Multisensory integration in action: Improving goal-directed movement in children with motor impairments

Perinatal and pediatric brain damages in children, such as those caused by perinatal stroke, often results in motor and sensory impairments that compromise autonomy and quality of life. Such conditions may also disrupt multisensory integration, which is essential for goal-directed actions. While previous studies have examined multisensory processing using laboratory-based paradigms, they often lacked ecological validity. To address this issue, we developed MSICLIMB, a novel climbing wall equipped with smart holds that emit auditory (A), visual (V), and audiovisual (VA) cues, which enables the study of multisensory integration in a dynamic, action-oriented context. We compared children with motor impairments to typically developing peers, measuring their reaching times (RT) in response to randomly presented sensory cues. Children with motor impairments exhibited significantly slower RT across all conditions. However, both groups showed faster RT to multisensory stimuli, highlighting the facilitative effect of multisensory integration. RTs improved over trials, particularly in the clinical group, suggesting learning potential. Age was also a significant factor, with older children demonstrating faster responses and reduced group differences. MSICLIMB is an innovative tool that can be used to assess and potentially train multisensory integration through ecologically valid sensorimotor tasks. It has promising applications in both clinical and typical populations.