Peter H . Wilson | Australian Catholic University (original) (raw)
Papers by Peter H . Wilson
Behaviour & Information Technology, 2016
Research in Developmental Disabilities, 2015
Highlights Previous research has found that online control is compromised in children with DCD ... more Highlights Previous research has found that online control is compromised in children with DCD on a double-step task Deficits in executive control (e.g. inhibition) are also commonly observed in this group. Superimposing an inhibitory constraint on a modified rapid reaching task exacerbates deficits in online control among children with DCD; however, this deficit appears to dissipate with age. Longitudinal data is needed to clarify the nature of the coupling between frontal executive and motor control systems. The interaction between motor control and executive function should be considered when planning interventions for DCD.
Disability and Rehabilitation, Feb 22, 2019
Purpose: To evaluate in children with developmental coordination disorder (DCD) the effects of Wi... more Purpose: To evaluate in children with developmental coordination disorder (DCD) the effects of Wii-training compared with task-specific matched training (TST). Material and methods: A randomized controlled trial (RCT) was conducted with 32 children having DCD, aged 7-10 years. Children were randomly assigned to the Wii or task-specific training. Both interventions consisted of 16, 60-min sessions over an 8-week period. The primary outcome measure of movement skill was the Movement Assessment Battery for Children-2 (MABC-2), administered by blinded assessors. Measures included total standard scores (TSS), manual dexterity, aiming/catching, and balance component scores. Results: From pre-to post-test, both groups improved significantly on TSS and balance after intervention. The Wii intervention group also improved on manual dexterity. Neither group improved significantly on aiming/catching. Conclusions: Both the Wii and task-specific training improved overall motor performance and balance. On other MABC-2 component scores, treatment effects differed between groups: Task-specific training had more pronounced effects on balance skills, while Wii training had slightly stronger treatment effects than task-specific training on manual dexterity. It was concluded that task-specific training affords stronger benefits for general motor skill than Wii-based training. Whether Wii training can promote clinically significant benefits for upper-limb function remains to be seen. Trial Registration: This study is registered in a clinical trials registry platform (Protocol: RBR-89YDGJ). Available on the Brazilian Clinical Trials Registry <http://www.ensaiosclinicos.gov.br/> ä IMPLICATIONS FOR REHABILITATION Wii-training and task-specific matched training programs afforded gains in motor performance in children with developmental coordination disorder, similarly; The selected Wii tasks were able to improve the motor performance in children with developmental coordination disorder, but should not be used as an exclusive strategy for these children; Our findings suggest caution in recommending Wii-based training as a viable alternative to more task-specific matched training for children with developmental coordination disorder.
The ability to move around and act seems a natural condition which is acquired during development... more The ability to move around and act seems a natural condition which is acquired during development without the necessity for specific training. We develop an amazing number of motor skills in relative short time in infancy and childhood, motor skills that range from locomotion to plaiting, requiring gross or fine motor coordination. And we seem to have vast capacities to apply the principles of coordination to new skills, thereby creating new possibilities for tool use, object manipulation, sportive activities, etc. In general, motor development is promoted by interaction with the environment which affords and constrains certain actions and offers models for imitation learning. Some of our skills need specific training and instruction, for example writing, an activity that is unlikely to develop naturally. Some children, however, do not seem to develop their motor skills to a level that is normal for their age. They seem to have difficulty in learning the motor skills that belong to the repertoire of other children of their age, and they are clumsy when using these skills. As a result, they perform at a similar level as younger children and seem to lag behind in their motor development. There may be structural or pathological causes for the motor impairment of these children, i.e. areas in the brain that have some form of structural damage, or a hormone deficit such as in congenital hypothyroidism. For many children with problems in motor skills however, no specific neurological or other medical cause can be found. These children are the subject of this book. In the international diagnostical classification system (DSM) these children are referred to as children with Developmental Coordination Disorder (DCD). In the literature you may find several other terms that relate to DCD, such as clumsiness, dyspraxia, perceptual-motor and sensori-motor integration problems, although there is still debate as to whether these are similar or distinct categories. I sometimes call them ‘delightful clumsy devils’ (dcd), although they themselves may often not feel that way. This book aims to inform the interested reader - professional, researcher, student, teacher and parent alike – about our current knowledge of DCD . It reviews the problems and limitations that children with DCD meet, the major available tests in the domain of perceptual-motor function, the evidence for subtypes and comorbidity, the deficits underlying DCD, the major intervention approaches and their effectiveness, and finally the management of DCD. It should convince the reader of the complementary nature of process and product oriented diagnostics and intervention. It should also stimulate the use of available knowledge, and the use of appropriate instruments for diagnosis, assessment, and treatment or stimulation. The ultimate goal being the optimal development – not just motor development – according to the capacities of the child with DCD, a task for parents, teachers and professionals involved.
