussion begins with the observation that some children, particularly those with dyspraxia, may not develop motor coordination skills effectively, which can persist into adulthood.

• A program is introduced aimed at enhancing body representation among all children, emphasizing its significance in early education.

Current Educational Gaps

• In France, preschool programs emphasize motor skill development but lack a structured and scientifically validated approach to improve body representation.

• The new program aims to fill this gap by helping children refine their mental representations of their bodies and interconnect these representations through cognitive neuroscience principles.

Program Development and Implementation

• The program was developed collaboratively with preschool teachers, educational advisors, and health professionals to ensure practical applicability in classrooms.

• Initial testing involved 100 students across eight classes to assess the program's effectiveness in real classroom settings.

Scientific Basis and Structure of the Program

• The initiative focuses on helping students articulate their understanding of body schema, structural knowledge about their bodies, and semantic knowledge related to bodily concepts.

• It includes daily routines over three weeks with six complementary sessions designed for preschool teachers to implement during class time.

Resources for Educators and Parents

• Comprehensive resources are provided for both educators and parents, including metacognitive booklets for children to take home.

• Materials used are simple and cost-effective to facilitate widespread adoption across various educational settings.

Evaluation of Program Effectiveness

• Studies measuring children's progress before and after participating in the program show significant improvements compared to traditional activities.

• Results indicate enhanced overall body representation scores as well as specific gains in fine motor skills linked directly to the intervention group.

Broader Implications of Findings

• Improvements also extend beyond physical skills; there are notable advancements in mathematical competencies among participants.

Future Considerations: Addressing Dyspraxia Risks

• A critical question arises regarding whether this program can also assist at-risk children in preventing dyspraxia development.

• The discussion highlights potential limitations of existing remediation strategies post-diagnosis due to access delays and socio-economic disparities.

Understanding Dyspraxia and Motor Skills Development

Preliminary Results on Dyspraxia Risk Reduction

• The study aims to explore how certain interventions may reduce the likelihood of developing dyspraxia among children.

• A population of 700 children was assessed, identifying those at risk for dyspraxia through family questionnaires.

Assessment Methodology

• Families completed a questionnaire called DCDQ, which screens for motor skills issues in children. Children below the threshold for developmental coordination disorder (TDC) were selected for further analysis.

• Approximately 50 children were included in the intervention group, with another 50 serving as a control group.

Questionnaire Results and Observations

• Initial results from parental questionnaires indicated significant changes in the intervention group's motor skills perception between T1 and T2 phases, surpassing the risk threshold for TDC. This effect was not observed in the control group.

• Improvements were maintained four months post-intervention, suggesting lasting effects of the program on children's motor skill development.

Standardized Testing Outcomes

• The effectiveness of interventions was also evaluated through standardized tests measuring body representation and motor skills, showing significant progress from T1 to T2 that remained statistically relevant over time.

• Notably, improvements in fine motor skills and oral-motor coordination appeared delayed but emerged later during assessments, indicating a gradual development process rather than immediate results.

Conclusions and Future Directions

• The findings underscore the importance of school environments in fostering body representation awareness among children at risk for dyspraxia, advocating for preventive studies on this topic.

• While preliminary results are promising within a short-term framework (four months), further research is needed to assess long-term sustainability of these improvements and frequency of monitoring motor skills across all children.