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A MECHANISTIC APPROACH TO POSTURAL DEVELOPMENT IN CHILDREN
Clark, Jane E
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Upright standing is intrinsically unstable and requires active control. The central nervous system's feedback process is the active control that integrates multi-sensory information to generate appropriate motor commands to control the plant (the body with its musculotendon actuators). Maintaining standing balance is not trivial for a developing child because the feedback and the plant are both developing and the sensory inputs used for feedback are continually changing. Knowledge gaps exist in characterizing the critical ability of adaptive multi-sensory reweighting for standing balance control in children. Furthermore, the separate contributions of the plant and feedback and their relationship are poorly understood in children, especially when considering that the body is multi-jointed and feedback is multi-sensory. The purposes of this dissertation are to use a mechanistic approach to study multi-sensory abilities of typically developing (TD) children and children with Developmental Coordination Disorder (DCD). The specific aims are: 1) to characterize postural control under different multi-sensory conditions in TD children and children with DCD; 2) to characterize the development of adaptive multi-sensory reweighting in TD children and children with DCD; and, 3) to identify the plant and feedback for postural control in TD children and how they change in response to visual reweighting. In the first experiment (Aim 1), TD children, adults, and 7-year-old children with DCD are tested under four sensory conditions (no touch/no vision, with touch/no vision, no touch/with vision, and with touch/with vision). We found that touch robustly attenuated standing sway in all age groups. Children with DCD used touch less effectively than their TD peers and they also benefited from using vision to reduce sway. In the second experiment (Aim 2), TD children (4- to 10-year-old) and children with DCD (6- to 11-year-old) were presented with simultaneous small-amplitude touch bar and visual scene movement at 0.28 and 0.2 Hz, respectively, within five conditions that independently varied the amplitude of the stimuli. We found that TD children can reweight to both touch and vision from 4 years on and the amount of reweighting increased with age. However, multi-sensory fusion (i.e., inter-modal reweighting) was only observed in the older children. Children with DCD reweight to both touch and vision at a later age (10.8 years) than their TD peers. Even older children with DCD do not show advanced multisensory fusion. Two signature deficits of multisensory reweighting are a weak vision reweighting and a general phase lag to both sensory modalities. The final aim involves closed-loop system identification of the plant and feedback using electromyography (EMG) and kinematic responses to a high- or low-amplitude visual perturbation and two mechanical perturbations in children ages six and ten years and adults. We found that the plant is different between children and adults. Children demonstrate a smaller phase difference between trunk and leg than adults at higher frequencies. Feedback in children is qualitatively similar to adults. Quantitatively, children show less phase advance at the peak of the feedback curve which may be due to a longer time delay. Under the high and low visual amplitude conditions, children show less gain change (interpreted as reweighting) than adults in the kinematic and EMG responses. The observed kinematic and EMG reweighting are mainly due to the different use of visual information by the central nervous system as measured by the open-loop mapping from visual scene angle to EMG activity. The plant and the feedback do not contribute to reweighting.