Archives of Physical Medicine and Rehabilitation, Feb 1, 2023
Alzheimer's & Dementia: Translational Research & Clinical Interventions, 2020
Introduction: Web-based platforms are used increasingly to assess cognitive function in unsupervi... more Introduction: Web-based platforms are used increasingly to assess cognitive function in unsupervised settings. The utility of cognitive data arising from unsupervised assessments remains unclear. We examined the acceptability, usability, and validity of unsupervised cognitive testing in middle-aged adults enrolled in the Healthy Brain Project. Methods: A total of 1594 participants completed unsupervised assessments of the Cogstate Brief Battery. Acceptability was defined by the amount of missing data, and usability by examining error of test performance and the time taken to read task instructions and complete tests (learnability). Results: Overall, we observed high acceptability (98% complete data) and high usability (95% met criteria for low error rates and high learnability). Test validity was confirmed by observation of expected inverse relationships between performance and increasing test difficulty and age. Conclusion: Consideration of test design paired with acceptability and usability criteria can provide valid indices of cognition in the unsupervised settings used to develop registries of individuals at risk for Alzheimer's disease. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Brain and Cognition, Nov 1, 2016
Introduction: Previous research indicates that children with Developmental Coordination Disorder ... more Introduction: Previous research indicates that children with Developmental Coordination Disorder (DCD) show deficits performing online corrections, an issue exacerbated by adding inhibitory constraints; however, cross-sectional data suggests that these deficits may reduce with age. Using a longitudinal design, the aim of the study presented here was to model the coupling that occurs between inhibitory systems and (predictive) online control in typically developing children (TDC) and in those with Developmental Coordination Disorder (DCD) over an extended period of time, using a framework of interactive specialization. We predicted that TDC would show a non-linear growth pattern, consistent with re-organisation in the coupling during the middle childhood period, while DCD would display a developmental lag. Method: A group of 196 children (111 girls and 85 boys) aged between 6 and 12 years participated in the study. Children were classified as DCD according to research criteria. Using a cohort sequential design, both TDC and DCD groups were divided into age cohorts. Predictive (online) control was defined operationally by performance on a Double-Jump Reaching Task (DJRT), which was assessed at 6-month intervals over two years (5 time points in total). Inhibitory control was examined using an anti-jump condition of the DJRT paradigm whereby children were instructed to touch a target location in the hemispace opposite a cued location. Results: For the TDC group, model comparison using growth curve analysis revealed that a quadratic trend was the most appropriate fit with evidence of rapid improvement in anti-reach performance up until middle childhood (around 8-9 years of age), followed by a more gradual rate of improvement into late childhood and early adolescence. This pattern was evident on both chronometric and kinematic measures. In contrast, for children with DCD, a linear function provided the best to fit on the key metrics, with a slower rate of improvement than controls. Conclusion: We conclude that children with DCD require a more extended period of development to effectively couple online motor control and executive systems when completing anti-reach movements, whereas TDC show rapid improvement in early and middle childhood. These group differences in growth curves are likely to reflect a maturational lag in the development of motor-cognitive networks in children with DCD.
Research in Developmental Disabilities, May 1, 2014
The development of static balance is a basic characteristic of normal motor development. Most dev... more The development of static balance is a basic characteristic of normal motor development. Most developmental motor tests include a measure of static balance. Children with Developmental Coordination Disorder (DCD) often fail this item. This study reviews the balance problems of children with DCD. The general conclusion is drawn that under normal conditions static balance control is not a problem for children with DCD. Only in difficult, unattended, or novel situations such children seem to suffer from increased postural sway. These findings raise the question of what happens when balance is lost. The present study addresses the strength of correlation between the electromyography (EMG) and force plate signals in one-leg stance over epochs of stable and unstable balance. Four groups of children were involved in the study: two age groups and a group of children with DCD and balance problems and their controls. The results show a clear involvement of tibialis anterior and peroneus muscles in the control of lateral balance in all conditions and groups. The group of children with DCD and balance problems, however, showed a weaker coupling between EMG and corrective force compared with control children, indicating non-optimal balance
Griffith Research Online.
BMC Health Services Research
Background Understanding how and why de-implementation of low-value practices is sustained remain... more Background Understanding how and why de-implementation of low-value practices is sustained remains unclear. The Paediatric Research in Emergency Departments International CollaboraTive (PREDICT) Bronchiolitis Knowledge Translation (KT) Study was a cluster randomised controlled trial conducted in 26 Australian and New Zealand hospitals (May-November 2017). Results showed targeted, theory-informed interventions (clinical leads, stakeholder meetings, train-the-trainer workshop, targeted educational package, audit/feedback) were effective at reducing use of five low-value practices for bronchiolitis (salbutamol, glucocorticoids, antibiotics, adrenaline and chest x-ray) by 14.1% in acute care settings. The primary aim of this study is to determine the sustainability (continued receipt of benefits) of these outcomes at intervention hospitals two-years after the removal of study supports. Secondary aims are to determine sustainability at one-year after removal of study support at intervent...
