TY - JOUR
T1 - Home-Based, Therapist-Assisted, Therapy for Young Children With Primary Complex Motor Stereotypies
AU - Singer, Harvey S.
AU - Rajendran, Shreenath
AU - Waranch, H. Richard
AU - Mahone, E. Mark
N1 - Funding Information:
The authors thank the Nesbitt-McMaster Foundation, the Klump and Graves families, and the many other donor families who have made this work possible through acts of philanthropy. This research was also supported by UL1 TR000424 and U54 079123. Special thanks to Lisa Ferenc, Kelsey Crowley, and Farhan Augustine for their assistance in manuscript preparation.
Funding Information:
Financial support: This research was supported by U54HD079123.
Funding Information:
The authors thank the Nesbitt-McMaster Foundation, the Klump and Graves families, and the many other donor families who have made this work possible through acts of philanthropy. This research was also supported by UL1 TR000424 and U54 079123. Special thanks to Lisa Ferenc, Kelsey Crowley, and Farhan Augustine for their assistance in manuscript preparation.
Publisher Copyright:
© 2018 Elsevier Inc.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/8
Y1 - 2018/8
N2 - Background: Complex motor stereotypies (CMS) typically begin before age three years and include rhythmic, repetitive, fixed movements that last for seconds to minutes and can be interrupted with distraction. Objective: We evaluated the effectiveness of a home-based, parent-provided therapy accompanied by scheduled telephone calls with a therapist, in five- to seven-year old children with primary CMS. Methods: Eligible families received an instructional digital versatile disk (DVD) written instructions, and scheduled telephone contacts with a therapist at baseline (DVD receipt), one, three, and eight weeks later. At each call, parents completed outcome measures and received feedback. Outcome scales Stereotypy Severity Scale (SSS) Motor and Impairment scales and a Stereotypy Linear Analogue Scale (SLAS) were also completed via the Iinternet (REDCap)—at screening, one and two months post-baseline call. At study conclusion, participants were divided into an intent-to-treat (ITT; had at least one call) or a lost-to-follow-up (LTF) group. Results: Thirty-eight children (mean = 6 years ± 11 months) were enrolled. The LTF group (n = 14) had significantly higher scores than the ITT (n = 24) group on all attention-deficit/hyperactivity disorder ratings (P < 0.01), but not stereotypy severity. Primary outcome scores, acquired by telephone and REDCap, showed a significant reduction in SSS Motor and Impairment scores between the initial and the last completed evaluation (P ≤ 0.001). Calculated change ratios were SSS Motor −0.23/−0.30 (cal/REDCap); SSS Impairment −0.31/−0.32; and SLAS −0.54 (REDCap). Clinical improvement was further supported by results from a parent improvement scale and end of study questionnaires. Conclusions: Home-based, parent-administered behavioral therapy supplemented by telephone contact with a therapist is effective in reducing complex motor stereotypies in children.
AB - Background: Complex motor stereotypies (CMS) typically begin before age three years and include rhythmic, repetitive, fixed movements that last for seconds to minutes and can be interrupted with distraction. Objective: We evaluated the effectiveness of a home-based, parent-provided therapy accompanied by scheduled telephone calls with a therapist, in five- to seven-year old children with primary CMS. Methods: Eligible families received an instructional digital versatile disk (DVD) written instructions, and scheduled telephone contacts with a therapist at baseline (DVD receipt), one, three, and eight weeks later. At each call, parents completed outcome measures and received feedback. Outcome scales Stereotypy Severity Scale (SSS) Motor and Impairment scales and a Stereotypy Linear Analogue Scale (SLAS) were also completed via the Iinternet (REDCap)—at screening, one and two months post-baseline call. At study conclusion, participants were divided into an intent-to-treat (ITT; had at least one call) or a lost-to-follow-up (LTF) group. Results: Thirty-eight children (mean = 6 years ± 11 months) were enrolled. The LTF group (n = 14) had significantly higher scores than the ITT (n = 24) group on all attention-deficit/hyperactivity disorder ratings (P < 0.01), but not stereotypy severity. Primary outcome scores, acquired by telephone and REDCap, showed a significant reduction in SSS Motor and Impairment scores between the initial and the last completed evaluation (P ≤ 0.001). Calculated change ratios were SSS Motor −0.23/−0.30 (cal/REDCap); SSS Impairment −0.31/−0.32; and SLAS −0.54 (REDCap). Clinical improvement was further supported by results from a parent improvement scale and end of study questionnaires. Conclusions: Home-based, parent-administered behavioral therapy supplemented by telephone contact with a therapist is effective in reducing complex motor stereotypies in children.
KW - Behavioral therapy
KW - Home-based therapy
KW - Motor stereotypies
KW - Movement disorder
KW - Stereotypy Severity Scale
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UR - http://www.scopus.com/inward/citedby.url?scp=85050197187&partnerID=8YFLogxK
U2 - 10.1016/j.pediatrneurol.2018.05.004
DO - 10.1016/j.pediatrneurol.2018.05.004
M3 - Article
C2 - 30049425
AN - SCOPUS:85050197187
VL - 85
SP - 51
EP - 57
JO - Pediatric Neurology
JF - Pediatric Neurology
SN - 0887-8994
ER -