11th International Conference on Developmental Coordination Disorder (DCD11)

DCD11 – Developmental coordination disorder and other neurodevelopmental disorders: a focus on comorbidity; Toulouse, France, July 2-4, 2015 Comorbidity refers to the presence of two or more disorders in the same person (especially DCD, dyslexia and attention deficit hyperactivity disorder in terms of developmental disorders). There has been growing interest in the presence of comorbidity in persons with neurodevelopmental disorders. Many recent studies suggest that up to half of all individuals diagnosed with a psychiatric or neurodevelopmental disorder have more than one condition. Comorbidity not only impacts patient outcomes but can also create a significant strain on both family and school life. It can also complicate diagnosis and healthcare organization. The 11 th congress on DCD aimed to address some of the important issues surrounding comorbidity in neurodevelopmental disorders. Three main topics were covered during oral and poster presentations: (1) assessment and diagnostic criteria, (2) underlying processes, causal factors, and prognostic markers, and (3) intervention and management of DCD and associated disorders. Journal of Comorbidity 2015;5(2):32–109

During the last decades there has been a growing interest in exploring the activity-dependent plasticity of the brain in order to develop new intervention programmes for children with motor disorders. Neuroimaging studies in humans have demonstrated both training associated alterations in brain volume (MRI), brain activity (fMRI) and changes in dopamine receptors (PET). Genetic studies have shown that some genotypes, including variation in dopamine genes and other plasticity genes, influence motor learning. Yet, there is a need to study animal models to understand the molecular mechanisms underlying learning induced plasticity.
Control of fine motor skills involves circuits in the frontal-striatalcerebellar network and differs thus distinctly from the well-studied memory systems in the hippocampus and related structures. Studies in rodents have demonstrated that training in a forelimb skilled reaching task leads to rapid turnover and selective stabilization of "spines" on the dendrites of efferent pyramidal neurons in motor cortex. The dopamine system innervating the motor cortex seems to be necessary for learning fine motor skills shown by, e.g., i) chemical elimination of dopaminergic projections, ii) application of D1R and D2R antagonists in motor cortex, and recently iii) in animal models with genetic variations of the dopamine system.
The lecture will give a brief summary of previous studies on deficits in the neural control of the precision grip in children with DCD indicating a failure to form memory representations of objects used to scale the programmed grip force output. In the second part, results from studies on a skilled motor learning task in rodents will be presented, including genetic models, e.g., ADHD. Finally, recent findings on the molecular mechanisms involved in skilled motor learning in rodents will be presented. The results suggest that there are modifications of the intracellular dopamine signalling. The potential to utilize learning induced plasticity to improve motor functions in children with DCD will be discussed. Compared to other neurodevelopmental disorders, such as ADHD or dyslexia, the literature pertaining to the brain substrate of DCD is relatively scarce, since a complete review of relevant works in 2013 only identified seven separate relevant studies. This is probably due both to the complexity of the brain systems potentially involved, and to the difficulty identifying pure, non-comorbid cases of DCD. Since then, a handful of mainly brain MRI studies have been added allowing to draw a tentative panorama of the dysfunction and morphology of these individuals' brain. In the present review, I will first consider brain regions potentially involved in motor coordination as derived from apraxic adults lesions and functional imaging studies of the intact brain (including during handwriting), then briefly review the main results of the few imaging studies of DCD cohorts. Among the latter, a special emphasis is put on the concept of comorbidity with other neurodevelopmental disorders suggesting that, not unlike the latters, brain changes in DCD might be mainly ascribed to a defect in connectivity between distant brain areas, including cerebellum, frontal and parietal regions. A comprehensive model of the neurodevelopmental disorders is proposed, featuring a general hypothesis of developmental disconnectivity of long-distance white matter tracts.
are interacted between them. The evaluation should also take into account the influence of these deficits on the daily life of the children. Only then, can a targeted intervention be provided including the evidence-based principles for the treatment of DCD and other disorders, if needed. For the purpose of research, one challenge is to identify the different profiles of children with DCD and to describe their specific features. Another challenge is to analyse the relationship between the different disorders, to identify when the motor coordination deficiencies result from another disorder. Lastly, in order to obtain valid results, it is essential to provide a good description of the profiles of the children included in research projects and to identify the influence of the environmental factors on the development of the children. Obviously, research and clinical practice need to interact with each other so as to offer a better understanding of the interactions between different deficits and the child's environment. This is the best way to offer the most appropriate intervention.

A. Kirby
The Dyscovery Centre, Felthorpe House, Caerleon Campus, University of South Wales, NP18 3QR, UK. amanda.kirby@newport.ac.uk DCD is a lifelong condition with a variable presentation depending on an individual's ecology now and in their past. No adult presents with DCD alone. For example they are likely to have other developmental disorders to a greater or lesser degree, and are at greater risk of having anxiety and depression. Executive functioning difficulties commonly have an impact on their day-to-day lives. There is no typical presentation despite many adults displaying significant difficulties with motor functioning if assessed. DCD needs to be considered as a multi-system complex and interwoven disorder. The secondary consequences of having DCD may result in reduced fitness and weight gain. This may have a longer-term impact on joints and cardiovascular functioning. Less participation in physical and social activities may also lead to greater social isolation, less social rehearsal, reduced confidence and further impact on development of close relationships and impact on wellbeing. Difficulties driving may make it harder to get out to participate as well. The reason individuals seek help or guidance may be for multiple reasons including for example potential loss of job, challenges with relationships, or difficulties in education.
The Dyscovery Centre at the University of South Wales, UK has been one of the few places seeing adults with DCD for more than fifteen years. This has presented a unique opportunity not only to follow children growing up with DCD, but also to see adults moving from education to employment, from parental supervision towards independence, and to witness the challenges that this presents. This paper will present a unique insight from both personal and professional perspectives, including a 29-year follow up single case study of an individual with DCD. The presentation will include what is currently known about DCD from emerging adulthood and the decades following including highlighting recent work by colleagues. It will discuss the potential direction for future research in an ageing population of individuals with DCD.
In the revised edition of the DSM-5, it is acknowledged that the acquisition and execution of coordinated motor skills is dependent on the availability of opportunities to learn and practice these skills (Criterion A). Consequently, a diagnosis of DCD will have to wait until a child has been exposed to a context where learning of a specific task is optimized. For how long and what has to been done in the mean time to meet this criterion, is not known. If we believe that training of children with DCD should be task oriented, which we do, the question rises how do you measure if the task performance is below the level that is expected, and how do we evaluate that the task has improved to a required level other than by using questionnaires or mere goal attainment. Although DCD is a disorder characterized by delayed acquisition of motor actions remarkably little research focused on how children with DCD learn new motor skills and what would be the best teaching strategy. Consequences of the paradigm shift for diagnosis, testing, and training and outcome measurement will be discussed.
in adults with developmental coordination disorder (DCD). Previous research suggests adults with DCD are less motivated to participate in physical activities and so are at higher risk of poorer physical and mental health. Adults with DCD may also experience difficulties obtaining a DCD diagnosis due to a lack of standardised diagnostic criteria. This qualitative study aims to investigate the effects of DCD in adulthood by considering feelings about diagnosis, social and emotional adjustment and participation in sports. Method: Semi-structured qualitative interviews were carried out with 15 adults aged 18 years or over. Ten adults had a DCD diagnosis and five adults did not have a formal DCD diagnosis but strongly suspected they had DCD (and exceeded the 'DCD at risk' threshold on The Adult/ Dyspraxia Checklist [ADC; Kirby, Edwards, Sugden, & Rosenblum, 2010]). Results: Thematic analysis identified four main themes with several subthemes: childhood (ball/team sports, humour); adulthood (ball/ team sports, humour, choice, coping mechanisms); diagnosis (positive retrospect, negative retrospect) and mental health (time, energy). The themes identified tentatively suggest differences between adults who had received a DCD diagnosis and those who had not. Adults with DCD who received a diagnosis at an earlier age tended to report more positive retrospective experiences from childhood. The interviews suggest these adults move through a process of understanding; naming; externalising and absolution which either happens later or not at all for adults who are left undiagnosed. Discussion: Specific diagnostic criteria for adults with DCD are yet to be fully defined. Many adults with motor coordination impairments may not receive an official diagnosis and may experience difficulties in daily living skills, such as cooking, self-care and budgeting. It is essential that guidelines for the diagnosis of DCD in adulthood are fully developed in order to provide adequate support, treatment and intervention for these individuals.

Aim:
The study was designed to assess a range of high-level abilities, known as executive functions, in children with DCD and motor difficulties (MD). These executive functions include tasks that affect activities of daily living and academic achievement, such as planning and multi-tasking, which are often reported to be difficult for individuals with DCD, as well as for those with a range of other neurodevelopmental disorders such as Attention Deficit-Hyperactivity Disorder. Specifically, this study aimed to assess a wide range of executive functions and to compare tasks with verbal and nonverbal task demands. It was predicted that children with motor impairments (both DCD and MD) would have greater difficulties with those tasks that involved a motor demand, but that performance in verbal tasks would be relatively less affected. Method: Children aged 7-11 with a clinical diagnosis of DCD (N =23), and with motor difficulties identified through screening (MD: N =30; MABC-2 Total score <16th percentile), were compared to typicallydeveloping children (TD: N =38) on verbal and nonverbal tests of executive-loaded working memory, inhibition, switching, planning and fluency. Nonverbal measures included tasks with a motor and/or visuospatial demand. In order to isolate the effect of motor impairments on executive functioning in these groups, children with co-occurring disorders were not included in the sample, and subclinical symptoms of inattention and hyperactivity and reading difficulties were taken into account in the analyses. Results: Once differences in executive functioning relating to age, IQ, reading ability and subclinical inattention/hyperactivity symptoms were taken into account, significant group differences were revealed for all of the nonverbal measures except for switching. Children with MD and DCD had significantly lower scores or produced more errors than TD children in nonverbal tasks of executive-loaded working memory, inhibition, planning and fluency, but were similarly accurate to the TD children on all of the verbal tasks. Discussion: Difficulties in nonverbal executive functions could have a significant impact on classroom functioning, particularly when tasks involve processing visuospatial information or a motor skill, such as handwriting. Future studies should include children with co-occurring Aim: Previous research has indicated a range of comorbid and secondary problems are associated with poor motor coordination. These findings have been established in both clinical and non-clinical samples. Recent empirical developments have moved beyond investigating only the comorbid neurodevelopmental comorbid and secondary problems, and have started to investigate the additional implications that poor motor coordination has for an individual's mental health. A relationship between motor coordination and internalizing symptoms (e.g. anxious and depressive symptoms) is well supported by research. However, an understanding of the causal nature of this relationship remains conceptually underdeveloped. The recently proposed Elaborated Environmental Stress Hypothesis (EESH) 1 provides a promising theoretical framework that allows the causal nature of this relationship to be empirically evaluated. The framework posits that the presence of poor motor coordination leads to the development of internalizing symptoms through several mediating constructs that are embedded within the individual and their surrounding environment (e.g. interpersonal conflict, peer social support, perceived self-competence). This study aims to investigate a subset of key pathways specified in the EESH, using a normative sample of West Australian children between 4 and 6 years of age. It is hypothesized that perceived self-competence and social acceptance will mediate the relationship between motor coordination and internalizing problems. Method: Participants were 445 West Australian children between 4 and 6 years of age. Cognitive, physiological, psychosocial and demographic measures were collected as part of the pre-test phase of a universal school-based motor coordination intervention program. Motor coordination was measured using the Movement Assessment Battery for Children-II (MABC-2), and the short form of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT2-SF). Perceived self-competence and social acceptance was measured using the four subscales of the Pictorial Scale of Perceived Competence and Social Acceptance (PSPCSA). Internalizing problems were measured using the teacher-rated Strength and Difficulties Questionnaire (SDQ-T). Results: Model testing using Path Analysis in LISREL is ongoing. Preliminary analysis indicated that, after controlling for age and verbal IQ, the MABC-2, the two PSPCSA subscales relating to social acceptance (maternal acceptance and peer acceptance) were not correlated with the outcome variable (internalizing problems) and subsequently excluded from the analysis. Similarly, preliminary analysis yielded results that indicated a small effect size, with the total model approximately accounting for a small, but significant 6% of variance in teacher rated levels of internalizing problems. Discussion: The present study provides support for a link between motor coordination and internalizing problems. While a complete analysis is currently ongoing, there is preliminary evidence to suggest that in the current study, the relationship between motor coordination and internalizing problems was not mediated by perceived self-competence and social acceptance. It is important to recognize the limitations of this study may have impacted results; low levels of internal reliability in some measures may have attenuated the relationship between variables. The results of this study provide only partial support for the EESH, though there are several additional pathways and variables specified in the model that remain theoretically proposed, but empirically untested. This will be addressed in a series of future studies.

A.E. Pienaar, D. Coetzee & A. Venter
Physical activity, Sport and Recreation (PhASRec), Faculty of Health Sciences, Potchefstroom Campus, North-West University, Republic of South Africa. anita.pienaar@nwu.ac.za Aim: Early identification of children who might run the risk of motor delays is important to ensure intervention as soon as possible to prevent such delays manifesting as larger problems 1,2 (Majnemer, 1998;Malina, 2004). A primary goal of early motor intervention is to increase the skill levels in all the motor development domains to prevent or minimalize further delays and secondary consequences. In order to identify DCD as soon as possible we need validated screening instruments that can be used for the early identification of motor coordination delays. The aim of this study was to establish the suitability of the Little Developmental Coordination Disorder Questionnaire for the identification of DCD in a selected group of 3-5 year old South African children (N=53). Method: Both reliability and validity of the Little DCDQ were assessed. Test items of the Little DCDQ, completed by the parents, were compared against the standardized Movement Assessment Battery for Children-2, in a group of 53 children aged 3 -5 years. Results: Correlations of r= 0.3 were established between 2 of the test items and good internal consistency (Chronbach's Alpha, r=>0.8) was established. The Little DCDQ showed poor sensitivity (57.14%) but reasonable specificity (81.25%). Discussion: These results indicate that the Little DCDQ has potential as a screening instrument to detect possible DCD but a few adjustments need to be considered. The questionnaire should therefore be refined in order to identify children with possible DCD more accurately in South African children. Modifications are recommended to the types of questions and their level of difficulty to make it more understandable, especially for illiterate parents.

Do measures of visual perception and visual motor integration help explain handwriting difficulties in children with DCD?
anti-jump trails; ToCdiff ); this measure also assesses how well inhibitory control can be enlisted during the course of online corrections. By comparison, for controls, performance trends conformed to a quadratic function, with evidence of re-organisation during middle childhood. Discussion: Modelling of this extensive dataset showed that the realtime coupling between online control and inhibitory systems follows an atypical pattern in DCD. Whereas children without motor impairment showed evidence of re-organisation (during middle childhood) in both online control and the coupling of inhibitory and motor control systems, children with DCD did not, indicating a more protracted period of development. Under the hypothesis of interactive specialisation, more time is required to integrate the function of different control systems in children with DCD. These findings have significant implications for later cognitive and motor development, which are discussed. Keywords: Online control; Predictive modeling; Inhibition; Cohort sequential design; Growth curve modeling. * Presenting author

S. Scott-Roberts & C. Purcell
The Dyscovery Centre, University of South Wales, Felthorpe House, Lodge Road, Newport NP18 3QT, UK. sally.scott-roberts@ southwales.ac.uk Aim: Balance is the ability to maintain a weight-bearing posture or to move through a sequence of postures, without falling. Balance represents a critical component of most movement activities, yet is often taken for granted. Previous evidence looking at children with Developmental Coordination Disorder (DCD) suggests that their walking patterns differ compared to their typically developing peers as a consequence of for example, gait instability 1 . Given the evidence demonstrating greater postural instability and increased trunk inclination during the gait cycle among children with DCD, it seems likely that the incidence of falls amongst adults with significant motor difficulties will be elevated. The aims of this project were to explore the frequency and severity of trips and falls in adults diagnosed with DCD following a full multi-team assessment and explore the adaptive responses they have made to minimize the risk of trips and falls. Method: To explore the incidents of trips and falls, a questionnaire which asked participants to indicate the frequency and severity of falls over the past six months was distributed to eighteen adults with a diagnosis of DCD. In addition, to explore the adaptations utilised to minimise falls six of these participants volunteered to take part in a 40 minute semi structured interview, conducted via the telephone.

Results:
The results showed that 43% of respondents had fallen more than ten times in the previous six months. Respondents reported being concerned about falling for example, when walking on slippery surfaces, uneven pavements, down stairs, particularly when carrying objects, as well as when completing a range of daily chores. Almost all participants had made adaptations to minimise the risk of falling, for example: choice of footwear, division of chores within their household. Interestingly many had felt that their adaptations had become so automatic that they no longer saw them as adaptions. Discussion: Falls are a serious public health concern and the results from the survey indicate that tripping and falling is common amongst this particular group of adults. The results from this study suggest that safe mobility should be assessed and fall prevention interventions should be considered by OTs working with children and adults with significant motor difficulties. However, the efficacy of traditional approaches to falls management would need to be demonstrated for this group. Additionally, the adults who participated have adapted many tasks and their environment to manage the risk and there are lessons to be learnt from these 'experts' that potentially could be shared with others who have motor difficulties.

Prevalence of attention and executive function in young adults with and without Developmental Coordination
Disorder-A comparative study also linked between LD and developmental disorders such as Developmental Coordination Disorder (DCD). Yet, LD literature lacks research regarding non-academic functioning. Therefore, there's a call to consider the multi-dimensional implications of this disorder since they affect different aspects of the child's functioning and participation. The aim of the study was to create a functional profile of children with LD with and without DCD according to ICF dimensions (body functions, activity and participation) and to determine whether motor dysfunctions have unique predictive value beyond other aspects of functioning, such as academic and attentional functions, within and outside of the school environment. Method: 90 children, ages 7.3 -12.4 years, diagnosed with LD were recruited to this study. Based on the Developmental Coordination Disorder Questionnaire participants were divided to two groups: children with DCD (40) and without DCD (50). Different ICF dimensions measures administered to the total sample included academic performance test; Dynamic Occupational Therapy Cognitive Assessment for Children; Test of Everyday Attention for Children; the Conner's Abbreviated Parent-Teacher Questionnaire; Child Behavioral Checklist and the School Function Assessment. A comparative study design (LD with and without DCD) was conducted. MANOVA was computed for between-group analyses on multiple outcome variables. Regression was conducted to predict degree of participation. Results: MANOVA revealed significant differences between LD with and without DCD, on most variables, primarily in participation (P<.02, η² =.06) pointing to lower participation scores amongst the LD with DCD group. Regression analysis revealed that motor performance has a unique contribution to predicting the participation of the child within the school environment beyond that accounted for by reading, writing, math and ADHD symptoms. Discussion: Children with LD and DCD have substantial difficulties on all ICF dimensions. Moreover, motor dysfunction has a significant impact on all ICF dimensions, and was found to predict the overall participation. The finding of a high percentage of motor deficits among children with LD, and the broad influence of this deficit on children's participation, supports the importance of identifying these children and enhancing their health and participation, both within and outside of school settings. Keywords: Learning disabilities; Developmental Coordination Disorder; Participation; ICF.  (Wagner et al., 2013). We assume that, in comparison to their typically developed peers, children with potential DCD show a higher risk for persistent grossmotor coordination problems (H1), overweight and obesity (H2), physical inactivity (H3), peer-relationship (H4) as well as internalizing (H5) problems in adolescents. Method: MoMo (a) started with a population-based representative sample of 4,529 German children and adolescents aged between 4 and 17 years at baseline (2003)(2004)(2005)(2006), (b) continued with a first follow-up (2009)(2010)(2011)(2012) and (c) includes standardized motor tasks, a physical activity questionnaire, as well as various health-measures. We focus on children between 6 and 10 years at baseline (N =1,681; mean age =8.27, SD =1.48; 50.4% boys) who were re-examined between the ages of 12 and 16 years (N =940; Response Rate: 55.9%; mean age =14.37, SD =1.46; 49.1% boys). Children in the longitudinal sample diagnosed as having potential DCD at baseline (N =115; 47.8% boys) were identified on the basis of three common grossmotor coordination tasks using the age-and gender-specific 15th percentile cut off and under careful consideration of the subordinated European Academy of Childhood Disability-criteria. Data were analyzed with binary logistic regressions including the stability of the respective dependent variable. Results: In comparison to their typically developed peers, children with potential DCD show a higher risk for (i) persistent grossmotor coordination problems (OR=7.98, p<.01), (ii) overweight and obesity (OR=1.75, p<.05), (iii) physical inactivity (OR=7.41, p<.05), (iv) peer-relationship (OR=1.52, p<.05) as well as (v) internalizing (OR=1.57, p<.05) problems in adolescents. Discussion: Our results provide evidence for the developmental impact of childhood DCD. Subsequent analysis will be focused on the mediating and moderating role of personal and social resources using the data of two subsequent survey waves (2014-2016; 2018-2020 Aim: Under-achievement in school has long been recognized in children with Developmental Coordination Disorder (DCD) and several studies have focused on handwriting as a link between poor motor control and academic success. For example, recent studies have found that children with DCD produced less text than their typically developing (TD) peers and paused for 60% of a free-writing task. The importance of this finding was highlighted in earlier studies which found a consistent relationship between the amount children wrote and the composition quality of the output, suggesting that being able to produce enough text is a pre-requisite to writing good composition. Interpreting these results through a theory of limited cognitive capacity, it was suggested that lack of automaticity in the production of the handwriting served to slow children down, but little is known about how the nature of the writing task interacts with the handwriting difficulty to increase the impact of the disorder. The aim of this study was to test capacity theory by manipulating the cognitive load of different writing tasks in English children with and without DCD and measuring the relative responses. Method: Fifteen 9-14 year-old children with measured DCD participated in the study together with 15 TD age, verbal ability and gender matched controls. Participants completed a specifically designed writing task in which a less demanding short copying task of 24 words lead on to a more demanding free writing task for the same allocation of time. The tasks were conducted on a digitising writing tablet using software which measured temporal, spatial and force components of the handwriting, when the pen was 'in air' as well as 'on paper'. Results: Results indicated that on the initial copying task the children in the DCD group took significantly longer to copy than those in the TD group, though there was no significant group difference in the proportion of time spent 'in the air' or 'on paper'. On the free writing part of the task the children in the DCD group produced significantly less text than those in the TD group. However, the main group difference of the impact of increase in task demand (from copying to self-generated text) was on the relative time the pen spent on the page. An interaction was noted between group and level of task demand: although, both groups spent less time 'on paper' when the task demand increased, this reduction was significantly greater in the DCD group. Discussion: This finding suggests that although children with DCD may be able to perform simple classroom tasks similarly to their unaffected peers, when task demand increases, the impact of the impairment may be felt more acutely, as indicated by a reduction in output. Further analysis of the temporal, spatial and force measures recorded during the two tasks for the two groups are discussed together with the implications of these differences for purposes of intervention.

