Occupational Therapy ETDs

Publication Date



Purpose. Augmented feedback is an important variable influencing motor learning. Previous studies show reduced feedback frequency benefits motor learning in young adults more than a comparison group of children, who benefit from frequent feedback during practice. It is unclear how motor and central nervous system differences in children with cerebral palsy may impact their use of feedback in motor skill acquisition. This study investigated the effect of augmented visual feedback (FB) on performance and learning of an upper extremity motor skill in children with spastic hemiplegic cerebral palsy (SHCP) as they practiced with their less affected arm, compared to typically developing children (TDC). Methods. Participants were 8-17 years with academic performance within two grade levels. Both TDC (n = 20) and participants with SHCP (n = 19) were screened for visual perception (MVPT-3) and manual dexterity (Box and Block). Children were divided into groups receiving frequent FB (100%) or faded FB (62%). Group differences for acquisition, retention, and reacquisition were compared in relation to FB level. Results. Both groups of children used visual FB to improve motor performance during skill practice. All children receiving 62% FB performed with greater error than children receiving 100% FB during the acquisition phase (p =.012), delayed retention no-feedback test (p =.017), and reacquisition phase (p =.042). Children with SHCP in both FB groups performed with significantly greater error than TDC during the entire acquisition phase (p < .001), delayed retention no-feedback test (p = .031) and reacquisition phase (p = .001). While no significant within group feedback effect was found for children with SHCP, there was a trend for greater accuracy in the 100% group as compared to the 62% group during acquisition (p =.092) and this trend was seen again during reacquisition when FB was reintroduced (p =.092). Conclusions. Results suggest that for children with SHCP skill acquisition is furthered by visual FB regarding their movement accuracy. Children with SHCP use visual FB in a manner similar to TDC, although differences in learning were evident during the acquisition, delayed retention, and reacquisition phases. Further investigation is needed to determine clinical implications.

Degree Name

Occupational Therapy

Level of Degree


Department Name

Occupational Therapy Graduate Program

First Advisor

Burtner, Patricia A.

First Committee Member (Chair)

Kantak, Shailesh S.

Second Committee Member

Poole, Janet

Third Committee Member

Rhee, Vera




Cerebral palsied children--Rehabilitation, Hemiplegia, Motor learning, Movement education, Feedback (Psychology), Sensory reinforcement.

Document Type