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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 54  |  Issue : 1  |  Page : 10-13

Motor proficiency of children with developmental speech and language disorder and typically developing children aged 4–7 years: A comparative cross-sectional study


1 Occupational Therapist, Civil Hospital, Nashik, Maharashtra, India
2 O.T School and Centre, T. N. Medical College and B.Y.L. Nair Ch. Hospital, Mumbai, Maharashtra, India

Date of Submission02-Jul-2020
Date of Decision18-Sep-2020
Date of Acceptance01-Mar-2022
Date of Web Publication25-Mar-2022

Correspondence Address:
Pratibha Milind Vaidya
O.T School and Centre, T.N.M.C and B.Y.L. Nair Ch. Hospital, Mumbai Central, Mumbai-08, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijoth.ijoth_23_20

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  Abstract 


Background: Developmental speech and language disorder (DSLD) is characterized by delay in speech and language development in the absence of mental or physical handicap, hearing loss, emotional disorder, or environmental deprivation. Many nonlinguistic factors contribute to the expression of DSLD, one of them is motor proficiency. Some problems with motor proficiency were observed in children with DSLD when they were compared with typically developing children (TDC). Objective: The objective of the study was to assess the performance of DSLD children for motor proficiency using the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2) and compare it with TDC. Study Design: A comparative, noninterventional, cross-sectional study. Methods: The study included 30 children with DSLD and 30 TDC aged 4–7 years. The study protocol was approved by the Institute Ethical Committee (ECARP/2017/21). A written informed consent form was signed by parents. All composites of BOT-2 were administered on both groups (fine manual control, manual coordination, body coordination, strength and agility). Scores obtained were compared between two groups for total motor composite as well as each subtest. Results: There was a significant difference between the performance of DSLD children and TDC on all the four composites, namely Fine Manual Control, Manual Coordination, Body Coordination, and Strength and Agility of BOT-2. Total motor composite score of DSLD children was significantly different from the scores of TDC at P = 0.000. Conclusion: Motor proficiency is significantly affected in children with DSLD as compared to TDC.

Keywords: Bruininks-Oseretsky Test Of Motor Proficiency Second Edition, Developmental Speech And Language Disorder, Motor Proficiency, Motor Skills, Typically Developing Children


How to cite this article:
Prajapati R, Vaidya PM. Motor proficiency of children with developmental speech and language disorder and typically developing children aged 4–7 years: A comparative cross-sectional study. Indian J Occup Ther 2022;54:10-3

How to cite this URL:
Prajapati R, Vaidya PM. Motor proficiency of children with developmental speech and language disorder and typically developing children aged 4–7 years: A comparative cross-sectional study. Indian J Occup Ther [serial online] 2022 [cited 2022 Aug 11];54:10-3. Available from: http://www.ijotonweb.org/text.asp?2022/54/1/10/340894




  Introduction Top


Developmental speech and language disorder (DSLD) is characterized by delay in speech and language development in the absence of mental or physical handicap, hearing loss, emotional disorder, or environmental deprivation.[1] Few children diagnosed with DSLD show speech as well as language disorder, others may have pure speech or pure language disorder.

Moving and talking are two different skills, but both the skills are interrelated. Many research shows clear relationship between learning to move and learning to talk as neural anatomical structures for language and movement overlaps. Motor acquisition provides the infant with an opportunity to practice skills relevant to language development or acquisition.[2] Learning new motor skills helps in development of communicative skills and language acquisition. Motor and cognitive development are interrelated and in many conditions (developmental disorders) both motor and cognitive functions are affected.[3]

Many nonlinguistic factors contribute to the expression of DSLD, one of these is motor proficiency. Motor proficiency is the ability to perform complex muscle and nerve acts that produce movement. Motor proficiency is a function which involves the precise movement of muscle. Acquiring motor proficiency or motor skill is one of the important parts of child's development. Good motor control helps a child to explore their environment or world around them. Motor proficiency is affected in many conditions such as Learning Disability, Developmental Coordination Disorder, Dyspraxia, and Attention Deficit Hyperactive Disorder.

There has been association of motor problem with DSLD, which has been proved in some researche. Owen and McKinlay, in 1997, had shown the association between the performance of motor (hand) skill problems in children with DSLD.[4]

As typically developing children (TDC) grow older, their motor skill performance improves owing to the maturation, experience, and age. However, the development of motor skills in children with DSLD may progress more slowly and differently. Hence, far little is known about actual progression of motor skills in this population. Hence, in this study, we assessed motor proficiency of children having DSLD and compared it with TDC.


  Methods Top


A noninterventional, cross-sectional, comparative study was conducted. The study protocol was approved by the Institute Ethical Committee on 31/03/2017 (ECARP/2017/21). A written informed consent form was signed by parents of the children recruited in the study and assent form was read to children.

