Neuromotor task training for children with developmental coordination disorder: a controlled trial

Abstract

The aim of this study was to evaluate neuromotor task training (NTT), a recently developed child-centred and taskoriented treatment programme for children with developmental coordination disorder (DCD). A treatment and a non-treatment control group of children with DCD were included. Children were selected if they scored below the 15th centile on the Movement Assessment Battery for Children (MABC). The children in the treatment group were recently referred for physiotherapy (n=26; 20 males, 6 females; mean age 7y 2mo [SD 1y 3mo]). The parents of the non-treated children were concerned about their children's motor performance and responded to advertisements for free testing (n=13; 10 males, 3 females; mean age 7y 2mo [SD 2y 1mo]). Before and after nine weekly 30-minute sessions of NTT or at least 9 weeks of no intervention, the MABC and the Test of Gross Motor Development -2 (TGMD-2) were administered. Therapists reported per session on treatment goals and tasks trained. The results indicate that motor performance does not improve spontaneously and that NTT is effective. During the intervention period, only the treated group improved on the MABC and the TGMD-2. Children improved most on tasks similar to those trained. In older children with poorer motor patterns, NTT's treatment success was higher. The Child Behavior Checklist subscales withdrawn, thought problems, anxious/depressed, and delinquency were determinants of effects on motor patterns.Approximately 5 to 10% of schoolchildren have difficulty learning motor skills. 1 A child is diagnosed with developmental coordination disorder (DCD) if the performance in daily activities that require motor coordination is substantially below that expected given the child's chronological age and intelligence, in the absence of any known neurological disorder or pervasive developmental disorder (PDD). 2 To diagnose a child as having DCD, inadequate proficiency in movement performance should negatively interfere with activities of daily life. 2 This latter criterion, and the fact that most children do not outgrow DCD, which can have potentially long-term consequences, 3,4 support the need for intervention.Evidence is lacking for the efficacy of treatment approaches that concentrate on the deficits in processes assumed to underlie poor motor coordination, such as sensory integration therapy and kinaesthetic training. 5,6 For a decade, more task-oriented approaches have been emphasized and reveal promising results. These approaches focus directly on the functional skills hindering the child. Because only a few studies have investigated task-oriented approaches, more efficacy research is needed.In the Netherlands, neuromotor task training (NTT) has recently been developed especially for children with DCD, because the existing intervention programmes show no or little effect, and are not explicitly developed for these children. 7,8 Until the introduction of NTT, Dutch therapists eclectically used what they had learned on various courses. 9 NTT is based upon a cognitive neurosc...

Effectiveness of Interventions for Children With Developmental Coordination Disorder in Physical Therapy Contexts: A Systematic Literature Review and Meta-Analysis

“…Three of the studies reported their NTT effect sizes. Figure 5 displays the summation of these studies' findings.Researchers in one study were blinded to group allocation when assessing results (Niemeijer et al, 2007). In this study, the difference between the MABC pre-and postintervention scores were statistically significant in the intervention group (p = .003), while there was no significant change in scores in the control group.…”

“…Physical therapists from the Netherlands developed a type of task-oriented training called neuromotor task training (NTT). NTT is based on a cognitive neuroscience approach to motor control (Niemeijer, Smits-Engelsman, & Schoemaker, 2007;, and uses a combination of motor learning and ecological principle of skill development through repeated learning sessions, as well as task and environmental constraint manipulations . A recent systematic literature review on the efficacy of motor interventions for children with DCD (task-oriented training, traditional physical and occupational therapy, process-oriented therapies, and chemical supplements) found evidence supporting traditional physical and occupational therapy and task-oriented interventions .…”

Motor coordination problems in children and adolescents with ADHD rated by parents and teachers: effects of age and gender

“…Recently, interventions for motor coordination problems were reviewed (Wilson 2005). It seems that especially the child-centred and task-oriented methods that include cognitive components are useful therapies (Schoemaker et al 2003;Polatajko and Cantin 2005;Niemeijer et al 2007;Sugden 2007). Clinicians diagnosing and treating children and adolescents with ADHD should additionally assess whether motor coordination problems are present, and offer those with ADHD and co-existing motor coordination problems evidence-based interventions.…”

Using a Multifaceted Approach to Working With Children Who Have Differences in Sensory Processing and Integration

“…Specific cognitive approaches that may be useful for children with differences in sensory processing and integration include problem-solving interventions such as the Cognitive Orientation to daily Occupational Performance (CO-OP; Polatajko & Mandich, 2004) and neuromotor task training (NTT; Niemeijer, Smits-Engelsman, & Schoemaker, 2007). Several studies support the use of CO-OP and NTT for children who have difficulties with motor coordination, including children with developmental coordination disorder (DCD) and ASD (Hyland & Polatajko, 2012;Rodger & Brandenburg, 2009;Rodger, Pham, & Mitchell, 2009;Smits-Engelsman et al, 2013).…”