Best evidence for improving function in children with cerebral palsy: Success is within reach

Jackman, Michelle; Sakzewski, Leanne; Morgan, Catherine; Boyd, Roslyn N.; Brennan, Sue; Langdon, Katherine; Toovey, Rachel; Greaves, Susan; Thorley, Megan; Novak, Iona

doi:10.1111/dmcn.15186

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…The comprehensiveness of the NTT treatment can be an important reason explaining the presented effect. This is in line with the evidence on dose-intensive studies, as reported in the field of children with Cerebral Palsy [ 35 ] and children with motor deficits [ 36 ], showing that increased dosage of intervention is showing higher effects compared to low dosage intervention.…”

Section: Discussionsupporting

confidence: 89%

Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study

et al. 2023

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Background: Task-oriented approaches are recommended for children with developmental coordination disorder (DCD) to address deficits in motor performance and reduce activity limitations. Although this approach is used in several settings, the efficacy of these approaches in children with in dual-diagnosis of specific learning disabilities (SLD) and DCD is less widely known. This study aims to determine the effect of a group-based intervention based on neuromotor task training (NTT) principles on the motor performance of children aged 6–10 years with SLD/DCD. Methods: A pre-post-test controlled study design was conducted in children with a primary diagnosis of specific learning disabilities (SLD). DCD status was confirmed based on clinical assessment. Children scoring ≤16th percentile on the Motor Assessment Battery for Children 2nd Edition (MABC-2), who also presented with a functional motor problem, according to the MABC checklist were considered as having DCD. Children were allocated to the NTT intervention group based on teachers’ perceived notion of need and received two 45–60 min training sessions per week for nine weeks. Children allocated to the usual care (UC) group, received their planned occupational therapy and physical education. The MABC-2 was used to assess changes in motor performance. Outcome and Results: Our numbers confirm that it is crucial to identify the presence of motor coordination difficulties in children who have been diagnosed with SLD. A task-oriented training program based on NTT principles, presented in small groups, has a positive effect on the motor performance in learners with neurodevelopmental disorders and this effect was larger than in the usual care group. Conclusion and Implications: Although using a small group format in children with multiple neurodevelopmental disorders may be challenging for the therapists, it may be a way of delivering services to children in schools for special education. What this paper adds: Children with DCD plus LSD show improvement in their motor skills by performing group-based NTT in the school environment. Group-based NTT shows a significant improvement in the TSS score of the MABC-2 compared to usual care. Children with DCD plus SLD show equal effect sizes after NTT intervention as DCD without SLD.

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Section: Discussionsupporting

confidence: 89%

Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study

et al. 2023

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“…2 Unfortunately, there are limitations in complex disability research, which has been found to lack rigour and thus the certainty to provide evidence-based intervention at all stages of life. [8][9][10] These limitations can be countered using good clinical reasoning, like the structured BCRF clinical reasoning cycle. This agrees with the suggestion that 'clinical reasoning and decision-making should always involve weighing up individual children and young people's and families' preferences, context, clinical and health system affordances, plus the certainty of the evidence'.…”

Section: E T T E R T O T H E E D I T O Rmentioning

confidence: 99%

“…7 While the letter from Damiano and Novak questions the absence of rigour in the BCRF, those published guidelines included only 4/13 good practice recommendations based on graded evidence while the remainder seemed to be based on the authors' opinion of what they considered best, which they acknowledged as being different from evidence-based recommendation. 7,9 There are also limitations to systematic reviews and metaanalyses, 9 although these are designed to look rigorously for consistency in treatment effects across a number of similar studies. This was not the case in the meta-analysis by Te Velde et al, as subject groups were mixed, dosage was not necessarily equal, some studies focused on upper limb and others on the lower limb.…”

Section: E T T E R T O T H E E D I T O Rmentioning

confidence: 99%

The Bobath Clinical Reasoning Framework: Open to debate

Mayston,

Saloojee,

Foley

2024

Develop Med Child Neuro

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Best evidence for improving function in children with cerebral palsy: Success is within reach

Abstract: This letter to the editor is on the Clinical Practice Guide by Jackman et al. on pages 536–549 of this issue.

Cited by 2 publications

References 8 publications

Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study

Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study

The Bobath Clinical Reasoning Framework: Open to debate

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