Parents and children were explained about the details of the study and were assured about confidentiality. The study included 30 children with DSLD and 30 TDC. Children of both the gender with normal Intelligence Quotient (IQ) aged 4–7 years were recruited in the study. Children with frank neurological deficits, physical impairment, hearing loss, or with any other comorbid conditions were excluded from the study. Duration of the study was 18 months (From April 2017 to September 2018).

Assessment

Bruininks-Oseretsky Test of Motor Proficiency Second Edition

Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2) is an individually administered test to assess motor functioning in individuals aged between 4 and 21 years 11 months. The complete test battery has eight subtests: fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running speed and agility, upper limb coordination, and strength which are organized in the form of four motor development composites: fine manual control, manual coordination, body coordination, and strength and agility. These eight subtests are comprised 53 separate items with subtest-specific scores for each item and provide a comprehensive index of both gross motor and fine motor skills. BOT-2 can be administered with separate components also.[5]

Procedure

The study sample recruited in this study is according to nonprobability convenient sampling. The study included two groups: thirty children with DSLD and 30 TDC. Parents were requested to fill the case record form which included demographic and medical records of the child to rule out any other complications. Children of both groups were evaluated for motor proficiency using BOT-2 and scores were recorded on score sheets. Children of both groups were graded for total of eight subtests, i.e., fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running speed and agility, upper limb coordination, and strength. Scores obtained on individual test (raw score) were recorded in record form. Raw score conversion into total point score, scale score, and standard score was calculated by referring appropriate tables provided in BOT-2 manual. For interpretation, descriptive categories corresponding to scale score, standard score, percentile ranks, and standard deviation from mean were noted.[5] Score obtained were compared for each subtest as well as for the total score.

Data Analysis

An analysis of data was conducted using SPSS Version 16.0 (SPSS Inc.2007., Chicago ).[6] The Chi-square test was used to compare the demographic data of two groups and Mann–Whitney U-test was used to compare the mean scores of BOT-2 between the groups. Alpha level was set at P < 0.05 at the outset of the study.


  Results Top


The total sample for the study analyzed was 60 children: thirty with DSLD (Male: 21, Female: 09) and 30 TDC (Male: 18, Female: 12). The difference between ages was statistically not significant between the two groups [Table 1]. Similarly, comparing gender distribution in both the groups was also not significant (P > 0.05) since the difference between mean age and sex was not significant; it indicates that the age-wise and sex-wise distribution between the two groups was homogeneous.
Table 1: Distribution of Age in Children with Developmental Speech and Language Disorder and Typically Developing Children Group

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There was a significant difference in the performance of children with DSLD and TDC for all four components and total motor composite component of BOT-2 (P < 0.05) confidence interval range for Total Motor Composite DSLD/TDS (39.17 ± 3.09, 55.57 ± 10.72) [Table 2].
Table 2: Comparison of Performance of Children with Developmental Speech and Language Disorder and Typically Developing Children on Total Motor Composite Component of Bruininks-Oseretsky Test of Motor Proficiency Second Edition

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[Figure 1] shows that larger value of fine manual control concentrated in the TDC group as compared to the DSLD group. [Figure 2] shows that larger value of manual coordination concentrated in the TDC group as compared to the DSLD group. [Figure 3] shows that larger value of body coordination concentrated in the TDC group as compared to the DSLD group. [Figure 4] shows that larger value of strength and agility is concentrated in the TDC group as compared to the DSLD group.
Figure 1: Comparison Of Fine Manual Control Median Score Between Developmental Speech and Language Disorder and Typically Developing Children Group

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Figure 2: Comparison of Manual Coordination Median Score Between Developmental Speech and Language Disorder and Typically Developing Children Group

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Figure 3: Comparison of Body Coordination Median Score Between Developmental Speech and Language Disorder and Typically Developing Children Group

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Figure 4: Comparison of Strength and Agility Median Score Between Developmental Speech and Language Disorder and Typically Developing Children Group

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  Discussion Top


DSLD is a condition where many children may have speech as well as language problems or some may have pure speech disorder. Hence, studies have been done with more attention given toward communication in these children. There is a possibility of the presence of motor problem in children with DSLD. This can be explained by the presence of genetic risk or neurologic deficit in DSLD. As per the neuropsychiatric perspective, the cooccurrence of language and motor problems may be explained by spatial similarity, i.e., the same brain structure is used for motor and cognitive domain. Abnormalities in basal ganglia and cerebellum cause motor as well as language problems.[7] There are very few studies which concentrated on fine motor task. Hence, our study has made an effort to see whether motor proficiency is affected in DSLD.