Diagnosing Developmental Coordination Disorder: A novel model for a research-integrated clinic
daily living and/or academic achievement. Children with a history of medical conditions that better explain motor difficulties (e.g., cerebral palsy, muscular dystrophy, genetic syndromes) or a history of intellectual disability that would prevent the child from completing a standardized motor assessment are referred to a more appropriate clinic. Children up to age 18 years who have a DCD diagnosis can be referred to the DCD Clinic for research purposes. Results: Our clinic began in January 2014. Measures of success include > 75 referrals from the community in the first year, and we intend to expand the clinic to meet the demand. Families have expressed their gratitude for receiving a diagnosis and recommendations to support their child, and the majority of families have consented/assented to participate in the research database. In addition, medical trainees participate in each clinic; thus, we are teaching the next generation of pediatricians, developmental pediatricians, and family physicians about DCD. Discussion: Our clinic fills a critical gap in providing a diagnosis and recommendations to families with DCD. In building a research database, we can begin to better understand the issues facing these children and inform better ways of meeting the holistic needs of this under-served population. Our research-integrated DCD clinic serves as a model for establishing a similar clinic and offers the potential for national and international collaborations to systematically collect similar data, thereby increasing sample size and our collective understanding of and service for children with DCD. Aim: Children with Developmental Coordination Disorder (DCD) often experience difficulties in both the legibility and speed of handwriting. This study investigates relationships between handwriting outcomes and limb kinematics to characterise movement patterns of children with DCD and typically developing children (TDC). Method: Levels of motor ability (MABC-2) and function (DCDQ-07) of children with and without DCD, matched for age, gender and parent education, were compared across handwriting tasks using a standardized handwriting assessment of copying and dictation (A-A Handwriting). A 3-D motion capture system (Qualysis) was used to analyze upper limb kinematics and characterise movement patterns and contrasted with output in copying and dictated tasks. Results: Thirty children (DCD, n=15 and non-DCD n=15; mean age 8.05; SD 11.1( participated in the study. Attention deficits and writing hours per week were significant factors correlating with outcome, with children with DCD more likely to show attention deficit (t= 4.34,p<0.01). Significant differences were evident in productivity with children with DCD writing fewer legible letters in the first minute than TDC in both copying (mean difference -5.6; t= 4.17,p<0.001) and dictation (mean difference -5.6;t=3.25,p<0.01) tasks. Partial correlations, controlling for attention, reflected differences in kinematic factors between groups. Comparisons of movement kinematics show higher values of maximal elbow extension associated with increased letters per minute in both groups in the first minute of writing (r>0.69;p<0.05) but only for children without DCD in the second minute (r= 0.63,p<0.05). More atypical wrist postures of excessive wrist extension and flexion (larger movements), were associated with the production of fewer letters per minute for children with DCD (r = -0.77,p<0.001, r = -0.65,p<0.01 respectively). Children with DCD also showed poor maintenance of the right and left margins in both copying and dictation (t>5.5,p<0.001 all). Discussion: Children with DCD showed differences in movement patterns between copying and dictation in handwriting; whereas TDC showed more consistency and less variability between the two handwriting tasks. Children with DCD also showed a lack of automisation of key writing concepts such as maintenance of margins in both copying and dictation. These results provide insights into the mechanisms underpinning handwriting problems in children with DCD and can promote our understanding of this condition and aid development of optimal treatment plans Keywords: Developmental Coordination Disorder; 3-D motion analysis; Kinematics; Handwriting.  (Wilson et al. 2013;Adams et al., 2014) have shown that the predictive control of movements is impaired in children with DCD, most likely due to a deficit in the internal modeling of movements. The aim of this study was to examine different parts of the internal modeling of movements in children with DCD by conducting tests of motor imagery, motor planning and rapid online control within one group of children with DCD. This study is the first to provide a comprehensive test of the internal modeling deficit hypothesis. The current study will increase fundamental insights into the etiology of this motor disorder and the aspects of disordered motor control that should be targeted in future intervention. Method: Participants were 66 children; 33 children (26 boys and 7 girls) between the ages of 6 and 11 years who met the DSM-V diagnostic criteria for DCD and 33 individual gender and age-matched controls. Motor imagery was assessed with the hand rotation task (HRT) and the radial virtual guided pointing task (VGPT). Action planning was assessed with the dowel task that tested planning for end-state comfort. Rapid online control was tested with the double step pointing task. Results: Results showed that children with DCD were slower and less accurate than the control group in the HRT. Surprisingly, both DCD and control group had difficulties with the imagery of movements in the VGPT. In the action planning task results showed that the control group ended significantly more often in a comfortable end position than the DCD group. The rapid online control task showed no difference between DCD and control group on all measures. Discussion: Our results show that the content and execution of the internal model of a movement is impaired in children with DCD, evidenced by the results on motor imagery and action planning tasks. However, the rapid online control task showed no deficit in the detection of online perturbations and use of online feedback loops. Based on these results, an interesting avenue would be study whether motor imagery training can help children with DCD to improve their motor skills.

References:
Adams, I.L.J., Lust, J.M. Wilson Aim: As we walk around our environment we are constantly faced with obstacles such as gaps or apertures, when these are narrow they force us to rotate our shoulders in order to pass through. In adults and children the decision to rotate the shoulders is based on both body size and movement control; where movement is more variable, walkers adopt a safer strategy rotating their shoulders for smaller apertures. It is generally observed that individuals with Developmental Coordination Disorder (DCD) have a tendency to bump into obstacles, yet exactly why this is the case is unclear. The aim of this study was therefore to determine the developmental pathway of how individuals with DCD make action judgments and movement adaptations while navigating apertures. Method: 15 children (12-17 years) and 15 adults (18-30 years) were recruited in line with DSM-5 diagnostic criteria for DCD. Typically developing (TD) controls were individually matched for age and gender. Participants walked up to and passed through a series of apertures, which were scaled to their body size (from 0.9-2.1 times shoulder width). Reflective markers placed on the shoulders and trunk were tracked with a VICON motion analysis system. Spatial and temporal characteristics of movement speed and shoulder rotation were collected over the initial approach phase and while crossing the aperture threshold. Results: The decision to rotate the shoulders was not scaled in the same way for the DCD and TD groups, with individuals with DCD turning their shoulders at larger apertures compared to the TD individuals when body size alone was accounted for. In terms of the movement adaptations, the individuals with DCD made an earlier and greater speed reduction compared to their typical peers when a shoulder rotation was required. A significant group (DCD and TD) by age (child and adult) interaction reflected greater improvement between the TD child and adult groups, compared to improvement between the DCD child and adult groups, with the latter showing an underdeveloped adaptive pattern. Discussion: The findings provide a better understanding of the different navigation patterns in individuals with DCD. Their adaptive strategy, which results in them turning more often and to a greater degree than their typical counterparts, is coupled with a more cautious approach strategy giving them more time in which to make the necessary movement adaptations to cross the aperture. Therefore, when these individuals are in more complex environments this adaptive strategy may prove impossible to implement, when there is not additional time to allow for a slower movement and thus a collision may occur. Aim: In previous studies, we showed that the perceptual low-level pre-processing step that is responsible for landing position pattern in oculomotor control is not yet implemented in dyslexic children without developmental coordination disorder (DCD). This result has been interpreted with the idea that saccade computation (i.e. where and when the eyes land in a word) is not dysfunctional but rather a mirror of their less reading exposure 1 (e.g. Bellocchi et al., 2013). In the same vain, some studies suggest a delay in the maturation of low-level oculomotor skills in children with DCD (e.g. pursuit system, Robert et al., 2014) 2 . Considering that DCD and developmental dyslexia (DD) are often associated, the aim of the present study was to investigate the role of co-occurrence between these two disorders in saccade computation. Method: We assessed the eye movements of four groups of children (12 DCD children with DD, 11 DCD children without DD, 20 DD children without DCD and 29 typical developing children -mean age: 117,3 months; SD: 10,2 months) using an oculomotor bisection task (participants were asked to move their eyes to a position they thought to be the middle of the stimulus). The type of stimulus -linguistic factor (words vs non-linguistic stimuli) and discreteness (lines vs strings of hashes)in combination with the stimulus presentation side (left vs. right) were manipulated. Results: Main results showed differences between groups with regard to saccade latency: "DCD + DD" and "DCD only" groups were slower compared to typical developing children in programming their first saccade. Moreover, in the LVF those two groups made shorter saccade size, suggesting that they struggled to reach the preferred viewing location (PVL) in this visual side. Furthermore, those two groups seem to suffer more for the absence of discreteness of the stimuli in order to compute their saccades and move their eyes in the middle of the stimulus. Finally, results seem to suggest differences between children with DCD (with or without DD) and children with DD only. Discussion: Overall, it seems that no differences emerged between "DCD+DD" and "DCD only" groups, suggesting that co-occurrence in itself does not sharpen difficulties in saccade computation. However, the presence of a motor disorder seems to generate a dysfunction in saccade computation. These results strengthen the importance to take into account oculomotor control involved in visual word recognition for clinical assessment and intervention in children with DCD. Manipulation Test) evaluate aspects of fine motor control, manual dexterity, bimanual coordination and in-hand manipulation. Reliability and validity properties are reported with adequate results for the fine-motor subdomains of the mABC-2 and the BOT-2. The naturalistic observations (the Functioning in Children with Developmental Coordination Disorder, the Assessment of Children's Hand Skills, and the "Do-Eat") provide an assessment of daily manual tasks. Adequate reliability of the naturalistic observations has been shown but concurrent validity has been less evaluated. Finally four questionnaires (the Developmental Coordination Disorder Questionnaire'07, the Little Developmental Coordination Disorders Questionnaire, the Daily Functioning in Children with Developmental Coordination Disorder Questionnaire, the Children Activity Scale-Parents/Teachers) target daily general performance in children with DCD. The Children's Hand-Skill ability Questionnaire focuses specifically on manual ability, but targets a broad range of pediatric populations. Reliability and validity of questionnaires was investigated into limited extent. Data on measurement error were only available for strength measures and one age band of mABC-2. Discussion: This review shows that a combination of different tools might be useful for a comprehensive assessment of manual function in children with DCD. However, further investigation of psychometric properties of those tools in children with DCD are warranted. Also other tests adopted in other populations could be used for measuring manual dexterity. Keywords: Assessment; Children; Manual function; Developmental Coordination Disorder. Aim: Understanding the reasons of frequent comorbidity between Developmental Coordination Disorder (DCD) and Developmental Dyslexia (DD) is a real challenge. Their high association frequency (40 to 60%) suggests common etiological bases. Yet, however DCD and DD are associated with functional and structural brain alterations, their association has never been studied in terms of brain development. The purpose of this study is therefore to examine whether the pattern of changes for concurrent disorders is distinct from the alterations seen in single disorders and above all whether the effects of comorbidity influence cortical thickness. We aim to identify, amongst others, if the co-occurrence of DD and DCD is associated with a distinct global pattern of cortical thickness, in order to highlight the unique or associate neurobiology of comorbid neurodevelopmental disorders. Method: 65 right-handed children (21♀-44♂-range 8-12y) with DCD or DD or DCD and DD in accordance with the DSM-IV-TR criteria (M-ABC test for motor skills and L'Alouette and ODEDYS-2 test for reading skills) were recruited into the study. They had no history of neurological or psychiatric disorder and no cons-indication for a MRI. Children with Specific Language Impairment, Attention Deficit/Hyperactivity Disorder and an IQ less than 70 were excluded. Participants were scanned one time and 9 children were lost due to incomplete scans or excessive motion. The remaining 56 participants (19 DD, 20 DCD and 17 DD+DCD) composed our total sample of children for MRI data analysis. Results: Cortical thickness analysis was performed to determine the patterns of cortical thickness/thinning in each disorder separately and in association. The patterns of cortical thickness were then compared across groups. First results already denote significant differences in cortical thickness in the motor, language and attentional areas (frontal, parietal, and temporal lobes) depending on the considerate group. Data analysis is currently in progress. Discussion: Cortical thinning has been recently been reported in the literature for DCD + ADHD (Langevin, 2014). Our results should be compared to these findings and helpful to better understand comorbidity and may provide clues to both the isolated and the shared neurobiological origins of motor and language disorders.  Aim: We address individual variability in rapid visuo-motor control among healthy adults and children (7-10 years old), and how this variability in behaviour corresponds with abilities on standardised motor tests. Method: We used a ‹double-step› reaching and grasping task to measure how long it took children (n=32) and adults (n=21) to alter their movement when reaching to grasp an illuminated ball. At the start of each trial, a single, central target ball was illuminated. On 60% of trials, the central ball remained lit throughout, but on the remaining 40% of trials, at the onset of movement the illumination switched from one ball to another in a centre-out configuration (left, right, up, or down). We measured the position of the index finger and thumb, and extracted the latency to initiate a movement correction from velocity profiles. We combined this task with a series of standardised tests of motor coordination skills (i.e., the MABC-2), cognitive performance (BAS-II), autistic traits (AQ-child) and attention deficit/hyperactivity disorder (Conners 3). In the adult sample, we used the MABC-2 (11-16 years) test along with standardised manual dexterity tasks -the Grooved and Perdue pegboards. Results: Our novel task resulted in trajectory correction times longer than those typically reported in the adult literature, which may be due to the increased cognitive and biomechanical complexity of switching movements in four different directions. Our initial analyses show that, in adults, the latency to initiate trajectory corrections was very well-correlated (across participants) between the four different movement directions. Between tasks, correction latency was well correlated with the Purdue task, particularly the assembly task, and less well correlated with grooved pegboard performance. Perhaps surprisingly, correction latency did not correlate with MABC-2 total score or any subscale. In children, latencies to correct movements were ~60ms longer than in adults, and correction latency correlated significantly with the aiming and catching subscale of the MABC-2, but not with the other subscales or the total score. Corrections towards the left or right targets were made significantly earlier than towards the upper or lower targets, in both adults (26ms), and children (24ms). Discussion: The novel centre-out reaching task may provide a measure of hand-eye coordination skills that is independent from other standardized tasks. It provides a continuous and high-resolution scale of measurement, and is directly comparable between adults and children, which makes it a promising task for further study. Aim and Method: This paper is a retrospective of the remarkable contribution of Dr. Dawne Larkin to the field of Developmental Coordination Disorder between the years of 1980 and 2013. We will draw on numerous sources including over 50 papers, 2 books, 9 book chapters, 30 student theses, over 80 conference papers and a screening test. What was unique about Dawne was her multidisciplinary interest in issues related to movement development. She collaborated with researchers from around the world in neurology, pediatrics, psychology, occupational therapy, physiotherapy, speech pathology. Results and Discussion: Six main themes characterize Dawne's teaching and research in the DCD field. Her early research focused on the mechanisms of DCD relating to laterality, motor asymmetry and the interaction of structure and function. She was also interested in identifying subtypes of DCD, involving kinaesthesia and soft motor signs, as well as DCD children with overlapping disorders such as ADHD. The second area in which she was very active was identification, screening and assessment. She developed a well-used screening tool, Stay in Step (Larkin & Revie, 1994) and spent considerable time examining the psychometric properties and protocols of motor skill assessments, in particular the McCarron Assessment of Neuromuscular Development (MAND). A third interest area related to physical activity and fitness in children and adolescents with DCD. She was especially skillful in understanding the constraints and benefits of fitness based on her broad theoretical and practical knowledge of anatomy, biomechanics, motor control and exercise physiology. A fourth interest involved the daily activities and routines of children with DCD and how motor problems constrained their participation, and that of their families in activities of daily life. The fifth theme she was well-known for was intervention. Her development of the Unigym program was based on a task-specific framework which has since been extensively applied around the world. Throughout her career she was also particularly passionate about the influence of gender and had a strong belief that assessment and intervention models should pay attention to the underlying biological, psychosocial and environmental differences that are unique to each person. In sum, Dr. Larkin made a remarkable contribution to the scientific literature not only in DCD but also in the more general area of child development. Aim: The present study analyzed the nature of praxis difficulties in children with Developmental Coordination Disorder (DCD) by comparing their performance with that of typically developing children across tasks and conditions that allow exploring distinct components of the functional architecture hypothesized by cognitive models of praxis processing in adults 1,2 . Within this theoretical framework, the study investigated the extent to which the gestural difficulties of children with DCD are related to a deficit of the production system. According to this hypothesis, DCD children perform significantly less well than do typically developing controls on all gesture production tasks, but have spared performance on conceptual tasks. We also examined the impact of other cognitive functions involved in gesture production. Method: Tasks were selected in order to enable a comprehensive assessment of gestures, including conceptual tasks (knowledge about tool functions and about actions; recognition of transitive gestures), representational (transitive, intransitive), and non-representational gestures (imitation of finger, hand, and bimanual postures). We realized an additional assessment of constructional abilities and cognitive domains known to be involved in gestural development: intellectual efficiency (Intelligence Quotient), executive functions, visual-perceptual and visuospatial functions. Participants between the ages of 7 and 13 years included 30 DCD children and 30 typically developing children matched for age, gender, handedness and socio-economic status.

