Application of remodeled glove puppetry for children with developmental disabilities: a randomized controlled trial.

This study aimed to improve hand performance and play behavior in children with developmental disabilities (DD) using a remodeled glove puppetry approach. Overall, 62 children with DD were randomly assigned to experimental and control groups (n = 31 each). The experimental group underwent a 12-week rehabilitation program by playing with the remodeled glove puppetry, while the children in the control group played with non-remodeled glove puppetry. The Chinese puppet was remodeled using a Lego EV3® robot. Hand kinematics were analyzed through the Siliconcoach® Pro 7 software, which measured the force produced by the baseline ® hydraulic pinch gauge. Play behavior was measured using the Knox Preschool Play Scale-revised (KPPS-r). The experimental group exhibited significant improvements compared to the control group in hand kinematics (wrist range of motion [ROM], p < .05; metacarpophalangeal ROM, p < .05; proximal interphalangeal ROM, p < .05) and KPPS-r scores (space management, p < .05; material management, p < .05; pretense-symbolic, p < .05; participation, p < .05). After the 12-week rehabilitation with the remodeled glove puppetry, the experimental group exhibited significant improvement in kinematics and KPPS-r scores.

Gender Differences in Auditory and Visual Attentional Performance in Children with and without ADHD.

OBJECTIVE: Despite the relatively high prevalence of attention deficit hyperactivity disorder (ADHD), the impairment of ADHD in women is underestimated due to the different ways the phenomenon manifests compared to traditional male symptoms. In order to close the gender gap in diagnosis and treatment, this study aims to explore the impact of gender on auditory and visual attention in children with and without ADHD. METHOD: A total of 220 children with and without ADHD participated in this study. Their auditory and visual attention performances were analyzed by comparative computerized auditory and visual subtests. RESULTS: Auditory and visual attention performance in children with and without ADHD did affect by gender, including typically developing (TD) boys are better than TD girls at distinguishing visual targets from non-target stimuli. When performing attention tasks, TD girls generally maintained a cautious response, which was different from TD boys, who generally adopted positive response methods. ADHD girls suffered from more serious auditory inattention problems than ADHD boys; however, ADHD boys suffered from more auditory and visual impulsive problems than ADHD girls. The internal attention problems of female ADHD children were broader than that of their male ADHD peers and were also more severe, especially in problems of auditory omission and auditory response acuity. CONCLUSIONS: ADHD children had a significant gap in auditory and visual attention performance compared to TD children. The research results support the impact of gender on the performance of auditory and visual attention in children with and without ADHD.

An Accessible Training Device for Children With Cerebral Palsy.

Walking and balance capabilities can be improved upon using repetitive ankle dorsiflexion exercises. Here we developed two types of pedal switches incorporated with training devices to improve their walking and balance performance of children with cerebral palsy. The first type of pedal switch can be used to operate a home appliance, while the second type of pedal switch can connect them to web games. Pedal switches can be used for home rehabilitation. This randomized controlled trial included patients in the intervention (n = 24) and control (n = 24) groups who completed 15 weeks of ankle training. The experimental group performed ankle dorsiflexion using a pressure-activated pedal switch connected to the web games. The control group performed ankle dorsiflexion exercises using a pedal switch that operated a home appliance (a fan). Standing balance and walking performance were estimated using the Zebris FDM system, a pressure force platform, the Pediatric Balance Scale score, and the 1-minute walk test. The pre- and posttest data were analyzed using analysis of variance and analysis of covariance, which revealed that the intervention group had more significant improvements in sway patterns and balance and walking. The developed facility of a modified pedal switch integrated with web games can achieve better exercise adherence to promote balance and walking performance than that with home appliances. Maintaining motivation in children with cerebral palsy plays a very important role in the rehabilitation process.

Relationship between intraindividual auditory and visual attention in children with ADHD.

