Enabled to Stand: A Single-subject Research Design Study Exploring Pediatric Power Wheelchair Standing Device Use.

PURPOSE: To investigate the influence of powered wheelchair standing device (PWSD) use on changes in activity/participation in children with neurodevelopmental conditions. METHODS: A mixed methods A-B-A single-subject research design was replicated with participants. The target behavior was parental perceptions of changes in children's performance of activity/participation goals measured via the Canadian Occupational Performance Measure (COPM). Secondary outcome measures included the COPM with children, an interview, and a 3-measure implementation survey. COPM data related to the target behavior were analyzed using the split-middle celeration line method. RESULTS: Four child-parent dyads participated in the study. All participants achieved statistically and clinically significant increases in COPM performance ratings for the 5 parent-identified activity/participation goals. CONCLUSIONS: For the participant dyads in this study, use of the PWSD appeared to positively influence parental perceptions of improvements in their child's performance of activity/participation goals.

Exploring the Effects of Power Mobility Training on Parents of Exploratory Power Mobility Learners: A Multiple-Baseline Single-Subject Research Design Study.

Purpose: This study investigated the effects of power mobility training provided to exploratory power mobility learners with cerebral palsy (CP; Gross Motor Function Classification System Level V) on (1) parenting stress, (2) parents' perceptions of their children, and (3) children's attainment of power mobility skills. Method: A non-concurrent, multiple-baseline A-B single-subject research design study was conducted with three participants. The target behaviour was changes in the magnitude of parenting stress as measured by the Parenting Stress Index-Short Form. Parents' perceptions of their children were assessed using the Caregiver Priorities and Child Health Index of Life with Disabilities Questionnaire and a parent interview. Children's attainment of power mobility skills was assessed using the Canadian Occupational Performance Measure (COPM), the Assessment of Learning Powered mobility use, and the Wheelchair Skills Checklist. Power mobility training was provided twice a week for 8 weeks using an alternative power mobility device. Results: Positive and negative changes in both magnitude of parenting stress and parents' perceptions were identified post-intervention. All participants gained power mobility skills, assessed with the COPM. Conclusions: Power mobility training provided to exploratory power mobility learners with CP may influence levels of parenting stress.

Objectif : étude des effets de la formation à la mobilité motorisée offerte aux personnes ayant la paralysie cérébrale (PC ­ niveau V du système de classification de la fonction motrice globale) sur 1) le stress lié aux pratiques parentales, 2) les perceptions qu'ont les parents de leur enfant et 3) les habiletés de mobilité motorisée acquises par les enfants. Méthodologie : plusieurs recherches à sujet unique A-B non concurrente et à niveau de base multiple auprès de trois participants. Ils ont ciblé des comportements de changements à la magnitude du stress lié aux pratiques parentales, mesurés par le formulaire court de l'indice de stress lié aux pratiques parentales. Pour évaluer les perceptions qu'ont les parents de leurs enfants, ils ont utilisé le questionnaire des priorités du proche aidant et de la santé de l'enfant selon l'indice de la vie avec des incapacités et fait une entrevue avec un parent. Ils ont également évalué les habiletés de mobilité motorisée acquises par les enfants au moyen de la mesure canadienne du rendement occupationnel (MCRO), de l'évaluation de l'apprentissage à utiliser la mobilité motorisée et de la liste des habiletés en fauteuil roulant. La formation à la mobilité motorisée a été offerte deux fois par semaine pendant huit semaines au moyen d'un autre appareil de mobilité motorisée. Résultats : les chercheurs ont déterminé les changements positifs et négatifs tant sur la magnitude du stress parental que sur les perceptions des parents après l'intervention. Tous les participants ont acquis des habiletés de mobilité motorisée, évaluées à l'aide de la MCRO. Conclusions : la formation à la mobilité motorisée qu'explorent les personnes ayant la PC peut influer sur les taux de stress lié aux pratiques parentales.

Changes in Electroencephalography Activity in Response to Power Mobility Training: A Pilot Project.

