Developmental Neurorehabilitation最新文献

Background: Neonatal sepsis is an important risk factor for lesions in the brain of preterm newborns (PTNB) and the most effective strategies to minimize its deleterious effects are early detection and intervention.

Aim: To investigate the presence of neurological abnormalities in PTNBs after neonatal sepsis.

Methods: This was a prospective cross-sectional study with 100 PTNBs selected at random, 50 of the study group (sepsis) and 50 of the control group (non-sepsis). The neurological evaluation protocol adopted was the Hammersmith Neonatal Neurological Examination (HNNE).

Results: The PTNBs of the sepsis group had total HNNE scores lower than expected for normality in 86% of the cases, and the non-sepsis group in 26% (p < .001). Higher prevalence levels of altered scores in tone category (p < .001), tone patterns (p = .026), reflexes (p = .002), movements (p < .001), abnormal signs (p < .001) and behavior (p < .001).

Conclusion: The neurological dysfunctions after neonatal sepsis could be identified by clinical neonatal neurological evaluation.

There is a need for psychometrically sound outcome measures for treatment studies that have a low burden for families and that are available in multiple languages. We have developed a language assessment in English and Spanish that parents can administer to their children at home via telehealth-delivered procedures. The current case study presents descriptive data on a single family of two parent-child dyads. Both the mother and father from a single family were trained in their primary language (Spanish) on how to administer the Expressive Language Sampling - Narration (ELS-N) in their secondary language (English) to their two English-speaking monolingual sons with ASD through telehealth-delivered procedures. Both parents learned to administer the procedures to a predetermined level of fidelity. Extension to a larger sample of bilingual families is needed for this home-based, parent-administered test; however, the present results suggest feasibility even when the language of training and administration differ.

Aim: The purpose of this pilot was to evaluate the effectiveness of the E-IDEAS curriculum, specifically designed for workplace inclusion of youths with intellectual disabilities (ID) and aimed to transfer social, communication, independent living and employment skills.

Method: The curriculum was attended by 5 participants, and it was provided concurrently with five different work-placements across a period of six months. Two assessment tools were used to demonstrate the acquisition of such skills and an evidence-base improvement of their quality of life. Pre and post-intervention standardized assessments were also taken for measuring the improvement in quality of life (through the San Martín Scale) and adaptive behavior (through the Vineland-II Adaptive Behavior Scale).

Results: The data collected showed increases in the acquisition of such skills. Evidence of maintenance and generalization were also demonstrated.

Conclusion: Implications for practice and further research are discussed.

Aim: The Rett Syndrome Gross Motor Scale (RSGMS) is an observational measurement, assessing gross motor skills in individuals with Rett syndrome. A Dutch version is lacking. The current study aims to translate and cross-culturally adapt the original RSMGS to Dutch and assess its inter-rater and intra-rater reliability.

Design: Translation and cross-cultural adaptation were performed in concordance with internationally accepted guidelines. A pretest was performed, and expert validation was assured. Video data of three girls with Rett syndrome was independently assessed by 27 physiotherapists via an online webinar to measure inter-rater reliability. Additionally, videos of 17 individuals with Rett syndrome were scored twice by two raters to assess intra-rater reliability. The reliability of the total score, the three subscale scores and the new items were analyzed using Intraclass Correlation Coefficients (ICC).

Results: Good comprehensibility and expert validation of the RSMGS-NL was achieved, and four items were added to the original scale. Inter-rater reliability for the total score was excellent (ICC 0.97, 95% CI 0.89-0.99), and good to perfect inter-rater reliability for the three subscales; Sitting, Standing & walking and Challenge was found (ICC values 1.0 (95% CI 0), 0.98 (95% CI 0.91-0.99) and 0.82 (95% CI 0.93-0.99) respectively). The intra-rater reliability was excellent for the total test score (ICC 0.98, 95% CI 0.97-0.99) and good to excellent for the subscale scores (ICC values 0.87 (95% CI 0.75-0.94), 0.99 (95% CI 0.98-1.0) and 0.97 (95% CI 0.95-0.99) respectively). The four new items (Standing to sitting, walking down a slope, ascending the stairs, descending the stairs) showed good to excellent intra-rater reliability.

Conclusion: The RSGMS-NL is a reliable measure of gross motor skills in Dutch individuals with Rett syndrome.

Background: Cerebral palsy (CP) possesses bilateral sensory-motor cortical excitability alterations. In past studies, researchers have applied unilateral anodal transcranial direct stimulation (tDCS) with inconsistent findings.

Objective: Examining the effects of treadmill training with either unilateral or bilateral anodal tDCS stimulation on brain activities, gait, and body functions of children with CP.

Design: Randomized-clinical-trial.

Participants: Eighty children with CP will be allocated into: treadmill/bilateral-tDCS, treadmill/unilateral-tDCS, treadmill/sham-tDCS, and treadmill groups. Additional 20 neurotypical children will be recruited for comparison.

