The Impact of Focus Instructions on Balance Performance in Normal Children and those with Developmental Coordination Disorder

Document Type : Original Articles


1 PhD Student, Department of Physical Education and Sport Sciences, School of Humanities and Social Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran

2 Assistant Professor, Department of Physical Education and Sport Sciences, School of Humanities and Social Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran

3 Assistant Professor, Department of Physical Education and Sport Sciences, School of Humanities, East Tehran Branch, Islamic Azad University, Tehran, Iran



Introduction: Motor learning studies on adults have shown that directing the learners’ attention to external cues is more effectual than internal cues. In this study, we investigated if this could be applied to children with and without developmental coordination disorder.Materials and Methods: 20 men, 20 normal boy students, and 20 boy students with developmental coordination disorder were selected using motor observation questionnaire for teachers. The task was stork balance test that was measured in two experimental conditions including internal (focus on minimizing movement of the foot) and external (focus on minimizing movement of the disk) focus of attention. For data analysis, ANOVA, Tukey’s post hoc, and paired t tests were used at the significant level of P < 0.05.Results: According to constrained action hypothesis, adults performed better in condition of external focus of attention, whereas for normal children, using internal focus of attention was more useful. In children with developmental coordination disorder, no significant difference was found between the two conditions.Conclusion: According to the results of this study, therapists and coaches should adjust their rehabilitation methods and instructions based on age, experience, and developmental conditions of clients.


  1. Jarus T, Ghanouni P, Abel RL, Fomenoff SL, Lundberg J, Davidson S, et al. Effect of internal versus external focus of attention on implicit motor learning in children with developmental coordination disorder. Res Dev Disabil 2015; 37: 119-26.
  2. Rezaei S, Arabameri E, Sohrabi Sohrabi MM. Examination of the impact of an eight-week exclusive exercise on the balance of children with developmental coordination disorders. Rehabilitation Medicine 2016; 5(4): 57-64. [In Persian].
  3. Emanuel M, Jarus T, Bart O. Effect of focus of attention and age on motor acquisition, retention, and transfer: a randomized trial. Phys Ther 2008; 88(2): 251-60.
  4. Lohse KR, Sherwood DE, Healy AF. On the advantage of an external focus of attention: a benefit to learning or performance? Hum Mov Sci 2014; 33: 120-34.
  5. Pelleck V, Passmore SR. Location versus task relevance: The impact of differing internal focus of attention instructions on motor performance. Acta Psychol (Amst) 2017; 176: 23-31.
  6. Lewthwaite R, Wulf G. Optimizing motivation and attention for motor performance and learning. Curr Opin Psychol 2017; 16: 38-42.
  7. McNevin NH, Shea CH, Wulf G. Increasing the distance of an external focus of attention enhances learning. Psychol Res 2003; 67(1): 22-9.
  8. Schucker L, Fleddermann M, de Lussanet M, Elischer J, Bohmer C, Zentgraf K. Focusing attention on circular pedaling reduces movement economy in cycling. Psychology of Sport and Exercise 2016; 27: 9-17.
  9. Wulf G, McNevin NH, Fuchs T, Ritter F, Toole T. Attentional focus in complex skill learning. Res Q Exerc Sport 2000; 71(3): 229-39.
  10. Wulf G, McConnel N, Gartner M, Schwarz A. Enhancing the learning of sport skills through external-focus feedback. J Mot Behav 2002; 34(2): 171-82.
  11. Wulf G, McNevin N, Shea CH. The automaticity of complex motor skill learning as a function of attentional focus. Q J Exp Psychol A 2001; 54(4): 1143-54.
  12. Perkins-Ceccato N, Passmore SR, Lee TD. Effects of focus of attention depend on golfers' skill. J Sports Sci 2003; 21(8): 593-600.
  13. Lidor R, Singer RN. Preperformance routines in self-paced tasks: Developmental and educational considerations. In: Lidor R, Henschen KP, editors. The psychology of team sports. Morgantown, WV: Fitness Information Technology; 2003. p. 69-98.
  14. Abdollahipour R, Palomo Nieto M, Psotta R, Wulf G. External focus of attention and autonomy support have additive benefits for motor performance in children. Psychol Sport Exerc 2017; 32: 17-24.
  15. Tse ACY, van Ginneken WF. Children's conscious control propensity moderates the role of attentional focus in motor skill acquisition. Psychol Sport Exerc 2017; 31: 35-9.
  16. Salehi H, Zarezadeh M, Salek B. Validity and reliability of the Persian version of Motor Observation Questionnaire for Teachers (PMOQ-T). Iran J Psychiatry Clin Psychol 2012; 18(3): 211-9. [In Persian].
  17. Wulf G. Attentional focus effects in balance acrobats. Res Q Exerc Sport 2008; 79(3): 319-25.
  18. Browne JE, O'Hare NJ. Review of the different methods for assessing standing balance. Physiotherapy 2001; 87(9): 489-95.
  19. Watemberg N, Waiserberg N, Zuk L, Lerman-Sagie T. Developmental coordination disorder in children with attention-deficit-hyperactivity disorder and physical therapy intervention. Dev Med Child Neurol 2007; 49(12): 920-5.
  20. Wilson PH, Ruddock S, Smits-Engelsman B, Polatajko H, Blank R. Understanding performance deficits in developmental coordination disorder: a meta-analysis of recent research. Dev Med Child Neurol 2013; 55(3): 217-28.
  21. Bo J, Lee CM. Motor skill learning in children with developmental coordination disorder. Res Dev Disabil 2013; 34(6): 2047-55.
  22. Piek JP, Dyck MJ, Francis M, Conwell A. Working memory, processing speed, and set-shifting in children with developmental coordination disorder and attention-deficit-hyperactivity disorder. Dev Med Child Neurol 2007; 49(9): 678-83.
  • Receive Date: 22 August 2017
  • Revise Date: 29 September 2023
  • Accept Date: 22 May 2022
  • First Publish Date: 22 May 2022