Author's School

School of Medicine

ORCID

https://orcid.org/0000-0001-8363-644X

Author's Department/Program

Movement Science

Language

English (en)

Date of Award

Spring 5-15-2024

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Catherine E. Lang

Committee Members

Gammon M. Earhart, Rebeka L. Lawrence, Keith R. Lohse, Natasha Marrus

Abstract

Movement drives childhood development. As motor skills improve across development, a child becomes capable of greater interactions with their physical and social environment. Children with motor impairments miss out on these interaction opportunities and their development across a variety of domains can suffer. There is accumulating evidence that poor motor competence relates to an array of developmental outcomes such as educational achievement, reading skills, social development, and emotional regulation. Two developmentally important motor impairments are poor motor competence and hyperactivity which are associated with Autism Spectrum Disorder (ASD), Developmental Coordination Disorder (DCD), and/or Attention Deficit Hyperactivity Disorder (ADHD). Critical to limiting the overall developmental impact of motor impairments is the ability to easily and objectively assess them and understand what motor learning capabilities these children have. This dissertation examined how developmental motor impairments relate to upper-limb movement measured by bilateral wearable sensors and skill acquisition across two motor learning pathways.

In Chapter 2, we explored the potential wearable sensors have in the assessment of motor impairments by exploring the relationships between the sensor variables and typical motor assessments in a sample composed of children with ASD and typically-developing children. We found that sensor variables capturing magnitude and variance related to parent-reported motor competence score. Chapter 2 also established that using wearable sensors over prolonged periods is feasible for children with ASD. There was no difference in wear times between the children with ASD and the typically-developing controls. Chapter 2 exclusively used wearable sensor recordings taken while the participant went about their daily activities with no structured activity provided by the research team.

In Chapter 3, the objective was to determine the influence of recording context and assessment type on the association between sensor variables and motor competence. To determine the influence of recording context, structured sensor variables were extracted from a motor task that all participants performed (a bean bag toss) and unstructured recordings were obtained with the same protocol used in Chapter 2. To determine the influence of the type of assessment, a direct measure of motor competence was used in addition to the indirect, parent-reported measure used in Chapter 2. We found that the structured sensor variables had stronger associations with the directly assessed motor competence score. This was true of the sensor variables from both limbs. The relationship between sensor variables and motor competence did not statistically differ across the assessment types.

In Chapter 4, we examined the relationship between motor learning and impaired motor competence. We found that, after controlling for baseline variability, error-based learning related to motor competence such that slower error-based acquisition was associated with lower motor competence. Reinforcement learning was unrelated to motor competence.

In Chapter 5, we explored trial-to-trial motor behavior in typically-developing children to determine if they exhibited failure-induced increases in variability, known as motor exploration. We found evidence that children do use motor exploration.

These findings provide foundational knowledge about the potential benefits and practical considerations of clinical wearable sensor usage that may be helpful in the care of pediatric disorders that affect movement. The results concerning motor learning advance our understanding of how children acquire motor skills and how we might best intervene in cases of impaired motor competence. Designing motor skill interventions that emphasize the most accessible forms of motor learning available to the learner has the potential to help them achieve more typical levels of motor learning and skill acquisition while also guarding against the negative effect motor impairments can have across developmental domains.

DOI

https://doi.org/10.48765/8vkx-3n02

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