Obstacle negotiation while dual-tasking in children with Developmental Coordination Disorder (DCD) : An augmented-reality approach

Background
Children with Developmental Coordination Disorder (DCD) exhibit deficits in predictive motor control, balance, and aspects of cognitive control, which are important for safely negotiating obstacles while walking. As concurrent performance of cognitive and motor tasks (dual-tasking) may exacerbate these deficits, we examined motor and cognitive dual-tasking differences between children with DCD and their typically developing (TD) peers during obstacle negotiation.

Methods
34 children aged 6–12 years (16 TD, 18 DCD) walked along a 12 m path, stepping over an obstacle (30 % or 50 % of leg length) at its mid-point. On dual-task trials, participants completed a simple or complex (cognitive) visual discrimination task presented via an augmented reality headset. Proportional dual-task costs (pDTCs) were measured on cognitive and gait outcomes over three phases: pre-obstacle, obstacle step-over, and post-obstacle.

Results
During the obstacle step-over phase, both groups increased their leading leg clearance when dual-tasking, while the DCD group had larger pDTC than TD for the high obstacle under simple stimulus conditions (viz simple-high combination). The complex cognitive task produced larger pDTCs than the simple one on leading leg clearance and post-obstacle gait variability.

Conclusions
In general, both DCD and TD groups showed similar pDTCs under complex conditions, while the specific deficit in DCD under the simple-high combination suggests a (default) compensatory strategy during step-over when attention is diverted to a secondary task. Competing cognitive and motor demands during obstacle negotiation present a potential safety risk for children.