Chapter 24-Motor Control and Motor Learning

*Motor learning: learning and refinement of motor skills over time -Takes place in a complex interaction between child and environment -Refers to the intrinsic process that accompanies a child experiencing and participating in meaningful activities and the long-lasting changes in motor performance -Based on principles of neuroplasticity

*The ways the brain can change by laying down new circuitry and making new neural connections -Occur when the brain receives new information/stimuli -In response, permanent changes happen in the brain.

-Learning requires feedback, feedforward, practice, modeling and transfer of learning.

*Motor control: the ability to regulate or direct the mechanisms essential to movement -Role of CNS, techniques to quantify movement, nature and quality of the movement -Addresses posture, mobility, and fine motor and gross motor skills; explores motor development throughout the lifespan -Supports a dynamic systems approach

*Dynamic systems theory: interplay between the neuromuscular system, the environment, cognition, and the intended task *Change in one system affects the others. *One task involves the dynamic interaction of many systems (e.g.

, visual, proprioceptive, tactile). *To engage, one must have an intent to move (guided by a cognitive process). *Change leads to neuroplasticity.

*Interventions are meaningful. -Children engage more and for longer when things are meaningful. *Interventions closely mimic occupations of childhood.

*Intervention occurs in the *setting similar to the natural *context where the *occupation takes place.

*Motor learning concepts can inform occupational therapy intervention. -Use the concepts in a meaningful, occupation-based activity within the natural context.

*Informs the learning about progress in acquiring new motor skills *Before (feedforward) and after (feedback) performance *Intrinsic (within the child) *Extrinsic (provided by an external source) *Verbal and nonverbal *Consider type, timing, motor outcomes.

*Feedforward: adjustments in anticipation of the movement required -OT may help by discussing the movement required before doing it *Feedback: adjustments based on performance -OT may help by asking the child to reflect on the movement *Intrinsic feedback: information a child received following a practice attempt (nervous system processes) *Extrinsic feedback: provided by OT, others. Helpful in identifying errors in movement

*May be provided in various ways: -Concurrent: during the movement -Immediate: just following -Terminal: right at the completion -Delayed: after the movement has been completed and a time interval has transpired *Sporadic (following some but not every trial) feedback was found to be more beneficial. *Children respond to consistent extrinsic feedback at the beginning of a new skill, and then internalize it after practice.

*Providing visual information about how to perform a skill or task -Most effective when presented in natural context *Demonstrations are best if provided: -Before practicing skill and in early stages of learning -Slowly, without verbal feedback -After emphasizing critical cues -Throughout practice as frequently as is helpful

*Can be used to teach children and youth motor skill -Practice is typically preceded or accompanied by verbal instruction or cues. ~Brief, 1-3 words -Once the child completes key components, the OT may provide additional verbal instruction to refine movement. -Providing repetitive practice with the same verbal instruction reinforces learning

*Knowledge of results (KR) -Information provided from external source about the outcome or end result -Helps children retain newly learned motor skills *Knowledge of performance -Providing information about the nature or characteristic of the movement -Helps children understand how they could adjust or change movements

*Repetition of motor tasks enhances brain development.

*Blocked practice: repeating the similar movements with short rest breaks *Distributed: repetition of different skills spread over the course of the intervention with rest breaks *Variable/random: practice of many different skills with periods of rest

*Applying past learning to new situations -Works best when client has opportunity for mastery of foundational skills first -Then you incorporate different skills.

*Motor memory includes registration of the influence and the internal feedback from the motor output back into the sensory system. -After this link is when learning occurs. -Motor control is best addressed by engaging the child in meaningful activities that closely mimic occupations of childhood and occur in natural context.

*Joints vary in the amount of movement allowed, may be difficult for a child to control the movements -For fine motor tasks, a child must control the shoulder, wrist, elbow, and hand joints. ~To increase control, the degrees of freedom can be limited by holding or stabilizing the joint

*Coordination: activation of specific muscles together -May be addressed by beginning with gross movements and progressing to more precise movements during intervention -Also by encouraging postural stability during tasks *Timing may be promoted by including music, rhythmic songs, or counting.

*Strength: ability to contact a muscle or muscle group against gravity and resistance -Children with motor deficits may have decreased strength and endurance, impacting occupational participation. *Muscle tone: amount of tension in resting muscle or muscle group -Discrepancies interfere with occupations. -OT may focus on helping the child engage, allow him or her to refine motor skills