Jill Zwicker

Professor

Research Interests

Brain development
developmental coordination disorder
Infant / Child Development
Learning Disorders in Children
Motor System
neuroplasticity
Prematurity
rehabilitation

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ADVICE AND INSIGHTS FROM UBC FACULTY ON REACHING OUT TO SUPERVISORS

These videos contain some general advice from faculty across UBC on finding and reaching out to a potential thesis supervisor.

Great Supervisor Week Mentions

Each year graduate students are encouraged to give kudos to their supervisors through social media and our website as part of #GreatSupervisorWeek. Below are students who mentioned this supervisor since the initiative was started in 2017.

 

We are so privileged to have a #GreatSupervisor who is knowledgeable, patient and a great clinician-scientist. Not only is @jillzwicker our mentor in research, but also incredibly supportive outside of the lab. From all of us at Zwicker Lab. #SupervisorAppreciationWeek @ubcgss

 

Graduate Student Supervision

Doctoral Student Supervision

Dissertations completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest dissertations.

Cognitive Orientation to Occupational Performance: effect on brain structure/function and motor outcomes in children with developmental coordination disorder (2021)

Children with developmental coordination disorder (DCD) have difficulty learning motor skills, which can affect their participation in activities of daily living and psychosocial well-being. Over 50% of children with DCD also have attention deficit hyperactivity disorder (ADHD), which further exacerbates their motor function and quality of life. Cognitive Orientation to Occupational Performance (CO-OP), a rehabilitation approach developed for children with DCD, uses problem-solving strategies to help children learn motor skills they wish to achieve. While this approach has been effective for children with DCD, few studies have examined its effectiveness for children with co-occurring ADHD. Further, the underlying mechanisms of this intervention are unknown. In this randomized waitlist-controlled trial (ClinicalTrials.gov ID: NCT02597751), I used MRI and motor outcome measures to determine whether CO-OP intervention: (1) was effective in improving motor goals in children with DCD +/- ADHD; (2) induced changes in functional connectivity of the brain; and (3) promoted positive neuroplastic changes in white matter microstructure. Thirty-seven children with DCD and 41 children with DCD+ADHD, aged 8-12 years old, were randomized to treatment or waitlist groups at their first MRI. The treatment group began the intervention after their MRI scan and pre-assessment, and returned for a post-treatment assessment/scan at 3 months, and a follow-up scan at 6 months; the waitlist group waited 3 months before their second MRI, received intervention, and then had a post-treatment assessment and MRI scan.Results showed that CO-OP is effective for children with DCD +/- ADHD, in achieving functional motor goals. Neuroimaging results showed improved functional connectivity within the default mode network (DMN) as well as improved microstructural properties in the white matter underlying the DMN in children with DCD only. However, there was a lack of transfer to other motor skills and brain changes in children with DCD+ADHD.Given the role of the DMN in self-regulation, emotion regulation, and attention regulation and in accordance with cognitive models of motor learning, I suggest that these cognitive processes may underlie motor skills improvement after CO-OP in children with DCD. Modifications to the CO-OP protocol may be required to induce similar brain changes in children with DCD+ADHD.

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From mice to children: investigating involvement of the cerebellum in developmental coordination disorder and cerebellar changes with rehabilitation (2021)

Developmental coordination disorder (DCD) significantly impairs a child’s ability to learn motor skills and to perform everyday activities. The cause of DCD is unknown; however, evidence suggests that the cerebellum may be involved. To date, no studies have specifically examined cerebellar structure in this population. Thus, this dissertation aims to address this gap by focusing on cerebellar involvement in DCD over three studies. First, I used a mouse model as proof of principle to establish the role of the cerebellum in DCD-like motor impairments. Next, I explored structural differences in the cerebellum in children with DCD compared to typically developing children. I then investigated changes in cerebellar structure in children with DCD before and after 10 weeks of rehabilitation intervention known as Cognitive Orientation to daily Occupational Performance (CO-OP). This is one of the most effective treatments for children with DCD, but the neural mechanisms underlying this approach are largely unknown. The first study revealed that mice with smaller cerebellar volume had impairments in fine and/or gross motor coordination and motor learning. The second study showed that, compared to typically developing children, children with DCD showed less grey matter volume in affective (right VIIb lobule), cognitive (right/left crus I, right crus II), and motor regions (left VI and right VIIIa lobules) of the cerebellum. Lower grey matter volume was correlated to lower motor abilities. After CO-OP intervention, grey matter volume increased in the brainstem as well as in cognitive (right crus II) and motor (right and left lobule VIIIb and lobule IX) regions of the cerebellum Additionally, improvements in movement quality, measured by the Performance Quality Rating Scale, predicted increases in grey matter volume in the right crus II, right lobule VIIb, and right and left lobule VIIIb, and vermis IX. These are the first studies to use a mouse model of DCD and to confirm that cerebellar volume differs in children with DCD. More importantly, results also showed that CO-OP increased cerebellar grey matter volume, which was associated with improved movement quality. These novel findings contribute to our understanding of DCD and provide neuroscientific evidence for the CO-OP approach.

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Master's Student Supervision

Theses completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest theses.

