Perception-action and adaptation in postural control of children and adolescents with cerebral palsy.
Kids with CP can follow moving visual cues but don’t adjust their postural responses as well when the visual signal gets stronger—target adaptive re-weighting in balance training.
01Research in Context
What this study did
Hattier et al. (2011) put kids with cerebral palsy inside a small room that slid back and forth. The room moved while the child stood still on a force plate.
The team wanted to know if children with CP could tune out the moving visual cue when it got faster or bigger. They compared sway patterns to same-age peers.
What they found
At first, both groups swayed with the room. The surprise came later. Typical kids quickly reduced their sway when the room speed increased. Kids with CP kept swaying almost as much.
The study says the CP group could link vision to posture but could not re-weight the signal. They stayed glued to the visual flow even when it hurt balance.
How this fits with other research
Chung et al. (2011) ran the same moving-room test on children with DCD. Those kids also swayed more, but only at certain speeds. The CP finding is stronger: poor down-weighting at every higher speed.
Godoi-Jacomassi et al. (2025) later showed DCD kids have both sensory and motor command problems. Hattier et al. (2011) narrows the CP issue to the sensory re-weighting step, not the motor output.
Spanoudis et al. (2011) used a tabletop visual task and saw DCD kids sway more as the task got harder. Again, the pattern flips: typical kids stabilize, CP kids do not. The common thread is weak visual re-weighting across diagnoses.
Why it matters
When you test balance, do not stop at static standing. Add slow, then faster visual motion. If sway stays high at the faster speed, target adaptive re-weighting: brief vision-off trials, unstable surfaces, or gaming headsets that scale optic flow. Train the child to trust proprioception and vestibular inputs instead of over-relying on eyes.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Tape a large sheet of patterned paper to a rolling cart, move it at two speeds while the child stands on a foam pad, and score if sway drops between speeds—if not, add short eyes-closed trials.
02At a glance
03Original abstract
The aim of this study was to examine the coupling between visual information and body sway and the adaptation in this coupling of individuals with cerebral palsy (CP). Fifteen children with and 15 without CP, 6-15 years old, were required to stand upright inside of a moving room. All children first performed two trials with no movement of the room and eyes open or closed, then four trials in which the room oscillated at 0.2 or 0.5 Hz (peak velocity of 0.6 cm/s), one trial in which the room oscillated at 0.2 Hz (peak velocity of 3.5 cm/s), and finally two other trials in which the room oscillated again at 0.2 Hz (peak velocity of 0.6 cm/s). Participants with CP coupled body sway to visual information provided by the moving room, comparable to the coupling of participants without CP. However, participants with CP exhibited larger body sway in maintaining upright position and more variable sway when body sway was induced by visual manipulation. They showed adaptive sensory motor coupling, e.g. down-weighting visual influence when a larger stimulus was provided, but not with the same magnitude as typically developing participants. This indicates that participants with CP have less capability of adaptation.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.08.018