Archive for March, 2009

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Motor Skills and ASD

Thursday, March 19th, 2009

Here are two interesting research studies on autism and motor skills both from Developmental Medicine and Child Neurology. One study reports that out of 101 children with ASD (wide range of ASD and IQ), 79% exhibits movement impairments as reported on the Movement Assessment Battery for Children. Children with childhood autism and IQ of less than 70 exhibits more movement impairments than children with IQ’s over 70 and broader autism.(1)

The second study appears to further explain the increased movement impairments in children with childhood autism. Using electroencephalography, researchers compared movement related potentials (MRP’s) between children with high functioning autism, children with Asperger’s and a healthy control group. The results showed abnormal MRP’s in the children with autism but not Asperger’s. The researchers concluded that this study supports a “neurobiological separateness” of autism and Asperger’s. (2)

I would guess most therapists who work with children on the autism spectrum would have experienced these results in day to day practice with regards to motor skill abilities in children with autism and Asperger’s. The interesting part of the research for me is the movement related potentials. These abnormal responses can indicate an interruption at the basal ganglia, thalamus, and supplementary motor area. Remember what the basal ganglia and the thalamus do? The basal ganglia helps to determine the intensity of motor activity. The thalamus prioritizes sensory information and maintains alertness. So the next question is can we infer anything from this study regarding sensory differences in children with autism? Something to think about.

References:
1. DIDO GREEN, TONY CHARMAN, ANDREW PICKLES, SUSIE CHANDLER, TOM LOUCAS, EMILY SIMONOFF, GILLIAN BAIRD (2009) Impairment in movement skills of children with autistic spectrum disorders Developmental Medicine & Child Neurology 51:4 (311-316)
DOI: 10.1111/j.1469-8749.2008.03242.x
2. PETER G ENTICOTT, JOHN L BRADSHAW, ROBERT IANSEK, BRUCE J TONGE, NICOLE J RINEHART (2009) Electrophysiological signs of supplementary-motor-area deficits in high-functioning autism but not Asperger syndrome: an examination of internally cued movement-related potentials Developmental Medicine & Child Neurology Published online on March 11, 2009. DOI: 10.1111/j.1469-8749.2009.03270.x
http://dx.doi.org/10.1111/j.1469-8749.2009.03270.x

Posted in asperger's, autism, motor skills, pediatric occupational therapy, pediatric physical therapy | No Comments »

Motor Skills During Adolescence in children with CP

Wednesday, March 18th, 2009

Developmental Medicine and Child Neurology published research stating that adolescent children with cerebral palsy GMFCS Level III, IV and V demonstrated a functional decline in skills which were clinically significant. This longitudinal study followed 657 children with CP using the Gross Motor Function Measure-66. Children with cerebral palsy levels I and II did not experience a functional decline. Children at GMFCS Levels III, IV and V showed a peak in functional skills at ages 7 years 11 months for Level III and 6 years 11 months for Levels IV and V.

As pediatric therapists, can we make a difference in preventing or delaying this functional decline in GMFCS Level III, IV and V through direct therapy and consultation with parents? I would like to hope that we can, but insurance companies don’t pay for hope they want evidence. The good news is that this is important research to share with parents of children with cerebral palsy. We can inform that at GMFCS Level I and II we do not expect to see a significant decline in skills during adolescence. For children who are Levels III, IV and V, we can inform parents to possible expect a decline and work on prevention. Please comment or share your experiences.

Reference: STEVEN E HANNA, PETER L ROSENBAUM, DOREEN J BARTLETT, ROBERT J PALISANO, STEPHEN D WALTER, LISA AVERY, DIANNE J RUSSELL Stability and decline in gross motor function among children and youth with cerebral palsy aged 2 to 21 years Developmental Medicine & Child Neurology 2009 1469-8749 0012-1622
DOI: 10.1111/j.1469-8749.2008.03196.x http://dx.doi.org/10.1111/j.1469-8749.2008.03196.x

Check out Teaching Motor Skills to Children with Cerebral Palsy digital edition. This is a great book for any pediatric therapist or parent of a child with cerebral palsy.

Posted in GMFCS, cerebral palsy, pediatric occupational therapy, pediatric physical therapy | No Comments »

ASD and Sensory Sensitivities

Tuesday, March 17th, 2009

This is certainly not news to those who work with young ASD children on sensory processing skills. The Journal of Autism and Developmental Disorders published research stating that young autistic children experience specific sensory sensitivities with regards to tactile input, taste, smell and auditory filtering when compared to other children with different developmental disabilities. The researchers recommend that these differences are considered as specific symptoms in young children with autism.

It still leaves the question – is sensory processing disorder a diagnosis or a symptom of other disabilities?? In my non expert opinion, this research study is a score for the theory that sensory sensitivities are a symptom and not a disorder by itself. Any comments?

Reference: Lisa D. Wiggins1, Diana L. Robins, Roger Bakeman1 and Lauren B. Adamson (2009) Brief Report: Sensory Abnormalities as Distinguishing Symptoms of Autism Spectrum Disorders in Young Children Journal of Autism and Developmental Disorders Published online March 13, 2009 doi 10.1007/s10803-009-0711-x

Posted in autism, pediatric occupational therapy, pediatric physical therapy, sensory processing disorder | 1 Comment »

Flat Feet and Hip Internal Rotation

Monday, March 16th, 2009

The latest issue of The Foot journal reports that flat feet in children ages 3-6 years old has a highly statistically significant relationship with increased hip internal rotation. Of the 569 children studied, 16% had flat feet. One hundred percent of those children had increased hip internal rotation compared to zero of the children without flat feet.