Results:
The DCD children exhibited impaired performance for both representational transitive and nonrepresentational gestures, with impaired visuospatial skills. Differences between groups remained significant when controlling for a measure of visuospatial skill only for representational transitive gestures. This dysfunction could not be related to a semantic deficit, an impairment of sensorimotor knowledge (gesture engrams), or a neuromotor dysfunction, since the clinical examinations were normal. Discussion: The fact that children with Developmental Coordination Disorder were impaired for both representational transitive and nonrepresentational gestures suggests a deficit of the production system. When considering an explanation in terms of a dysfunction of visuospatial processing, the main question being whether the underlying deficit is specific to gestures and motor actions. Further researches are needed to explore whether another line of explanation could concern the mechanisms of predictive motor control for both manual and oculomotor activities.  Aim: This study was aimed at screening for DCD in a large area-based population of school-age children born very preterm (i.e. before 32 weeks gestation), and exploring comorbidities and risk factors. Method: Very preterm children born in Lazio region in 2003-04 and survived to school age were included. The Kaufman Assessment Battery second edition (KABC-II) and selected items of NEPSY-II were used to assess cognitive and neuropsychological development. Parents completed the Conners' Parent Rating Scale Revised-long form (CPRS-R:L) and the ICAP questionnaire to assess ADHD traits and eating problems respectively. Screening for DCD was carried out through the Developmental Coordination Disorder Questionnaire (DCDQ, Italian version1). 427 children participated in the study (response rate 70.6%). In 27 cases, the DCDQ was not completed. For this analysis, children with cerebral palsy (n.36), vision (n.7) and hearing (n.5) problems were excluded, together with cases of severe cognitive impairment (KABC-MPI < 2SD, n.24). Thus, 328 cases were analyzed. Multiple logistic regression analysis was used to assess the relation between perinatal and infancy risk factors and DCD score. Results: Mean gestational age was 29.1 weeks (SD 1.8). 144 children were females (43.9%) and 87 (26.5%) multiples. 49 (14.9%) were born from non Italian mothers. Mean age at assessment was 9 years (SD 0.97). Overall DCD score had a mean of 57.3 (SD 10.9). 146 children (44.5%) had a DCD score indicating/suggesting DCD. These children were significantly more likely to screen positive for ADHD (p = 0.026) and eating problems (p = 0.017). At multivariable analysis, factors significantly associated with positive DCD screening results were male gender, older maternal age (≥ 35 years), higher illness severity score (combining base deficit and oxygen requirements in the first 12 hours of life) and lower cognition measured at 2 years of age corrected for prematurity2. Discussion: In this large area-based sample of very preterm children, almost half screened positive for DCD. Male gender, older maternal age, early neonatal respiratory and cognitive problems appeared to be significant predictive factors, whose relevance should be tested after DCD diagnosis confirmation.

The neurobiology of co-occurring Developmental Coordination Disorder and Attention-Deficit/Hyperactivity Disorder provides clues for genetic research
Aim: Developmental coordination disorder (DCD) and attention-deficit/ hyperactivity disorder (ADHD) co-occur in up to 50% of cases 1 . Previous imaging studies have typically looked at these disorders in isolation. This research investigated whether children with isolated or co-occurring DCD and ADHD display differing brain structure and function. Methods: All imaging took place on the same GE 3T system. The imaging protocol consisted of anatomical imaging (T1-weighted), diffusion tensor imaging (DTI), resting-state fMRI and task-based fMRI, Children with DCD only, ADHD only, co-occurring DCD/ADHD and controls participated. Cortical thickness, diffusion tensor imaging, resting state fMRI and task-based fMRI were conducted. Motor, cognitive and neuropsychological functions were assessed using standardized tests and correlated to fMRI measures. Results: Children with co-occurring DCD+ADHD demonstrate significant widespread decreases in cortical thickness in the frontal, parietal and temporal lobes, whereas children with DCD only demonstrate the cortical thickness reductions in regions of the temporal lobe associated with attention and spatial memory 2 . Analysis of DTI data revealed reductions in fractional anisotropy (FA) in the posterior region of the corpus in children DCD and comorbid DCD and ADHD. Abnormalities in the frontal region of the corpus callosum were found in children with ADHD and co-occurring DCD and ADHD. Finally, higher radial diffusivity values were found in in the callosal region subserving the primary and supplementary motor areas in the DCD+ADHD group 3 . Resting state fMRI revealed that the bilateral inferior frontal gyri, the right supramarginal gyrus, angular gyri, insular cortices, amygdala, putamen and pallidum exhibited similar alterations in functional connectivity (FC) in children with DCD and/or ADHD compared to controls. However, compared to children with only DCD or ADHD, the DCD+ADHD group exhibited greater FC between the primary motor cortex and brain regions involved in motor control (bilateral caudate, left premotor cortex, right inferior frontal gyrus), speech processing and prosody (bilateral anterior superior temporal gyri), sensorimotor processing (left postcentral gyrus, right parietal operculum cortex, bilateral precuneus cortices, angular gyri), and attention and error detection (bilateral anterior cingulate cortices) 4 . Finally, on task-based fMRI (i.e., GO-NOGO) children with cooccurring DCD+ADHD showed decreased brain activation compared to controls in the bilateral inferior parietal lobules, superior parietal lobules, right angular gyrus, left precentral gyrus and left inferior frontal gyrus. No significant differences were found between the DCD only, ADHD only and control groups 5 . Discussion: The co-occurrence of DCD+ADHD was associated with distinct alterations in brain structure and function. The global pattern of cortical thickness decrease seen in children with co-occurring DCD and ADHD highlights the unique neurobiology of comorbid neurodevelopmental disorders. The novel neurobiological features associated with co-occurring disorders may inform diagnostic definitions and provide clues to both the shared and the isolated neurobiological and genetic origins of motor and attention disorders 6 .  Aim: As an important everyday locomotor skill, walking has been examined in individuals with DCD and is anecdotally reported to be poorly executed in this population. However, studies have produced mixed results, with some reporting a shortened stride length or shorter double support, and some finding no quantitative differences between children with DCD and their typically developing peers. Thus the standard measures of foot placement used in previous studies do not give a clear picture of how gait in DCD is different from that seen in typical development. In ageing research, measures of velocity and acceleration patterns of the centre of mass (CoM), as well as the variability of these measures have been used as an indicator of stability when walking. These measures might be useful in understanding the poor stability (e.g. tripping and bumping into things) reported in DCD. The aim of this study was therefore to examine the developmental pathway of foot placement and CoM velocity and acceleration, as well as the movement variability during level walking in children and adults with and without DCD. Method: 15 primary school aged children (7-11years), 15 secondary school aged children (12-17years), and 15 adults (18-30years) were recruited in line with DSM-5 diagnostic criteria for DCD. Typically developing (TD) controls were individually matched for age and gender. Participants walked barefoot at a natural pace up and down an 11m walkway for one minute. Reflective markers placed on the sacrum (to mimic CoM) and feet were tracked with a VICON motion analysis system. Spatial and temporal characteristics of foot placement and velocity and acceleration of the CoM were calculated and recorded, as well as measures of movement variability. Results: The DCD groups showed similar gait patterns to the TD groups in terms of foot placement measures, including step length, step width, double support time and stride time. The DCD groups also showed similar CoM velocity and acceleration to their peers. However, the DCD groups exhibited greater variability in some of the measures. Discussion: The finding that individuals with DCD have a reduced ability to produce consistent movement patterns will be discussed in relation to postural control limitations and compared to variability of walking measures, which have been found to underlie the increased incidence of falling in elderly populations. Effects of age will also be discussed. Keywords: Gait; Locomotion; Movement variability; Acceleration.
Battery for Children (MABC) (Henderson & Sugden, 1992) (below the 15th percentile). The control group included 53 children with typical development. Children in this group scored above the 15th percentile on the MABC. The parents of all children completed a health status/sociodemographic questionnaire and the Short Sensory Profile (SSP) which evaluates the child's sensory processing abilities as expressed in daily life in regard to all sensory modalities. The SSP has good internal consistency: α=.70-.90 and discriminant validity of >95% in identifying children with and without SPD (McIntosh et al., 1999). Results: SPD were significantly more prevalent among children with DCD with no relation to DCD severity level. This was mainly expressed in greater auditory and visual sensitivity (χ² 2 =8.38, p=.02); in lower energy level (χ² 2 =16.71, p≤.001); and in seeking for sensations (χ² 2 = 6.75, p=.03). In the study group SPD was not correlated with child's age or with familial socio-economic level. However, a significant correlation was found between SPD and mothers' education. Discussion: SPD may be more prevalent among children with DCD. The expression of SPD in specific modalities and behaviors such as greater sensitivity and lower energy level may partially explain motor difficulties in this population. SPD should be screened among children with DCD and when diagnosed, should be included in the intervention program in order to focus intervention on child's specific needs. The intervention process should elevate child and parents' awareness to the possible involvement of SPD in child's motor abilities and in daily life. This attitude may enhance child's performance and participation and elevate child's well being. Aim: To determine whether South African children with Developmental Coordination Disorder (DCD) perform differently to typically developing (TD) children when assessed on paradigms that are presumed to tap into internal models of motor control. Method: In the first study, we compared the performance of TD (n=30) and children with DCD (n=30) on a manual task executed on a digitizing tablet (age range 6-10 years). In the second study, we compared the performance of 40 children with DCD and 40 TD children (age range 6-8 years) who were required to track a target moving along a circular path presented on a monitor by moving an electronic pen on a digitizing tablet. The task was performed under two visibility conditions (target visible throughout the trajectory and target intermittently occluded) and at two different target velocities (30° and 60° per second). Results: In the first study, we show that the TD group had fewer velocity changes during the movement trajectory compared with the DCD group. The DCD group was less accurate and ended a further distance from the targets compared to the TD group who made fewer endpoint errors. Amplitude error was significantly greater for the DCD group as was directional error. In the second study, results showed that children with DCD were less proficient in tracking a moving target. Their performance deteriorated even more when the target was occluded and when the target speed increased. The mean tracking speed of the DCD group exceeded the speed at which the target rotated. Discussion: The perception, interpretation and use of visual cues are essential elements that guide our behaviours in daily life, and any maladaptive decision or choice made in a specific situation might have serious consequences. Understanding how specific task constraints affect the way tasks are executed should be an important consideration when developing more effective and targeted intervention strategies. The kinematic profiles on the digitizing tablet show that children with DCD make more corrective movements when aiming at an array of distinct targets. We hypothesize that the presence of increased neuromotor noise is likely to constrain the ability to build accurate internal (forward) models. The poor tracking performance of the DCD group adds evidence of impairments in predictive control and poor dynamic internal representation of target or hand motion. Aim: The neural correlates of Developmental Coordination Disorder (DCD) remain understudied 1 . DCD does not only affect the coordination of movements, it also impairs other cognitive abilities, crucial for academic achievement, such as mathematical learning. Given the hypothesis of a common parietal mechanism underlying calculation and eye-movements 2 , we hypothesized that a parietal dysfunction could play a role into mathematical and saccadic impairments reported in children with DCD. Method: To assess this hypothesis, 17 8-9 years-old children with DCD and 15 typically developping (TD) children, performed an approximate calculation and a saccade task during a 3T fMRI scanning. Main contrasts of interests, conjunction analysis across groups, inter-group analyses (p<0.001, k=5) and Region Of Interest (ROI) analyses (based on developmental studies of numerical cognition 3 ) were performed to identify specific and common activity in both groups. Results: In the saccade task, the group conjunction analysis showed a classical fronto-parietal network in the saccades vs. central fixation task contrast. However, the left superior parietal lobule (BA 7), middle frontal gyrus (BA 6), precentral gyrus (BA 4), and thalamus were significantly more activated in TD children than in children with DCD. In the calculation task, the group conjunction analysis showed a common activation of the right inferior frontal gyrus (BA 47). Moreover, the right middle frontal gyrus (BA 9) was significantly more activated in children with DCD than in TD children. In contrast, ROI analysis showed higher activations of the left inferior parietal lobule (BA 40) in TD children than in children with DCD.  Aim: To determine if maternal hypertensive diseases during pregnancy are a risk factor for compromised motor development at 10, 14, and 17 years. Method: Offspring (N=2868) from the Raine Study (1) were classified by their mothers pregnancy blood pressure profile: normotension (n=2133), hypertension (n= 626) and preeclampsia (n=109). Offspring motor development, at 10 (n=1622), 14 (n=1584), and 17 (n=1221) years were measured by the Neuromuscular Developmental Index (NDI) (M=100, SD =15) of the McCarron Assessment of Motor Development (MAND) (2). Linear mixed models, controlling for sociodemographic and obstetric risk factors, were used to compare outcomes between pregnancy groups. Doppler waveform data were examined to explore the theory of restricted placental blood flow as a potential mechanism (3). Results: Offspring from pregnancies with preeclampsia had poorer motor outcomes at all ages than offspring from mothers with normotension (p ≤ 0.001) or hypertension (p = 0.002). The preeclampsia group contained a higher percentage of individuals (46.8%) who fell below the cutoff (≤85) used to determine motor disability compared to the hypertension (27.9%) and normotension (24.6%) groups (p = <0.001). Mothers with preeclampsia and restricted placental blood flow were more likely to be diagnosed with early onset preeclampsia, considered by some researchers as a more severe type of preeclampsia with greater associated health risks (4,5). Discussion: Preeclampsia, especially early onset preeclampsia with associated placental blood flow restrictions was related to lower motor outcomes. Abnormal placental morphology may interrupt the development of neurological pathways, resulting in a long term deficit of motor development. Aim: Research using clinical populations to explore the relationship between hemispheric speech lateralisation and handedness has focussed on individuals with language disorders, such as dyslexia or specific language impairment (SLI). Results from such work reveal atypical patterns of cerebral lateralisation and handedness in these groups compared to controls.

Maternal preeclampsia negatively effects long term motor development
There are few studies that examine this relationship in people with motor coordination impairments but without speech or reading deficits, which is a surprising omission given the prevalence of theories suggesting a common neural network underlying both functions. This study fills that gap by using an emerging imaging technique in cognitive neuroscience; functional Transcranial Doppler (fTCD) sonography, and an electronic peg moving task, to assess the relationship between speech lateralisation and motor control in participants with Developmental Coordination Disorder (DCD). Method: 12 adult control participants (5 males; aged 18-28 yrs, mean = 20yrs) and 12 adults with DCD and no other developmental/cognitive impairments (4 males; aged 18-43 yrs, mean = 25.3yrs), performed a word generation task whilst undergoing f TCD imaging to establish a hemispheric lateralisation index for speech production. DCD status was confirmed via the Adult Developmental Co-ordination Disorders /Dyspraxia Checklist (ADC) (Kirby, Edwards, Sugden & Rosenblum, 2010). All participants completed a handedness questionnaire, an electronic peg moving task to determine hand skill, a shortened version of the Raven's Matrices non-verbal reasoning test and the phonological processing section of the York Adult Assessment Battery (YAA-R). Results: As predicted the DCD group showed a significantly reduced left lateralisation pattern for the speech production task compared to controls (mean laterality indices = 1.89 and 3.77 respectively, t(22) = -2.2, p < .05).
Results from the Ravens Matrices test were equivalent across groups (t(22) = .008, p = .993) and the groups did not differ significantly on the handedness classification. Performance on the motor skill task showed a clear preference for the dominant hand across both groups (t(23) = -4.472, p < .001), however the DCD group showed significantly slower mean movement times for the non-dominant hand compared to controls (t(22) = 2.270, p < .05). Discussion: This is the first study of its kind to assess hand skill and speech lateralisation in individuals with DCD. The results reveal a reduced leftwards asymmetry for speech and a slower motor performance specific to the nondominant hand. This fits alongside previous work showing atypical cerebral lateralisation in DCD for other cognitive processes (e.g. executive function and short term memory). The findings are clinically relevant for understanding the profile of handedness in DCD and speak to debates on theories of hemispheric specialisation and language lateralisation.  Aim: Children with Developmental Coordination Disorder (DCD) experience problems in the learning and execution of motor actions. Learning a new movement by action observation is very important in for example classroom settings and entails the transposition of the observed action to the existing internal motor representations of the observer. The automatic activation of motor representations during action observation, as well as the functional coupling between perception and action have been hypothesized as important neural processes supporting observational action learning. In the present study we aim to study these brain mechanisms of observational motor learning in children with and without DCD.

Neural mechanisms supporting observational motor learning in children with Developmental Coordination Disorder -An EEG study
Method: Motor neural network activation will be measured by electroencephalography (EEG), specifically event-related desynchronization (ERD) of mu rhythms and fronto-parietal coherence. We will include 15 children with DCD and 15 matched controls in two different tasks conditions: action observation to learn (imitate the action afterwards) and action observation to detect (report a deviant movement afterwards). Children with DCD are expected to imitate the action with a lower level of accuracy than controls. As mu-suppression has been suggested as a measure of the activation of internal motor representations, children with DCD are expected to show less mu-suppression compared to the controls. Moreover, as individual differences in fronto-parietal coherence have been found to be positively related to imitation accuracy, children with DCD are expected to show decreased coherence during the observation to learn condition. Results: Results from adult participants without motor problems performing this task, reported by co-authors HvS and JvdH 1 , have shown that mu-suppression is maximal during pause intervals in the action observation condition, consistent with rehearsal of movement sequences using motor imagery. Importantly, individual differences in the strength of fronto-parietal coherence were found to predict imitation accuracy. Results in children with and without DCD will be presented on the conference. Discussion: Findings will be discussed in the context of the internal modeling deficit hypothesis for children with DCD and will be related to existing knowledge from other developmental disorders associated with high levels of clumsiness such as autism spectrum disorder (ASD). Aim: The aim of the study was to investigate how the availability of visual information sources can affect the motor control of walking in children at risk of DCD. Methods: Sixteen children at risk of DCD (DCDR) (8.7 ± 0.8 years) indicated by the total test score TTS ≤ 15th percentile in the MABC-2 test, and sixteen typically developing children (TD) (9.1 ± 1.0 years) with TTS ≥ 16th percentile participated in the experiment. Each child walked along a 10m walkway under four vision conditions: full vision (FV), nonvision (NV), and limited vision consisting of 2000 ms intervals of vision interrupted by 150 ms and 100 ms of non-vision (LV150 and LV100), with the use of Plato portable liquid-crystal goggles. While walking, the Optojump Next Microgate device was used to measure the kinematic measurements of the gait cycle. Results: Two-way ANOVA 2 (TD vs. DCDR) x 4 (FV, LV150, LV100 & NV) (α = 0.05) carried out for each variable of a gait cycle revealed that the DCDR children manifested a significantly shorter stride length (cm), shorter single support time and stance time (s), longer pre-swing time (s; %) and load response time (s; %), and lower speed of stride scaled to functional leg length (FLL) as compared to the TD children. In addition, the stride length (cm), single support time (s; %), stance time (s; %) and speed of stride/FLL were significantly affected by visual conditions. Discussion: The results provided evidence that children at risk of DCD produce the slower walk with shorter steps than their TD peers. Differences in the gait cycle between these groups were higher when performed with more limited visual information. The study has provided support for the notion that children with DCD rely more on visual information than children without a deficit in motor coordination.  ., 2011). However, the ability to safely cross a road is a perceptual-motor skill which involves the coordination of a pedestrian's perception of the time available and their locomotive capability. The road crossing task therefore requires the observer to ensure that the size of the gap is related to the time needed to cross safely. The aim of this study was to systematically measure the temporal gaps that children with DCD accept in the context of road crossing. Method: The temporal crossing gaps that 11 children with DCD aged 6-11 years and 11 age and gender matched typically developing children accepted was measured, using a psychophysical procedure in a virtual road crossing environment, where multiple vehicles, in three speed conditions, approached from only the near-side lane or bi-directionally. In addition, to assess the sufficiency of their temporal gaps, the difference between gap acceptance thresholds and their crossing time was calculated. Results: In line with previous research (e.g. Connelly et al., 1998), the temporal gaps accepted within each group decreased as approach speed increased. However, unlike their typically developing peers, for vehicles approaching at speeds greater than 20mph, children with DCD accepted temporal gaps that were significantly insufficient and would have resulted in collision. Discussion: These findings suggest that the temporal gaps that children with DCD accept would result in collision if translated to the roadside. These findings will be discussed in relation experience at the roadside.  . Timing deficits may also occur in certain subtypes of DCD population. Yet, it is unclear whether deficits are associated or not with motor factors. The aim of the present work is to examine perceptual and sensorimotor timing abilities in children with ADHD with and without associated DCD. We expect to find more severe deficits in sensorimotor timing tasks DCD+ADHD as they involve motor performance. However, differences are not expected in purely perceptual timing tasks. Method: 23 DCD+ADHD children, 20 ADHD children, and 14 healthy age-matched controls, all from 7 to 14 years of age, took part in the experiment. They were submitted to the Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA, Benoît et al., 2014) which consists of both perceptual timing and sensorimotor timing tasks. Each measure was submitted to a one-way ANOVA, with a significance level set at p < .05. Then, post hoc analyses using Tukey tests were performed. Results: Data analysis is currently in progress. Preliminary results suggest a greater impairment in timing abilities in the DCD+ADHD group as compared to ADHD and control groups, even when the tasks do not require a motor response. However, this difference is not visible with all timing measures. The ADHD group also tends to show worse timing capacities than the controls. Discussion: The goal of this study was to examine the potential effect of DCD+ADHD condition on timing abilities. Our results will pave the ground to remediation methods aimed to improve perceptual, motor and sensorimotor abilities among children with neurodevelopmental disorders.  Aim: It has recently been hypothesized that a deficit in the functioning of the mirror neuron system (MNS) may contribute to the motor impairments associated with DCD. The aim of this study was to reveal cortical areas that may contribute to the movement difficulties seen in children with probable DCD (pDCD), and to examine suspected deficits in the MNS using functional magnetic resonance imaging (fMRI). Method: Twenty-four right handed boys participated in this study, 12 with pDCD (mean age = 10.06yrs ± 1.47) and 12 typically developing controls (mean age = 10.23yrs ± 0.98). Prior to scanning, children were tested on the MABC-2, with children in the pDCD group ≤16th percentile and controls ≥20th percentile. MR imaging was conducted on a 3T Philips Achieva TX scanner using a 12 channel head coil. High resolution anatomical images were acquired first (T1-weighted 3D FFE 160 slices 1x1x1 mm), followed by two functional studies (T2-weighted gradient echo, TR/TE = 3000/35ms, flip angle 90°, 25 axial slices with a thickness of 4mm, no gaps). A randomized block design was used for functional runs, during which a right index finger adduction/abduction tapping task was performed under four MNS activation conditions: observation, execution, imagery and imitation. Visual and auditory stimuli were used to prompt and coordinate each task. Active tasks (18secs) were interspersed with rest periods (12secs). Cortical activations of mirror neuron regions, including posterior inferior frontal gyrus (IFG), ventral premotor cortex, anterior inferior parietal lobule and superior temporal sulcus were examined. Preprocessing and analysis was performed using SPM12. Results: Full results will be presented at DCD-11. Preliminary results indicate children with pDCD have decreased cortical activation in MNS related regions, including the precentral gyrus and IFG, as well as in the posterior cingulate and precuneus (PCC/Pcu) complex. Discussion: Initial evidence supports a deficit in the MNS in children with pDCD. Due to its key role in imitation, motor imagery, and visual learning, dysfunction of the MNS is likely to result in a reduced ability to develop motor programs, impacting functionally on activities of daily living, sport participation and social situations. A greater understanding of MNS function in children with DCD has the potential to inform and tailor intervention programs for this population.  Aim: To compare gaze patterns in children with developmental coordination disorder (DCD) and typically developing (TD) children using an eye tracker during a fine motor pouring task performed in a natural setting. Method: Using a mobile eye-tracker and gaze analysis paradigm, we compared visual fixation patterns in children with DCD and their TD peers during a serial motor task. Wearing eye tracking glasses, children poured water from each of 3 'pouring' cups into 3 colour-matched 'filling' cups in sequence. All participants completed 12 trials; the order/ position of the filling cups was altered on every 3rd trial (pouring cups stayed in the same position). Gaze overlay videos were extracted. An eye-tracking video observation coding scheme was developed and intrarater reliability determined. First-person perspective videos (with a forward-facing view of the task scene) with superimposed gaze provided measures of: 1) total fixation time on a) pouring cups, b) filling cups, and c) dominant upper extremity; 2) proportion of total time spent visually fixating on 'objects of importance' (pouring and filling cups); and 3) average fixation time on pouring and filling cups, either before or during 3 functional task phases (forward transport, pour, back transport/set down/release). Results: 12 TD children (10M, 2F), mean age 9.7 years, and 12 children with DCD (11M, 1F), mean age 10.5 years, participated. Children with DCD visually fixated for significantly more time on their dominant upper extremity than TD children (p<.05, ES= 0.5). TD children visually fixated for a significantly longer proportion of total time on pouring/filling cups than children with DCD (p<.05, ES= 0.4). Children with DCD fixated for a significantly longer average duration time on the pouring cups during the pour phase (p<.05, ES= 0.6). A similar trend was noted for visual fixations on pouring cups during forward transport but was non-significant. Discussion: Previously, children with DCD have been noted to depend on vision during motor performance, suggesting poorly developed or integrated internal models of movement control. Our results suggest that children with DCD may use vision specifically to monitor their body position rather than other important aspects of a motor task. In addition, they do not appear to use predictive 'look-ahead' visual fixations, with a need to visually monitor their motor movements throughout a motor task, supporting the notion of an internal-model deficit.