Intervention: Planned intervention will implement ten-sessions of treadmill training (50% of maximum-ground speed) either with unilateral-tDCS over left sensory-motor, or bilateral-tDCS over left/right sensory-motor areas. Brain activities, gait, body functions, and participation will be assessed at pre-intervention, post-intervention, and at one-month follow-up.

Result and discussion: This study would contribute to extant findings on the use of tDCS stimulation in children with CP and to our understanding of the appropriateness of the planned outcome measures.

Aim: We conducted two separate but related multiple baseline with alternating treatment single-case design studies to investigate the effect of the same reading intervention for students with autism spectrum disorder being implemented under different conditions.

Method: We conducted a researcher-implemented study in a public school (Study 1) and a teacher-implemented study in a specialized private charter school for children with ASD (Study 2). In each study, we compared a typical intervention approach with interest-based text intervention that included reading on each child's interest area. The treatment included systematic vocabulary instruction and main-summarization strategy instruction.

Results: Findings from Study One showed consistent increases in comprehension and vocabulary outcomes compared to baseline. In Study Two the baselines phases were unstable with small differences in mean scores detected for vocabulary during the intervention phase favoring the interest-based treatment for three of four participants.

Conclusion: The results across studies were mixed indicating the importance of taking into account contextual factors including student characteristics and learning environment.

Objective: This study addresses the issue of drawing valid conclusions about the assessment of executive functioning (EF) in long-term survivors of pediatric posterior fossa tumors (PPFT).

Method: All 44 patients (females = 18, mean age = 11 years) were treated consecutively at our department for PPFTs (medulloblastomas, ependymomas, low-grade-gliomas). Four years after diagnosis, their EF was investigated, considering age at diagnosis and treatment type. The validity, sensitivity, and specificity of different EF measures (TMT-B, Number Repetition, WCST, BRIEF) were compared and Strengths-and-Difficulties-Questionnaire was incorporated as a potential screening for EF issues.

Results: EF impairments were found, especially in patients with chemo-/radiotherapy. Caregiver-ratings and performance-based-EF-tests identified different patients as below average. Sensitivity was highest in TMT-B. Strengths-and-Difficulties-Questionnaire was not an adequate screening for EF.

Conclusion: It is essential to assess patients with PPFT with performance-based-tests as well as caregiver-questionnaires, since EF impairments are not always visible at the behavioral level but may still influence everyday life.

Purpose: To examine inter-rater and intra-rater reliability of the Head Control Scale (HCS).

Methods: Introduction of the HCS to eight physical therapists in a pediatric post-acute hospital was followed by use in a repeated-measures design across two trials to establish reliability of the raters. Therapists scored the HCS twice within 4 weeks, using videos of infants at both 2 and 6 months of age, one infant described as typically developing and one with atypical development.

Results: For the HCS overall score, reliability was excellent with an inter-rater reliability intraclass correlation coefficient ((ICC) (3,1) = 0.97 (95% confidence interval, 0.899-0.998) and intra-rater reliability ICC (3,1) range = 0.815-1.0. HCS position scores between and within raters ranged from slight to substantial agreement.

Conclusion: In this small study of inter- and intra-rater reliability, HCS overall score demonstrated excellent reliability for all raters however, HCS position scores demonstrated some variability, especially for the prone position.

Purpose: To assess which pediatric patients experiencing persistent post-concussive symptoms (PCS) benefit most from multidisciplinary treatment including specialists in Neurology, Neuropsychology, Physical Therapy, and Athletic Training, and to explore the effectiveness of this approach.

Methods: A retrospective chart review of 56 adolescents 10-20 years old (M = 15.0 ± 2.1) receiving multidisciplinary care for PCS (>30 days) was conducted.

Results: Systolic blood pressure and Body Mass Index predicted time to concussion resolution (p < .05), such that higher values were associated with slower resolution. PCS scores significantly decreased between participants' initial and final clinic visits, p < .01, and among the 25 participants for whom pre-intervention PCS scores were available, symptom severity scores significantly declined following multidisciplinary intervention compared to pre-referral values (p < .01).

Conclusions: Exploratory analyses reveal that multidisciplinary treatment is a promising approach for reducing symptoms among adolescents with PCS, and that those with greater levels of physical fitness may benefit most.

Aim: Research is required to study the relationship between age of autism spectrum disorder (ASD) diagnosis and the presence of comorbidities.

Method: The Gastrointestinal Symptom Inventory, Autism Spectrum Disorder-Comorbid for Children, Behavior Problem Inventory-Short Form and Social Communication Questionnaire were completed by parents of 129 children and adolescents with a diagnosis of ASD.

Results: Results revealed significant relationships between the age of ASD diagnosis, the presence of comorbidities and intellectual disability. Significant correlations were found between the age of ASD diagnosis and self-injurious and stereotyped behavior. Comorbid psychopathology significantly predicted the presence of GI symptoms. In addition, the relationship between comorbid psychopathology and challenging behavior in this study was reported as bi-directional as both comorbidities predicted one another in the sample.

Conclusion: Future research needs to consider the role of comorbidities in relation to ASD diagnosis.