Investigating grey matter volume in children with developmental coordination disorder before and after rehabilitation intervention (2021)

Developmental Coordination Disorder (DCD) is neurodevelopmental disorder that affects a child's ability to learn and perform motor skills which significantly interferes with their activities of daily living. Currently only one study has identified volume-based brain differences in children with DCD compared to typically developing (TD) children. Furthermore, no study has yet determined if occupational therapy intervention induces a change in grey matter volume in this population. The objectives for this study were to: (1) compare grey matter volume in children with DCD and TD children; (2) examine the relationship of grey matter volume to motor function and attentional performance; and (3) examine neuroplastic changes in grey matter volume in children with DCD following Cognitive Orientation to Occupational Performance intervention. Objectives 1 and 2 were addressed using 30 DCD and 12 TD MRI scans for cross-sectional voxel-based morphometry with a one-way Analysis of Variance (ANOVA) design. Objective 3 was addressed using 20 MRI scans for pre-post longitudinal voxel-based morphometry with a Repeated Measures ANOVA design. Regression analyses were used to examine the relationship between grey matter volume, motor function, and attentional performance. The baseline results revealed that children with DCD had greater grey matter volume in the left superior frontal gyrus (working memory). Poorer motor function was associated with greater grey matter volume in the right middle frontal gyrus, left frontal pole, and superior frontal gyrus. Greater grey matter volume in parietal regions (left precuneus, left superior parietal lobe) was associated with poorer attentional performance. After intervention, grey matter volume decreased in right-sided regions associated with self-regulation (posterior cingulate gyrus), voluntary thinking, cognitive and motor connections (middle cingulate) and executive functioning (superior frontal gyrus). This study suggests that children with DCD may have altered brain development and that CO-OP intervention may facilitate brain maturation in targeted regions.

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Navigating the healthcare and school systems when your child has developmental coordination disorder (2021)

Developmental coordination disorder is a common neurodevelopmental disorder that is under-recognized, under-diagnosed, and under-treated. No standard of care exists in British Columbia to assist families to access diagnostic and rehabilitative services and supports. To affect change, it is imperative to understand parent perspectives on needed resources to access diagnosis and treatment. A cross-sectional study using the impACT for DCD questionnaire explored barriers and facilitators families encounter when navigating school and healthcare systems in British Columbia. This study aimed to understand parent perspectives and priorities regarding needed resources and programs. Descriptive data analysis for close-ended questions was used to understand data trends. Inferential statistics were utilized to understand differences between variables. Content analysis was used to explore emergent themes from open-ended questions. Families identified barriers to access a timely diagnosis, which included their own limited awareness and poor understanding from healthcare professionals and educators. Long waitlists for publicly funded assessments and inconsistent access to school-funded clinical evaluations possibly led families to seek private testing. A lack of dedicated funding for treatment, coupled with inconsistent access to school-based therapy, likely contributed to obtaining private treatment for families who had the resources to pursue this option. There was a decline in active therapy with age, with younger children more likely to receive therapy. Changing priorities of social and emotional function for older children, in conjunction with increasing financial burden, likely led to this decline in therapy use. Parents reported that inconsistent access to classroom supports may have contributed to social and emotional challenges for their children. Families identified the need for funded diagnostic services, coupled with education for healthcare professionals, educators, and the community. Collaborative partnerships between physicians, therapists, and educators are integral for early detection. Children with DCD require funded, multidisciplinary treatment that addresses physical, social, and emotional function. At school, children with DCD need classroom supports, to enable successful participation in the curriculum. Regrettably, all children in this study presented with social and emotional challenges, suggesting that the current service model in British Columbia is not meeting their needs, necessitating policy changes to increase supports and services for children with DCD.

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Functional connectivity in children with Developmental Coordination Disorder: an exploratory study (2019)

Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder that affects a child’s ability to learn motor skills and participate in self-care, educational, and leisure activities. The cause of DCD is unknown, but evidence suggests that children with DCD have atypical brain structure and function. Resting-state MRI assesses functional connectivity by identifying brain regions that have correlated activation during rest. As only a few studies have examined functional connectivity in this population, our objective was to compare whole-brain resting-state functional connectivity of children with DCD and typically-developing children, and examine the correlation of functional connectivity with behavioural measures of motor function and ADHD symptoms. Children 8-12 years old were classified as DCD if they scored ≤16th percentile on the Movement Assessment Battery for Children - 2nd edition (MABC-2) and scored in the suspected or indicative range on the DCD Questionnaire (N=35). The control group included children with a score ≥25th percentile on the MABC-2 (N=23). Children were excluded if they were born preterm (
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Characterizing the neural correlates of children with developmental coordination disorder using diffusion tensor imaging (2017)

Developmental coordination disorder (DCD) is a neurodevelopmental disorder of unknown etiology characterized by poor motor coordination and difficulty learning motor skills. Recent research has shown brain differences in children with DCD compared to typically-developing children. Diffusion Tensor Imaging (DTI) is a neuroimaging technique used to identify diffusion properties of white matter of the brain. Only a handful of studies have started to elucidate the white matter pathways that are implicated in children with DCD. These studies used tractography to look at a priori white matter pathways. The objective of this thesis is to be the first to apply a DTI method called tract-based spatial statistics (TBSS), a user independent analysis of the whole brain white matter to investigate the neural correlates of children with and without DCD. We hypothesized that the white matter differences would be widespread and implicate white matter pathways such as the: corticospinal motor tract (CST); sensorimotor pathways of the posterior thalamic radiation (PTR); corpus callosum; and cerebellar pathways (CP). To achieve our research goals, DTI data were collected from 61 children between 8-12 years of age (31 DCD; 30 TD) who had an MRI scan at a mean age of 10.02 years. Voxel-wise statistical analysis of diffusion metrics such as fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) was conducted using TBSS. A two-group comparison design matrix with age and attention as covariates was used. Data were corrected for multiple comparisons across space and statistical significance was set at p
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