BACKGROUND AND AIM: Most previous attention-deficit/hyperactivity disorder (ADHD) studies have used only a single sensory modality (usually vision) to investigate attentional problems, although patients with ADHD might display deficits of auditory attention similar to their visual attention. This study explored intraindividual auditory and visual attention in children with and without ADHD to examine the relationship between these two dimensions of attention. METHODS: Attentional performances of 140 children (70 children with ADHD and 70 typically developing peers) were measured through the Test of Variables of Attention (TOVA) in the present study. RESULTS: For both groups, most attentional indices showed significant differences between the two modalities (d ranging from 0.32 to 0.72). The correlation coefficients of most of the attentional variables in children with ADHD were lower than their typically developing peers. All attentional indices of children with ADHD (ranging from 12.8%-55.7%) were much higher than those of their typically developing peers (ranging from 1.4%-8.6%). CONCLUSION: These results not only indicate that typically developing children display more consistent attentional performance, but also support the view that children with ADHD may show attention deficiency in one modality but not necessarily in the other.

Preliminary Study of the Effect of Training With a Gaming Balance Board on Balance Control in Children With Cerebral Palsy: A Randomized Controlled Trial.

OBJECTIVE: A new protocol based on the use of a gaming balance board for children with cerebral palsy was tested. DESIGN: A total of 56 children with cerebral palsy were enrolled and randomly divided into two groups: experimental and control. The children in experimental group underwent 12 wks of rehabilitation using their foot to play personal computer games with the proposed balance board, whereas those in the control group played personal computer games with a computer mouse in the standing position. Balance control was assessed before and after the intervention using the Zebris FDM System for measuring the center of pressure. The Pediatric Balance Scale and 2-min walk test were used for evaluating functional balance. RESULTS: In the analysis of covariance, the proposed new balance board used for the personal computer games decreased the postural sway (sway path, F = 6.95, P = 0.011; sway area, F = 11.79, P = 0.001) and improved the performance of the functional balance tests. CONCLUSIONS: This study demonstrated the possibility that this new gaming balance board can be used for balance control in children with cerebral palsy.

Use of a Gaming Platform for Balance Training After a Stroke: A Randomized Trial.

OBJECTIVE: To evaluate a personal computer (PC) gaming platform as a means of improving postural balance in stroke patients. PARTICIPANTS: Stroke patients (N=54) were enrolled and randomly divided into experimental and control groups. DESIGN: The experimental group underwent 12 weeks of rehabilitation involving playing PC games with the proposed gaming platform, whereas the control group played PC games with a computer mouse in the standing position. INTERVENTIONS: The experimental PC gaming platform allowed trunk movements in 3 directions, including lateral, downward, or upward reaching. MAIN OUTCOME MEASURES: Balance control was assessed before and after the intervention with the Midot Posture Scale Analyzer (a pressure platform) by measuring the center of pressure during quiet stance. The Berg Balance Scale, Fullerton Advanced Balance Scale, and timed Up and Go tests were used to evaluate functional balance. RESULTS: Analysis of covariance was used to assess how the PC games improve balance abilities. There were significant differences between the experimental and control groups in the results of sway kinematics and functional balance tests. The experimental group showed greater improvement than the control group. CONCLUSION: This new gaming platform with adaptive PC games could be a useful therapy to stroke rehabilitation in patients with postural imbalance.

Effects of a Gaming Platform on Balance Training for Children With Cerebral Palsy.

PURPOSE: A platform requiring multidimensional trunk movement facilitated postural balance in children with cerebral palsy. METHODS: The intervention group (n = 20) received 12 weeks of playing personal computer (PC) games using the platform, and the control group (n = 20) played the same games using a computer mouse. Outcomes were center-of-pressure sway, the Berg Balance Scale (BBS), Fullerton Advanced Balance Scale (FAB), and Timed Up and Go (TUG) test scores. RESULTS: There were significant interactions between groups and time. There was a significant between-group difference in center-of-pressure sway excursion, BBS test, and TUG test over time. Participants in the intervention group had better balance performance compared with the control group. CONCLUSION: Balance training using a PC gaming platform may improve exercise compliance and enhance recovery of balance in children with cerebral palsy.

