Rhythmic Motor Learning in Children With Developmental Coordination Disorders (EPIC2)

Children with poor motor skill acquisition and execution despite having opportunity for learning, are now described as having developmental coordination disorder (DCD). There is a prevalence of 5-6% of young people who have normal intelligence who meet this category who have problems affecting their activities of daily living (ADL's). Young people with lower motor skills are one of a number of conditions affecting children identified by the Chief Medical Officer as requiring an improved evidence base for management. Poor motor skill acquisition and execution, whereby skills remain substantially lower than expected despite opportunities for learning; interferes with participation in academic, sporting and leisure activities. Motor performance is slower and of poor quality; and children may have difficulties learning all kinds of motor skills including sporting activities. Importantly people with poor motor skill acquisition and execution can fail to establish the fundamental movement skills and literacy required to integrate in physical pursuits, such as sport, and become exposed to long-term conditions associated with inactivity. Motor sporting skills can be learnt if trained, but difficulties in performing and learning skills persist into adulthood.

Brain imaging during rhythmic motor tasks which are essential in day-to-day (non-)sporting activities, have established that children with poor motor skill acquisition and execution show differences to healthy controls in grey and white matter functional connectivity and in cortical activation patterns during performance of simple movement tasks . Provisional evidence suggests that individuals with poor motor skill acquisition and execution utilise activation processes when learning motor tasks that are more controlled and require extra processing demands, but a systematic review of neural correlates of those with poor motor skill acquisition and execution concludes that data is scarce and more studies are needed. Performance of motor tasks requires a balance between automatic and controlled processes that is dependent upon the demands of the task and the capabilities of the individual. Young people need to be able to consider their environment when performing a sport rather than just thinking about the skill, so that they can work out where the best place to kick a ball on a football pitch is, not just kick the ball. Typically developing (TDC) children acquire motor skills either implicitly or explicitly by observing and imitating other children and adults or by trial and error. Acquisition of motor tasks requires plasticity in the nervous system with improvements in motor performance underpinned by a move from cortically controlled mechanism, towards more automatic performance, freeing up cortical resources. The ability to automate certain parts of motor skills allows the execution of tasks in more complex environments. Provisional evidence suggests that people with poor motor skill acquisition and execution may learn motor skills in a more controlled manner and have a reduced ability to move automatically. To date no studies have explored the brain changes underpinning fundamental motor skills attainment over a training period in people with poor motor skill acquisition and execution.

The main aim contribute evidence towards describing motor performance in relation to brain structure and functioning in children with lower motor skills and DCD,. This study proposes to test both the feasibility and determine the extent of the impact of learning a novel coordination task on motor performance and brain structure and functioning in children with DCD to inform a full-scale trial of skill acquisition.