Addictive Behaviors, 2017
Internet addiction (IA) has become an increasingly researched topic. In the present study, IA sym... more Internet addiction (IA) has become an increasingly researched topic. In the present study, IA symptoms in adolescents were investigated longitudinally with specific focus on the individual's hostility, gaming use (of Massively Multiplayer Online Role Playing Games [MMORPGs]) and gaming on the classroom level (calculated using the percentage of MMORPG players within classes). The sample comprised 648 Greek adolescents who were assessed over a two-year period (aged 16-18 years). IA symptoms were assessed with the Internet Addiction Test (IAT), and hostility with the relevant subscale of the Symptom Checklist-90 (SCL-90). A three-level hierarchical linear model was used to differentiate individual and classroom-level influences on IA symptoms at age 16 years and over time. MMORPG gamers and more hostile adolescents presented more symptoms of IA. However, being a member of a classroom with a higher percentage of MMORPG gamers appeared to be a protective factor for IA. These longitudinal data emphasize the importance of contextual factors at the level of the classroom in determining differences in IA symptoms during adolescence.
Virtual Reality, Jul 22, 2020
Stroke rehabilitation suffers from low levels of patient engagement, impeding recovery. Virtual r... more Stroke rehabilitation suffers from low levels of patient engagement, impeding recovery. Virtual rehabilitation (VR) approaches can improve patient outcomes; however, there is limited understanding of the participant's user experience and the field lacks a validated, objective measure of VR engagement. A neurophysiological measure of engagement in healthy adults was therefore examined, to inform future clinical studies. Twenty-four participants (M age 26.7 years, range 18-47) interacted with a tabletop VR system (Elements DNA, or EDNA), after which they rated their experience on the presence questionnaire (PQ). Separately, participants completed tasks eliciting low (resting eyes-open and-closed) and high (EDNA VR and roller coaster simulation) levels of engagement while continuous electroencephalogram (EEG) was recorded from a single, left pre-frontal electrode. EEG differences between the resting and simulation conditions included an increase in theta power (p < 0.01) and a decrease in alpha power (p < 0.01). Importantly, theta power in simulation conditions correlated with PQ scores expressing the hands-on EDNA VR experience (r s = 0.38-0.48). In conclusion, the current results provide proof of concept that increased frontal theta power in healthy adults provides a valid measure of user engagement in VR simulation and participation. As the practical potential of VR is increasingly realised in stroke rehabilitation, objective EEG-based measures of engagement may provide a convenient and sensitive technique to assist in evaluating these interventions.
Brain Injury, Apr 7, 2010
To evaluate the effectiveness of a tabletop virtual-reality (VR) based upper-limb rehabilitation ... more To evaluate the effectiveness of a tabletop virtual-reality (VR) based upper-limb rehabilitation system (called Elements) for promoting movement skill in patients with TBI. An ABA case study design with multiple baselines was employed. Baseline performance in this design is contrasted against the results during the treatment phase. Three patients with TBI participated in 12 1-hour sessions of VR-based training. The VR system consisted of a 42-inch tabletop LCD, camera tracking system and tangible user interface. The system requires participants to move an object to cued locations while receiving augmented movement feedback to reinforce speed, trajectory and placement. Upper limb performance was assessed using these three system-measured variables and standardized tests. Trends in the time-sequence plots for each patient were assessed by sight inspection of smoothed data and then by statistical analyses. Participants demonstrated improvements on movement accuracy, efficiency and bimanual dexterity and mixed improvement on speed and other measures of movement skill. Taken together, the findings demonstrate that the Elements system shows promise in facilitating motor learning in these TBI patients. Larger scale trials are now deemed a viable step in further validating the system.
Journal of Clinical and Experimental Neuropsychology, Oct 23, 2017
Introduction: Motor planning is important for daily functioning. Deficits in motor planning can r... more Introduction: Motor planning is important for daily functioning. Deficits in motor planning can result in slow, inefficient, and clumsy motor behavior and are linked to disruptions in performance of activities of daily living in children with cerebral palsy (CP). However, the evidence in CP is primarily based on cross-sectional data. Method: Data are presented on the development of motor planning in children with CP using a longitudinal design with three measurement occasions, each separated by 1 year. Twenty-two children with CP (9 boys, 13 girls; age in years;months, M = 7;1, SD = 1;2) and 22 age-matched controls (10 boys, 12 girls, M = 7;1, SD = 1;3) participated. Children performed a bar transport task in which some conditions ("critical angles") required participants to sacrifice initial posture comfort in order to achieve end-state comfort. Performance on critical trials was analyzed using linear growth curve modeling. Results: In general, children with CP showed poor end-state planning for critical angles. Importantly, unlike in controls, motor planning ability did not improve across the three measurement occasions in children with CP. Conclusion: These longitudinal results show that motor planning issues in CP do not resolve with development over childhood. Strategies to enhance motor planning are suggested for intervention.
