Jessica Lust

Development of motor planning and motor imagery in children with Cerebral Palsy

Children with Cerebral Palsy (CP) clearly show motor problems. These can make the use of regular rehabilitation methods troublesome. Motor imagery (MI) is the ability to mentally simulate the movement of a limb, without actually moving that limb. Research in adult stroke patients has shown that MI training can help in (re)learning movements. A prerequisite for developing this technique for the use in children with CP is gaining knowledge about the extent to which these children are able to use MI. In the present project we study the development of motor function and MI ability in children with CP between the ages of 5 and 10 years. First, we aim to reveal the age at which these children are able to use MI. Second, we will analyze the relation between real movements and MI during development. The results of this project will provide an answer to the question if and when MI training can be used in children with CP in order to help them improve their motor function.

Observational learning in children with Developmental Coordination Disorder (DCD)
 

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 class room 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.  

The DCD experience: Parental experiences in the diagnostic process of Developmental Coordination Disorder (DCD) in the Netherlands.  

Aim: To identify factors that are related to parents’ satisfaction with the diagnostic process of Developmental Coordination Disorder (DCD), from the first concerns to receiving the DCD diagnosis, in the Netherlands.

Background: Receiving a diagnosis can have a major impact on the child and its family. Parental satisfaction concerning the diagnostic process is important with regard to acceptance and coping with their child’s problems.

Method: Parents of children with a DCD diagnosis in the Netherlands were invited to participate in an online survey. Parents (all mothers, mean(SD) age = 41.8(5.4 years)) of 60 children (mean(SD) age = 10.2(3.8) years) responded. On average, the children received a DCD diagnosis 3.9 years prior to completion of the survey. The survey included questions concerning background, (experiences during) the diagnostic process and the period after the diagnostic process. Completing the questionnaire took 20-30 minutes. Factors were identified based on (CAT)PCA. Spearman’s rank correlations (rho) were calculated to examine relations with parental satisfaction using a multiple correlations procedure.  Multiple (stepwise) regression was used to identify the most important factors in predicting parental satisfaction with the diagnostic process.

Results: 75% of the parents were (very) satisfied about the overall diagnostic process. The multiple correlations procedure revealed that the attitude of the professional involved in the diagnostic process, his/her perceived degree of expertise and post-diagnostic support (a follow-up appointment and the opportunity to ask questions) were the most important factors for the degree of satisfaction in parents. In addition, the extent to which parents experienced stress during the diagnostic process was an important predictor of satisfaction with this process (p = .02). The diagnostic process took on average 33.5 months (SD = 25.6 months). The duration was not related to the satisfaction of the parents, but the longer the duration of the diagnostic process the less parents experienced a feeling of understanding for the problems of their child. 

Discussion and conclusion (including the significance of the study): The results underline the importance of increasing knowledge and awareness about DCD amongst professionals and for providing post-diagnostic support to parents. Although the majority of the participating parents indicated to be satisfied about the diagnostic process, it is essential that the duration of the diagnostic progress is reduced.

Parents’ perceptions of received care and Empowerment of parents of children with Developmental Coordination Disorder (DCD)

Aim: To identify relationships between aspects of processes of care and feelings of empowerment in parents of children with Developmental Coordination Disorder (DCD).

Background: Enhancing parent empowerment, the feeling of being in control over decisions and actions that effect the wellbeing of their child, is important in increasing the ability of parents to support their child and cope with its problems after receiving the diagnosis. In the present study we will analyze the relation between different aspects of processes of care and feelings of empowerment among parents of children with DCD.

Method: Parents of children with a DCD diagnosis filled in the Family Empowerment Scale (FES) and the Measure of Processes of Care (MPOC-NL) self-report questionnaires. Spearman’s rho will be used to analyze relations between the MPOC- and FES subscales. Multiple regression was used to identify the the most important predictors for empowerment.

Results: Parents (96.4% mothers) of 83 children (78.3% boys) with DCD completed the questionnaires. Preliminary analyses show that on average, the participants often felt empowered about taking care of their family. Parent’s perceptions of the extent to which professionals provided specific information about their child, were enabling and showing partnership, and provided coordinated and comprehensive care for the child and family were significantly related to their degree of experienced empowerment both with regard to their family and with regard to their child’s services. Multiple regression entering all five MPOC subscales showed that the scale Enabling and Partnership was the sole significant predictor for empowerment. Within this scale the items ‘provide opportunities for you to make decisions about treatment’ and ‘listen to what you have to say about your child’s needs for equipment, services, etc.’ seem the most important in predicting empowerment. 

Discussion: Preliminary analyses suggest that it is the extent to which parents perceive to be actively involved in their child’s care, particularly in decision-making and in eliciting parental input, concerns and opinions, by health care professionals that is related to feelings of empowerment.