Effects of a visual perception-based occupational therapy program on reading and motor skills in children with developmental dyslexia: Single blind randomized cross-over study design.

This study aimed to examine the effects of a visual praxis-based occupational therapy (VPOT) program on reading and motor skills for children with developmental dyslexia (DD). Forty-two children were included in the study. Additionally, before VPOT, the Reading-Aloud and Reading-Comprehension Test 2 (ORSRC-2) and the Bruininks-Oseretsky Motor-Proficiency-Test-2-Brief Form (BOT2-BF) were applied to the participants. According to the study design, VPOT was applied to two sessions per week for 8 weeks to group A. During this period, group B was accepted as the control group. At the end of these 8 weeks, evaluation tests were applied to both groups. Then, group A was defined as the control group and Group B as the intervention group, and VPOT was applied to Group B. At the end of another 8 weeks, evaluation tests were applied to both groups for the third time. When the final ORSRC-2 results were examined, VPOT was found to be an effective program for improving reading skills. Additionally, when the final BOT2-BF results were examined, VPOT was determined to be effective in improving motor skills (p < 0.05). We believe that it is important to carry out comprehensive studies such as the VPOT program to solve problems in the physical and learning activities of children with DD.

Community Participation, Supports and Barriers of Adolescents with and without Attention Deficit Hyperactivity Disorder.

AIM: To compare participation patterns, environmental supports, and barriers to community activities in adolescents with and without attention deficit hyperactivity disorder (ADHD) in Turkey. METHODS: Participants were 94 adolescents with ADHD and 109 adolescents without ADHD ages 13-17 years (mean age 14.6, S.D 1.49 years) Participation frequency, involvement rate, mothers who desired change, and environmental supports and barriers in a community setting were assessed with the Participation and Environment Measure for Children and Youth (PEM-CY). RESULTS: Adolescents with ADHD participated 20.3% less frequently in socializing with peers in the community than adolescents without ADHD. With moderate to large effect sizes, the mean involvement rate in four community activities, including neighborhood outings, community events, socializing with peers in the community, and religious activities, was significantly lower for adolescents with ADHD than for adolescents without ADHD. CONCLUSION: Adolescents with ADHD participate less frequently and are less involved in socializing with peers in the community. Almost half of all ADHD adolescents never participate in community events. It was seen that cognitive difficulties, sensory qualities, and safety may prevent adolescents with ADHD from socializing with peers in the community.

Impact of stroke on people that receive rehabilitation and are living in Ankara, Turkey.

Background: Clinical guidelines for stroke rehabilitation and practices vary between high and low/middle-income countries (LMICs). Knowledge of the perceived impact of stroke in Turkey is limited. Understanding these perceptions can serve as a basis for developing rehabilitation. Design and methods: The aim was to investigate and compare the perceived impact of stroke in two groups of people living in Ankara. A cross-sectional study with 150 participants divided by stroke onset (Group I: stroke onset <12 months; Group II: >12 months) was conducted. The Barthel Index was used to describe the level of independence in daily living activities and stroke severity. The Stroke Impact Scale (SIS 3.0) was used to investigate the perceived impact of stroke. Results: The proportion of mild strokes was 78 and 82%, respectively, and 46% of participants in the total sample were moderately dependent. The impact of stroke was high; mean domain scores were below 50 in six of the eight SIS domains. Conclusions: Turkish stroke survivors perceived a higher impact of stroke regardless of the time passed since stroke onset, compared to survivors from other countries, including other LMICs. The high impact among survivors with mostly mild stroke indicates that Turkish survivors might not receive adequate rehabilitation. The content of rehabilitation services needs to be developed, and an evaluation of individually tailored interventions, preferably with a multidisciplinary approach, is warranted to find ways to decrease the perceived impact of stroke among Turkish stroke survivors.

How cognitive and behavioural body-functions of children with ADHD are linked to their participation and environmental supports?

BACKGROUND: Children with chronic conditions face participation restrictions and exclusions. AIMS: To investigate how cognitive and behavioural body-functions are associated with 1) participation patterns and 2) environmental factors among children with attention deficit hyperactivity disorder (ADHD). METHODS AND PROCEDURES: The study included 83 children with ADHD. Cognitive and behavioural body-functions were assessed with Conners' Parent Rating Scale-Revised Long-Version. The participation patterns of children were assessed with Participation and Environment Measure for Children and Youth (PEM-CY). Multiple regression analyses were used to examine the relationships between cognitive and behavioural body-functions and (1) participation patterns at home, school and community settings, and (2) environmental supports and barriers. OUTCOME AND RESULTS: In home setting, inattention and ADHD index which determine ADHD children from typically developing peers, were the strongest factors, explaining 24.9 % of variance in activities that mothers wanted to change. In school setting, presence/level of oppositional behaviours had the strongest effect on environmental barriers, with variation of 29.8 %. In community setting, the strongest factor explaining environmental helpfulness was anxious/shy behaviours (16.1 %). CONCLUSIONS AND IMPLICATIONS: When seeking to improve participation of children with ADHD both the cognitive and behavioural demands of chosen activities should be modified while creating environments that supports these challenges.