Archives of Physical Medicine and Rehabilitation, Jun 1, 2023
Human Movement Science, 2015
Recent research shows that children with motor coordination problems (or developmental coordinati... more Recent research shows that children with motor coordination problems (or developmental coordination disorder – DCD) show deficits in not only cool executive function (EF), but also hot EF. We aimed to determine whether this deficit of hot EF is due to heightened sensitivity to rewarding stimuli, specifically, or to a general deficit of cognitive control, like inhibition. Using two versions of a go/no-go task, one with neutral facial expressions and the other with happy and fearful faces, we compared 12 children with DCD with 28 typically-developing children, aged 7–12 years. Like earlier studies, children responded faster to happy faces. Both groups showed comparable accuracy in response to go targets, and also had similar commission errors, except when the no-go stimulus was a happy face. Importantly, the DCD group made significantly more commission errors to happy faces failing to suppress their response on more than half of the no-go trials. These results suggest a heightened sensitivity to emotionally significant distractors in DCD; this type of impulsivity may undermine self-regulation in DCD, with possible implications for adaptive function and emotional well-being. We argue that the interaction of cognitive control and emotion processing networks may be disrupted in DCD or delayed in development.
Brain Injury, Feb 1, 2012
The aim of this study was to assess the efficacy of the Elements virtual reality (VR) system for ... more The aim of this study was to assess the efficacy of the Elements virtual reality (VR) system for rehabilitation of upper-limb function in patients with traumatic brain injury (TBI). Using a within-group design, patients were tested three times, each 4 weeks apart: Pre-intervention 1 and 2 and Post-intervention. During intervention, participants received 12 1-hour training sessions over 4 weeks in addition to their usual care. Five males and four females aged 18-48 years with severe TBI were recruited. The Elements system consisted of a 100-cm tabletop LCD, camera tracking system, tangible user interfaces (i.e. graspable objects of basic shape) and software. The system provided two modes of interaction with augmented feedback: goal-directed and exploratory. Upper-limb performance was assessed using system-rated measures (movement speed, accuracy and efficiency) and standardized tests. Planned comparisons revealed little change in performance over the pre-test period apart from an increase in movement speed. There were significant training effects, with large effect sizes on all measures except the nuts-and-bolts task. These preliminary findings support the results of an early case study of the Elements system, further demonstrating that VR training is a viable adjunct to conventional physical therapy in facilitating motor learning in patients with TBI.
In this paper we discuss potential benefits and future directions in virtual reality rehabilitati... more In this paper we discuss potential benefits and future directions in virtual reality rehabilitation for co-located motor training in children with developmental movement disorders. We discuss the potential for co-located VR to promote participation using cooperative virtual environments, facilitate social learning, and quantify levels of social interaction. We pay particular attention to the capacity of co-located systems to enhance levels of participation and the psychosocial outcomes of VR therapy. Finally, we offer directions for future research.
Lecture Notes in Computer Science, 2014
In this paper we provide a rationale for using tabletop displays for the upper-limb movement reha... more In this paper we provide a rationale for using tabletop displays for the upper-limb movement rehabilitation of individuals with brain injury. We consider how computer game mechanics may leverage this technology to increase patient engagement and social interaction, and subsequently enhance prescribed training. In recent years there has been a growing interest among health professionals in the use of computer games and interactive technology for rehabilitation. Research indicates that games have the potential to stimulate a high level of interest and enjoyment in patients; enhance learning; provide safe task conditions; complement conventional therapy; and become intrinsically motivating. We explore how game mechanics that include reward structures, game challenges and augmented audiovisual feedback may enhance a goal-orientated rehabilitation learning space for individuals with brain injury. We pay particular attention to game design elements that support multiple players and show how these might be designed for interactive tabletop display systems in group rehabilitation.
Behaviour & Information Technology, 2016
Research in Developmental Disabilities, 2015
Highlights Previous research has found that online control is compromised in children with DCD ... more Highlights Previous research has found that online control is compromised in children with DCD on a double-step task Deficits in executive control (e.g. inhibition) are also commonly observed in this group. Superimposing an inhibitory constraint on a modified rapid reaching task exacerbates deficits in online control among children with DCD; however, this deficit appears to dissipate with age. Longitudinal data is needed to clarify the nature of the coupling between frontal executive and motor control systems. The interaction between motor control and executive function should be considered when planning interventions for DCD.