N. Schott & I. El-Rajab
Institute for Sport and Exercise Science, University of Stuttgart, Germany. nadja.schott@inspo.uni-stuttgart.de Aim: While typically developing children produce relatively automatized postural control processes, children with DCD exhibit an automatization deficit (Tsai et al., 2009). Dual tasks with various cognitive loads seem to be an effective way to assess the automatic deficit hypothesis. The aims of the study were to (1) examine the effect of a concurrent task on walking in children with DCD; and (2) to evaluate if easy cognitive tasks can lead to performance improvements in the motor domain. Method: We examined dual-task performance of a cognitive and a sensorimotor task (walking) in 20 children with DCD (boys, n = 12; girls, n = 8; mean age, 8.10 ± 1.07 years) and 39 typically developing children (boys, n = 18; girls, n = 21; mean age, 8.44 ± 1.19 years). Based on the idea of the paper-and-pencil Trail Making Test, participants walked along a fixed pathway (TWT-A), stepped on targets with sequentially increasing numbers (i.e., 1-2-3; TWT-B), and sequentially increasing numbers and letters (i.e., 1-A-2-B-3-C; TWT-C; Schott, in press). The dual-task costs (DTC) were calculated for each task. Additionally the following items were assessed: Movement Assessment Battery for Children, test and checklist (MABC-2), and the Trail-Making Test (TMT). Results: In the primary walking task condition (trail tracing), the differences were not statistically significant (p = 0.215) between children with and without DCD; however, we found significant differences for the seated condition of the trail tracing task (TMT 1; p =.003). A concurrent cognitive task increased times significantly in all three groups, with the effect greater in children with DCD. Increased cognitive task complexity resulted in greater slowing of gait: gaits DTCs as well as handwriting DTCs were least for the simplest conditions and greatest for the complex conditions in children with DCD more so than in comparison children. Additionally, gait DTCs were significantly lower than handwriting DTCs. Discussion: These results support previous studies suggesting that children with DCD are more cognitively dependent and may have an automatization deficit, especially in the fine motor control task. Aim: Affordance theory takes the view that objects are perceived not only in terms of their size and shape, but also in relation to the possibilities for action. Research has shown that adults activate internal representations related to the execution of power or precision grips when viewing compatible objects. The aim of this study was to explore whether children with and without Developmental Coordination Disorder (DCD) elicit motor programs that support possible actions towards an object in their visual field. Method: Data collection is ongoing at the time of writing. Thirty children, aged 7-10 years, with a diagnosis of DCD (DSM-5) are being recruited alongside 30 typically developing age-matched children. In one hand children hold a cylinder device that they press using a power grip, and in the other hand is a small button mimicing a precision grip. Children view individually photographed objects (8 neutral object, 8 affording power grips, 8 affording a precision grip) on a laptop and are told the aim of the task is to respond quickly when they see a colour appear over the object; using the two devices, pressing one device if orange and the other if purple. Colour allocation is counterbalanced and each object is shown four times, resulting in two object grip/colour compatible, and two incompatible possibilities. Children responded to colour rather than the object because a range of objects were presented that did not have one obvious theme, aside from their associated grip. Children were told to stay focused on the objects as they would be asked questions about them on completion of the task. Halfway through the experiment, children swap the devices to the other hand to control for hand preference. Results: Preliminary analyses of 16 participants in each group showed that children with DCD made a higher number of errors and had slower reaction times than the control group. Children were able to successfully identify the objects they saw. A compatibility effect was evident for both children with DCD and the control group when viewing objects that afford a power grip, meaning they were quicker to respond when objects matched the colour and device grip they had been assigned. However, this compatibility effect was only evident for the control group on the precision grip objects, and not for children with DCD. A significant negative correlation (r = -.46, p < .001) was found between manual dexterity performance and precision compatible reaction times. Discussion: Initial findings show an interaction between type of response and object for both groups, when the object afforded a power grip. These Aim: Very preterm infants are at high risk of developing developmental coordination disorder (DCD), which is often undiagnosed before schoolage. Although early identification of DCD is recommended, the course of motor performance from infancy to early childhood and the presence of DCD at the age of school entry is largely unknown. The purpose of this study was to examine the relationship between motor assessments conducted early in life [4,8,18 months corrected age (CA) and 36 months] with motor outcomes of very preterm children identified with DCD at 4.5 years. Method: In a retrospective cohort of 320 very preterm infants (median gestational age: 26 weeks; median birth weight: 788 grams), the Movement Assessment of Infants (4 and 8 months CA) and Peabody Developmental Motor Scales-2 (18 months CA, 36 months), and Movement Assessment Battery for Children 1 or 2 (4.5 years) were conducted. Children with cerebral palsy and global developmental delay were excluded. DCD was defined as MABC ≤ 5th percentile. Differences between children with and without DCD were determined using Fisher's exact test for categorical variables and the Mann-Whitney U test for continuous variables.
Step-wise logistic regression and receiver operating curves used to determine if serial motor assessments were predictive of DCD at 4.5 years, adjusting for sex, birth weight, and days of ventilation. Results: 85/320 (27%) of children were diagnosed with DCD. Children with DCD were primarily male, born earlier, had smaller birth weight, and scored more poorly on motor assessments at each time point compared to children without DCD (all p's ≤ 0.001). MAI at 4 months significantly predicted DCD (OR 1.09, p= 0.02; AUC= 0.77), but not when MAI at 8 months was entered into model (8 month MAI: OR 1.13, p= 0.001, AUC= 0.81). Peabody total motor scores (TMQ) at 18 months CA (OR= 0.89, p<0.001, AUC= 0.81) and combined with 36 month scores (OR= 0.88, p<0.001, AUC= 0.84) also predicted DCD. The best predictive model included 8 month MAI and both TMQ scores, with the 8 month MAI (p= 0.009) and 36 month TMQ (p= 0.002) being significant (AUC= 0.86). Discussion: Pattern of motor performance on the MAI at 8 months and the TMQ at 36 months is predictive of DCD in very preterm children at 4.5 years. This is the first study to suggest that early motor performance of preterm infants is predictive of DCD and may allow for earlier identification of these high-risk infants. Results: Even though a number of children did not show progress in motor performance, as measured by MABC-2, occupational performance of all the children improved significantly, seven children were able to generalize learning and six children used the strategies and skills acquired in therapy to learn other tasks. Discussion: There were significant differences on individual and group performance after CO-OP according to parents, children and external evaluators. There were also gains in performance of activities that were not trained in therapy, demonstrating the ability of some children to generalize and transfer the acquired skills to other tasks. Although the small sample, results were robust and consistent with previous studies, reaching statistical significance. Parents' engagement in therapy is an important variable -children, whose parents were mostly engaged, achieved higher improvements in performance and satisfaction levels. Future studies should focus on parents training, a key component of CO-OP, and it is important to develop strategies to monitor objectively parents' participation. Aim: Past studies have found that children with Developmental Coordination Disorder (DCD) engage in less physical activity than typically developing children. This "activity deficit" may result in children with DCD being less physically fit and more likely to be overweight or obese, potentially increasing later risk for poor cardiovascular health. Unfortunately, the majority of DCD research has been limited to cross-sectional designs, leading to questions about the complex relationships among motor ability, inactivity and health-related fitness. Of the few longitudinal studies on the topic, determining precedence amongst these factors is difficult because study cohorts typically focus on mid to late childhood. By this age, both decreased physical fitness and obesity are often established. The purpose of the Coordination and Activity Tracking in CHildren (CATCH) study is to examine the pathways connecting DCD, physical activity, physical fitness, and body composition from early to middle childhood. Methods: The CATCH study is a prospective cohort study. We aim to recruit a cohort of 600 children aged 4 to 5 years (300 children at risk for DCD (DCDr) and 300 controls) and test them once a year for 4 years. At Phase 1 of baseline testing, we assess motor skills, cognitive ability (IQ), basic anthropometry, flexibility and lower body muscle strength, while parents complete an interview and questionnaires regarding family demographics, their child's physical activity, and behavioural characteristics. Based on the motor skill assessment, some children move on to Phase 2 (longitudinal cohort) and have their body fat percentage, foot structure, aerobic and anaerobic fitness assessed. An accelerometer to measure physical activity is then given to the child and interested family members. The family also receives an accelerometer logbook and 3-day food dairy. At years 2 to 4, children in the longitudinal cohort will have all baseline assessments repeated (excluding the IQ test). Parents will complete an ADHD index twice within the follow-up period. To assess the association between DCDr, fitness and adiposity, our primary analysis will involve longitudinal growth models with fixed effects. Discussion: The CATCH study will provide a clearer understanding of pathways between DCD and health-related fitness necessary to determine the types of interventions children with DCD require. Keywords: Underlying process; Early childhood; Fitness; Body composition; Health.
Implementing the "Partnering for Change" service delivery model: What do stakeholders say?  Aim: Partnering for Change (P4C) is a school-based, occupational therapy service delivery model for children with Developmental Coordination Disorder (DCD). In 2013, P4C was implemented in 40 schools in Ontario, Canada. The goal of this study was to identify stakeholders' perceptions of the implementation process and outcomes, with an emphasis on the factors that influence the model's sustainability. Method: Between December 2013 and June 2014, individual interviews were conducted with 5 occupational therapists (OTs), 14 school board managers and principals, 12 health care managers, and 3 research team members. Audio files were transcribed verbatim and entered into QSR NVivo 10 ©. Content analysis was completed using an implementation science framework. Comments relating to the implementation and sustainability of P4C were extracted to identify recommendations for expansion of P4C. In addition, 15 OTs completed daily logs to document services provided to children with DCD as well as requests to provide services to other populations of children. Results: All stakeholder groups perceived P4C to be an effective service delivery model for fostering participation of children with DCD and, potentially, for other children with disabilities. For health care managers, expanding P4C to other populations of children was identified as an equity issue and was recommended to financially sustain P4C. Partnership with schools was also a key factor for success. School stakeholders commented that it was helpful to have an OT as part of their team -to have someone who could problem-solve quickly without requiring a formal referral or the constraint of a diagnosis. OTs were asked to see children with varied needs; they offered 3329 individual sessions to 592 children with coordination difficulties, and were requested to see 435 children with other conditions (70% of whom did receive service). OTs described the supports needed to become part of the school team, to implement all of the P4C components (e.g. universal design learning and accommodation), and to manage large numbers of referrals/requests. Discussion: Stakeholders perceived P4C to be an efficient service delivery model and suggested that effective and sustainable service delivery should be responsive to the needs of all children. Their comments highlighted the many changes and the support required at different levels to implement this kind of model.  Aim: An evidence-based occupational therapy (OT) service for children with DCD was introduced in 40 schools to facilitate educators' capacity to manage children's needs and to support children's participation. Using best-practices in educator professional development and job-embedded learning, occupational therapists (OTs) work 1 day/week in the school to: 1) learn school culture; 2) develop relationships with educators; 3) exchange contextual knowledge from the educational setting to facilitate collaboration; 4) increase understanding of DCD; and 5) coach educators in a way that enhances application of new knowledge, skills, and behaviours. The intent is to empower educators to support children with DCD more effectively but also support all children's motor skill development. Building educator capacity may impact educators' ability to work successfully with children with DCD and thus reduce secondary disabilities. This presentation will describe educators' experiences with this service. Method: Educators completed a questionnaire at the start and end of the 1st year of the new OT service that captured educators' acquisition of knowledge of motor development and ability to identify children with motor delays; transfer knowledge to others; and use information to problem-solve and promote participation. Pre-post questionnaires were matched to measure individual change over time. Semi-structured interviews conducted with a convenience sample of school principals, special educators, and school board administrators further informed the findings. Results: Year 1 pre-post questionnaires showed an increase in educators' perceptions of their levels of competency and skills working with children with DCD in their classrooms. Interview findings confirmed principals and educators were highly satisfied with this model of service and valued the support and collaborative learning offered. Responses from the 1st year will be matched to questionnaires currently being collected for the 2nd year to further understand educators' experiences and change in knowledge and skills. Discussion: Findings show that providing collaborative OT services in context can change educators' knowledge and skills to support children with DCD and enhance the skillset of OTs to consider important contextual school based knowledge, structures and practices when providing services. Implications for health and educational policy, especially with respect to inclusive education, will be discussed. Keywords: Intervention; School-based management; Collaboration; Knowledge translation; Occupational therapy. Aim: Evidence-based management of Developmental Coordination Disorder (DCD) in school-age children requires putting into practice the best available and most current research findings, including evidence that early identification, self-management, prevention of secondary disability, and enhanced participation are the most appropriate foci of school-based occupational therapy. Partnering for Change (P4C) is new model of service delivery based upon these principles that is currently being evaluated in Ontario, Canada. Our experience to date indicates that its implementation in schools is highly complex with many factors influencing its success. This presentation will introduce attendees to a new field called implementation science, which focuses on the study of factors that facilitate uptake of evidence-based practices. We will use the "Active Implementation Driver's Framework" (Fixsen et al., 2005) to examine key factors or "drivers" that impact implementation of P4C, including: competency drivers related to the individuals who deliver the intervention; organization drivers related to how systems and institutions change their practices, processes, and work environment; and leadership drivers related to how well leaders are able to put in place the supports needed to make and sustain change. Method: Focus groups with therapists and individual interviews with stakeholders from health, education, and the research team were conducted between December 2013 and June 2014. Audio files were transcribed verbatim and entered into QSR NVivo 10 ©. Content analysis was conducted by team members to extract macro-level "lessons learned" about implementation from the first year of the P4C evaluation study. Results: Lessons learned about implementation included: (1) systematic training and regular opportunities for mentorship and networking are critical to people and systems making and sustaining change; (2) people in organizations need to dedicate time to building relationships and developing strong communication processes; (3) consistent and ongoing communication with all stakeholders at all levels facilitates change; (4) change needs to be gradual -too much at once may overwhelm individuals and systems; and (5) strong leadership is needed at every level within and across organizations. Discussion: Findings will be related to the Active Implementation Drivers Framework. Implications for implementing new evidence-based practices for children with DCD will be discussed. Keywords: Management of DCD; Evidence-based practice; Implementation science; Research to practice; Qualitative research.

Feeling better now: The impact of an exercise intervention on self-concept and happiness in adolescents with low motor competence.
program involved two 90-minute exercise sessions a week over 13 weeks, the current study focused on 16 sessions. Participants completed the Short Depression-Happiness scale (SDHS; Joseph, Linley, Harwood & Lewis, 2004) to measure feelings of happiness and the Harter-Self Perception Profile for Adolescents (SPP; Harter, 2012) to measure self-concept before and after the intervention. The AMPitup Environment Assessment Scale (EAS) measured short-term changes in happiness pre and post each session and the impact of contributing factors (exercise, the group and the relationship with trainer). The Wilcoxon Signed Rank Test was used to test significant differences in overall happiness and self-concept. A Chi Square Test, paired T Test and Linear Mixed Model were used to test significant changes in short term happiness and the impact of contributing factors. Results: No significant difference was found pre and post intervention for overall happiness (p = .843) or self-concept sub domains. A Chi Square Test revealed significant increases in happiness in 9 out of 16 sessions. Paired T Tests found a significant increase in feelings of total happiness over 16 sessions (p =.013). A Linear Mixed Model revealed that the exercise (p =.001), group (p =.001) and trainer (p =.007) were all significant factors in predicting happiness. Discussion: Due to the quantitative method of data collection and small sample size overall happiness and self-concept showed no significant differences. However, significant changes were found in short term happiness for each session and cumulatively across 16 sessions, with the exercise, group and trainer contributing to the increase in happiness. Future research should include qualitative interviews with participants and parents. This will provide further insight into overall happiness and self-concept and what particular aspects of the program they enjoy the most, so that exercise interventions can be individually tailored for adolescents with low motor competence. Aim: Receiving a diagnosis of a developmental disorder has a major impact on a family. The aim of the current research was to highlight the views and experiences of parents who had received a diagnosis of developmental coordination disorder (DCD) for their child in the United Kingdom. Specific aims were: (1) To examine the common ways that DCD presents (e.g. nature of initial concerns regarding their's child development), and the journey that the parents go through in order to obtain a diagnosis for their child; (2) To evaluate parents' satisfaction levels with different aspects of the diagnostic process and subsequent support; (3) To investigate which factors affect parental satisfaction, in order to determine areas in which improvements would be beneficial. Method: A total of 228 parents completed an online survey about their experiences of obtaining a diagnosis of DCD for their child. The survey was adapted from a recent study exploring parental experiences of receiving a diagnosis of autism spectrum disorder (Crane et al., in press) and questioned parents on: their child's early development; the age of their child when they first sought professional help; the professionals seen and the outcome of each consultation; the disclosure of the diagnosis; the time taken to receive a diagnosis; their satisfaction with various aspects of the diagnostic process; and the support (if any) that they subsequently received.