Children from both the groups were evaluated using Bruininks- Oseretsky Test of Motor Proficiency Second Edition (BOT-2) to find out the level of motor proficiency. Comparison of performance of children with DSLD and TDC was done separately for fine manual control, manual coordination, body coordination, strength and agility, and total motor composite of BOT-2.

The performance of children with DSLD was significantly slower than TDC with task involving fine coordination such as filling color in small shapes (circle and star), drawing a line through curved and crooked path, cutting out a circle, and copying shapes.

In manual coordination component of BOT-2, the performance of both the group was tested for manual dexterity skills and upper limb coordination. The performance of the DSLD group was significantly affected than that of the TDC group (P < 0.05) [Table 2] and [Figure 4]. In this study, the overall performance of the DSLD group for upper limb coordination was observed to be better than manual dexterity which may be related to the fact that tasks involved in manual dexterity component were timed tasks. Similar findings were noted in the study done by Visscher et al. in the task involving manual dexterity skill, ball skill, and balance skill.[1] Whereas study done by Zelaznik and Goffman showed that timed task in the manual domain were found to be equivalent to TDC when compared with specific language impairment.[8]

Body coordination component consists of bilateral coordination and balance subcomponent. Overall performance of the DSLD group for these subtests was significantly affected than that of the TDC group (P < 0.05) [Table 2] and [Figure 3]. It was observed that children with DSLD performed better with the task involving balance than bilateral coordination

The overall motor performance, i.e., total motor composite was affected in children with DSLD [Table 2]. Similar findings were found by Webster et al. in 2005.[9]

Maturation of the nervous system is responsible for neural control of muscle in children and myelination of motor nerves expresses muscle strength in human being. However, the process of myelination gets completed when a person achieves sexual maturity. Speech and language delay may reflect motor immaturity in children rather than specific disorder.[10] The overall gross motor skill in children with DSLD might be related to delayed development of motor control mechanism.[9]

Thus, our study showed that motor proficiency is comparatively lower in children with DSLD than TDC. Moreover, it satisfies the alternative hypothesis that motor proficiency is affected in children with DSLD.

Recommendations

  1. Comparative study between female and male gender as well as separately for speech and language or only language affectation in DSLD can be recommended
  2. A study may be planned to see the effect of intervention on motor proficiency in children with DSLD.



  Conclusion Top


Motor proficiency was significantly affected for all the components of fine manual control, manual coordination, body coordination, and strength and agility in children with DSLD as compared to TDC. Children with DSLD performed better in the upper limb coordination involving activities such as ball dropping and catching, ball dribbling, and throwing a ball at target. They had difficulty in activities requiring fine manual coordination, manual dexterity, and bilateral coordination. These results were suggestive of motor problems in DSLD children.

Acknowledgement

We would like to express our sincere gratitude to Dr Ramesh Bharmal, Dean, TNMC for his support during the study and to all the participants of the study for their cooperation.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.



 
  References Top

1.
Visscher C, Houwen S, Moolenaar B, Lyons J, Scherder EJ, Hartman E. Motor proficiency of 6- to 9-year-old children with speech and language problems. Dev Med Child Neurol 2010;52:e254-e258.  Back to cited text no. 1
    
2.
Iverson JM. Developing language in a developing body: The relationship between motor development and language development. J Child Lang 2010;37:229-261.  Back to cited text no. 2
    
3.
Diamond A. Close interrelation of motor development and cognitive development and of the cerebellum and prefrontal cortex. Child Dev 2000;71:44-56.  Back to cited text no. 3
    
4.
Owen SE, McKinlay IA. Motor difficulties in children with developmental disorders of speech and language. Child Care Health Dev 1997;23:315-325.  Back to cited text no. 4
    
5.
Deitz JC, Kartin D, Kopp K. Review of the Bruininks-Oseretsky test of motor proficiency, second edition (BOT-2). Phys Occup Ther Pediatr 2007;27:87-102.  Back to cited text no. 5
    
6.
SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. Chicago, SPSS Inc.;2007.  Back to cited text no. 6
    
7.
Booth JR, Wood L, Lu D, Houk JC, Bitan T. The role of the basal ganglia and cerebellum in language processing. Brain Res 2007;1133:136-144.  Back to cited text no. 7
    
8.
Zelaznik HN, Goffman L. Generalized motor abilities and timing behavior in children with specific language impairment. J Speech Lang Hear Res 2010;53:383-393.  Back to cited text no. 8
    
9.
Webster RI, Majnemer A, Platt RW, Shevell MI. Motor function at school age in children with a preschool diagnosis of developmental language impairment. J Pediatr 2005;146:80-85.  Back to cited text no. 9
    
10.
Müürsepp I, Ereline J, Gapeyeva H, Pääsuke M. Motor performance in 5-year-old preschool children with developmental speech and language disorders. Acta Paediatr 2009;98:1334-1338.  Back to cited text no. 10
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2]



 

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