Disability and Rehabilitation, Feb 22, 2019
Purpose: To evaluate in children with developmental coordination disorder (DCD) the effects of Wi... more Purpose: To evaluate in children with developmental coordination disorder (DCD) the effects of Wii-training compared with task-specific matched training (TST). Material and methods: A randomized controlled trial (RCT) was conducted with 32 children having DCD, aged 7-10 years. Children were randomly assigned to the Wii or task-specific training. Both interventions consisted of 16, 60-min sessions over an 8-week period. The primary outcome measure of movement skill was the Movement Assessment Battery for Children-2 (MABC-2), administered by blinded assessors. Measures included total standard scores (TSS), manual dexterity, aiming/catching, and balance component scores. Results: From pre-to post-test, both groups improved significantly on TSS and balance after intervention. The Wii intervention group also improved on manual dexterity. Neither group improved significantly on aiming/catching. Conclusions: Both the Wii and task-specific training improved overall motor performance and balance. On other MABC-2 component scores, treatment effects differed between groups: Task-specific training had more pronounced effects on balance skills, while Wii training had slightly stronger treatment effects than task-specific training on manual dexterity. It was concluded that task-specific training affords stronger benefits for general motor skill than Wii-based training. Whether Wii training can promote clinically significant benefits for upper-limb function remains to be seen. Trial Registration: This study is registered in a clinical trials registry platform (Protocol: RBR-89YDGJ). Available on the Brazilian Clinical Trials Registry <http://www.ensaiosclinicos.gov.br/> ä IMPLICATIONS FOR REHABILITATION Wii-training and task-specific matched training programs afforded gains in motor performance in children with developmental coordination disorder, similarly; The selected Wii tasks were able to improve the motor performance in children with developmental coordination disorder, but should not be used as an exclusive strategy for these children; Our findings suggest caution in recommending Wii-based training as a viable alternative to more task-specific matched training for children with developmental coordination disorder.
The ability to move around and act seems a natural condition which is acquired during development... more The ability to move around and act seems a natural condition which is acquired during development without the necessity for specific training. We develop an amazing number of motor skills in relative short time in infancy and childhood, motor skills that range from locomotion to plaiting, requiring gross or fine motor coordination. And we seem to have vast capacities to apply the principles of coordination to new skills, thereby creating new possibilities for tool use, object manipulation, sportive activities, etc. In general, motor development is promoted by interaction with the environment which affords and constrains certain actions and offers models for imitation learning. Some of our skills need specific training and instruction, for example writing, an activity that is unlikely to develop naturally. Some children, however, do not seem to develop their motor skills to a level that is normal for their age. They seem to have difficulty in learning the motor skills that belong to the repertoire of other children of their age, and they are clumsy when using these skills. As a result, they perform at a similar level as younger children and seem to lag behind in their motor development. There may be structural or pathological causes for the motor impairment of these children, i.e. areas in the brain that have some form of structural damage, or a hormone deficit such as in congenital hypothyroidism. For many children with problems in motor skills however, no specific neurological or other medical cause can be found. These children are the subject of this book. In the international diagnostical classification system (DSM) these children are referred to as children with Developmental Coordination Disorder (DCD). In the literature you may find several other terms that relate to DCD, such as clumsiness, dyspraxia, perceptual-motor and sensori-motor integration problems, although there is still debate as to whether these are similar or distinct categories. I sometimes call them ‘delightful clumsy devils’ (dcd), although they themselves may often not feel that way. This book aims to inform the interested reader - professional, researcher, student, teacher and parent alike – about our current knowledge of DCD . It reviews the problems and limitations that children with DCD meet, the major available tests in the domain of perceptual-motor function, the evidence for subtypes and comorbidity, the deficits underlying DCD, the major intervention approaches and their effectiveness, and finally the management of DCD. It should convince the reader of the complementary nature of process and product oriented diagnostics and intervention. It should also stimulate the use of available knowledge, and the use of appropriate instruments for diagnosis, assessment, and treatment or stimulation. The ultimate goal being the optimal development – not just motor development – according to the capacities of the child with DCD, a task for parents, teachers and professionals involved.
