The Role of Self-Regulatory and Metacognitive Competence in the Motor Performance Difficulties of Children with Developmental Coordination Disorder: A Theoretical and Empirical Review

Children with developmental coordination disorder (DCD) experience difficulty coping with everyday demands due to difficulties in performing motor tasks. Recently, a cognitive learning paradigm has been applied to studying the nature of the problems experienced by children with DCD, which assumes that these children have fewer cognitive and metacognitive skills with which to acquire motor skills. However, despite the emergence of such cognitive models, individual differences in children’s use of self-regulatory and metacognitive skill during motor learning have received little research attention. The aim of this review article was to examine the roots of this emerging field of research, locate it within the larger body of metacognitive and self-regulation literature, and examine some of the preliminary work that has been conducted on the role of self-regulation and metacognition in motor learning and in the motor performance difficulties of children with DCD.     

Cognitive functioning in children with and without Attention-deficit/Hyperactivity Disorder with and without comorbid learning disabilities

This study attempted to determine whether children with the combined subtype of attention-deficit/hyperactivity disorder (ADHD) have impairments in cognitive functioning and motor skills. The specific effect of the comorbidity of learning disabilities (LD) was also investigated. A battery of cognitive tests was administered to 26 children with a clinical diagnosis of ADHD-combined subtype (ADHD/C), to 24 children with ADHD/C with a comorbid diagnosis of LD (ADHD/C+LD), and to 102 participants without disabilities, all between ages 7 and 10. The testing battery consisted of tasks assessing memory, visuospatial and verbal abilities, and fine motor skills. In general, the test results of children with ADHD/C were poorer than those of the control group but better than the results of children with a combined ADHD/C+LD diagnosis (with the exception of motor skills). The predictive accuracy of the testing battery tasks in children with ADHD/C and ADHD/C+LD was examined. The results of a standard procedure of discriminant function analyses revealed that the measures correctly classified 73.6% of the children.     

The inhibition of exogenous distracting information in children with learning disabilities

Several studies have shown that children with learning disabilities (LD) have difficulty in inhibiting irrelevant information, which generates endogenous interference from working memory. Other inhibition capacities have not yet been investigated, however. This article reports on an experiment examining the capacities of children with LD to inhibit exogenous interference, such as automatic, prepotent responses and distractor interference. Fifteen 11-year-old children with LD and 15 matched controls completed four tasks of inhibition, using the Stroop and Eriksen's flanker paradigms. To test the hypothesis that inhibition can be differentiated in terms of the type of material it acts on, each paradigm was used with numerical and nonnumerical stimuli. Our results showed that children with LD did not exhibit significantly larger interference effects than controls. Moreover, the pattern of results did not differ according to the type of material used. These findings indicate that children with LD do not show impairment in the inhibition of exogenous information--a finding that contradicts the material-specific inhibition hypothesis.     

Executive functions in kindergarten children at risk for developmental coordination disorder

Executive functioning (EF) is a key cognitive process for development. Little is known about EF in Kindergarten children at risk for developmental coordination disorder (DCD), despite this age being one of the most critical and intensive period of motor and cognitive development. In our investigation we compared EF in kindergarten children at risk for DCD with Typically Developing (TD) children. Participants were 36 Italian children, 18 at risk for DCD (9 boys and 9 girls) who had a mean age of 4.6 years and 18 TD (9 boys and 9 girls) who had a mean age of 4.6. Executive functions were measured by tasks targeting cold executive functioning (working memory, fluency, inhibitory control) and two assessments of hot executive functioning (Snack Delay and Gift Wrap). Significant differences were found between children at risk for DCD and TD children on cold EF tasks of visuo-spatial working memory abilities, fluency and inhibitory control, but not on hot EF tasks. The findings suggest that it is advisable to implement preschool cognitively challenging physical activities programmes.     

