Body representation plasticity in typical and atypical motor development – BODYS

Developmental coordination disorder (DCD), commonly known as dyspraxia, is a major developmental disorder that impacts the autonomy of 5% of the population in several daily life activity and education. While historically attributed to problems of motor control and coordination, recent evidence points to the presence of Body Representation (BR) deficits in DCD, which may subsequently impact motor control. Accessing reliable and refined BR is indeed critical to plan and execute movements efficiently. Yet, our understanding of how BR develop in typical and DCD children remain very poor. Despite its relevance for action control, the development of body representation in children with dyspraxia remains indeed unexplored (INSERM, 2019). Here, we set the project for filling this gap by addressing two main aims: 1) to identify cognitive and cerebral factors of BR and its plasticity in neurotypical participants and 2) to assess if children with DCD have a fuzzier and less plastic BR, to ultimately propose preventive soft educational interventions.

The question of the development of BR will be explored at several levels, from the behavioral, to the cerebral and the social one, which will be tackled directly in the classroom. In addition, the plasticity of BR will also be assessed, at different temporal scales (hours, months, years). To identify the clinical and developmental characteristics of DCD children, the project is structured on a comparative population approach (with dyspraxia vs. neurotypical, children vs. adults) and leverages behavioral tasks implicating the representation of the body (tactile, proprioceptive and motor acuity) and its plasticity (as induced by the use of tools). Most notably, our stance includes functional neuroimaging to relate brain structure activity to function. We anticipate that altered BR, as witnessed at behavioral level, will be reflected at cerebral level. Comparative fMRI studies will reveal whether cortical somatotopy, notably the specialization of motor and somatosensory brain regions for each body part, is less precise in DCD children. To identify brain mechanism causally linked to this fuzziness, we will test whether lateral inhibition between body parts is impaired using a suppression index derived from electroencephalographic recording (EEG) of somatosensory evoked potentials. Coupled with state-of-art analytical tools, this will allow us to identify the physiopathological mechanisms underlying DCD, thus providing groundbreaking insights for its theoretical understanding and opening new avenues for societally affordable, efficient treatments.

Far from being promissory statements, our project includes the application of two pedagogical modules for training BR (‘ENCOR’) and their plasticity (‘MATOO’), with a preventive aim regarding DCD and an early beneficial improvement for all preschool children. These modules are co-constructed by teachers, educational advisors, researchers, psychomotor, occupational therapists and didactic designers. They will be delivered by preschool teachers and their effectiveness will be compared with usual classroom practices. We expect not only BR improvements, but also transfer to cognitive and academic skills to emerge.

This project represents a multiscale interdisciplinary breakthrough for the theoretical, clinical and educational domains of DCD. It holds the potential to generate unprecedented data linking cerebral and behavioral levels of BR during typical and atypical development. The preventive, soft educational intervention additionally bears interests for reducing the societal burden and costs for the nation, as it will help keeping expensive individualized services (e.g., occupational therapist) dedicated to children resisting 1st-level intervention. This project answers the priority for our society to better understand the pathophysiological mechanisms underlying sensorimotor problems and to help those who suffer from this condition.