Results:
On average, a diagnosis was confirmed two and a half years after parents initially sought professional help in relation to their child's motor difficulties. Satisfaction with the diagnostic process was mixed: 45% of parents were dissatisfied and 39% were satisfied. Three factors were predictive of parental satisfaction with the diagnostic process: levels of stress during the process; the manner of the disclosing professional; and satisfaction with post-diagnostic support. Post-diagnostic provision was the area in which parents reported most dissatisfaction, which was not surprising given that 43% of parents were not offered any practical help or support during the diagnostic process or in follow up appointments. A total of 61% of parents reported that their child had a cooccurring condition (often autism, ADHD, or learning/physical disabilities). However, parental satisfaction with the diagnostic process did not vary as a function of whether the child had a comorbid disorder. Discussion: Based on these findings, we propose three key areas in which improvements in the diagnostic process for DCD are needed: (1)

Laboratory of Motor Development and Learning, Department of Physical Education, University of Sao Paulo State, Av. 24 A, n. 1515, 13506-900, Rio Claro/SP -Brazil. cyhiraga@rc.unesp.br
Aim: The aim of the present study was to investigate the modulation of the SNA in children with DCD through Heart Rate Variability (HRV) analyses, during free practice and under timing and precision pressure practice of dominoes lined up setting motor task. Method: Thirty children from 8 to 12 years old participated in this study. Following the American Psychiatric Association (APA-DSM V) criteria for DCD, 30 children were selected to participate in the present study, grouped as follow: 15 DCD children (9 boys and 6 girls, mean age 10.8 y) and 15 Typically Developed (TD) children (9 boys and 6 girls, mean age 10.5 y). Groups were paired by age, gender, Peak Volume of Oxygen uptake (VO2 peak) and Body Mass Index (BMI) outcomes. Spectral, symbolic and conditional entropy HRV analyses of DCD children were compared to Typically Developed (TD) children during resting, free and under pressure practice. Results: As expected, DCD children motor task performance was poorer than TD children`s performance during free and under pressure practice. HRV results indicated that during free practice TD children showed parasympathetic modulations significantly higher than the ones showed by DCD children. During practice under pressure, TD children reduced parasympathetic modulation closer to the level of modulation showed by children with DCD. Discussion: Children with Developmental Coordination Disorders (DCD) show many executive functions difficulties in decision-making, learning, control and memory involved by the Central Nervous System (SNC). Those difficulties impact negatively DCD children development. The Autonomous Nervous System (SNA) modulation is in the context of SNC executive functions. However, during motor performance, the SNA modulation in children with Developmental Coordination Disorder (DCD) has not been focus of empirical systematic investigation. Furthermore, the literature has strongly confirmed that parasympathetic modulation of SNA is positively related to the activation of cerebral centers of executive functions. Therefore, DCD children`s neurophysiologic systemic modulation during motor task free practice and both groups (DT and TDC) neurophysiologic systemic modulation during motor task under timing and precision pressure were not ideal to the motor performance demands throughout executive functions process.  Aim: To our knowledge, no study has exhaustively examined the perceptions of children with DCD, their parents and their teachers. However, to be able to offer the best services, a needs assessment should be done, which includes probing the stakeholders (Rossi et al., 2004). This study aimed to explore and compare their perceptions regarding the participation and needs of school-aged children with DCD in their living environments. Method: Data were derived from an ecosystemic needs assessment based on a multiple case study design ( Jasmin et al., 2014). A multiple case study design was chosen because it can be used to describe and analyze, indepth, a particular social phenomenon in its real context (Yin, 2009). Participants included ten children with DCD, their parents (n = 12) and their teachers (n = 9). Individual semi-structured interviews were conducted with each participant. Qualitative data were analyzed according to Miles and Huberman (2003). Results: Results describe the participation and needs of children with DCD at home, at school and in the community, from the perspective of children, parents and teachers. More specifically, results show that all participants perceived difficulties with school activities. However, participation and needs at home, at school and in the community varied for each child. Children rarely expressed the same expectations as their parents and teachers. Contrary to their parents and teachers, most children did not want more services. Parents and teachers mainly requested additional services at school and training. Aim: Many studies report balance problems in children with Developmental Coordination Disorder (DCD). Dynamic balance, when evaluated as the control of Centre of Pressure (CoP), differs from typical developing to children with DCD. The latter group shows an increase of variability mainly during tasks under complex or changed circumstances. How children with DCD learn to control dynamic balance in dynamic conditions is unknown. This study examines changes over time in a task requiring high level of dynamic balance control (the Wii-Fit ski slalom game). Our hypotheses are 1) children with DCD will show larger and more variable CoP excursions than control children; 2) balance will improve after repetition as measured by a reduction of the variability of the Centre of Pressure (CoP); 3) differences in CoP excursions reflect differences in movement strategies. Method: Twenty eight children with DCD between the age of 6-12 year, participated in this study. Twenty one typically developing children (TD) matched for age and with a score >16th percentile on the Movement Assessment Battery for Children 2 (MABC2) were included as the control group. The Wii balance board was placed on an AMTI force plate. The children played the Wii Fit ski slalom game for ten consecutive runs before (T0) and after (T1) a period of six weeks. The force plate data were analysed for CoP variability and total path length.  Figure). Repeated measures ANOVA revealed a difference between groups (F(5,28)=2.9, p =.03), with a significant interaction effect between group and time for the variability of lateral CoP (p =.048), the counted changes in anteriorposterior direction (p =.043), and a trend for pathlength (p =.066). Discussion: The TD group seems to gain efficiency over time in reducing path length; the BP group seems less active at first, gaining more efficiency over time by increasing path length. As the change of group differences at T0 and T1 does not match the change in performance (# missed gates) we conclude that inaccurate timing may be a better predictor of performance than control of dynamic balance during the first phase of learning. Keywords: Balance control; DCD; Force plate; Centre of Pressure (CoP).

Participation and needs of school-aged children with DCD in their living environments: Perceptions of children, parents and teachers
Aim: In addition to academic and self-care difficulties, there is compelling research showing children with Developmental Coordination Disorder (DCD) engage in less physical activity (PA) than their typicallydeveloping (TD) peers 1 . There is very little in the research literature, however, which examines PA behaviours and the psychosocial factors related to PA in young children with motoric difficulties. The purpose of the current study was to compare objectively assessed PA behaviours of children at risk for DCD (DCDr) and TD children, and the relationships between PA and salient parental influences. Methods: Children recruited as a part of the Coordination and Activity Tracking in CHildren (CATCH) study were included (N= 86; 60% DCDr; 57% boys). Parents completed a questionnaire measuring their perceived importance of PA, enjoyment of PA, parental support for PA, and perceptions of their child's competence. Additionally, each child wore an RT3 Triaxial Actical Accelerometer for seven consecutive days. Results: Univariate analysis of variance found no significant differences in time spent in moderate-to-vigorous PA between DCDr (M = 76.32 +20.62) and TD children (M = 74.42 +19.73). Similarly, no differences were found in light PA or sedentary behaviours. Correlation analyses did not find significant relationships between children's PA and parental influences, but there was a significant difference in parents' perceived competence for DCDr and TD children (F(1,82) = 21.86, p<.001). Discussion: Findings suggest that there are no differences in PA behaviours between DCDr children and their TD peers during early childhood. As expected, parents of DCDr children reported lower perceived competence for their child; however, parental enjoyment, support, and perceived importance of activity were unrelated to a young child's PA. Overall, preliminary findings suggest that these young children tend to be fairly active, working toward the progression of 60 minutes of energetic activity by age 5, as per PA recommendations. While PA behaviours do not appear to be influenced by motoric capabilities and parental influences during this early life stage, future research will examine how these patterns of PA and its relationships change over time, potentially identifying the critical periods and targets for intervention efforts.  Aims: 1) To examine gender differences in physical fitness and overweight in a sample of DCD children in comparison to typical children in Israel; 2) To examine the same differences within a comparable US sample. Method: DCD was identified through total scores on the Movement Assessment Battery for Children 2 (MABC-2) equal to or less than the 16th percentile as well as parents' report that the child's deficits in motor skills interfered with at least two daily life activities.  -2), the Six Minute Walk Test (6MWT) with heart rate measure, BMI and the percentage of body fat. Results: Significant differences between DCD and typical children were found on all variables of physical fitness (BOT-2 and 6MWT) in both cultural samples. A two-way analysis of variance (ANOVA) (group/ gender) within the Israeli sample revealed significant interactions for the percentage of body fat (F =8.51, p<.005) and BMI (F=4.50, p<.038) meaning that less fit children were more obese. Within the DCD group significant differences were found between girls and boys, where girls had higher % body fat (t = 2.36, p < .028); and approached significance for BMI (t=1.89, p<.074) in the same direction. However, in the US none of these interactions were significant. Discussion: The current study supports previous findings that children with DCD are less physically fit and more overweight compared to typically developing children. Moreover, in comparing between the genders Results: The 171 children referred from waitlists were, on average, one year older than those children identified directly by OTs (mean age = 8.78 vs. 7.79 years). Children referred from waitlists were more likely to have multiple diagnoses than those identified by OTs (64% vs. 57%). Regardless of referral source, the most frequent comorbidities were attention difficulties, learning disabilities, and speech delay. Interestingly, children identified by OTs were 3 times more likely to have anxiety problems than children on waitlists. Perhaps most notably, children from the waitlists were more likely to have a formal individualized education plan at school (49% vs. 28%). DCD-Q scores indicated that over half of the children in both referral groups met criteria for probable DCD; however, while only 18% of the children on waitlists were younger than 8 years, 41% of those referred by OTs were less than age 8. Discussion: Delivering health services at a whole school level leads to much earlier identification of children with DCD and successfully identifies many children who otherwise would "fall through the cracks." Implications for enhanced equity and accessibility of school-based therapy services will be discussed. Keywords: Comorbidity; School-based interventions; Early identification; Early intervention; Description of DCD. Aim: Systematic and meta analytic reviews have been conducted to evaluate and summarise existing empirical evidence. Because the findings from the reviews are often used for informed decision-making, it is critical to ensure that the reviews are undertaken properly and that the conclusions drawn from the reviews are trustworthy. To date, no attempt has been made to appraise the quality of systematic review and meta analysis on the effectiveness of intervention for children with developmental coordination disorder (DCD). This meta review, or a review of the reviews, is the first of its kind for this population. Method: We conducted a review of published systematic and metaanalytic reviews on the intervention outcome for children with DCD between 1806 and October 2014. The methodological quality of the identified systematic and meta-analytic reviews was independently assessed by two assessors with the assessment of multiple systematic reviews (AMSTAR) 1 . Disagreements of the assessment were resolved by discussion. The methodological quality score of the AMSTAR was expressed as a percentage of full score. Results: The literature search yielded a total of four reviews 2-5 on the intervention outcome for children with DCD from 1996 until 2014. The AMSTAR percentage quality scores of the four reviewed studies ranged from 0 to 55 percent. No previous review has provided a priori review design, a search for "grey literature" or unpublished studies, a thorough homogeneity analysis with forest plots, an assessment of publication bias, or adequate disclosure of conflict of interest. Discussion: The quality scores of the reviews progressively improved over the years. However, there is a room for further improvement. By fully addressing the shortcomings, future reviews would become of higher quality, thus offering more trustworthy and useful findings for evidence-based practice.  Aim: A serious game -Teacher in a Box (TiaB; in Dutch Juf-in-a-Box, www.jufinabox.com)-was developed to train young children with fine motor skills disorder to practice preparatory writing movements with a stylus on an interactive tablet, built into a classroom desk. TiaB is based on principles of neuromotor task training 1 . In this exploratory study, feasibility and preliminary efficacy of TiaB training on motor handwriting skills were investigated. Method: Three groups of children (6-8 yrs old) participated: children in regular education (RE; n=23), children with motor handwriting problems, who were treated by a pediatric physical therapist (PPT; n=22), and children in special education (SE; n=16). Children were instructed to train on TiaB for 2 times/week, 25 minutes during 6 weeks 2 . Feasibility was investigated after training using semi-structured interviews with children, teachers, and therapists. Time on task and the amount of different tasks were recorded during each training session. Quality of motor performance was assessed pre-and post training with a testing module within TiaB. Results: Mean grades for the children for TiaB were 7.9 (RE) and 8.6 (SE and PPT) on a 10 point scale. Most of the children preferred practice with TiaB above traditional paper-pencil practice. Feasibility was graded with a mean of 7.5 by the teachers and therapists. Rating for independent practice differed between teachers (mean 8.9) and therapists (mean 2.6). Points of criticism were mainly focused on technical problems and logistics. Mean practice time was only 147.7 minutes (SD 78.8) with a significant difference between groups (p<0.001): the PPT practiced the most 204.4 min (SD 82.3), and the SE the least with 97.9 min (SD 47.2). Over 88% of mean practice time was spent on the basic level of exercises. No differences were found on accuracy and velocity between pre-and post training. The effect of training differed significantly between groups: The PPT group improved on velocity with unchanged level of accuracy. In both pre-and post test, accuracy was significantly higher for the RE group with a lower velocity compared to the PPT and SE group. Discussion: This particular Teacher speaks to the children. Preliminary effect on motor performance was proved in the PPT group. To improve practice time, the development of an application in a handheld tablet was recommended. Release of this app-version Monster Zoo is planned in April 2015.

Playful learning to write with a particular Teacher: feasibility of the digital writing program Teacher in a Box in education and rehabilitation
Aim: Physical and occupational therapists aim to improve motor performance in children with Developmental Coordination Disorder (DCD) by using motor teaching principles. Examples of motor teaching principles are how to instruct children, how to guide practice, how to provide feedback about their performance, and how to impart knowledge. It is known from literature that some motor teaching principles are more effective than others. In 2003, a pilot version of the Motor Teaching Principles Taxonomy (MTPT) was developed (Niemeijer, Smits-Engelsman, Reynders & Schoemaker, 2003). Aim of the current study was to adapt this taxonomy in order to include recent knowledge about motor teaching, and to investigate the utility and reliability of the taxonomy. The ultimate goal of this study is to use the Motor Teaching Principles Taxonomy as a tool to describe which motor teaching principles are used in interventions of children with DCD. Method: Several steps were taken to adapt the original MTPT. First, relevant textbooks and papers about motor learning were studied to update the original MTPT. Second, a Delphi round was held with pediatric physical therapists to incorporate their practical knowledge about motor teaching principles in the taxonomy. This process resulted in an updated version of the original MTPT. Two intervention sessions of about 10 children with DCD treated by pediatric physical therapists were recorded. Next, master students in Human Movement Science observed these recordings and classified all verbal actions aimed to enhance motor learning using the taxonomy. Both inter-and intra-reliability were determined by calculating Cohen's Kappa.

Results:
The new MTPT covers four categories: Instructing, Sharing knowledge before a task is completed, Providing feedback, and Sharing knowledge after a task is completed. The results regarding intra-rater reliability and inter-rater reliability will be presented during the conference, as data gathering is still ongoing. Discussion: The implications of the results for further research and clinical practice will be discussed during the conference.  Aim: Impaired sleep is associated with a range of negative effects on children's quality of life and their behavioural, emotional and cognitive functioning. Previous research has shown a higher rate of sleep disturbance in children with a range of developmental disorders in comparison to the general population. In our previous work parents of children with and without DCD completed the Children's Sleep Habits Questionnaire (CSHQ). This showed significantly higher sleep disturbance for children with DCD compared to controls. Sub-scale scores indicated particular problems with bedtime resistance, parasomnias and daytime sleepiness. These results suggested that sleep patterns of children with DCD should be investigated further. The aim of the current study was to examine sleep in DCD using more extensive and objective measures. Method: Two groups of 15 children with DCD were recruited, one from primary school (7-11 years), one from secondary school (11-16 years). Typically developing children were individually matched on age and gender to the children with DCD. Sleep behaviour was assessed using the CSHQ plus actigraphy (movement sensors), which provided an objective assessment of the children's sleep-wake patterns over one week. Aspects of self-rated child functioning which may be associated with the presence of sleep disturbance were assessed with various questionnaires (Pre-sleep Arousal Scale, Pediatric Daytime Sleepiness Scale, PedsQL Multidimensional Fatigue Scale). The Maternal Cognitions about Infant Sleep Questionnaire was used to assess parents' thoughts about their child's sleep. Results: The DCD group scored significantly higher than controls on the CSHQ, indicating greater overall parent-reported sleep disturbance. In particular, sleep duration, parasomnias and daytime sleepiness were problematic. Actigraphy indicated that the nocturnal sleep of children with DCD was objectively more fragmented than controls'. The DCD group reported feeling more cognitively aroused before sleep and feeling more sleepy during the day than the control children. Discussion: The children with DCD had more problematic sleep than typically developing children, according to both objective measures and parent report. The underlying cause of this disturbance cannot be ascertained from this study but is an important area for future research. There seems to be a link between the sleep problems and daytime tiredness. Awareness of sleep problems in DCD is important for early identification and implementation of support to potentially ease tiredness during the day, which might enable children to cope better during the daytime. Keywords: Sleep; Actigraphy; Daytime sleepiness; Parasomnias; Presleep cognitive arousal.