Purpose: The purposes of this pilot project were to examine the impact of power mobility training on (1) electroencephalography (EEG) activity in children with severe cerebral palsy (CP) and (2) power mobility skill acquisition. Method: A single-subject A-B-A-B research design with a 5-week duration for each phase (20 wk total) was replicated across three participants with severe CP (Gross Motor Function Classification System Level V). Data related to the target behaviour, as represented by EEG activity, were collected each week. Power mobility skills were assessed using the Canadian Occupational Performance Measure (COPM), the Wheelchair Skills Checklist (WSC), and the Assessment of Learning Powered mobility use (ALP). Weekly power mobility training was provided during the intervention phases. EEG data were analyzed by means of three measurement metrics (power spectral density, mutual information, and transfer entropy). Results: All three participants demonstrated changes in activation in frontoparietal EEG recordings and clinically significant improvements in power mobility skill acquisition as measured by the COPM as well as by the ALP and WSC. Conclusions: Power mobility training appeared to affect both neuroplastic and skill acquisition. Combining the use of EEG with direct therapist-observation measurement tools may provide a more complete understanding of the impact of power mobility training on children with severe CP.

Objectif : le présent projet pilote vise à examiner les répercussions de l'entraînement à la mobilité motorisée sur 1) l'activité électroencéphalographique (ÉEG) chez les enfants atteints d'une paralysie cérébrale (PC) marquée et 2) l'acquisition d'habiletés à la mobilité motorisée. Méthodologie : les chercheurs ont répliqué une méthodologie de recherche A-B-A-B individuelle d'une durée de cinq semaines par phase (total de 20 semaines) chez trois participants ayant une PC marquée (niveau V du système de classification de la motricité brute). Chaque semaine, ils ont colligé les données relatives au comportement ciblé, représentées par l'activité ÉEG. Ils ont évalué l'habileté à la mobilité motorisée au moyen de la mesure canadienne du rendement occupationnel (MCRO), de la liste des habiletés en fauteuil roulant (LHFR) et de l'évaluation de l'apprentissage d'utilisation de la mobilité motorisée (ÉAUMM). Pendant les phases d'intervention, ils ont fourni un entraînement hebdomadaire à la mobilité motorisée. Ils ont analysé les données d'ÉEG à l'aide de trois mesures de rendement (densité du spectre de puissance, information mutuelle et entropie de transfert). Résultats : les trois participants ont démontré des changements à l'activation des enregistrements ÉEG frontopariétaux et des améliorations cliniquement significatives à l'acquisition des habiletés de mobilité motorisée mesurée par la MCRO, l'ÉAUMM et la LHFR. Conclusion : l'entraînement à la mobilité motorisée semble avoir des effets à la fois sur la plasticité neurale et sur l'acquisition d'habiletés. La combinaison de l'ÉEG avec des outils de mesure observés directement par le thérapeute pourrait permettre de mieux comprendre les répercussions de l'entraînement à la mobilité motorisée chez les enfants ayant une PC marquée.

Does power mobility training impact a child's mastery motivation and spectrum of EEG activity? An exploratory project.

PURPOSE: The purposes of this exploratory project were: (1) to evaluate the impact of power mobility training with a child who has multiple, severe impairments and (2) to determine if the child's spectrum of electroencephalography (EEG) activity changed during power mobility training. STUDY DESIGN: A single-subject A-B-A-B research design was conducted with a four-week duration for each phase. Two target behaviours were explored: (1) mastery motivation assessed via the dimensions of mastery questionnaire (DMQ) and (2) EEG data collected under various conditions. Power mobility skills were also assessed. METHODS: The participant was a three-year, two-month-old girl with spastic quadriplegic cerebral palsy, gross motor function classification system level V. Each target behaviour was measured weekly. During intervention phases, power mobility training was provided. RESULTS: Improvements were noted in subscale scores of the DMQ. Short-term and long-term EEG changes were also noted. Improvements were noted in power mobility skills. CONCLUSIONS: The participant in this exploratory project demonstrated improvements in power mobility skill and function. EEG data collection procedures and variability in an individual's EEG activity make it difficult to determine if the participant's spectrum of EEG activity actually changed in response to power mobility training. Additional studies are needed to investigate the impact of power mobility training on the spectrum of EEG activity in children who have multiple, severe impairments. Implications for Rehabilitation Power mobility training appeared to be beneficial for a child with multiple, severe impairments though the child may never become an independent, community-based power wheelchair user. Electroencephalography may be a valuable addition to the study of power mobility use in children with multiple, severe impairments. Power mobility training appeared to impact mastery motivation (the internal drive to solve complex problems and master new skills) in a child who has multiple, severe impairments.