Working memory and learning in children with developmental coordination disorder and specific language impairment

The authors compared 6- to 11-year-olds with developmental coordination disorder (DCD) and those with specific language impairment (SLI) on measures of memory (verbal and visuospatial short-term and working memory) and learning (reading and mathematics). Children with DCD with typical language skills were impaired in all four areas of memory function for their age level, and this pattern was also found to be characteristic of a larger DCD group with varied language abilities. SLI-group deficits in standard scores were observed for the verbal versions of the short-term and working memory tasks only. There were also differential links between memory and attainment between the two groups, with visuospatial working memory strongly related to numeracy in the SLI group and all of the memory measures correlated with at least one attainment measure in the DCD group. Reasons for why working memory contributes to learning in these two developmental groups are discussed.     

A synthesis on the research of the comorbidity of ADHD and LD in Korea: perspective and trend

Attention-deficit/hyperactivity disorder (ADHD) and learning disabilities (LD) are the most commonly diagnosed childhood disorders, and they frequently co-occur with each other. It has been found that students with comorbidity of ADHD and LD experience more difficulties in school. Even though the research interests in the comorbidity of ADHD and LD are increasing, there are inconsistent results in research studies and insufficient understanding of the comorbidity of ADHD and LD. This study attempts to grasp the progress of the studies in the comorbidity of ADHD and LD in Korea and to suggest the future directions for following research. A total of 90 studies published between 1987 and 2009 are examined. First, we analyze the studies that examined the learning problems of ADHD and then identify the characteristics of the learning problems in ADHD group. Afterwards, we investigate the studies that dealt with the attention problems of LD and then discuss the characteristics of the attention problems in LD group. Third, we identify the differences between ADHD and LD and synthesize the research findings. Finally, we analyze the studies conducted in conjunction with the comorbidity of ADHD and LD. On lightening the research of the comorbidity on three aspects, we find the research trend in Korea and provide the implications for future studies on the comorbidity of ADHD and LD. Furthermore, we suggest that it is important to identify comorbid conditions at the early stage, and it is necessary to conduct multidisciplinary research and international comparison research.     

Neurocognitive function and joint attention ability in young children with autism spectrum disorder versus developmental delay

Studies have shown that young children with autism are not impaired on prefrontal tasks relative to what would be expected for their mental age, raising questions about the executive dysfunction hypothesis of autism. These studies did not include ventromedial prefrontal tasks, however. The present study examined whether young children with autism spectrum disorder (ASD) are impaired on ventromedial prefrontal tasks, and whether performance on such tasks is correlated with a core autism symptom, joint attention ability. Seventy-two 3- to 4-year-old children with ASD, 34 3- to 4-year-old developmentally delayed children, and 39 12- to 46-month-old typically developing children, matched on mental age, were administered ventromedial and dorsolateral prefrontal tasks and joint attention tasks. Children with ASD performed similarly to comparison groups on all executive function tasks, indicating that at this early age, there is no autism-specific pattern of executive dysfunction. Ventromedial, but not dorsolateral, prefrontal task performance was strongly correlated with joint attention ability, however. The ventromedial prefrontal cortex is hypothesized to play a role in the development of joint attention and possibly some aspects of the autistic syndrome.     

Learning disabilities and ADHD: overlapping spectrumn disorders

Clinical and psychoeducational data were analyzed for 119 children ages 8 to 16 years who were evaluated in a child diagnostic clinic. A learning disability (LD) was present in 70% of the children with attention-deficit/hyperactivity disorder (ADHD), with a learning disability in written expression two times more common (65%) than a learning disability in reading, math, or spelling. Children with LD and ADHD had more severe learning problems than children who had LD but no ADHD, and the former also had more severe attention problems than children who had ADHD but no LD. Further, children with ADHD but no LD had some degree of learning problem, and children with LD but no ADHD had some degree of attention problem. Results suggest that learning and attention problems are on a continuum, are interrelated, and usually coexist.     