Evaluating motor performance and the presence of signs of inattention/hyperactivity in 6-years-old Brazilian children
Method: Six year old Brazilian children randomly selected from private and public schools were evaluated with the Movement Assessment of Battery for Children 2nd Edition (MABC-2) 1 , the Developmental Coordination Disorder Questionnaire (DCDQ-Brazil) 2 and the Swanson, Nolan and Pelham IV Scale (SNAP-IV) 3 . An occupational therapist and a research student assessed all children with the MABC-2 and their parents and teachers completed the DCDQ -Brazil and SNAP-IV, respectively. Results: A total of 85 children (42 girls -49.4%) considered as typically developing participated in the study, their mean age was 77.91 (± 3.17) months and 77 (90, 6%) were enrolled in the first grade of elementary schools and eight (9.4%) were enrolled in Childhood Education (preschool). According to the results of the SNAP-IV, nine (10.6%) children showed signs of inattention, six (7.1%) showed signs of hyperactivity/ impulsivity, one (1.2%) showed signs of inattention and hyperactivity/ impulsivity; one (1.2%) questionnaire was not returned. Regarding performance on the MABC-2, two children (2.4%) had results bellow the 5th percentile, three (3.5%) had suspect results and 80 children performed above the 15th percentile. Based on the DCDQ-Brazil, the scores of 8 (8.4%) children indicated possible DCD. Combining results, on the SNAP-IV, of the eight children who showed signs of DCD on the DCDQ-Brazil, half had symptoms of inattention (3) and combination of inattention and hyperactivity (1). Among the five children with results suggestive of DCD on the MABC-2, one showed signs of inattention and other presented signs of inattention and hyperactivity/impulsivity on the SNAP-IV. There was agreement between the MABC-2 and DCDQ-Brazil on only two children regarding the presence of motor problems. Discussion: Even though the study was conducted with typically developing children, 5.9% children were found to present signs of motor coordination problems. Children with probable DCD, as defined by the MABC-2 and DCDQ-Brazil, showed more signs of hyperactivity and inattention, however, the motor test and questionnaire identified motor problems in different children. Future studies should further investigate the relationship between the DCDQ-Brazil and the MABC-2 as well as the co-occurrence of motor performance and attentional problems among Brazilian children.  Aim: Prevalence of Developmental Coordination Disorder (DCD) is 5-6% for term infants, and 40-50% for preterm infants 1 . Children with DCD may also have attention deficit disorder, hyperactivity, speech and learning problems 2,3 . This study aims to compare visual perception of preterm born children with DCD to term born children with DCD. Method: Initially, 60 children (thirty of them born under 32 weeks of gestational age and the others were term) between ages of 4-6, were included in the study. We excluded children whose diagnoses are cerebral palsy, intrauterine growth restriction, loss of hearing and vision, mental retardation. Movement Assessment Battery-Second Edition and Frostig Developmental Test of Visual Perception have been used for assessment of motor skills and visual perception. We continued the study with 18 children (7 term, 11 preterm) who had <15th centile in Movement ABC-2 test. Due to Frostig test <60th centile was accepted as a visual perception problem. Sub parameters of Frostig test (eye motor coordination, figureground, form constancy, position in space, spatial relations) and Frostig total point were compared to the term and preterm groups who diagnosed as DCD. There isn't any significant difference between children according to preschool education and social-economical status of their families (p>0,05). Results: As a result of Frostig test, visual perception problem was detected as 91.9% (n:10) for the preterm group with DCD, and 14% (n:1) for the term group with DCD. When the groups were compared, hand-eye motor coordination and Frostig total score of preterm group with DCD were found significantly lower than term group with DCD (p= 0.005 and p= 0.001). Although no statistically significant difference were detected for other parameters of Frostig test (figure-ground, form constancy, position in space, spatial relations), average scores were found lower for the preterm group with DCD. Discussion: The motor, learning, social and speech ability problems caused by prenatal, perinatal and postnatal risk factors that affect the immature brain of preterm infants are still discussed. When the children with DCD are evaluated and treated it is needed to demonstrate particular attention to the accompanying visual perception and learning problems. Aim: A number of studies have shown that children with developmental coordination disorder (DCD) show poor performance on health-related physical fitness components 1 . Specifically, physical fitness performance is lower than that of their typically developing (TD) peers 2 . Many of the studies comparing physical fitness performance between children with and without DCD have not taking into account the body mass index (BMI) status of their participants. The present study examines (1) whether overweight/obesity influences on physical fitness components of children with and without DCD; and (2) whether different BMIs (normal BMI vs. overweight/obesity) influence on physical fitness of children with DCD. Method: A total of forty-nine children aged between 7 to 10 years participated in the study. Movement Assessment Battery for Children 2 (MABC-2) was used to identify children with DCD and TD children. The assessment of physical fitness of all participants was done by the sit and reach, long jump, modified pull-up, curl-up and 9-min run tests. Comparison analyses on physical fitness components between children with DCD and overweight/obesity (DCD_o/o) vs. typically developing overweight/obesity children (TD_o/o) were done. Furthermore, comparisons between children with DCD and normal BMI (DCD_nBMI) vs. children with DCD and overweight/obesity (DCD_o/o) were carried out. For a fair comparison between groups, participants were matched by age, gender and BMI status.

Results:
The results of comparisons between DCD_o/o vs. DT_o/o indicated that physical fitness of DCD_o/o group was significantly lower than that of the TD_o/o group for the standing long jump test, t(34) = -3.8, p < .01, modified pull-up test, Z(34) = -2.0, p < .05 and curl-up t(34) = -2.9, p < .01. There was no significant difference between groups for sit and reach test and 9-min run test. The results of comparisons between DCD_nBMI vs. DCD_o/o, showed that there were no significant differences on physical fitness components (sit and reach, modified pull-up, curl-up and 9-min run tests) between children with DCD_nBMI and DCD_o/o, except for the long jump test, t(24) = 3.1, p < .01. Discussion: Overall, the results of the present study suggest that BMI, overweigh/obese, appears not to determine the performance of physical fitness components of children with DCD, but their own coordination problem seems to be decisive to low physical fitness.  Aim: Some adults experience motor difficulties that have a negative impact on their ability to perform everyday life tasks at home, work and/or in education. Developmental Coordination Disorder (DCD) often persists into adulthood, with continuing difficulties with a range of self-care tasks, handwriting, sports, recreational activities and driving. For others, motor difficulties are associated with known physical or neurological deficits. Whatever the nature of the motor difficulties, it is important to identify individuals and assess their motor difficulties so that appropriate support can be provided by educators and employers. Self-report questionnaires can provide useful information as part of a broader assessment. The aim of the current study was to develop a selfreport, online questionnaire for young adults, focused on everyday life motor skills. Method: Item Generation: Items were generated using the DSM-5 criteria for DCD, a review of the literature on adult motor difficulties, our own experience and existing adult and child questionnaires. The questionnaire comprised a short section on difficulties in childhood and a section on current difficulties in adulthood. The latter had six parts: Daily Living skills; Everyday Movement; Study/Work skills; Sports/Recreational skills; Participation and Driving. A 4-point scoring scale similar to that in the MABC-2 Checklist was used. Piloting items: Minor amendments were made to wording, following feedback from eight adults. Expert Validity: Ten experts in the field, with experience of developing and using tests and of working with individuals with motor difficulties, were asked to provide feedback on the content and clarity of the questionnaire. The experts included psychologists, occupational therapists, teachers and student disability officers. Revisions to items and wording were made on the basis of information received from this panel of experts. Online formatting: The revised questionnaire was prepared for online completion, using Qualtrics software. Validity & Reliability: Preliminary aspects of validity and reliability were investigated by asking 120 adults aged 18-35 to complete the questionnaire online. Factor analysis was used to explore the number Aim: The study investigated response inhibition (RI) in children with impaired and typical motor skills. It was expected that children with poor motor skills would be less accurate and slower at inhibiting motor responses than children without motor impairments, while performing appropriately when inhibiting verbal responses. Method: Participants were 91 children aged 7-11 years, split into three groups: children with a clinical diagnosis of Developmental Coordination Disorder (DCD), children with motor difficulties (MD) but no diagnosis, and typically-developing (TD) children. Children with co-occurring neurodevelopmental disorders were not included in the DCD group in order to assess the extent of the impact of motor impairments only on RI. RI was measured using the Verbal Inhibition Motor Inhibition test, in which the response to inhibit was either a word (verbal task) or a gesture (motor task). The Total Error and the Total Completion Time were used as measures of RI accuracy and speed, respectively, and processing speed measures were also included in the analyses. Results: In the motor RI task children with DCD and MD produced more errors than TD children but did not take longer to complete the task. In the verbal task, children with DCD and MD were as accurate as TD children but the DCD group was significantly slower than the other groups at inhibiting verbal responses. These differences were evident even after subclinical symptoms of inattention and hyperactivity were taken into account. When processing speed was controlled for in the analyses, the DCD group remained slower than the other groups on the verbal RI task. Discussion: Children with poor motor skills (both DCD and MD) demonstrated significant difficulties in inhibiting motor responses. It may be that the motor demand of the task impacted on their ability to respond accurately and discouraged them from taking extra time to attempt to perform well. Children with DCD and MD performed as accurately as TD children in RI tasks once the motor demand was removed. However, the slower performance of children with DCD in the verbal RI task may reflect inefficiency with the process of inhibiting a response, such that typical levels of accuracy can only be obtained at the expense of very slow and careful responding. Future studies should include children with DCD and co-occurring disorders in order to compare RI across a clinical sample. Keywords: Response inhibition; Processing speed; Motor difficulties; Developmental Coordination Disorder; Executive functioning. Aim: Motor impairments in dyslexia were observed long ago (Denckla, 1985;Haslum, 1989) and overlap between Developmental Coordination Disorder (DCD) and Developmental Dyslexia (DD) is substantial, with over half of dyslexic children having DCD and conversely. However, few studies give details on such association. To attempt to bridge this gap, our team members have conducted three studies based on the same sample composed of children with only dyslexia, or only DCD or dyslexia and DCD. Those three levels of analysis have allowed us to compare the intellectual, behavioural and neural characteristics of these three populations (DD, DCD and DD+DCD). We especially paid a particular concern to the profiles of children with co-occurrence. Method: A group of 65 children (21♀-44♂) were recruited: 20 DD (8♀-12♂), 22 DCD (6♀-16♂) and 23 DD+DCD (7♀-16♂). Inclusion criteria were: 8 to 12 years old, with DCD or DD or DCD and DD, no known psychiatric or neurological disorder and an IQ score greater than 70. Diagnosis DD and DCD were in accordance with the DSM-IV-TR criteria with M-ABC test for motor skills and L'Alouette and ODEDYS-2 test for reading skills. Children with Specific Language Impairment and/or Attention Deficit/Hyperactivity Disorder according to the DSM-IV-TR criteria were excluded. Participants were submitted to the same evaluation, comprising an assessment of intellectual abilities (WISC-IV), procedural learning (Finger Tapping Task) and a functional brain imaging (FMRI). Results: Firstly, none of our three studies showed any evidence of compounding effects of dual-diagnosis. Comorbidity does not seems to constitute an aggravating factor. There is no additive effect, never on intellectual abilities, nor behavioural skills or brain organization. Secondly, there was no differences between DD and DD+DCD groups, but important difference was observed between DCD children and the two other groups. Surprisingly, characteristics which were clearly typical of the DCD group (visuospatial deficiency, procedural learning difficulties or additional activations in the attentional circuit), did not appear in the comorbid group. Discussion: The results from the children with dual association are particularly relevant, highlighting a feature of the comorbid group, which behaves like the DD group, and on several levels (behavioural, neurological and cognitive aspects). All together, this raises the question of the status of the comorbid group: as a sub-group of DD or an independent disorder, closer to DD than to DCD? This finding is a real improvement and constitutes an important basis for further reflection. Now, the question is naturally what will happen to this specific status, given the specificities of their motor and functional skills, and what therapy and medical care can best help them overcome their difficulties? Keywords: Comorbidity; Developmental Coordination Disorder; Developmental Dyslexia.

Department of Psychology, Goldsmiths, University of London, New Cross, London, SE14 6NW, UK. Dan.brady@gold.ac.uk
Aim: There is increasing evidence that the primary motor cortex (M1) plays a role in the early stages of motor learning 1,2,3 , and there are genetic and environmental factors influencing M1 plasticity which may affect motor learning 4,5 . There is also evidence that the degree of connectivity between M1 and other areas can be used to predict subsequent motor learning 6 . Despite this there has been little research looking at the potential contribution of the primary motor cortex to the motor learning difficulties experience by individuals diagnosed with DCD 7 . Therefore the aim of this study is look at the neural correlates of movement during the early stages of motor learning and from these correlates attempt to determine whether the primary motor cortex could be implicated in the disorder. A secondary aim was to look at the connectivity between M1 and other areas in adults with and without DCD to determine if there were any significant and reliable differences. Method: Participants: Right-handed adults, aged 18-35, diagnosed with DCD or synonymous condition (e.g. dyspraxia), and age-matched, typically-developing controls. All participants will undertake the modified Movement ABC 8 to differentiate those with DCD and those without. Task: Participants practice a simple motor learning task involving responding to numbers presented on screen by pressing the corresponding key on a numerical keypad. This will be divided into several blocks. Measures: Behavioural performance (accuracy and reaction time) for the task was recorded. Resting state EEG was recorded before and after the task, and EEG was also recorded throughout the task. Results: Data collection is on-going and preliminary results will presented at the conference. Behavioural data will be analysed to determine if participants showed an improvement over the course of the blocks. The EEG recorded during the task will be analysed looking at changes in Movement related event related potentials, specifically the amplitude and onset, as well as changes in event-related mu desynchronisation over the course of the blocks. Both of these neural correlates have been shown to be localised to the primary motor cortex 9,10 . In addition the resting state data will be analysed to look at differences in connectivity between the participants diagnosed with DCD and the typically developing participants, and any differences in connectivity before and after completion of the task. Aim: Attaining motor milestones such as standing and walking are important aspects of a child's overall motor development 1. Children with Developmental Coordination Disorder (DCD) experience significant movement difficulties 2 ; however, it is not well understood when children with DCD begin to fall behind their peers with typical development (TD) developmentally. We examined the average age motor milestones were attained in children at risk for DCD (DCDr) and TD children. The relationship between average age of motor milestone attainment and current level of motor coordination was also examined. Method: The sample was a part of the larger Coordination and Activity Tracking in CHildren (CATCH) study, comprised of 133 children 4-to-5 years of age (n= 64 DCDr; n= 87 boys). All participants were assessed with the Movement Assessment Battery for Children version 2 (MABC2), and parents provided information regarding the age (in months) that their child achieved the following milestones: sitting without support, standing with assistance, crawling on hands and knees, walking with assistance, standing alone, and walking alone. Independent t-tests were conducted to evaluate differences in the average age the milestones were achieved between DCDr (≤16th percentile on the MABC2) and TD children. Pearson product correlations were conducted between age of motor milestone attainment and MABC2 scores. Results: TD children achieved 3 motor milestones at significantly younger ages than DCDr children: sitting without support (t(131)=-2.207, p=.029), crawling on hands and knees (t(131)=-2.109, p=.037), and walking alone (t(131)=-2.335, p=.021). MABC2 scores were significantly negatively correlated with sitting without support (r=-0.173, p =.046), walking with assistance (r=-0.176, p =.043), and walking alone (r=-0.197, p=.023). Discussion: The results suggest that DCDr children achieve motor milestones such as sitting, crawling, and walking at a later age than TD children; however, they still often achieve these milestones within typical time frames. We also found that children who achieve their motor milestones earlier may be more likely to have better motor coordination in early childhood. Aim: Compared to typically developing (TD) children, those with Developmental Coordination Disorder (DCD) have difficulties estimating reach to a stationary target with a long tool (e.g., 40 cm). Here, we compared estimation accuracy of children with DCD and TD children when using a dynamic action representation of coincident-timing ability with their hand and various tool lengths. Coincident-timing, or interception ability, is defined as performing a motor response at the same time (coincident) that a moving object arrives at a designated intercept point. Method: Forty-seven participants performed in this study; 25 DCD (8.92 ± 1.47 years) and 22 TD (9.41 ± 1.94 years). DCD diagnosis complied with the DSM-5 and all children scored below the 15th percentile for motor skills with the MABC-2. The task involved estimating reach and intercepting a target moving towards the subject along the midline under 5 conditions (hand, and tools of 10-, 20-, 30-, and 40 cm length). Participants were instructed to imagine themselves reaching out with their hand or tool and press the center button of a keypad when they believed the target had arrived at their interception point. Results: A 2x5 repeated measures ANOVA was used to compare "match" (stop distance -actual distance) values in the five conditions. The group main effect was significant indicating that children with DCD were significantly less accurate than TD children in all conditions (ps<.05). Overall, all participants overestimated their reach ability, with children with DCD overestimating an average of 6.65 cm more than TD children. Discussion: These results indicate that children with DCD are less accurate in a coincident-timing context and show greater overestimation with TD children. It appears that children with DCD have problems with spatially representing a motor action that requires the use of coincidenttiming; an ability that may apply to common motor activities such as catching a ball or striking a baseball pitch. The results also support the notion that children with DCD do not have an efficient strategy for terminal accuracy, and tend to move earlier (faster) than their peers. Furthermore, that ability does not seem to be constrained by the length of the tool used.  Aim: Developmental Coordination Disorder (DCD) is a chronic and prevalent health condition that impacts on daily functioning of children and increases the risk for preventable secondary health issues. Few tools are available to transfer knowledge to families about how to effectively manage DCD. The goal of this study was to evaluate change in parents' perceived knowledge and competence managing their own children and explore the impact on daily life following completion of an online evidence-based workshop translated into French. Method: This collaborative research used a pre-post mixed methods design. A working committee including representatives of two clinical centers and a DCD parent association met monthly to overview the study and facilitate recruitment. Participants were invited to complete online questionnaires before and after completion of the workshop, and three months later. Descriptive and thematic analyses were performed. Results: 170, 106 and 90 participants (mostly mothers of a child with DCD in Québec) completed the pre, post and follow up questionnaires, respectively. Most participants heard about the study by the DCD association or through Internet (92%). Most items (79%) evaluating selfreported knowledge and skills increased significantly (p<0.001) following workshop completion. Three months later, this increase was maintained. Participants reported sharing information with others and modifying attitudes (e.g., being more supportive) and daily routines (e.g., homework) to better support children with DCD. Discussion: Clinicians and the parent association appreciated having access to this tool to share with families, and reported that it helped them supporting parents to understand and manage better DCD. Keywords: Knowledge translation; Participatory-action research; Developmental Coordination Disorder.

