Motor and perceptual–motor competence in children with Down syndrome: variation in performance with age

doi:10.1053/ejpn.1999.0173

European Journal of Paediatric Neurology

Volume 3, Issue 1, January 1999, Pages 7-14

https://doi.org/10.1053/ejpn.1999.0173 Get rights and content

Abstract

The aim of this study was to determine whether perceptual–motor competence in school-age children with Down syndrome was generally delayed or varied as a function of type of action. Twenty-two children with Down syndrome (13 males, 9 females), aged between 4.5 and 14 years were assessed on two standardized tests, the Movement Assessment Battery for Children (Movement ABC), a test of motor competence assessing gross and fine motor coordination, and on the Developmental Test of Visual–Motor Integration, a test focusing on shape copying. In order to obtain a profile of each child's performance on the different items contained in the Movement ABC, the test was used in its extended form. This involves testing any child who failed an item appropriate for his/her level, at progressively lower levels until a base-line measure was obtained.

All the children obtained scores below the 5th percentile for their age on both tests. However, superimposed on this delay, we found distinct variation as a function of task. Whereas some aspects of gross motor function showed age development with delayed but regular acquisitions, all the aspects of fine motor skills assessed were more severely impaired and showed little development with age. Accuracy and timing of tasks requiring bimanual coordination were most impaired in our sample while balance and ball skills showed more variability. These results suggest that intervention in the motor domain should be varied according to each child's particular profile of performance.

