Grant: Foundation Grant

Brain Imaging; Children; Cognitive Orientation To Occupational Performance (Co-Op); Developmental Coordination Disorder; Functional Outcomes; Intervention; Motor Development; Neuroplasticity; Prematurity; Rehabilitation

<html> <body> <p>My research career emerged from 20 years' work as an occupational therapist helping children to adapt to developmental challenges. Some children had difficulties with activities like tying shoes, printing or playing games. Each class usually had at least one such child, who was often described by teachers as lazy or unmotivated. Typically, these children were misunderstood and they received no assistance. We now know that these children have a common but under-recognized condition called developmental coordination disorder (DCD). DCD affects 5-6% of people; at any one time, this is &gt;400,000 children in Canada. It occurs in ~50% of children born preterm, but also in those born at term. Children with DCD struggle to learn motor skills for everyday activities, and have a high risk for lifelong health and psycho&shy;social problems. The cause of DCD is unknown, and it is still under-diagnosed and under-treated.</p> <p>My goal is to advance understanding of DCD and improve outcomes for affected children. As a clinician scientist with expertise in rehabilitation and developmental neuroscience, I use magnetic resonance (MR) imaging to identify clinical risk factors, brain biomarkers and motor patterns that we can use to predict and treat DCD. I created Canada's first research-integrated DCD Clinic.<br> </p> <p>In the next 5 years, I plan parallel studies in 4 cohorts (A-D):<br> <strong>A:</strong> Trajectories cohort, 200 preterm infants; MRI at birth/term-equivalent age; clinical data and follow-up to age 8y.<br> <strong>B:</strong> Neonatal Follow-up Program cohort, ~300 preterm infants; clinical data and motor skills to age 4.5y<br> <strong>C:</strong> DCD Clinic/community cohort, 90 children (preterm/term) with/without DCD<br> <strong>D:</strong> DCD Clinic cohort, children with DCD (preterm and term), ongoing</p> <p> <strong>Study 1</strong> (Cohort A): Compare brain development in preterm children at age 8y to determine effect of preterm birth on DCD, and if early brain development is predictive.<br> <strong>Study 2</strong> (Cohort B): Compare development of motor skills in preterm children with/without DCD to determine effect of preterm birth on DCD and if early motor skills are predictive.<br> <strong>Study 3</strong> (Cohorts A, C): Compare MR images to define neural correlates of DCD in preterm and term-born children and perform an RCT to determine effects of a rehabilitation intervention to improve brain/motor development<br> <strong>Study 4</strong> (Cohort D): Undertake exploratory studies to assess effects on psychosocial well-being and quality of life of children with DCD and their families (cohort D)</p> <p>These studies build on my research to date and leverage the unique resources to which I have access: my DCD clinic, the Trajectories cohort, the Neonatal Follow-Up Program, and the Child &amp; Family Research Imaging Facility. I have collaborators who are experts in developmental pediatrics, pediatric neurology, neonatalogy, psychology, occupational therapy and statistics/RCT design. My program draws trainees from many disciplines; they learn advanced neuroimaging techniques, clinical research design, ethics and knowledge translation. They benefit from the rich training environment of the Child &amp; Family Research Institute.</p> <p>Our discoveries may inform avenues for prevention of DCD in high-risk infants and initiation of early rehabilitation. These studies also provide a foundation for studies that integrate neuroimaging and rehabilitation to improve outcomes of children with other neurodevelopmental disabilities. As a clinician who sees children with DCD, I am well-placed to ensure my findings inform clinical practice.</p> </body> </html>