Neural Oscillation Reveals Deficits in Visuospatial Working Memory in Children With Developmental Coordination Disorder

The electroencephalographic (EEG) oscillations associated with visuospatial working memory (VSWM) were examined in children with developmental coordination disorder (DCD; 10–11 years; N = 29) and typically developing (TD) children (10–11 years; N = 29). Behaviorally, DCD showed poorer VSWM than TD, which coincided with the diminished ability of DCD in modulating neural oscillations. Furthermore, prestimulus oscillatory alpha activity was correlated with VSWM performance. The results suggest that children with DCD might have a reduced ability to encode and recognize new information, and in particular have difficulty in maintaining task‐relevant information, resulting in poorer VSWM. This study thus concludes that changes in oscillatory EEG activity reflect some of the problems leading to cognitive deficits in DCD.     

WISC-III profiles for children with and without learning disabilities

The degree of WISC-III intersubtest scatter was normal and similar for 66 children with LD and 51 children without LD, but the pattern of scores differed. In the 8- to 16-year-old sample, children with LD scored lower on the Freedom from Distractibility Index relative to FSIQ than children without LD. This difference was found in both the ADHD and nonADHD subgroups, suggesting that children with LD may have an attention deficit even if they do not meet the diagnostic criteria for ADHD. The CAD profile was evident in the mean scores for both the LD/ADHD and LD/nonADHD subgroups, but it was not found among the lowest subtest scores for any of the nonLD subgroups. Though WISC-III profile types were apparent in LD group data, only a minority of individual children with LD actually had these profiles. In the 6- and 7-year-old group, children with and without LD were indistinguishable on the WISC-III, which may reflect the difficulty of ruling out LD at this young age. © 1998 John Wiley & Sons, Inc.     

Frequency of reading,math, and writing disabilities in children with clinical disorders

Learning disabilities (LD) are common in clinical disorders, but no study has compared the relative prevalence in referred children with different diagnoses. Our sample comprised 949 children (6 to 16 years). LD percentages were highest for bipolar disorder (79%), ADHD combined type (71%), autism (67%), ADHD inattentive type (66%), and spina bifida (60%). Children with oppositional-defiant disorder, adjustment disorder, anxiety, and depression had relatively low LD percentages (18–19%). LD in written expression was twice as common as LD in reading or math. Findings indicate that children with neurogenetic disorders should be assessed for possible LD because of the high potential yield and the need to intervene educationally if learning problems exist.     

A developmental index using the Wechsler Intelligence Scale for Children: implications for the diagnosis and nature of ADHD.

The possible utility of Wechsler's Deterioration Index (WDI) in analyzing children's Wechsler Intelligence Scale for Children-Revised (WISC-R) results was explored in this study. Clinical records of children with learning disabilities (LD) and children with attention deficit-hyperactivity disorder (ADHD) were reviewed to determine if the WDI predicted the presence or severity of the disorders. The ages of the children ranged from 6 to 14. In two independent samples of children with LD (n = 35 and n = 26), the WDI did not predict LD status or severity. The LD samples were mostly male--85% and 57%, respectively. However, the WDI scores did significantly distinguish children with ADHD (n = 10) from nondisabled children (n = 10). The results were cross-validated on an independent sample of children with ADHD (n = 17) when compared to non-ADHD children (n = 22) who experienced significant behavioral difficulties. The ADHD samples were also mostly male--90% and 89%, respectively. The WDI classified only 59% of the children with ADHD and 86% of the non-ADHD children correctly. It is recommended that the WDI be considered a developmental index rather than a deterioration index in children. It is also recommended that significant WDI elevation (greater than .20) be considered to raise the question of ADHD, rather than simply yielding a diagnosis of ADHD.     