Localisation of touch in children with developmental coordination disorder (DCD): the 'crossed hands effect'
been taken to indicate the use of an external frame of reference for locating touches, and has been demonstrated in children and infants as young as 6 months of age 3,4 . However, it is not apparent in congenitally blind individuals, suggesting that the use of an external reference frame is reliant on visual development 5 . As children with DCD are thought to rely more heavily on vision than TD children for some tasks 6 , we hypothesised that they would show a greater crossed hands effect than controls. Method: Children with DCD aged 7-11 years are currently completing a tactile localisation task 3 . Participants feel a gentle vibrotactile stimulus on one of two fingers, each situated underneath a cuddly toy, and report whether the "penguin" or the "hedgehog" tickled their finger. Across four blocks, posture (uncrossed, crossed) and view (seen, unseen) are varied systematically. TD control and DCD participants were individually matched on the Raven's Coloured Progressive Matrices (Raven, 2004) to within two points. Children in the DCD group had received a previous DCD/dyspraxia diagnosis. Existing Movement-ABC (2nd edition) data was available for a subset of 12: of these, two were on the 16th percentile overall while the remaining children scored below the 15th percentile. Results: Preliminary findings (n=14 per group; target ns =20) indicate lower percentage accuracy for the DCD group (M=95.5%) than the TD group (M=98.6%) overall (Mann-Whitney U = 47.0, p =.019). Crossed conditions (M=95.2%) were completed with lower accuracy than uncrossed conditions (M=98.9%), and this applied to both groups (TD: Wilcoxon Z= -2.12, p =.034; DCD: Wilcoxon Z= -2.22, p =.026). There was neither a significant main effect of View nor any reliable interactions. Discussion: These preliminary findings demonstrate: a) poorer performance of children with DCD when locating touch than controls matched for nonverbal ability and chronological age, and b) a crossed hands effect in the DCD group. Comparisons with the younger motor-matched group, available by the time of the conference, should facilitate a description of these abilities with respect to motor development. Aim: There is a body of evidence demonstrating comorbidity of motor and cognitive deficit in « idiopathic » developmental disorders. These associations are also found in developmental disorders secondary to monogenic disorders as in Neurofibromatosis type 1 for which the principal complication during childhood is learning disabilities. The comparison of motor impairment between developmental disorders either idiopathic or secondary as in NF1 could help us to better understand the cause of the combined language/motor deficit in these populations. The current study investigated motor impairment in children with NF1 for which oral language had been specified and then to compare the motors skills of the NF1 group to motor performance of children with Specific Language Disorder (SLD). Method: Children with a diagnosis of NF1 according to the conference consensus criteria, were included from the Toulouse Children Hospital Reference Center for NF1. Children were age between 5 to 12 years olds and motor performances were assessed with the M ABC and Purdue Pegboard tests. Cognitive general level, oral language and attentional skills were assessed with French standardized tests adapted for age. The SLD group was constituted with children diagnosed at the Reference Center for Language and Learning Disabilities of the same hospital. Children (NF1 and SLD groups) were matched for sex, age and IQ. Results: 98 children have been included in this study with 49 children with NF1 and 49 children with SLD. In the NF1 group, 43% of children exhibited a Speech and/or language disorders. Motor impairment with a total M ABC score < 15th percentile was found in 53 % in NF1 group and in 33% in SLD group and the difference was statistically significant (p= 0.041). Otherwise, the total score for M-ABC was significantly higher in the NF1 group compared to the SLD group (11.01 versus 8.21; p= 0.046) but only the sub test balance was different between the two groups (5.18 versus 3.40; p= 0.023). Nevertheless the comparison of motor scores of NF1 children with or without language impairment was not statistically different. Correlations studies show differences between the 2 groups. For NF1 Group, none correlation was found between motor scores and cognitive variables. Conversely, for SLD Group 1) significant negative correlations were found between total score for M-ABC and FSIQ (r=-0.30, p= 0.035) and balance score M-ABC and Block design (r=-0.35, p= 0.014) 2) significant positive correlation was found between Purdue Pegboard Right Hand and FSIQ (r= 0.37, p = 0.015). Discussion: In NF1 group, motor impairment was more frequent and more severe and concerned specifically balance rather than manual dexterity or ball skills, compared to a group of children with SLD. This motor impairment was independent of language status in the NF1 group. These results and the difference between correlations according the groups could suggest the implication of different cerebral networks for motor impairment in these two conditions: the cortico-cerebellar network in NF1 and the cortico-striatal network in SLD. Nevertheless recent studies do not support an impaired cerebellar mechanism. Researches on procedural learning in children with NF1 could help to resolve these issues. Aim: Current thinking in the field of developmental disorders such as DCD is that not only are co-occurring characteristics important when diagnosing children but also that a dual diagnosis should not be ruled out. For the past two years we have been conducting research work on motor ability in deaf children and in particular how their motor skills impact on daily living. This is an under researched area compared to other developmental disorders (eg ASD; ADHD)and their relation to DCD. This paper draws upon case studies of children with a dual diagnosis of varying degrees of deafness and DCD and aims to illustrate how the dual diagnosis leads to different intervention strategies. Method: The children have a current diagnosis of DCD peformed locally by occupational and physiotherapists, and in order to be consistent they have also been given both the Checklist and the Test from the Movement Aim: Poor bone health is an emerging health risk in children and adolescents with possible long-term consequences due to an increased risk of osteoporosis, fractures and related complications in adulthood 1 . Little is known about bone strength and structure in adolescents with motor difficulties, yet low levels of physical activity and fitness are reported to be associated with poor bone strength and structure in those without motor difficulties. This study analysed local bone mineral density (BMD), assessed parameters of fracture risk (Stress Strain Index: SSI) and reported history of fractures in adolescents with motor difficulties. Method: Thirty-three adolescents (20 males, 13 females), ranging in age from 12.5 years to 17.6 years (M=14.3 SD =1.5 years), with motor difficulties were included in the study. Motor performance was screened using the McCarron Assessment of Neuromuscular Development (MAND) 2 . Participants were eligible for the program if they had a Neuromuscular Development Index (NDI) of 85 or below (≤ 1SD) (mild motor disability) and/or a history of movement difficulties (such as poor coordination or clumsiness, slowness and inaccuracy of motor skills that negatively impact daily living, school, leisure and play activities 3 ). Eligible participants underwent peripheral quantitative computed tomography (pQCT) measurements at proximal (66%) and distal (4%) sites of the non-dominant radius (R4 and R66) and tibia (T4 and T66). Results were compared to standardized norms using Z-scores for total BMD, trabecular density, cortical density and stress strain index (SSI) using one-sample t-tests. Results: Significant differences were present at R4: BMD t=-6.96 (p<.001), R66: cortical density t=-2.16 (p=.038), R66: SSI t=5.32 (p<.001) and T66: SSI t=-4.02 (p<.001). There was a higher incidence of fractures (26.9%) compared to the normal population (3-9%) with more than half of caregivers identifying a tendency for their child to trip or fall more than their peers. Discussion: This study extends previous pilot data, presenting local bone densiometric data based on pQCT analysis for adolescents with motor difficulties. We identified a previously unreported risk factor -low motor competence, for low BMD and fracture based on a detailed analysis of pQCT measurements including trabecular and cortical density. We found lower than average z-scores across most bone density measurements, which were more pronounced on the forearm, even when considering puberty and BMI. In addition, the radial and tibial SSI z-scores were in the low range indicating low bone strength and increased risk of fracture. Our results identified a higher incidence of reported fractures in this group compared to the normal population. We conclude that poor coordination should be considered a risk factor for below average bone strength and structure, and fracture risk. Strategies that improve bone health in this high-risk-group should be considered in intervention programs for developing motor competence. Results: Participants attended on average 21 sessions (SD =3) and were involved in an average of 6 (SD =4) 13-week program cycles over the reported period. Only significant model predictors are reported for the LMM. Multistage Fitness Test performance improved over time (p<.001), was higher with increasing NDI (p<.001), increasing age (p=.004), and with decreasing BMI. Males reported higher Multistage Fitness Test scores compared to females (p=.004). Curl up performance improved over time (p<.001) and with increased adherence to the 13-week program (p=.024) and higher NDI (p<.001), with females out performing males (p<.001). Grip strength performance also improved over time (p<.001), was higher with increasing BMI (p<.001), increasing NDI (p<.001) and increasing age (p<.001). Standing Broad Jump performance did not improve over time, with performance scores higher with increasing NDI (p<.001), increasing age (p<.001) and decreasing BMI (p=.001). Discussion: The LMM provided the opportunity to investigate withinperson and between-person change over time, controlling for differences in the number of sessions attended. This study found that an individually targeted exercise program can achieve sustainable improvement in fitness outcomes in adolescents with DCD. Importantly, sustained participation over time (total sessions attended) is more important than specific program adherence. Aim: Praxis skills are commonly defined as the ability to perform purposeful motor actions and to use tools. The lack of theoretical framework to explore praxis in children has been problematic for clinical/experimental tasks design and consequently for understanding the underlying deficits to gestural difficulties. Although praxis assessment in developmental coordination disorder (DCD) children mostly used adult's clinical tests, including comparisons across types of gestures and input modalities, the cognitive models of adult praxis processing are rarely used in a comprehensive interpretation. These models 1,2 generally involve two systems: a conceptual system (semantic knowledge about tool function or about actions, and sensorimotor knowledge about manipulation), and a production system (execution of a gesture). Whereas heterogeneity of deficits is consistently reported, few researches have investigated the implication of other cognitive skills assumed to be involved in DCD, such as executive or visual-perceptual and visuospatial functions 3,4 . Our study aimed at discussing the nature and specificity of the gestural deficit in children with DCD using a multiple case study approach. Method: We elaborated a comprehensive assessment of gestures that allows exploring distinct levels hypothesized by adult models of praxis processing. We also examined constructional abilities, executive functions, visual perception, and visuospatial processing. We recruited 27 children diagnosed with DCD by Pediatric Wards of University Hospitals, based on a multidisciplinary assessment following DSM-IV-R criteria. Neuropsychological profiles were classified using an inferential clinical analysis based on the modified t-test 5 , and compared with 100 typically developing children divided into 5 age groups. Results: Among the 27 DCD children, we first classified profiles that are characterized by impairment in tasks assessing perceptual visual or visuospatial skills (n = 8). Children with a weakness in executive functions (n = 6) were then identified, followed by those with an impaired performance in conceptual knowledge tasks (n = 4). Among the 9 remaining children, 6 could be classified as having a visual spatial/visual constructional dyspraxia as proposed by Vaivre-Douret et al. (2011). Gestural production deficits were variable between and within profiles. Discussion: This study confirmed the heterogeneity of gestural production deficit among children with a diagnosis of DCD, at both intra-and inter-individual levels. The contribution of other cognitive deficits in most of the profiles allows discussing the specificity of gestural difficulties, and the current conception of praxis in children.

W. Du, K. Wilmut & A.L. Barnett Perception and Motion Analysis (PuMA) Lab, Department of Psychology, Social Work and Public Health, Oxford Brookes University, UK. wdu@brookes.ac.uk
Aim: The ability to locomote through the environment without falling or bumping into objects is a fundamental everyday skill, which is typically assessed using static obstacles in the lab. In everyday life, however, we are often faced with a dynamic environment, such as a busy street, where obstacles appear and move across our path in an unpredictable fashion. This is usually performed effortlessly but actually involves complex skills to visually perceive the obstacle and adapt our own body movements. For individuals with Developmental Coordination Disorder (DCD), who are reported to find adjustments to ongoing movements difficult, such an environment presents a real challenge and can have a negative impact on safe participation in daily life activities. The aim of the current study was therefore to determine whether movement adaptations in an unpredictable environment differ in individuals with DCD compared to typically developing individuals. Method: A new paradigm was developed for this study, to create a simple yet unpredictable environment to be negotiated. 15 adults with DCD (assessed in line with DSM-5 criteria) and 15 age and gender matched controls walked along a 10m walkway. On some trials a 'gate' closed in front of them blocking part of the pathway. Reflective markers placed on the trunk and feet were tracked with a VICON motion analysis system. Spatial and temporal characteristics of their movements were collected over the approach phase, and while they walked around the obstacle. In 'gate closed' trails, the number of adjustments to step width and step length were calculated to determine the individual strategies employed to negotiate the obstacle in the pathway. Results: Individuals with DCD employed different types of adaptive strategies compared to the control group. Effects of group will also be reported in terms of approach speed, timing of the decision to alter the walking path, the type of adaptive strategies employed, and the distance maintained from the gate. Discussion: The different adaptive strategies of individuals with DCD might reflect their poor coordination skills. These findings will provide a better understanding of the navigation patterns in individuals with DCD in a dynamic environment. Results: Two aspects now appear as part of DCD: "slowness and inaccuracy of motor skills (e.g., catching an object, using scissors or cutlery, handwriting, riding a bike, or participating in sports)", sometimes isolated among DCD subjects. These are cited in the first paragraph of the definition and allows the inclusion of subjects with relatively simple measures of school facilities who are able to compensate for their difficulties. Furthermore, the previous DCD definition was inherently referring to a school-age population. Adding in the former a sentence concerning "professional" activities (prevocational and vocational activities) now implies that DCD persists over time and is also found in adult subjects. Discussion: Several publications have described the delays encountered in DCD characteristics as well as the persistence of the disorder in adulthood. DSM is a reference tool, and for DCD, changes to the definition contribute to better recognition and management of the disorder. Aim: The aim of the study was to propose a means to select a cohort of patients affected by Developmental Coordination Disorder (DCD) based on their phenotypes.

Method:
The study was carried out in 129 paediatric patients addressed to our outpatient 3rd line clinic dedicated to DCD. A questionnaire with 33 items concerning the developmental stages, education, social interactions and specific clinical examination was developed according to an exhaustive review of the literature. This questionnaire was administered to each new patient. To confirm DCD diagnoses, complementary measurements were performed with magnetic resonance imaging, electroencephalography and other standard psychological tests. Results: Among the 200 patients, 129 were confirmed having DCD including 47% who were treated for Attention Deficit Hyperactivity Disorder, in conformation with DSM-5 definitions. In these DCD subjects, among other results, 100 % had a slow implementation of actions in requested tasks, 47% were left-handed or ambidextrous, 76% were male, 95% showed handwriting difficulties, 56% moved in a sitting position before acquiring normal walking. Discussion: From this study and in an attempt to homogenize groups of patients for further experimental procedures, we classified our DCD subjects into 3 categories: 1) slow and clumsy; 2) slow without awkwardness; and 3) slow with "language impairment" (verbal dyspraxia and/or oral -facial dyspraxia). Keywords: Developmental Coordination Disorder; DSM-5; Paediatrics; Brain development.

Motor impairment in children with specific language impairment: Effect of comorbidity on school outcomes
Method: In this retrospective study, we contacted 32 children who attended the language school of the Reference Center for language and learning disabilities in Toulouse Children Hospital between 2003 and 2014. At the time of the assessment, these children were between 6 and 18 years old. Of all the children with SLI (assessed by French standardized tests such as TCG, Ecosse, NEEL, O52), 12 (37%) additionally have a DCD diagnosed with the M-ABC test (score < 15 e percentile) and with the impact on the daily living estimate at the time of discussions with the parents. Three questionnaires were sent, covering repectively generalities, schooling and activities. The psycho-behavior profile was evaluated using the Child Behavior Check List (CBCL). Self-esteem was assessed using the Echelle Toulousaine d'Estime de Soi (ETES). Results and discussion: Data collection and analysis are in progress. At the moment 27 participants, 9 of whom are girls, completed the first questionnaire. A third of the children were sent to a specific education school (CESSDA) after the language school and 74,1% have repeated a grade. For the other questionnaires, we hypothesise that the psycho-behavior profile and the self-esteem will differ between the two groups (SLI, SLI+DCD). The disorder consequences should be more pronounced on internalizing clinical profiles and 'physical' self-esteem for the SLI+DCD group. Keywords: Developmental Coordination Disorder; Comorbidity; Specific language impairment; Education; Psycho-behaviour; Self-esteem. Aim: A major challenge in biomedical psychiatric research is to model the main symptoms of mental disorders in animal models with good construct and predictive validities. The heterogeneous nature of the Developmental Coordination Disorder (DCD) and the absence of established pathophysiological etiology are many obstacles for establishing such models. However, animal models of DCD and related comorbid troubles, like ADHD remain necessary for investigating easily and rapidly the related neurochemical, neuropathological and genetical alterations and to develop new therapeutic strategies. A promising approach, based on natural behavioral inter-individual differences, consists in identifying within a « normal » population, some individuals with extreme or atypical behaviors that mimic the symptoms of the disorder for identifying causal factors. This approach presents the advantage to avoid preconceived etiological hypothesis. It is based on a dimensional vision of the trouble and considers that most of disorders related to executive dysfunction are an extreme manifestation of a continuum including unimpaired individuals. Method: Based on this approach, we have explored the neural bases of executive dysfunction (attention 1 or working memory deficits 2 , impaired inhibition 3 , poor decision-making 4,5 ) and more recently, we focused on one particular symptom of DCD related to the impaired ability to process the transitions between goal-directed and automated motor skill. This process can be addressed in rats through the capacity to adapt actions in instrumental conditioning, when decreasing the contingency between the action and earning the outcome. We explored brain activity within the fronto-striatal network using immunodetection of Zif268 protein.

Modeling executive functioning by a dimensional approach in rodents
Results: Using the contingency degradation paradigm, we showed large inter-individual differences in goal-directed behavior, some rats demonstrating impaired capacity to adapt to the environmental changes. We showed that these inter-individual differences were related to the balance of activity between the medio prefrontal cortex and the dorsal striatum. Discussion: These findings indicate that a rat model is suitable to assess differences in the ability to adapt motor skills to changes in environmental contingencies. This model allows identifying the specific neural network involved within the fronto-striatal circuitry. Further investigations will be necessary to establish a valid animal model of DCD, notably by combining several other symptoms and comorbid troubles, like deficits in timing, inhibition, working memory or attention. Aim: Body schema is an internal representation of the body in action. As executing and perceiving human movements share common representations, the body schema could be involved in the ability to perceive and understand other's action. Its construction during ontogenesis is based on sensory inputs. An early sensitivity to biological aspects of movement was reported in infants, as well as a robustness of the perception of human movement during adolescence 1 . Also, many studies based on motor planning and execution during development confirm the late maturation of multisensory integration for central motor control 2 . The aim of this study is to evaluate the body schema construction during childhood via the functional link between the sensory representations activated during action perception and the motor representations used during action execution. Method: 20 adults (28.9±7.4 y; 10♀) and 20 TD children from 7 to 10 years participated to this study. The task consisted in a sequential "samedifferent" visual matching task 3 . Two types of stimuli were presented: pictures of bodies' posture and Lego's shapes. In both cases, the stimulus was presented first in a front view and secondly with a rotation of 45° with or without modification in the body or object configuration. While viewed the second stimulus, participants had to decide whether its shape was identical or different as quickly and accurately as possible. During this task participants had to execute unrestrictive movements or to imitate the human posture. A control condition for both stimuli without movement was also executed. All conditions were presented in blocks randomly counter-balanced between participants. Reaction time and response accuracy were recorded. Results: Whatever the conditions, adults presented a high-level of body perception performances with significantly higher correct answers in human posture than in object. Preliminary results in children showed that specificity to detect human posture variation is already present at 7 years. Discussion: This finding supports that posture recognition is specifically subtended by the body schema. By contrast with adults, movement involvement during posture discrimination is expected to influence children performances. These findings would provide a simple tool for better Results: In total, 47.2% of children were identified with motor problems. According to the analysis of the Economic Classification Criterion Brazil, 79% of these families were classified in economic classes C, D and E which means that they live with an income of $500 or less per month; 23% showed signs of inattention, hyperactivity, or both, associated with motor problems; 5% were born premature according to data collected in the child's notebook -a commonly used instrument in primary health care to monitor child's growth and development. Discussion: Prevalence of motor problems are reported to be between 5 and 19% in the literature, but the present study found that 47.2% of children received scores indicative of motor problems/possible TDC, according to the cutoff points from DCDQ used in other studies, including in Brazil. Seventy nine percent of the families are among the economic level classes C, D and E, whose purchasing power is low. More studies should be done to investigate the environmental and social contexts these children live. It is extremely important to carry out a more thorough assessment of these children with motor performance and sustained attention tests, as indicated in the DSM-V to confirm how many of these children are in fact DCD. Another point to be raised is the possibility of difficulty in understanding the DCDQ-Brazil test, which requires caregivers compare your child with another of the same age and give you a score for your performance on certain tasks. As these children are identified earlier, it can be developed school programs, reducing the damage caused in these children's daily life. Aim: Muscle strength is a key component of fitness and research in typically developing (TD) children suggests up to 70% of the variability of performance, across a range of motor skills, could be due to muscular strength and physical development variables. Recent research has reported that children with probable Developmental Coordination Disorder (p-DCD) have lower muscular strength than TD children; however, strength assessments have traditionally included exercises that require a high level of coordination, a potential limitation for children with pDCD. Therefore, the aim of this research was to develop a modified version of the Resistance Training Skills Battery (RTSB) for children aged 7-12 years with potential movement impairments and determine the inter rater reliability of the modified-RTSB for the field-based assessment of competence and proficiency related to muscle strength. Method: 10 children aged 7-12 years with pDCD were recruited prior to entry into a community based exercise program. Children with musculoskeletal impairments were excluded. Age appropriate amendments were made to the RTSB in consultation with a panel of experts in paediatric exercise. Movement proficiency was assessed using the Movement Assessment Battery for Children-2 (MABC-2), with children below the 15th percentile classified as pDCD. For each individual skill of the RTSB participants observed the movement, received verbal instructions and were given a trial attempt to ensure instructions were understood. General encouragement was provided but no skill-specific feedback. Participants completed two trials of four repetitions for the skills that included body weight squat, push-up, step-up, suspended row, standing overhead press and front support with chest touches. All skills were recorded using a digital video camera positioned to capture the technical aspects of movement in both the sagittal and frontal plane. Video recordings of the participants performing the RTSB were used post-hoc to assess the quality of movement and determine inter-rater reliability of the scoring protocol. Results & Discussion: Given the potential role of resistance training in improving movement for children with pDCD, valid and reliable assessments to determine competency and proficiency are required. Data collection and analysis for the modified-RTSB is currently in progress, with full results and conclusions from this study presented at the conference. Keywords: Developmental Coordination Disorder; Resistance training; Movement impairments; Muscle strength; Strength assessment.