Auditory and Visual Attention Performance in Children With ADHD: The Attentional Deficiency of ADHD Is Modality Specific.

OBJECTIVE: This study explored auditory and visual attention in children with ADHD. METHOD: In a randomized, two-period crossover design, 50 children with ADHD and 50 age- and sex-matched typically developing peers were measured with the Test of Various Attention (TOVA). RESULTS: The deficiency of visual attention is more serious than that of auditory attention in children with ADHD. On the auditory modality, only the deficit of attentional inconsistency is sufficient to explain most cases of ADHD; however, most of the children with ADHD suffered from deficits of sustained attention, response inhibition, and attentional inconsistency on the visual modality. Our results also showed that the deficit of attentional inconsistency is the most important indicator in diagnosing and intervening in ADHD when both auditory and visual modalities are considered. CONCLUSION: The findings provide strong evidence that the deficits of auditory attention are different from those of visual attention in children with ADHD.

Upper-Limb Rehabilitation With Adaptive Video Games for Preschool Children With Developmental Disabilities.

OBJECTIVE: This study used a novel device to make video games accessible to children with developmental disabilities (DD) by modifying the training software and interfaces to enhance motor training. METHOD: In the pretest-posttest design, 20 children (13 boys, 7 girls; mean age=5.2 yr) with DD received adaptive upper-limb motor rehabilitation consisting of fifteen 30-min individual sessions 3 times per week for 5 wk. RESULTS: Improvement in Beery-Buktenica Developmental Test of Visual Motor Integration and Peabody Developmental Motor Scales, Second Edition, scores for children with DD indicated significant differences between pretest and posttest. CONCLUSION: The rehabilitation device modified for the needs of children with DD is effective in improving visual-motor performance of children with DD.

Effectiveness of adaptive pretend play on affective expression and imagination of children with cerebral palsy.

PURPOSE: Children with cerebral palsy (CP) have difficulty participating in role-pretending activities. The concept of adaptive play makes play accessible by modifying play materials for different needs or treatment goals for children with CP. This study examines the affective expressions and imagination in children with CP as a function of ordinary versus adaptive pretend play. METHOD: The Affect in Play Scale-Brief Rating measured the affective expression and imagination for 29 children with CP and 29 typically developing children (mean age=7.34 years). Two groups of children were observed while playing with a standard set of ordinary toys for ten times and with a standard procedure of adaptive pretend play for ten times. RESULT: The results show significantly different affective expressions and imagination between the two groups. Typically developing children displayed much more affective expression and imagination. However, a more positive influence of affective expression and imagination occurred in children with CP than in typically developing children. In repeated measures analysis, the frequency of positive affective expression and imagination of children with CP was higher when pretending with adaptive toys. CONCLUSION: Adaptive pretend play can promote more role-pretending behaviors and a sense of environmental control during the manipulating process for children with CP.

Effects of ordinary and adaptive toys on pre-school children with developmental disabilities.

Toys help children in mastering developmental tasks. This study investigated toy effect on children with developmental disabilities as they engage in using ordinary and adaptive toys. A single-subject design was used to identify the effects on their toy play abilities. Differences in toy effects between playing ordinary and adaptive toys were examined. Three special education teachers chose ordinary toys and modified ordinary toys. Modified ordinary toys, i.e., adaptive toys, were designed according to the individual disabilities of participating children, treatment goals, and the toy types. Three children with developmental disabilities from pre-schools in Taiwan were enrolled. Appropriate participation of three pre-schoolers increased dramatically in playing adaptive toys during intervention phase. The toy effects demonstrate that when using adaptive toys, children with developmental disabilities may response better during toy play sessions.