Archives of Physical Medicine and Rehabilitation, Feb 1, 2023
Alzheimer's & Dementia: Translational Research & Clinical Interventions, 2020
Introduction: Web-based platforms are used increasingly to assess cognitive function in unsupervi... more Introduction: Web-based platforms are used increasingly to assess cognitive function in unsupervised settings. The utility of cognitive data arising from unsupervised assessments remains unclear. We examined the acceptability, usability, and validity of unsupervised cognitive testing in middle-aged adults enrolled in the Healthy Brain Project. Methods: A total of 1594 participants completed unsupervised assessments of the Cogstate Brief Battery. Acceptability was defined by the amount of missing data, and usability by examining error of test performance and the time taken to read task instructions and complete tests (learnability). Results: Overall, we observed high acceptability (98% complete data) and high usability (95% met criteria for low error rates and high learnability). Test validity was confirmed by observation of expected inverse relationships between performance and increasing test difficulty and age. Conclusion: Consideration of test design paired with acceptability and usability criteria can provide valid indices of cognition in the unsupervised settings used to develop registries of individuals at risk for Alzheimer's disease. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Brain and Cognition, Nov 1, 2016
Introduction: Previous research indicates that children with Developmental Coordination Disorder ... more Introduction: Previous research indicates that children with Developmental Coordination Disorder (DCD) show deficits performing online corrections, an issue exacerbated by adding inhibitory constraints; however, cross-sectional data suggests that these deficits may reduce with age. Using a longitudinal design, the aim of the study presented here was to model the coupling that occurs between inhibitory systems and (predictive) online control in typically developing children (TDC) and in those with Developmental Coordination Disorder (DCD) over an extended period of time, using a framework of interactive specialization. We predicted that TDC would show a non-linear growth pattern, consistent with re-organisation in the coupling during the middle childhood period, while DCD would display a developmental lag. Method: A group of 196 children (111 girls and 85 boys) aged between 6 and 12 years participated in the study. Children were classified as DCD according to research criteria. Using a cohort sequential design, both TDC and DCD groups were divided into age cohorts. Predictive (online) control was defined operationally by performance on a Double-Jump Reaching Task (DJRT), which was assessed at 6-month intervals over two years (5 time points in total). Inhibitory control was examined using an anti-jump condition of the DJRT paradigm whereby children were instructed to touch a target location in the hemispace opposite a cued location. Results: For the TDC group, model comparison using growth curve analysis revealed that a quadratic trend was the most appropriate fit with evidence of rapid improvement in anti-reach performance up until middle childhood (around 8-9 years of age), followed by a more gradual rate of improvement into late childhood and early adolescence. This pattern was evident on both chronometric and kinematic measures. In contrast, for children with DCD, a linear function provided the best to fit on the key metrics, with a slower rate of improvement than controls. Conclusion: We conclude that children with DCD require a more extended period of development to effectively couple online motor control and executive systems when completing anti-reach movements, whereas TDC show rapid improvement in early and middle childhood. These group differences in growth curves are likely to reflect a maturational lag in the development of motor-cognitive networks in children with DCD.
Research in Developmental Disabilities, May 1, 2014
The development of static balance is a basic characteristic of normal motor development. Most dev... more The development of static balance is a basic characteristic of normal motor development. Most developmental motor tests include a measure of static balance. Children with Developmental Coordination Disorder (DCD) often fail this item. This study reviews the balance problems of children with DCD. The general conclusion is drawn that under normal conditions static balance control is not a problem for children with DCD. Only in difficult, unattended, or novel situations such children seem to suffer from increased postural sway. These findings raise the question of what happens when balance is lost. The present study addresses the strength of correlation between the electromyography (EMG) and force plate signals in one-leg stance over epochs of stable and unstable balance. Four groups of children were involved in the study: two age groups and a group of children with DCD and balance problems and their controls. The results show a clear involvement of tibialis anterior and peroneus muscles in the control of lateral balance in all conditions and groups. The group of children with DCD and balance problems, however, showed a weaker coupling between EMG and corrective force compared with control children, indicating non-optimal balance
Griffith Research Online.
BMC Health Services Research
Background Understanding how and why de-implementation of low-value practices is sustained remain... more Background Understanding how and why de-implementation of low-value practices is sustained remains unclear. The Paediatric Research in Emergency Departments International CollaboraTive (PREDICT) Bronchiolitis Knowledge Translation (KT) Study was a cluster randomised controlled trial conducted in 26 Australian and New Zealand hospitals (May-November 2017). Results showed targeted, theory-informed interventions (clinical leads, stakeholder meetings, train-the-trainer workshop, targeted educational package, audit/feedback) were effective at reducing use of five low-value practices for bronchiolitis (salbutamol, glucocorticoids, antibiotics, adrenaline and chest x-ray) by 14.1% in acute care settings. The primary aim of this study is to determine the sustainability (continued receipt of benefits) of these outcomes at intervention hospitals two-years after the removal of study supports. Secondary aims are to determine sustainability at one-year after removal of study support at intervent...