Pediatric physical therapists work with many children for in-toeing when walking. Frequently the focus of treatment is muscle strengthening and stretching to correct for muscle imbalances. This study reminds us to always check the feet as well. Both the feet and the hips need to be addressed when working with children who have increased hip internal rotation.

Reference: George Zafiropoulosa, Kodali Siva R.K. Prasada, Thomai Koubourab and George Danis (2008) Flat foot and femoral anteversion in children—A prospective study The Foot Volume 19, Issue 1, March 2009, Pages 50-54 doi:10.1016/j.foot.2008.09.003

Posted in flat feet, hip internal rotation, pediatric physical therapy | No Comments »

Purposeful Hyperactivity, ADHD and Sensory Diet activities

Saturday, March 14th, 2009

Recent research in Abnormal Child Psychology reports on a study of 12 boys with ADHD were compared to 11 typically developing boys. All of the boys ages 8-12 years old wore actigraphs on their wrists and ankles during working memory tasks. The research indicated that all children moved more during working memory tasks but the boys with ADHD moved significantly more that the typically developing children. The researchers concluded that excessive movement in boys with ADHD may have a functional purpose during working memory tasks.

This is some great research to support sensory diet activities in the classroom. You can explain to teachers that movement may help the children to accomplish working memory tasks. Here is where theraband around desk chairs, swinging foot rests, balls, and other movement ideas can be helpful additions to the classroom. Reinforce the idea with teachers that by forcing any child to sit perfectly still during certain tasks may actually inhibit working memory.

On 4/9/09 Time Magazine printed an article about the previously mentioned study entitled Kids With ADHD May Learn Better By Fidgeting. Worth a read if interested in this topic.

Reference: Rapport, M, Bolden, J, Kofler, M et al (2008) Hyperactivity in Boys with Attenteion-Deficit/Hyperactivity Disorder (ADHD): A Ubiquitous Core Symptom or Manefestation of Working Memory Deficits? J Abnorm Child Psychol DOI 10.1007/s10802-008-9287-8

Posted in ADHD, pediatric occupational therapy, pediatric physical therapy, sensory processing disorder | 3 Comments »

Clothes Pin Counting

Thursday, March 12th, 2009

Here a child has index cards with numbers on them. Using clothes pins, the child is hanging the cards in the correct numerical order. Then the child presses the clothes pins to drop the cards. Hanging the line next to the wall helps to control the clothes line and makes it easier for the child. Need more activities like this? Check out Get Up and Learn!, Clothes Pin Collection or Colorful Clips at our website, www.YourTherapySource.com.

Posted in fine motor skills, pediatric occupational therapy, pediatric physical therapy | No Comments »

Listen to Podcast

Wednesday, March 11th, 2009

You can listen to the podcast of the live show from March 11, 2009 on the right hand side of the blog from the TalkShoe badge. It is a 30 minute broadcast of a large mix of items such as the purpose of the podcasts, perceptions of school based therapists, educating teachers and parents and bringing physical activity into the school day. The next live show will be April 2, 2009. Comment on topic ideas that you would like to discuss.

Posted in pediatric occupational therapy, pediatric physical therapy, podcast | No Comments »

Live TalkShoe Pediatric Therapy "Radio" Show Tonight at 9pm EST

Wednesday, March 11th, 2009

Don’t forget to tune in tonight at TalkShoe, for our first ever LIVE talk show about pediatric therapy. It is scheduled at 9pm Eastern standard time. Join us for a live discussion on pediatric occupational and physical therapy. Please be patient with me for this is first broadcast. I am hoping it goes smoothly but I can not make any promises. I just think it will be fun and informative for us to collaborate and discuss pediatric therapy topics together. You can either call into the show via VOIP or a phone. You can join in by text as well. Stop by and just listen if you would prefer not to participate.

Again, tune into Your Therapy Source’s Talkshoe tonight at 9pm.

Posted in pediatric occupational therapy, pediatric physical therapy, podcast | No Comments »

Adaptive Seating

Tuesday, March 10th, 2009

Here is some research to possibly include in a letter of medical justification for children with disabilities. Archives of Physical Medicine and Rehabilitation reports that adaptive seating on the floor and the toilet for children with GMFCS III and IV with cerebral palsy resulted in a positive impact on the child’s and family’s life. Removal of the adaptive seating had a negative impact on family life.

Reference: The Impact of Adaptive Seating Devices on the Lives of Young Children With Cerebral Palsy and Their Families Stephen E. Ryan, Kent A. Campbell, Patricia J. Rigby, Barbara Fishbein-Germon, Darlene Hubley, Betty Chan Archives of Physical Medicine and Rehabilitation - January 2009 (Vol. 90, Issue 1, Pages 27-33, DOI: 10.1016/j.apmr.2008.07.011)

Posted in adaptive seating, pediatric occupational therapy, pediatric physical therapy | No Comments »

Occupational Therapy Blog Carnival

Monday, March 9th, 2009

Wanted to let you know about the Occupational Blog Carnival that was recently posted. This is the first edition where blog articles could be submitted on the topic of occupational therapy. We submitted our article on 10 Things They Don’t Teach You in School – Learning on the Job as a School Based Therapist. This first issue was hosted by E-nable OT blog.

We will be hosting the May edition of the OT Blog Carnival. Articles will have to be submitted by May 1st and the blog will be published May 4th. More details to follow.

Posted in pediatric occupational therapy | No Comments »

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