This feasibility study investigated teachers' assessment of Move-Into-Learning (MIL), an eight-week school-based Mindfulness-based intervention (MBI), designed to reduce stress and improve behavior in at-risk elementary students. MIL was implemented with two classrooms of third-grade students (n = 41) in a low income, urban neighborhood using a pretest to posttest single group design. One of the two classrooms (n = 20) completed a two-month follow-up measure examining sustainability of results. The program included mindfulness meditation, yoga movement with breathing exercises, and Appreciative Inquiry (AI) exercises that invited students to express themselves in the written and visual arts. MIL was evaluated via semi-structured teacher interviews and the Connors' Behavior Rating Scale. Pre/post intervention showed significant improvement in behaviors, such as hyperactivity (t[1,39 = 3.1; p = 0.002), and highly significant differences in the attention-deficit/hyperactivity disorder index (t[1,39] = 5.42; p < 0.001) and cognitive/inattentiveness (t[1,39] = 5.56; p < 0.001) subscales. Teacher interview data supported these findings suggesting MIL as a feasible and acceptable MBI that can be implemented in a third-grade classroom.
GAS is a clinically useful tool for measuring progress toward goals, but has not been utilized with a high level of methodological rigor in research. Emphasis on reduced variation in administration and interpretation will strengthen the utility of GAS for efficacy and program evaluation in future research. Implications for rehabilitation Goal Attainment Scaling (GAS) can be used across a diversity of interventions and diagnoses as an outcome measure in pediatric rehabilitation. Careful consideration should be used in the study design to standardize administration and scoring of GAS to strengthen the study. Goal Attainment Scaling is responsive to change, and the tool appears to detect meaningful change the majority of the time in pediatric rehabilitation.
This case report is the first in a series of reports designed to determine the feasibility of implementing game-based neurorehabilitation using telehealth technologies (GbN+TT) for children with cerebral palsy, evaluate the responsiveness of relevant outcome measures to changes in motor impairment and activity participation after intervention, and identify technological challenges associated with implementation of GbN+TT. The participant completed more than 56 hr of game-based neurorehabilitation over 8 wk using the Timocco platform in his home. The primary measures of motor impairment (Bruininks-Oseretsky Test of Motor Proficiency, Second Edition) and function (Pediatric Motor Activity Log) were both sensitive to change. Results indicate that it is feasible to administer GbN+TT to a child with cerebral palsy and monitor outcomes using standardized assessments.
Objective To identify perinatal clinical diseases and treatments that are associated with the development of objectively diagnosed diffuse white matter abnormality (DWMA) on structural magnetic resonance imaging (MRI) at term-equivalent age in infants born very preterm.Study design A prospective cohort of 392 infants born very preterm (£32 weeks of gestational age) was enrolled from 5 level III/IV neonatal intensive care units between September 2016 and November 2019. MRIs of the brain were collected at 39 to 45 weeks of postmenstrual age to evaluate DWMA volume. A predefined list of pertinent maternal characteristics, pregnancy/delivery data, and neonatal intensive care unit data were collected for enrolled patients to identify antecedents of objectively diagnosed DWMA.
ResultsOf the 392 infants in the cohort, 377 (96%) had high-quality MRI data. Their mean (SD) gestational age was 29.3 (2.5) weeks. In multivariable linear regression analyses, pneumothorax (P = .027), severe bronchopulmonary dysplasia (BPD) (P = .009), severe retinopathy of prematurity (P < .001), and male sex (P = .041) were associated with increasing volume of DWMA. The following factors were associated with decreased risk of DWMA: postnatal dexamethasone therapy for severe BPD (P = .004), duration of caffeine therapy for severe BPD (P = .009), and exclusive maternal milk diet at neonatal intensive care unit discharge (P = .049).Conclusions Severe retinopathy of prematurity and BPD exhibited the strongest adverse association with development of DWMA. We also identified treatments and nutritional factors that appear protective against the development of DWMA that also have implications for the clinical care of infants born very preterm.
These results suggest that a delay in fine and gross motor skills at an early age is a characteristic of infants referred to an ASD clinic. Furthermore, the BSID-III may not be sensitive enough to distinguish between referred children with and without ASD.
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