Addictive Behaviors, 2017
Internet addiction (IA) has become an increasingly researched topic. In the present study, IA sym... more Internet addiction (IA) has become an increasingly researched topic. In the present study, IA symptoms in adolescents were investigated longitudinally with specific focus on the individual's hostility, gaming use (of Massively Multiplayer Online Role Playing Games [MMORPGs]) and gaming on the classroom level (calculated using the percentage of MMORPG players within classes). The sample comprised 648 Greek adolescents who were assessed over a two-year period (aged 16-18 years). IA symptoms were assessed with the Internet Addiction Test (IAT), and hostility with the relevant subscale of the Symptom Checklist-90 (SCL-90). A three-level hierarchical linear model was used to differentiate individual and classroom-level influences on IA symptoms at age 16 years and over time. MMORPG gamers and more hostile adolescents presented more symptoms of IA. However, being a member of a classroom with a higher percentage of MMORPG gamers appeared to be a protective factor for IA. These longitudinal data emphasize the importance of contextual factors at the level of the classroom in determining differences in IA symptoms during adolescence.
Virtual Reality, Jul 22, 2020
Stroke rehabilitation suffers from low levels of patient engagement, impeding recovery. Virtual r... more Stroke rehabilitation suffers from low levels of patient engagement, impeding recovery. Virtual rehabilitation (VR) approaches can improve patient outcomes; however, there is limited understanding of the participant's user experience and the field lacks a validated, objective measure of VR engagement. A neurophysiological measure of engagement in healthy adults was therefore examined, to inform future clinical studies. Twenty-four participants (M age 26.7 years, range 18-47) interacted with a tabletop VR system (Elements DNA, or EDNA), after which they rated their experience on the presence questionnaire (PQ). Separately, participants completed tasks eliciting low (resting eyes-open and-closed) and high (EDNA VR and roller coaster simulation) levels of engagement while continuous electroencephalogram (EEG) was recorded from a single, left pre-frontal electrode. EEG differences between the resting and simulation conditions included an increase in theta power (p < 0.01) and a decrease in alpha power (p < 0.01). Importantly, theta power in simulation conditions correlated with PQ scores expressing the hands-on EDNA VR experience (r s = 0.38-0.48). In conclusion, the current results provide proof of concept that increased frontal theta power in healthy adults provides a valid measure of user engagement in VR simulation and participation. As the practical potential of VR is increasingly realised in stroke rehabilitation, objective EEG-based measures of engagement may provide a convenient and sensitive technique to assist in evaluating these interventions.
Brain Injury, Apr 7, 2010
To evaluate the effectiveness of a tabletop virtual-reality (VR) based upper-limb rehabilitation ... more To evaluate the effectiveness of a tabletop virtual-reality (VR) based upper-limb rehabilitation system (called Elements) for promoting movement skill in patients with TBI. An ABA case study design with multiple baselines was employed. Baseline performance in this design is contrasted against the results during the treatment phase. Three patients with TBI participated in 12 1-hour sessions of VR-based training. The VR system consisted of a 42-inch tabletop LCD, camera tracking system and tangible user interface. The system requires participants to move an object to cued locations while receiving augmented movement feedback to reinforce speed, trajectory and placement. Upper limb performance was assessed using these three system-measured variables and standardized tests. Trends in the time-sequence plots for each patient were assessed by sight inspection of smoothed data and then by statistical analyses. Participants demonstrated improvements on movement accuracy, efficiency and bimanual dexterity and mixed improvement on speed and other measures of movement skill. Taken together, the findings demonstrate that the Elements system shows promise in facilitating motor learning in these TBI patients. Larger scale trials are now deemed a viable step in further validating the system.
Journal of Clinical and Experimental Neuropsychology, Oct 23, 2017
Introduction: Motor planning is important for daily functioning. Deficits in motor planning can r... more Introduction: Motor planning is important for daily functioning. Deficits in motor planning can result in slow, inefficient, and clumsy motor behavior and are linked to disruptions in performance of activities of daily living in children with cerebral palsy (CP). However, the evidence in CP is primarily based on cross-sectional data. Method: Data are presented on the development of motor planning in children with CP using a longitudinal design with three measurement occasions, each separated by 1 year. Twenty-two children with CP (9 boys, 13 girls; age in years;months, M = 7;1, SD = 1;2) and 22 age-matched controls (10 boys, 12 girls, M = 7;1, SD = 1;3) participated. Children performed a bar transport task in which some conditions ("critical angles") required participants to sacrifice initial posture comfort in order to achieve end-state comfort. Performance on critical trials was analyzed using linear growth curve modeling. Results: In general, children with CP showed poor end-state planning for critical angles. Importantly, unlike in controls, motor planning ability did not improve across the three measurement occasions in children with CP. Conclusion: These longitudinal results show that motor planning issues in CP do not resolve with development over childhood. Strategies to enhance motor planning are suggested for intervention.
