Developmental Neurorehabilitation最新文献

This study was designed to extend research on motor skill development in autism spectrum disorder using a dual-task skill. Nine autistic and 18 non-autistic youths walked without grasping or while reaching to grasp a small or large object. Step extremity ratio, percent time in double support, and normalized speed were quantified. We hypothesized that gait would differ between autistic and non-autistic youth and that differences would be moderated by the phase (approach and grasp) and the complexity of the task (walking and grasping versus walking alone). Although gait parameters were similar during the walking-only trials, the combined task resulted in slower speed and shorter steps in autistic youth, particularly during the grasp phase. These findings, while in a small sample, offer preliminary evidence that autistic youth who show typical gait during simple assessments of motor ability may have difficulties in more complex tasks that require the coordination of movements.

Purpose: This study aimed to examine the responsiveness and minimal clinically important difference of the Motor Function Measure 32-Chinese version (MFM 32-CN) in children and adolescents with Duchenne muscular dystrophy (DMD).

Methods: This observational, prospective cohort study assessed changes in motor function over 12 months using the MFM 32-CN in 108 pediatric patients with DMD.

Results: Moderate to high internal responsiveness was found for MFM total, D1, and D2 scores (SRM = 0.46-0.83). Sufficient external responsiveness was observed in all MFM scores, as determined by a good correlation with the Patient Global Impression of Change (PGIC) ratings (r = 0.54-0.72, p < .01). The estimated MCID values derived from different anchor-based methods ranged from 4.7 to 6.0, with a median of 5.0 points (%).

Conclusion: The MFM 32-CN demonstrates sufficient internal and external responsiveness as a measure of motor function in children and adolescents with DMD. The present study established the MCID of MFM-32 in pediatric patients with DMD.

Purpose: Early identification of autism spectrum disorder (ASD) via screeners for diagnostic measures are a high priority. At present, there is no consensus on one screener due to the need for better sensitivity and specificity. In this study, we report on the development and utility of the BABY-BISCUIT, a six-item screener based on a modified subset of items from the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT).

Methods: A sample of 504 children between 17-3 9months of age, who consisted of toddlers identified as at-risk for neurodevelopmental and other health disorders, were tested during an annual screening through the Louisiana EarlySteps program.

Results: An exploratory factor analysis yielded a one-factor solution (X2 = 48.62, df = 9, p = <.001). High sensitivity (i.e., 100.0%) at the cost of reduced specificity (i.e., 33.3%, AUC = 0.957) was found for an optimal screening cutoff score of 1.

Conclusions: Findings from this study suggest that the BABY-BISCUIT has the potential to be a short and easily administered screener for ASD to inform whether further ASD assessment is necessary. Further investigation of convergent validity with established ASD measures is recommended.

Introduction: Psychotropic medication is often prescribed to individuals with intellectual and developmental disabilities who engage in challenging and other behavior (e.g., aggression and stereotypy, respectively), but there is limited understanding of the effects of these medications on behavior.

Objective: Within the context of a larger study that evaluated the effects of psychotropic medication regimen changes on the presentation of challenging behavior, this study describes the presentation of stereotypic behavior of three individuals diagnosed with autism spectrum disorder.

Methods: Stereotypy was measured during weekly, one-hour, direct observations and during the control and ignore conditions of functional analyses of challenging behavior (which were conducted following changes in psychotropic medication regimens).

Results: Patterns of stereotypy varied over time, but not significantly, and at times seemed to coincide with medication changes.

Discussion: Our results suggest stereotypy persists throughout adulthood; however, additional research is needed.

Background: Parents of children with disabilities often report stress, depression, and anxiety. This review identified screening tools and practices that pediatric rehabilitation service providers can use to screen the mental health of parents of children with disabilities.

Methods: An interdisciplinary team and patient partner completed the systematic review in which 16,015 articles were screened and 473 articles were included to i) identify mental health tools that were used with parents, ii) determine the clinical utility of frequently used tools, iii) examine the screening practices used in pediatric rehabilitation contexts.

Results: 115 screening tools were used to screen parents' mental health. The Parenting Stress Index was used most often. Seven studies reported screening in order to recommend further assessment or supports. Increased awareness, training, resources, and infrastructure are needed to support parents' mental health.

Discussion: Evidence is needed to guide mental health screening practices in pediatric rehabilitation and determine their effectiveness.