Power Mobility Training for Young Children with Multiple, Severe Impairments: A Case Series.

AIMS: Young children with neurodevelopmental conditions are often limited in their ability to explore and learn from their environment. The purposes of this case series were to (1) describe the outcomes of using an alternative power mobility device with young children who had multiple, severe impairments; (2) develop power mobility training methods for use with these children; and (3) determine the feasibility of using various outcome measures. METHODS: Three children with cerebral palsy (Gross Motor Function Classification System Levels IV, V, and V) ages 17 months to 3.5 years participated in the case series. Examination included the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) and the Dimensions of Mastery Questionnaire (DMQ). An individualized, engaging power mobility training environment was created for each participant. Intervention was provided for 60 minutes per week over 12 weeks. RESULTS: All participants exhibited improvements in power mobility skills. Post-intervention PEDI-CAT scores increased in various domains for all participants. Post-intervention DMQ scores improved in Participants 1 and 2. DISCUSSION: The participants appeared to make improvements in their beginning power mobility skills. Additional research is planned to further explore the impact of power mobility training in this unique population.

Infant twins' social interactions with caregivers and same-age siblings.

The study of twin behavior offers the opportunity to study differential patterns of social and communicative interactions in a context where the adult partner and same-age peer are equally familiar. We investigated the development of social engagement, communicative gestures, and imitation in 7- to 25-month-old twins. Twin dyads (N=20 pairs) participated in 10-min, semi-structured play sessions, with the mother seated in a chair completing paperwork for half the session, and on the floor with her children for the other half. Overall, twins engaged more with their mothers than with their siblings: they showed objects and imitated speech and object use more frequently when interacting with their mothers than with their siblings. When the mother was otherwise engaged, the twins played with toys separately, observed each other's toy play, or were unengaged. These results demonstrate that adult scaffolding of social interactions supports increased communicative bids even in a context where both familiar peers and adults are available as communicative partners.

Effects of video-game play on information processing: a meta-analytic investigation.

Do video games enhance cognitive functioning? We conducted two meta-analyses based on different research designs to investigate how video games impact information-processing skills (auditory processing, executive functions, motor skills, spatial imagery, and visual processing). Quasi-experimental studies (72 studies, 318 comparisons) compare habitual gamers with controls; true experiments (46 studies, 251 comparisons) use commercial video games in training. Using random-effects models, video games led to improved information processing in both the quasi-experimental studies, d = 0.61, 95% CI [0.50, 0.73], and the true experiments, d = 0.48, 95% CI [0.35, 0.60]. Whereas the quasi-experimental studies yielded small to large effect sizes across domains, the true experiments yielded negligible effects for executive functions, which contrasted with the small to medium effect sizes in other domains. The quasi-experimental studies appeared more susceptible to bias than were the true experiments, with larger effects being reported in higher-tier than in lower-tier journals, and larger effects reported by the most active research groups in comparison with other labs. The results are further discussed with respect to other moderators and limitations in the extant literature.

Perspective taking in children's narratives about jealousy.

This study explored relationships between perspective-taking, emotion understanding, and children's narrative abilities. Younger (23 5-/6-year-olds) and older (24 7-/8-year-olds) children generated fictional narratives, using a wordless picture book, about a frog experiencing jealousy. Children's emotion understanding was assessed through a standardized test of emotion comprehension and their ability to convey the jealousy theme of the story. Perspective-taking ability was assessed with respect to children's use of narrative evaluation (i.e., narrative coherence, mental state language, supplementary evaluative speech, use of subjective language, and placement of emotion expression). Older children scored higher than younger children on emotion comprehension and on understanding the story's complex emotional theme, including the ability to identify a rival. They were more advanced in perspective-taking abilities, and selectively used emotion expressions to highlight story episodes. Subjective perspective taking and narrative coherence were predictive of children's elaboration of the jealousy theme. Use of supplementary evaluative speech, in turn, was predictive of both subjective perspective taking and narrative coherence.