Archives of Physical Medicine and Rehabilitation, Jun 1, 2023
Human Movement Science, 2015
Recent research shows that children with motor coordination problems (or developmental coordinati... more Recent research shows that children with motor coordination problems (or developmental coordination disorder – DCD) show deficits in not only cool executive function (EF), but also hot EF. We aimed to determine whether this deficit of hot EF is due to heightened sensitivity to rewarding stimuli, specifically, or to a general deficit of cognitive control, like inhibition. Using two versions of a go/no-go task, one with neutral facial expressions and the other with happy and fearful faces, we compared 12 children with DCD with 28 typically-developing children, aged 7–12 years. Like earlier studies, children responded faster to happy faces. Both groups showed comparable accuracy in response to go targets, and also had similar commission errors, except when the no-go stimulus was a happy face. Importantly, the DCD group made significantly more commission errors to happy faces failing to suppress their response on more than half of the no-go trials. These results suggest a heightened sensitivity to emotionally significant distractors in DCD; this type of impulsivity may undermine self-regulation in DCD, with possible implications for adaptive function and emotional well-being. We argue that the interaction of cognitive control and emotion processing networks may be disrupted in DCD or delayed in development.
Brain Injury, Feb 1, 2012
The aim of this study was to assess the efficacy of the Elements virtual reality (VR) system for ... more The aim of this study was to assess the efficacy of the Elements virtual reality (VR) system for rehabilitation of upper-limb function in patients with traumatic brain injury (TBI). Using a within-group design, patients were tested three times, each 4 weeks apart: Pre-intervention 1 and 2 and Post-intervention. During intervention, participants received 12 1-hour training sessions over 4 weeks in addition to their usual care. Five males and four females aged 18-48 years with severe TBI were recruited. The Elements system consisted of a 100-cm tabletop LCD, camera tracking system, tangible user interfaces (i.e. graspable objects of basic shape) and software. The system provided two modes of interaction with augmented feedback: goal-directed and exploratory. Upper-limb performance was assessed using system-rated measures (movement speed, accuracy and efficiency) and standardized tests. Planned comparisons revealed little change in performance over the pre-test period apart from an increase in movement speed. There were significant training effects, with large effect sizes on all measures except the nuts-and-bolts task. These preliminary findings support the results of an early case study of the Elements system, further demonstrating that VR training is a viable adjunct to conventional physical therapy in facilitating motor learning in patients with TBI.
In this paper we discuss potential benefits and future directions in virtual reality rehabilitati... more In this paper we discuss potential benefits and future directions in virtual reality rehabilitation for co-located motor training in children with developmental movement disorders. We discuss the potential for co-located VR to promote participation using cooperative virtual environments, facilitate social learning, and quantify levels of social interaction. We pay particular attention to the capacity of co-located systems to enhance levels of participation and the psychosocial outcomes of VR therapy. Finally, we offer directions for future research.
Lecture Notes in Computer Science, 2014
In this paper we provide a rationale for using tabletop displays for the upper-limb movement reha... more In this paper we provide a rationale for using tabletop displays for the upper-limb movement rehabilitation of individuals with brain injury. We consider how computer game mechanics may leverage this technology to increase patient engagement and social interaction, and subsequently enhance prescribed training. In recent years there has been a growing interest among health professionals in the use of computer games and interactive technology for rehabilitation. Research indicates that games have the potential to stimulate a high level of interest and enjoyment in patients; enhance learning; provide safe task conditions; complement conventional therapy; and become intrinsically motivating. We explore how game mechanics that include reward structures, game challenges and augmented audiovisual feedback may enhance a goal-orientated rehabilitation learning space for individuals with brain injury. We pay particular attention to game design elements that support multiple players and show how these might be designed for interactive tabletop display systems in group rehabilitation.
this chapter examines the neurocognitive processing deficits that are common in children with dev... more this chapter examines the neurocognitive processing deficits that are common in children with developmental coordination disorder (DCD), focusing on issues of motor control and executive function. taking an embodied approach, it is argued that the development of motor behaviour is constrained by maturational and experiential factors. movement skills and underlying control processes emerge over a relatively protracted period of development and are viewed as being embedded within a broader neurocognitive system. one prominent account of DCD that is a focus of this chapter is the internal modelling deficit (imD) account, perhaps better termed a deficit of predictive control. the chapter will trace the main lines of evidence that support this model and will then give particular focus to the development of online control in children. a mature system of online control can orchestrate movement corrections in-flight with minimal time lag (in many cases responding to visual and other perturbations in less than 100 ms). this remarkable feat can be achieved only to the extent that feedforward (or predictive) control is well developed and integrated seamlessly with real-time sensory feedback. this refined level of control is supported by maturation of neurocognitive networks involving fronto-parietal and parieto-cerebellar loops. more importantly, it is argued that the process of motor prediction must be constantly updated with maturation and experience as individual biomechanics change during physical growth and as other brain systems emerge. of the latter, the chapter will describe trends in the development of spatial and executive control systems in children with and without DCD. the increasing level of neural coupling that occurs between anterior (viz., executive) and posterior (perceptual-motor) systems over childhood has important implications for learning and skill