The term comorbidity is of questionable value in reference to developmental disorders: data and theory

Over the last decade, there has been an enormous increase in the number of studies evaluating the overlap of developmental syndromes or disorders in both children and adults. This overlap of symptoms is often referred to as comorbidity, a term we criticize in this article because of its unsubstantiated presumption of independent etiologies. The premise of this article is that discrete categories do not exist in real life, and that it is misleading to refer to overlapping categories or symptoms as "comorbidities." We illustrate our point by presenting data from 179 school-age children evaluated with rigorous research criteria for seven disorders: reading disability (RD), attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorder (DCD), oppositional defiant disorder (ODD), conduct disorder (CD), depression, and anxiety. Fully 50% of this sample met the criteria for at least two diagnoses. The children with ADHD were at higher risk of having at least a second disorder compared to the children with RD. Overall, the high rates of overlap of these behavioral, emotional, and educational deficits in this broadly ascertained sample support the idea that the concept of comorbidity is inadequate. We discuss the concept of atypical brain development as an explanatory idea to interpret the high rate of overlap of developmental disorders.     

Task-related variation in communication of mothers and their sons with learning disability

The purpose of the present study was to examine whether mother-child communication patterns vary as a function of the type of the task. Groups of learning disabled (LD=30) and normally achieving boys (NLD=30) were videotaped interacting with their mothers in two different tasks. The children were matched for age (8 to 11 year-olds) and for parent’s SES. The results indicated that the teaching task differentiated the groups more than did the story task. Academic character of the teaching task increased mothers’ task involvement in both groups. Mothers of the LD group showed, however, significantly more dominance and expressed less emotionality while teaching their child. Mothers’ interaction partly followed from their children’s behaviour on this task. The children with LD did not cooperate with their mothers and were not emotionally involved in the teaching task as highly as were the normally achieving children. Corresponding features of interaction were not found for the LD group in the story task. Consistency of children’s communication across the tasks was significant in the LD group. The normally achieving boys were more responsive to changes in task conditions showing different behavior as a function of task.     

The boundaries of attention deficit disorder

This report examines distinctions and interrelationships among attention deficit disorder (ADD) and two closely related conditions: learning disability (LD) and oppositional/conduct (O/C) disorder. To evaluate our hypothesis that some of the difficulty in resolving the relationship between ADD and, particularly, O/C may reflect the consequences of selective referral patterns, we studied groups of children diagnosed as ADD from different referral sources. Results suggest that referral bias does exist and that children referred to mental health settings differ from those referred to pediatricians, child neurologists, or psychologists. Because of the nature of the subjects referred to mental health services, nonrepresentative associations may emerge. Rather than being considered as prototypical of all children with attention disorder, children referred to mental health facilities may represent simply an extreme of the continuum of ADD. Evidence suggests that many children with ADD will be represented by those referred primarily for attentional deficits and learning problems, rather than those with inattention, hyperactivity, or aggression referred for child psychiatric evaluation.     

Central auditory processing ability in children with ADHD with and without learning disabilities

A few studies have shown more central auditory processing deficits in children with attention-deficit/hyperactivity disorder (ADHD) than in nondisabled children. Because these studies failed to screen participants with ADHD for learning disabilities (LD), it is not clear whether these deficits are correlates of ADHD or LD or both. In the present study, the central auditory processing ability of children with ADHD, ADHD with LD, and no disabilities was examined. Results indicated lower central auditory processing ability, and significant correlations between reading and ADHD symptoms and reading and central auditory processing ability in the ADHD with LD group compared with the other two groups. These findings suggest that central auditory processing deficits are more likely to be associated with LD than ADHD.     