Effect of tool choice and length on reach distance estimation in children with Developmental Coordination Disorder
Results: On average, children were rated as participating in all school settings with either no or some modifications. Some children were judged to have limited participation or require assistance. Teachers also reported that children required, on average, minimal to no assistance and modifications when completing most physical or cognitive/ behavioral tasks. Statistical comparisons of the extent to which teachers provided assistance versus modifications indicated that teachers consistently reported relying on assistance more frequently, although this was a small effect. Discussion: Evidence shows that DCD is under-recognized and that children with DCD often do not receive adequate support. Pre-intervention teacher ratings support this observation: in general, teachers did not perceive children with suspected DCD as being limited in their participation or needing assistance or modifications with school tasks. We hypothesize that teachers may not recognize the needs of the children with DCD; hence, their provision of little support. We anticipate the knowledge translation component of P4C will highlight the many unrecognized needs of this population. Comparisons to year 2 data will allow us to test this hypothesis. Of note, when teachers do provide support they are slightly more likely to provide overt assistance rather than modify the environment. We anticipate that their ability to make environmental modifications will be strengthened by the P4C service.  Aim: Children with DCD (Developmental Coordination Disorder) constitute a heterogeneous group in which the possible impairment of visuospatial perception should be evaluated in order to orient toward specific therapies (visual or motor). However, visuospatial perception is usually assessed in clinical routine by multifactorial tests, involving in particular motor responses. In a previous study, we normalized a simple, fast and specific test of elementary visuospatial perception (whose responses do not require action, multi-choice, object recognition or language) on 96 children between 4 and 12 years old 1 . The aim of this study is therefore to assess the presence of visuospatial perception impairment in children with DCD, using this test. Method: We tested visuospatial perception in a group of 43 DCD children using this test to compare with age-matched controls. We also assessed the correlation of these scores of visuospatial perception with scores in other tests evaluating praxic, cognitive and writing abilities (Wechsler, NEPSY-II and BHK). Results: The visuospatial perceptual performance in DCD children significantly differed from age-matched controls, establishing that this test can be discriminant to diagnose DCD (Mann Whitney test and ROC curve), with 60% of DCD children lying below the interquartile range of controls. Moreover, the score of visuospatial ability was significantly correlated (Spearman test) to the scores of the Wechsler PIQ, to the subscores Cube and Copy of the NEPSY-II, but neither to the writing scores of the BHK (neither the speed nor the quality) nor to the Wechsler scores VIQ and Processing speed. Discussion: Based on these results, we expect that the test of visuospatial perception can become an interesting tool for an early and large detection of potential DCD and also for a differential care of visuo-spatial and nonvisuospatial forms of DCD (with dysgraphia probably rather associated with the latter). Aim: We examined the extent to which nursery teachers' development assessment of fine and gross movement predicts later psychosocial maladaptation and educational achievement in elementary schools. The Developmental Scale for Nursery Record (DSNR) we developed yielded nine subscales in principal component analysis, including fine and gross movement. We have already confirmed reliability and validity in this scale. Method: A 7-year longitudinal investigation was conducted on 2,501 children (female 1,209, male 1,292) from all nursery and elementary schools in a suburban city. We used the NDSC for the development assessment by nursery teachers. Preschool children were assessed by their nursery teacher right before entering elementary school using the NDSC. We conducted multiple regression analysis on the collected data. The independent variables were fine and gross movement in the DSNR subscales. The dependent variable was later educational achievement (a deviation score on an academic achievement test), friendship, behavioral problems, and emotional problems (subscale scores on the Strengths and Difficulties Questionnaire). Results: We found that fine movement suffers significantly under the influence of educational achievement. Furthermore, gross movement suffers significantly under the influence of friendship and emotional problems. There was no relationship between motor skills and behavioral problems. Discussion: These findings indicated that fine motor skill predicts later educational achievement, and gross motor skill predicts later friendship and anxiety and/or depressive tendency. Thus, problems with motor skills in preschool children lead to the potential for lower educational achievement and psychosocial maladaptation. In conclusion, assessment of motor skills in preschool children may enable early detection and appropriate treatment of children who have special educational needs and/or psychosocial maladaptation. In addition, elementary schools need to contribute to educational planning after due consideration of motor skills in children. Keywords: Fine motor skill; Gross motor skill; Psychosocial maladaptation; Educational achievement. Aim: It has been hypothesised that deficits in the functioning of internal modelling may contribute to the motor impairments associated with DCD. This process can be explored behaviourally through motor imagery paradigms. This study examined motor imagery proficiency of children with and without DCD using a complex hand rotation task. Method: 47 boys aged 7-13 yrs participated in this study, 25 with DCD (mean age=9.66yrs±1.56) and 22 controls (mean age=9.69yrs±1.61). Children were tested on the MABC-2, with children in the DCD group ≤16th percentile and controls ≥20th percentile. Motor imagery proficiency was measured using a complex hand rotation task administered via E-Prime 2.0. Images were presented in two rotational axes -palm view and back view, and eight 45° rotational steps between 0° and 360°. Participants completed the task twice: first with no instructions, and the second time with motor imagery instructions. To explore the effect of instructions and whether response patterns followed biomechanical constraints, response time (RT) and accuracy (ACC) data were submitted to separate RM-ANOVAs ( ) were then conducted to explore RT and ACC response patterns for back and palm view separately. Results: Significant effects for instructions (p<0.001), view (p<0.001) and laterality (p<0.001) were revealed for both RT and ACC, indicating both groups were faster and more accurate with instructions, for back compared to palm view, and medial compared to lateral rotations. No significant group effects for RT (p= 0.061) or ACC (p= 0.076) were identified for responses to back view, although both approached significance. A significant group effect was revealed for palm view response accuracy (p= 0.011), with children with DCD having lower accuracy levels than controls. Discussion: There was partial support for the hypothesis that children with DCD would display atypical response patterns on the hand rotation task. A large degree of variation was observed within the DCD group, with a number falling within the control response range. It appears, however, that deficits in motor imagery proficiency may become more apparent as the task complexity increases, with group differences identified for palm view. A greater understanding of motor imagery performance in children with DCD has the potential to inform intervention programs. Keywords: Motor imagery; Mental rotation, Internal modelling, Mirror neuron system. and found the recommended cut-point showed relatively poor agreement against the Movement Assessment Battery for Children version 2 (MABC2) (Parmar et al., 2014). We also determined that a higher threshold score could be used to improve sensitivity. The purpose of this study was to investigate the revised cut-point in a new sample of children 4 and 5 years of age. Method: Young children enrolled in the Coordination and Activity Tracking in CHildren (CATCH) study comprise the study sample (n=583). A two-step procedure was used to identify children at risk for DCD (DCDr). Parents completed the DCDQ-07 by telephone. Using the revised cut-point of 55, 146 children were identified as DCDr (DCDQ-07<55), and 437 children were considered typically developing (TD) (DCDQ-07 >55). DCDr children (n=111) and a random sample of TD children (n=42) were invited to the lab to complete the MABC2. Children scoring ≤16th %ile on the MABC2 test were classified as DCDr (n=77). Receiver-Operator Characteristics Curve (ROC) analysis was used to examine agreement. Results: The overall sensitivity and specificity of the DCDQ-07 against the MABC2 were 85.7% (95% CI=75.5% -92.3%) and 40.8% (95% CI=29.8% -52.7%), respectively. The ROC curve analysis indicated the area under the curve (AUC) was .707 (95% CI=.623 to.791, p<.001). In the 4-year-old group (n=77), the sensitivity and specificity were 94.4% (95% CI=80.0% -99.0%) and 26.8% (95% CI=14.8% -43.2%), respectively; and 78.0% (95% CI= 62.0% -88.9%) and 57.1% (95% CI=39.5% -73.2%), respectively, in the 5-year-old group. The AUC was .682 (95% CI=.564 to .800, p<.01) for 4-year-olds, and .716 (95% CI=.592 to .840, p<.01) for 5-year-olds. Discussion: Overall, our revised cut-offs improved sensitivity of the DCDQ-07 to a point acceptable for recommended screening standards. However, due to a high number of false positives and a low number of true negatives, the overall diagnostic accuracy of the test is poor to fair. Even with a revised cut-point, we cannot recommend the DCDQ-07 for general screening for this developmental period. In situations where maximizing sensitivity is the goal (e.g. recruitment for research; two-step screening procedures), our revised cut-point can be recommended for use in this age group.  Aim: The MABC-2 is being used in Brazil and although there are two validity studies, none of them compared actual data. The aim of this study was to compare the performance of children ages 4 to 8 years old from Brazil (BR) and the United Kingdom (UK) on individual items of the motor test component of the Movement Assessment Battery for Children 2nd edition (MABC-2). Method: 887 typically developing children (396 BR; 491 UK) stratified by age and gender were assessed with the MABC-2. Data on UK children were obtained from the MABC-2 normative data set. Brazilian children were recruited and assessed in public and private schools, according to standardized procedures. Means and standard deviation were calculated for the raw score of each individual item for the ages 4, 5, 6,7, and 8 years old. ANOVA was used for group comparison (p≤.05). Results: There was no significant age difference between groups on each age group. Concerning motor performance, there were scattered differences in means for different items and ages. On manual dexterity, UK children were better on Placing Pegs with preferred hand at age 7 (p =.001) and they committed less mistakes on the Drawing Trail at ages 5 (p=.001), 6 (p=.001), 7 (p=.016), and 8 (p=.007); there were no differences on the Threading tasks, and 7-y-old BR children were better on Placing Pegs with non-preferred hand (p=.002). On Ball Skills, there were no significant differences on Catching, but UK children were better on Throwing at ages 7 (p=.001) and 8 (p=.001). There were no differences on the Jumping and Hopping tasks, but 6-y-old BR were better on preferred (p = .001) and non-preferred leg (p=.001) One-Leg Balance, and UK were better on Heel-to-Toe walking at ages 6 (p=.004) and 7 (p=.023). Further analysis will investigate gender and socioeconomic issues. Discussion: There were differences in several motor items at different ages and, overall, UK children tended to outperform Brazilians when differences were found. These differences could be related to cultural as well as to socioeconomic factors as half of the Brazilian sample was recruited in public schools, which have higher representation of children from socially disadvantaged backgrounds. Although Brazilians are recognized for their ball skills, they did not perform better on the MABC-2, maybe because most children are not familiar with the tennis ball, used in the test. The impact of these differences on the MABC-2 cut off scores will be discussed.  Aim: Developmental Coordination Disorder is characterized by poor motor skills. Motor control relies on two modes of control, a feedforward mode that anticipates the goal and system characteristics and a feedback mode that corrects on-line the residual errors. To determine the nature and the specificity of motor deficits in DCD, we examine both feedforward and feedback modes in Typically Developing (TD) children aged from 5 to 10 and in DCD children aged 9-10 years old. Method: Children were required to reach and grasp an object in order to displace it to a lateral location. The objects, two visually identical opaque bottles, could be heavy or much lighter. We manipulated the child's previous knowledge of the object weight: when known, participant could anticipate the consequences of the weight when reaching for the object, prior to contact with it, thus allowing for feedforward control. Conversely, when unknown prior to contact, participants had to cope with the object weight after contact (feedback control), in the displacing phase of the movement. Movement kinematics was recorded with a high-resolution optoelectronic motion tracking system. Aim: This project originates from our intervention studies, our current work examining children with DCD and the effects of associated difficulties over time, and work in the sporting arena notably "the aggregation of marginal gains". Studies have shown that some children with DCD, with or without intervention, improve and sustain their motor performance, but it has been difficult to predict which children do this. Many children with DCD have associated difficulties of attention, language, social interaction and learning. However, few studies have examined the nature of their interaction and effect on outcomes over time. This paper firstly examines profiles of children with DCD with and without associated characteristics aged 8-16 years in relation to participation in functional outcomes over time. Secondly, implications for intervention are made based upon the dynamic variables noted. Method: Children with DCD are identified according to DSM V. Assessment measures include the MABC2 to measure motor proficiency; DCDQ to assess the impact of motor ability on daily activities; CSAPPA to measure the children's enjoyment of physical activity; CCC2 to indicate any pragmatic or other language difficulties. Children are monitored and assessed over a 24-month period with comparisons made between those with DCD, those with DCD plus associated characteristics and a group of typically developing peers. Some children, their parents and teachers are interviewed to provide case studies showing the nature of change. Results: Four data points over two years are being analysed and the first two data points show the motor proficiency pattern and impact on participation, function and enjoyment for children with DCD and those with DCD plus associated characteristics and their typically developing peers. Case studies of children are presented identifying those that improve, those that remain the same and those that deteriorate, together with the dynamic variables affecting these outcomes. Discussion: Intervention should recognize the total resources the child brings to the movement situation. We recommend an ecological perspective employing the concept of the aggregation of marginal gains, whereby several targeted areas in a child's life are slightly modified by different individuals to improve their function in activities of daily living. The totality of these marginal gains leads to an overall improvement in the child's participation and performance as illustrated in the case studies. Keywords: DCD; Associated characteristics; Change; Intervention. approach, P4C builds the capacity of families and educators to promote the child's successful participation and long-term health. OTs work collaboratively with educators in the classroom using principles of universal design for learning to create accessible curricula and environments; differentiate instruction for children experiencing challenges; and provide individual strategies for children who require accommodation. This significant shift in practice is challenging for OTs. The aim of this poster is to describe the strategies that the research team has used to support this change. Method: Fifteen OTs are delivering P4C in 40 schools. Strategies to promote the shift in practice and to ensure fidelity to the P4C service delivery model have included: 1) targeted recruitment of therapists using self-evaluation; 2) training workshops; 3) completion of a series of online learning modules regarding DCD and co-morbidities, health promotion, collaborative consultation, capacity building and sustainability; 4) mentorship from expert practitioners. OTs completed pre-post knowledge questionnaires and participated in focus groups and interviews to enable understanding of their transition to this new model of care. Results: Strategies aimed at developing OTs knowledge, skills and confidence have supported OTs' transition to a capacity-building model for children with DCD. Pre-post questionnaires showed a significant increase in knowledge and perceived competence in many skill areas. Qualitative analysis of interview and focus group transcripts provided insight into the process of change and revealed OTs' increased satisfaction with this model of service. Although OTs perceived the shift in practice to be challenging, belief in the effectiveness of the new model supported change. Discussion: Making the shift to a very different model of intervention for children with DCD is a complex process. The research team used varied strategies to study and support the development of new knowledge and skills. Project findings support the need for strong leadership, ongoing mentorship and professional development opportunities to facilitate successful change in management for children with DCD. Aim: Despite primarily a social disorder, most individuals with ASD also report difficulty with fundamental motor skills 1,2 . The development of motor skill relies on postural control and along with social skills is facilitated by the active use of visual information. The use of visual information for postural control in ASD has not been reported. The purpose of this study was to compare how adults with ASD and typically developed adults (TDA) use visual information to control posture during quiet standing. Method: The study used intermittent (15off, 5on) posterior neck vibration during 100 seconds of quiet stance to induce a postural illusion. In typically developed adults and only in the absence of vision this protocol induces a forward body lean. Participants (12ASD, 20 TDA) undertook four conditions combining vibration and visual occlusion. Results: Significant main effects were observed for group, F(1, 2355) = 5.50, p<.05, vibration illusion F(1, 2355) = 232.26, p<.0001, and visual occlusion condition F(3, 2355) = 4.22, p<.01. For both ASD and TDI the magnitude of postural movement during vibration under visual occlusion was in the order of between 7.8 and 10.2 mm. A significant interaction was also observed between group and visual occlusion condition F(3, 2355) = 10.11, p<.0001. The ASD group leaned forwards more than the TDI group when vision was either fully or partially available (EO-EO, EO-EC, EC-EO p<0.01); whereas, there was no difference between groups when vision was not available (EC-EC t= 0.63 p= 0.527). There were no differences in the postural position of the ASD group regardless of whether vision was fully, partially or not available (p>0.0335). Discussion: Our findings indicate that the individuals with ASD do not use visual information to control standing posture. In light of evidence of that vision-for-perception is processed typically in ASD, our findings support a specific deficit in vision-for-action. These findings may explain why individual with ASD experience difficulties with both social and motor skills since both require vision-for-action. Further research needs to investigate the division of these visual learning pathways in order to provide more specific intervention opportunities in ASD.

The Development of the Japanese version of the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC)
publications about the topic. In the second stage, a systematic review of articles that addressed the interventions with children diagnosed with DCD was performed. Research was performed in SciELO, Lilacs and Medline electronic databases, without a publishing date restriction. Keywords "Disorders", "Development", "Coordination" and "DCD" were used both in English and Portuguese, in order to characterize Brazilian studies. A critical review was conducted using the Occupational Therapy Systematic Evaluation of Evidence Results: 23 articles were found. Results showed few studies in the area in Brazil and publications with low to median quality. Discussion: The reduced amount of studies on DCD indicates the little number of researches conducted in the area at the country suggests the relevance of scientific investigation of the disorder, since this condition can interfere not only in the lives of children, but also persist through adolescence and adulthood, generating a significant impact on social and academic environments. Aim: Developmental coordination disorder (DCD) has been linked to deficits of cold and hot executive function (EF). Requiring clarification is the critical relationship between cold and hot EF in this cohort. At the level of individual differences, our aim was to investigate whether children with DCD who show reduced hot EF also show deficits of cold EF. Study 1 -Method: 36 children (14 DCD) aged 6 to 12 years completed two cold EF tasks (i.e., One-Back Task (OBT), and Groton Maze Learning Test (GMLT)) and one hot EF task based on the Iowa Gambling Task, the Hungry Donkey Task (HDT). Results: First, we identified those children who scored either within or outside the 95% confidence interval (CI) of the controls on each task. Six (43%) of the DCD group performed worse than controls on both the hot EF task and at least one cold EF task. Another seven (50%) showed deficits in one domain, only, and only one child scored within the 95% CI of the controls on all the three tasks. There was no significant correlation between the HDT and the cold tasks. Study 2 -Method: 36 children (12 DCD) were examined on a facial go/ no-go task tapping hot EF; here neutral facial expressions were paired with either happy or sad faces. Facial expressions were used as both go and no-go targets in different blocks. The cold EF tasks were the same ones used in study 1. Results: Four (33%) of the DCD group showed reduced hot EF as well as poor performance on at least one of the cold tasks, five (42%) had scores outside the 95% CI of the controls on either the hot task or one of the cold ones, and three performed as well as controls on all three tasks. Commission errors on the go/no-go task were correlated positively with errors on the GMLT, and negatively with accuracy of the OBT. Discussion: Critically, our findings support the view that DCD is a heterogeneous disorder at the level of cognition; a proportion of children show no deficits on either hot or cold EF tasks, and a smaller number perform at age appropriate levels on all EF tasks. Developmental data show moderate correlations between different EF abilities, perhaps a reflection of common (underlying) processing abilities like inhibitory control. However, our findings do accord with recent neuroimaging studies that point to some dissociation between abilities under conditions of varying emotional investment. This has important implications for the remediation of motor and EF deficits in this cohort, and underlies the need to tailor EF training to the individual needs of each child with DCD. were also administered. Parents signed written informed consent from the Psychology and Neuropsychology units from HC-FMUSP prior to testing. A descriptive method was used for the data analysis and presentation of the results. Results: DCD was found in children with the following diagnosis: 72% of Attention deficit hyperactivity disorder (ADHD), (8 out of 11 cases), in 65% of early onset bipolar disorder and in severe depressive episodes (11 out of 17 cases), 67% of psychosis (2 out of 3 cases), 62% of anxiety disorder (5 out of 8 cases), 100% of autism spectrum disorder (ASD), 6 out of 6 cases, 100% of somatoform disorder and dissociative conversion disorder (2 out of 2 cases) and in conduct disorder (1 case). DCD was not observed in any of individuals with emotionally instable personality disorder symptomatology, presenting disruptive behaviour and exhibit symptoms suggesting the development of a personality disorder (5 cases). Discussion: The results showed a high prevalence of developmental coordination disorder in a group of children along with disruptive behaviour and psychiatric disorders. An already solid literature describes that the presence of psychomotor dysfunctions are expect in neurodevelopmental diagnosis such as ADHD (50%), learning disorders and ASD. Few studies are dedicated to investigate the incidence of the comorbid psychomotor disorder in children and adolescents presenting mood, anxiety or psychotic symptomatology. Thus further research should be conducted to investigate the correlation between psychomotor disorders and those conditions. Such evidence also justifies the importance of psychomotor assessment followed by intervention as standard practice for the treatment of early onset psychiatric disorders. the MABC-2. These differences might be caused by differences in test methods. Posture and equilibrium on the JPAN includes 'Standing balance with eyes closed' and 'One hand one leg balance' which is not in the MABC-2. Since the scores of these tests for most participants were below -1SD, low Posture and equilibrium scores on the JPAN may be a result of the larger number of components. Children with ASD are more likely to score poorly on these tests. Posture and equilibrium on the JPAN might evaluate similar skills to Balance on the MABC-2, and there is possibility that the JPAN is more sensitive to identifying balance problems. The large number of children with scores below -1SD on Praxis suggests that praxis problems may occur frequently in children with ASD. Since Praxis on the JPAN includes some fine motor tests and significantly correlates with Manual Dexterity on the MABC-2, lower Praxis scores might reflect not only praxis skills, but also fine motor dysfunction. Although the JPAN has different tests and evaluates motor function in a different way compared to the MABC-2, it may be able to detect balance and praxis problems in children with ASD as well as the MABC-2. Further studies with a larger sample size should be conducted to validate this initial research.

Reference:
The Japanese Academy of Sensory Integration (2011). Japanese Playful Assessment for Neuropsychological Abilities. Japan: Pacific Supply Co. (in Japanese) Keywords: Movement Assessment Battery for Children-2; Japanese Playful Assessment for Neuropsychological Abilities; Autism spectrum disorder.