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This study aimed to empirically assess the usefulness of a new and necessary practical daily living test (P-DLT) of individuals with Williams syndrome (WS: N = 21) and individuals with Down syndrome (DS: N = 18). It also aimed to compare P-DLT performance to that on standardised measures of daily living (Vineland Adaptive Behavior Scales, second edition; VABS-II; Sparrow et al., 2016) and motor competence (Bruininks-Oseretsky Test of Motor Proficiency, Second Edition short form BOT2-SF; Bruininks & Bruininks, 2005).
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We conclude that not all daily living skills are negatively impacted by impaired motor competence in WS or in DS, but that motor competence is strongly associated with many everyday tasks such as getting dressed, using a knife and fork, washing up and clearing up. This has implications for the potential for wide-reaching impact of training to improve motor competence, on independence for these groups. We also demonstrate that a P-DLT is a feasible daily living measure for use with populations with intellectual disabilities, and that it can help mitigate the effect of parent report bias.
Cognitive aspects of Down syndrome
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This chapter sets out the general characteristics of cognitive development in individuals with Down syndrome (DS), also called trisomy 21, a disabling disorder of genetic origin that combines recognizable physical features with intellectual disability of varying severity. After providing a few epidemiological facts and figures for DS, we outline its phenotypical features, summarizing recent research on cognitive domains (memory, executive functions, and language) and motor skills. This information should allow clinicians to tailor the care given to patients according to their particular profile and need for personal support, in line with the recommendations set out in current international classifications (American Psychiatric Association, 2013).
The emergence of fine motor skills in children with Down syndrome
2021, International Review of Research in Developmental Disabilities
In this chapter, we review the literature on the early development of fine motor skills in young children with Down syndrome. Fine motor skills are the behaviors we engage in using the small muscles of our hands and fingers. These abilities are important because they support the production of skills that are necessary for independence such as activities of daily living and academic skills. They also can be part of developmental cascades, which enable the emergence of different skills later in development. Some key conclusions emerge from this review. There is considerable variability in the emergence and development of fine motor skills in young children with Down syndrome. Some children develop these skills along timetables that are not notably different from typically developing infants and young children. But for other children, these skills develop later and with some differences. Some of these differences are quite subtle and others are more pronounced. Overall, we note the paucity of studies conducted on this topic. In order to find enough research to write this review, we utilized many studies that were not focused on the development of fine motor skills in Down syndrome but did include at least one measure of these skills. There is an urgent need for additional research, including studies with larger sample sizes and multiple longitudinal observations. These studies would allow researchers to gain a more complete understanding of the developmental trajectories that characterize the emergence and development of these skills. In addition, the use of sophisticated statistical techniques would provide opportunities to describe different heterogeneous profiles that exist within the population of children. Our overall conclusions include a call for more research on this topic and some suggestions for future research questions that would be especially useful.
Analysis of dynamic balance in preschool children through the balance beam test: A cross-sectional study providing reference values
2021, Gait and Posture
Citation Excerpt :
However, maintaining balance during locomotion is a complex ability that combines forward propulsion of the body, lateral stability, and holding the body on one leg during the swing phase of the gait [10]. In this regard, balance deficits have been well-demonstrated in children with several disorders, including autism [11], Down’s syndrome [12], and developmental coordination disorders [13]. Balance control can be analysed by the Systems framework that describes six components required for the maintenance of posture: (1) constraints on the biomechanical system, (2) movement strategies, (3) sensory strategies, (4) orientation in space, (5) dynamic control, and (6) cognitive processing.
dynamic balance (DB) is a complex ability at an early age and balance deficits are related to numerous disorders. There are several balance measures but wide variation in their use has restricted the capacity to synthesise references values. The main purpose of this study was to analyse the performance of the Balance beam test (BBT) in preschool children, according to age and sex providing BBT reference values, and also to analyse its reliability and validity.
Research question: could the BBT be a reliable test for measuring dynamic balance in preschool children?
593 preschool children (3–6 years) participated in this study. The BBT was used to evaluate DB by measuring distance reached, time spent, and number of steps. Differences between sex and age groups were analysed using the Mann–Whitney U and Kruskal–Wallis tests. Test-retest reliability analysis was performed using intraclass correlation coefficients and the Bland–Altman graphic. Convergent validity was investigated with the Stork Balance stand test (SBST).
no significant differences were found for sex in any components of the BBT. Age had positive effects on BBT performance in distance (χ² = 63.474, p < 0.001), time (χ² = 46.441, p < 0.001), and step numbers (χ² = 40.967, p < 0.001). Younger children performed more poorly than older children. No significant interactions between age groups and sex were found. The BBT showed adequate validity and reliability.
the reference values established for Spanish preschool children in the current study could be used to monitor DB development. It is necessary to take into account distance reached, time spent, and the steps taken to obtain a more precise measure of DB in this population.
Motor development and Down syndrome
2019, International Review of Research in Developmental Disabilities
Citation Excerpt :
They permit to gain independence and successfully engage in activities of everyday functioning because they allow self-care activities such as dressing, feeding, bathing, holding objects, cutting (Memišević & Mačak, 2014). In children with ID fine motor skills were found to be more impaired than gross motor ones and to have lower developmental increases (Memišević & Mačak, 2014; Spanò et al., 1999; Wuang, Wang, Huang, & Su, 2008). Leonard and coll. (
The chapter aims to analyze motor development in Down syndrome (DS) population. In the light of a holistic perspective to typical and atypical development, there is a renewed scientific interest on the role of motor skills to promote general health. A multidisciplinary approach, that involves findings from psychology, neuroscience, kinesiology and education is employed.
Motor proficiency is a set of functions necessary for everyday life which allow moving around in the environment and manipulating tools; it's typically articulated into posture, gross motor and fine motor skills. Ample research highlighted a strong correlation among Intellectual Quotient and motor skills demonstrating how children with Intellectual Disabilities show impaired motor development with consequences on daily functioning and autonomy. DS motor impairments are generally characterized by restrictions in motor planning and control, retarded achievement of locomotor milestones, deficiencies in fine motor and writing skills and difficulties on manual dexterity tasks. Poor motor proficiency in people with DS arises a scientific debate between two perspectives: the “delay hypothesis” and the “interindividual variability hypothesis”. The first one is based on the evidence that milestones of motor development in people with DS exhibit delayed mean ages of achievement compared to typically developing peers and this gap increases with the age and the difficulty of motor tasks. Nevertheless, the variability hypothesis is based on the evidence that people with DS exhibit a large variability in their motor performances and in the chronological age range of acquisition of their motor skills. These two perspectives drive assessment methods and intervention programs.
Transitioning from the level surface to stairs in children with and without Down syndrome: Motor strategy and anticipatory locomotor adjustments
2018, Gait and Posture
Children with Down syndrome (DS) show underdeveloped motor strategy and anticipatory locomotor adjustments (ALA) before crossing an obstacle. Stairs presents another important setting to study environment navigation and motor adaptation. Inclusion of external ankle load is often used to perturb the stability of a system and observe the emergence of new patterns.
How do stair height and external ankle load affect motor strategy and ALA in 5-to-11-year-old children with typical development (TD) and with DS when approaching the stairs?
Fourteen children with DS and 14 age- and sex-matched children with TD participated in the study. They walked along a 5-meter walkway and ascended 3-step staircases. There were three staircases (low, moderate, and high heights) and 2 loading conditions (no load and ankle load). A 3D motion capture system was used to collect data. Motor strategy was coded for each trial. Step length, width, time, and velocity, minimum toe clearance, and horizontal toe velocity were calculated for the last four steps before stair ascent. Mixed ANOVAs with repeated measures were conducted for statistical analysis.
The TD group walked up all the stairs, while the DS group displayed a strategy shift from walking to crawling when the stairs became higher. While the TD group maintained the values of most spatiotemporal variables, the DS group continuously decreased step length and velocity but not step width over the last four approaching steps. Ankle load decreased step length, step velocity, minimum toe clearance, and horizontal toe velocity in the DS group, to a greater extent, than in the TD group.
Children with DS show underdeveloped motor strategy and ALA when approaching the stairs, and external ankle load further disrupts these patterns. Stair negotiation appears to be an effective assessment tool for evaluating motor adaptation in children with DS.

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^f1: Correspondence: Dr Eugenio Mercuri, Department of Paediatrics, Hammersmith Hospital, Du Cane Road, London W12 0HN, UK

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Regular ArticleMotor and perceptual–motor competence in children with Down syndrome: variation in performance with age

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Regular Article
Motor and perceptual–motor competence in children with Down syndrome: variation in performance with age