Predicting performance on academic and non-academic tasks: A comparison of adolescents with and without learning disabilities

Previous research suggests that adolescents with learning disabilities (LD) are less accurate in predicting academic performance than normally achieving (NA) adolescents and display a tendency to overestimate their level of performance (e.g., Klassen, 2007). However, no studies have been conducted investigating whether this overestimation is specific to academic contexts or a phenomenon that extends across domains. Ninety-four adolescents (46 LD, 48 NA) predicted their performance on a spelling task and on a ball-throwing task. Results revealed group differences in performance calibration across domains with adolescents with LD showing an overestimation of ability on the spelling and ball-throwing tasks, and NA adolescents demonstrating more precise self-appraisals. Additionally, the accuracy of non-academic performance predictions remained stable with increasing difficulty in the NA group whereas the adolescents with LD demonstrated a decrease in accurate performance prediction as the difficulty level increased.     

Children's attitudes towards ADHD,depression and learning disabilities

Attention deficit hyperactivity disorder (ADHD), depression and general learning disabilities (LD) are common difficulties for British primary school children. It has been found that characteristics associated with these difficulties can result in negative attitudes and stigma from other children, causing problems with peer relationships. Furthermore, problematic peer relations can intensify the difficulties associated with these disorders. Packages such as ‘Tackling Stigma: A Practical Toolkit’ aim to combat stigma in schools. However, these packages have not been based on evidence regarding children's attitudes towards different disorders. This study aims to explore children's attitudes towards ADHD, depression and LD from a conative (measure of social distance) and cognitive (measure of positive or negative attributes ascribed to a person) perspective. Participants were 273 children (M= 9.2 years). Vignettes were used to describe a child with ADHD, depression, or LD or a ‘normal’ child. The Shared Activities Questionnaire was utilised to assess conative attitudes, and the Adjective Checklist was utilised to assess cognitive attitudes. Results showed that children generally displayed more negative attitudes to vignettes describing mental health difficulties (MHD) (ADHD and depression) than LD. Children had more negative attitudes towards the ADHD (externalising disorder) vignette than the depression vignette (internalising disorder). Younger children had more positive conative attitudes than older children. Those who had previous contact with children with ADHD, depression and LD had more positive attitudes. These findings can enhance current stigma reduction interventions through contributing a deeper understanding of children's attitudes towards the most common MHD and LD in childhood.     

Social information processing and emotional understanding in children with LD

The present study aimed to comprehensively examine social cognition processes in children with and without learning disabilities (LD), focusing on social information processing (SIP) and complex emotional understanding capabilities such as understanding complex, mixed, and hidden emotions. Participants were 50 children with LD (age range 9.4-12.7; 35 boys, 15 girls) and 50 children without LD matched on grade, age, and gender. Children analyzed 4 social vignettes using Dodge's SIP model and completed 2 emotional recognition tasks (pictures and stories) and 4 emotional knowledge tasks, such as providing definitions and examples for 5 emotions (e.g., loneliness, pride, embarrassment). Study results demonstrated that children with LD had major difficulties in SIP processes and consistent difficulties with the different tasks in the understanding of complex emotions and in higher emotional understanding capabilities, such as understanding that 2 conflicting emotions (love and hate) can be simultaneously experienced. We discuss the implications of such difficulties for the understanding of social competence in children with LD as well as their implications for social skills intervention.     

Diagnostic Utility of the Bannatyne WISC‐III Pattern

Regrouping Wechsler Intelligence Scale for Children‐Third Edition (WISC‐III) subtests into Bannatyne's spatial, conceptual, and sequential patterns has been thought by many to identify children with learning disabilities (LD). This study investigated the prevalence and diagnostic utility of WISC‐III Bannatyne patterns by comparing 1,302 children with LD to 2,158 children in the WISC‐III normative sample. Further analysis was conducted on a subsample of students with specific reading disabilities. Results indicated that the presence of the Bannatyne WISC‐III pattern would not lead to decisions that are useful in differentiating children with LD from children without LD. For example, receiver operating characteristic (ROC) analysis, measured by the area under the curve (AUC), indicated that the Bannatyne WISC‐III pattern exhibited low diagnostic utility (AUC = 0.54–0.55). Due to its inaccuracy, use of the Bannatyne WISC‐III pattern is not recommended.