Topics

Occupational Therapy to Treat Children Who Over or Under React to Their Environment

2014-07-23 21:56:16 | BioPortfolio

Summary

Children with Sensory Modulation Dysfunction (SMD) either over- or under-react to stimuli in their environment. This can cause significant problems with daily activities and may lead to anxiety, poor attention, low self-esteem, and further complications in motor, cognitive, social and emotional development. Diagnosis of SMD is based on physiological responses to specific stimuli, measures of behavioral/social/emotional symptoms, and studies of the resulting functional limitation and disability. Treatments involve direct biomedical and behavioral intervention to improve sensory processing, as well as adjustments to the home, school and community environment. This study will compare the effect of occupational therapy vs. alternative therapy on the reactivity and function of children who have SMD.

Description

This single masked, crossover trial will randomize children with Sensory Modulation Dysfunction (SMD) to either Occupational Therapy (OT), alternative treatment (Activity Protocol), or delayed treatment (initially the control group). Children are assigned to one of the three treatment groups using a random numbers table with block randomization. Assignments are made by the research assistant, who is masked to assessments, parent priorities, and family needs/characteristics. Using block procedures, the first child is randomly assigned to treatment group A, B, or C. The next child entered to the study at that age, gender and socioeconomic status (parents' education) is randomly assigned to one of the two remaining groups. The third child meeting age, gender and SES criteria is automatically assigned to the remaining group. This procedure reduces seasonal confounds and chance variation between group characteristics. The order of treatment by group is: GROUP A (OT - 1st 10 weeks; Activity - 2nd 10 weeks); GROUP B (Activity - 1st 10 weeks; OT - 2nd 10 wks); GROUP C (Wait list - 1st 10 weeks; OT - 2nd 10 wks; Activity - 3rd 10 wks). Inclusion in the study is based on standardized assessments of physiological reactivity after a "Sensory Challenge Protocol", a technique developed by this research group and published in several medical journals. Standardized measurements of physiologic, behavioral and emotional status, are administered before treatment, after each treatment condition, and after all treatments are completed by investigators masked to treatment; and including the following:

Measurements in the Impairment: The Sensory Challenge protocol is a laboratory paradigm in which the child's physiologic reactivity after sensation is tested using electrodermal reactivity and vagal tone indices to assess sympathetic and parasympathetic systems. Measurements of functional limitations include aggression, withdrawal, impulsivity, hyperactivity, inattention, and sensitivity to tactile, movement, taste, smell, auditory and visual stimuli. These are measured in the areas: (1) attention (subscales of the parent-report Child Behavior Checklist [CBCL],and Leiter International Performance Scale-Revised; the Continuous Performance Task, the StopTask and the Go-No Go Task); (2) emotion (the CBCL); (3) sensation (the Short Sensory Profile; the Leiter-R; the Multidimensional Anxiety Scale for Children; the Stop Task; the Go-No-Go Task; the Auditory Continuous Performance Test). Measures of the Disability Dimension include the Vineland Scales of Adaptive Behavior, the Goal Attainment Scale, and play and dinner-time paradigms. Finally, measures in Societal Limitations Dimension include a parent semi-structured interview and the Visual Analogue Scale.

Occupational therapy is a targeted protocol involving functional and sensory-integration activities, supported by family-based activities at home.

Study Design

Allocation: Randomized, Control: Active Control, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Single Blind, Primary Purpose: Treatment

Conditions

Sensory Disorders

Intervention

Occupational Therapy

Location

University of Colorado Health Sciences Center
Littleton
Colorado
United States
80120

Status

Completed

Source

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-07-23T21:56:16-0400

Clinical Trials [1014 Associated Clinical Trials listed on BioPortfolio]

The Effect Of Occupational Therapy On Sensory-Based Feeding Problems

Feeding problems are common in individuals with Autism Spectrum Disorder (ASD).This study was planned to investigate the effect of occupational theraphy on sensory feeding problems in ASD.

Occupational Therapy With Ayres Sensory Integration Approach for School-age Children

Introduction: Sensory Integration (SI) is a theory and framework conceptualized by Dr. Jean Ayres, a highly experienced occupational therapist, with its main objective as enhancing the br...

Evaluating the Personal Computer as a Treatment Activity in Occupational Therapy

This study will evaluate the use of the personal computer (PC) in occupational therapy. The results of the study will help occupational therapists develop improved treatment activities usi...

The Effect of Occupational Therapy on Subthreshold Attention Deficit Hyperactivity Disorder

The purpose of this study is to investigate the effectiveness of occupational therapy in subthreshold attention deficit hyperactivity disorder.

Handwriting Intervention, SML vs. Conventional Occupational Therapy (OT), in a Junior High School

Children who attend School-Based Occupational Therapy (SBOT) show mixed dominance and a liable decreased in the structural and functional differentiation between the two hemispheres. The l...

PubMed Articles [15800 Associated PubMed Articles listed on BioPortfolio]

Occupational Therapy Interventions for Children and Youth With Challenges in Sensory Integration and Sensory Processing: A School-Based Practice Case Example.

Evidence Connection articles provide case examples of how practice decisions may be informed by findings of systematic reviews sponsored by the American Occupational Therapy Association Evidence-Based...

Sensory Integration Concerns in Children With Functional Defecation Disorders: A Scoping Review.

We examined the literature to identify reports of sensory integration concerns in children with functional defecation issues and to explore whether difficulty processing sensation may be related to th...

Reference Values for the Adolescent/Adult Sensory Profile in Spain.

In Spain, only one culturally adapted assessment tool is available for children between ages 3 and 11 yr. There are no assessments of adolescent and adult sensory processing, and no normative data.

Opportunities for Occupational Therapy on a Primary Care Team.

Leaders in the occupational therapy profession have called for occupational therapy's inclusion in primary care, but little is known about the occupational needs of patients in this setting.

Somatosensory Discrimination in People With Autism Spectrum Disorder: A Scoping Review.

Sensory symptoms in people with autism spectrum disorder (ASD) are commonly reported by researchers. However, an often overlooked sensory aspect of ASD is sensory discrimination in general, and somato...

Medical and Biotech [MESH] Definitions

Hospital department responsible for the administration and provision of any occupational or work activity for remedial purposes.

SOMATOFORM DISORDERS characterized by preoccupation with some imagined defect in appearance not of delusional intensity but severe enough to impair social or occupational functioning. (American Psychiatric Glossary, 1994)

Training or retraining of the buccal, facial, labial, and lingual musculature in toothless conditions; DEGLUTITION DISORDERS; TEMPOROMANDIBULAR JOINT DISORDERS; MALOCCLUSION; and ARTICULATION DISORDERS.

The use of art as an adjunctive therapy in the treatment of neurological, mental, or behavioral disorders.

These are a group of conditions with onset in the developmental period. The disorders typically manifest early in development, often before the child enters grade school, and are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning. (From DSM-V).

More From BioPortfolio on "Occupational Therapy to Treat Children Who Over or Under React to Their Environment"

Quick Search

Relevant Topics

Pediatrics
Pediatrics is the general medicine of childhood. Because of the developmental processes (psychological and physical) of childhood, the involvement of parents, and the social management of conditions at home and at school, pediatrics is a specialty. With ...

Urology
Benign Prostatic Hyperplasia (BPH) Erectile Dysfunction Urology Urology is the branch of medicine concerned with the urinary tract and diseases that affect it. Examples include urethritis, urethrostenosis and incontinence. Urology is a su...


Searches Linking to this Trial