Purpose: A systematic review of the psychometric properties and feasibility of outcome measures assessing lower limb somatosensory function and body awareness in children with upper motor neuron lesion.

Methods: We followed the COnsensus-based Standards for the selection of health Measurement INstruments guidelines. Two raters independently judged the quality and risk of bias of each study. Data synthesis was performed, and aspects of feasibility were extracted.

Results: Twelve studies investigated eleven somatosensory function measures quantifying four modalities and eight body awareness measures quantifying two modalities. The best evidence synthesis was very low to low for somatosensory function modalities and low for body awareness modalities. Few feasibility aspects were reported (e.g., the percentage or minimum age of participants able to perform the tests).

Conclusion: Current evidence on the psychometric characteristics of somatosensory function and body awareness outcome measures are relatively sparse. Further research on psychometric properties and practical application is needed.

Purpose: Describing language development in children with sex chromosome trisomies (SCT) and testing the predictive value of early language measures on later outcomes.

Method: Thirteen children with SCT were followed longitudinally. Their developmental profile was assessed, with particular attention to language, at 2 and 4 years. The predictive value of direct (spontaneous speech analysis) and indirect (communicative development inventory) language measures at 2 on performances at 4 was tested.

Results: Language performances at both ages were lower than non-verbal development. At 2, more than 50% of the group produced less than 50 words. At 4, impaired performances were observed in speech sound development and expressive morpho-syntax. Direct measures of Pre-syntactic development predicted later global language outcomes and Sentence Repetition. The number of consonants used at 2 was significantly related to Nonword Repetition at 4.

Conclusions: The study highlights the importance of early detection and careful follow-up for children with SCT.

Purpose: To investigate the occurrence of oral feeding problems in preterm infants up to one year after hospital discharge.

Methods: Thirty-six infants born <34 weeks gestation were enrolled in a prospective exploratory longitudinal pilot study prior to hospital discharge. Parents of eligible infants completed telephone questionnaires at 3, 6, and 12 months corrected gestational age. The occurrence and type of feeding problems; medical problems; and rehabilitation services received were collected.

Results: A total of 26 (72.2%) parents responded, with 11 (42%) identifying feeding problems that developed within the first year of life. Avoidant behavior (including crying, agitated/fussy, and refusing to eat) was the most common feeding problem that occurred.

Conclusion: Feeding problems in 'healthy' preterm infants may occur at any point in development within the first year of life. Increased screening after hospitalization is needed for early identification and to make appropriate referrals in a timely manner to prevent and/or reduce the severity of long-term feeding problems.

Background: Comorbidity is the co-occurrence of two or more disorders in the same person.

Aim: This study investigated the frequency of comorbid conditions, in children and adolescents, with autism spectrum disorder (ASD), cerebral palsy (CP), and a comorbid diagnosis of ASD and CP.

Method: Ninety-six children and adolescents with ASD, CP, and both ASD and CP aged between 4 and 18 years participated in this study. Parents completed the Gastrointestinal Symptom Inventory, Children's Sleep Habits Questionnaire, Child Behavior Checklist, Social Communication Questionnaire, and the Vineland Adaptive Behavior Scales.

Results: Results of ANOVA analyses revealed significant group differences in sleep problems, social communication difficulties, and adaptive behavior. Regression analysis found that the presence of an intellectual disability significantly predicted levels of adaptive behavior.

Conclusion: This research demonstrated the importance of studying comorbidities in children and adolescents with CP alone, ASD alone, and combined ASD and CP.

Purpose: To examine relationships between functional outcomes after pediatric acquired brain injury (ABI) and measures of rehabilitation dose.

Methods: An observational study of children receiving residential neurorehabilitation after severe ABI.

Results: Basic total rehabilitation dose shows a paradoxical inverse relationship to global outcome. This is due to confounding by both initial injury severity and length of stay, and variation in treatment content for a given total rehabilitation dose. Content-aware rehabilitation dose measures show robust positive correlations between fractions of rehabilitation treatment received and plausibly related aspects of outcome: specifically, between rates of recovery of gross motor function and the fraction of rehabilitation effort directed to active practice and motor learning. This relationship was robust to adjustment for therapists' expectations of recovery.

Conclusion: Content-aware measures of rehabilitation dose are robustly causally related to pertinent aspects of outcome. These findings are step toward a goal of comparative effectiveness research in pediatric neurorehabilitation.