Effects of the Visual Praxis-Based Occupational Therapy Education Program on different kinds of reading skills: Single-blind randomized follow-up study.

This study aims to examine the long-term effects of Visual Praxis Based Occupational Therapy Program (VP-OTP) on the reading skills of children with Developmental Dyslexia. A total of 126 children with Developmental Dyslexia participated in the study. The participants were then divided into two groups (Intervention and Control groups) of equal sizes (n = 63) using a random number generator without replacement. The intervention group received VP-OTP in two weekly sessions for 8 weeks. All participants were assessed with the Oral Reading Skills and Comprehension Test-II (Sobat®-II) at three time points; pretest, post-test, and follow-up. The intervention group showed promising results as the Sobat®-II's Reading Accuracy, Reading Speed, Fluent Reading, Reading Comprehension Total Score significantly increased after the intervention (p ≤ 0.05) and the scores were maintained at the follow-up (p > 0.05). The VP-OTP intervention provided a maintained improvement in reading skills of children with Developmental Dyslexia.

Where Exactly Is the Therapist in Virtual Reality and Game-Based Rehabilitation Applications? A Randomized Controlled Trial in Children with Specific Learning Disability.

Objective: Children with specific learning disability (SLD) experience problems in visual perception that influence academical skills and activities of daily living. Virtual reality and game-based rehabilitation applications are becoming increasingly popular in rehabilitation, including visual perception rehabilitation. However, the usage of commercially available and easily accessible games as intervention tools raises the question whether rehabilitation conducted with these games is really rehabilitation, or just casual gameplay. Therefore, we aimed to investigate the effects of a nonactively supervised (game-based intervention program [GIP]) and an actively supervised (therapist guided game-based intervention program [TGGIP]) on the visual perception skills of children with SLD. Materials and Methods: This study was designed as a single-blind randomized, controlled trial of a TGGIP on visual perception skills in children with SLD compared with the self-oriented, nonsupervised program (GIP). A total of 138 children with SLD participated in the study and were randomly divided into two groups (TGGIP and GIP). Children's visual perception skills were assessed with Motor-Free Visual Perception Test-3. Results: Both groups showed significant improvements in visual perception after the intervention programs (P < 0.05). However, the TGGIP (a supervised and structured intervention program) was significantly more effective in improving the visual perception skills compared with the GIP (a standard, nonsupervised, and unstructured intervention program) (P < 0.05). Conclusion: We think that the TGGIP methodology that we designed acts as a facilitator for therapists in using trademarked, commercially available, and easily accessible games for structured and supervised virtual reality and game-based rehabilitation applications.

Investigating the compatibility, interchangeability, and clinical usability of BOT2-BF and BOT2-SF in primary school-aged children with and without developmental dyslexia.

The aim of our study was to determine the sensitivity and specificity levels of BOT2-BF and BOT2-SF tests applied to children with developmental dyslexia and to examine their clinical usability. This study was designed as a case-controlled study. 82 (study group 41, control group 41) 7-12 year children were included. The study occurred three stages. In the first place, the similarities and differences of BOT2-BF and BOT2-SF tests observed in clinical practices were examined by taking the feedback of experts and test correlations. In the second step, BOT2-BF and BOT2-SF tests were examined with reference to the Core Outcome Set (COS) evaluation criteria. In the last step, in order to examine the sensitivity and specificity levels of the tests, assessments were performed in two groups with 1-week intervals. According to the COS results, the BOT2-BF test was examined better than the BOT2-SF test under cross-cultural validity title. The sensitivity and specificity of BOT2-SF were 0.92 and 0.51, and for BOT2-BF were 0.92 and 0.41, respectively. This study will help clinicians working on children with developmental dyslexia to decide the type of test they will use to evaluate and easy access to materials motor proficiency.

The relationship of motor development with sensory processing among infants born very preterm: a prospective case-control study.

BACKGROUND: Little is known about the relationship between sensory processing and motor development in very preterm infants. The purpose of this study was to explore the relationship of motor development with sensory processing among such infants with developmental delay and those who had typical development at the ages of 8 and 12 months. METHODS: This prospective case-control study included 61 preterm infants (31 males, 30 females, mean gestational age: 29.1 weeks). The infants had a gestational age of 32 weeks or less and a current corrected age of 8 months, and they had spent at least 15 days in the neonatal intensive care unit. Motor development was assessed with the Neuro-sensory Motor Developmental Assessment (NSMDA), and sensory processing was evaluated with the Test of Sensory Functions in Infants (TSFI). RESULTS: There were very strong positive correlations between the gross and fine motor scores of the NSMDA and the TSFI`s subdomain scores and total scores (r=0.85-0.93, p < 0.001). There were also very strong negative correlations between the functional level according to the NSMDA and the subdomain scores and total scores of the TSFI (r=-0.89-0.94, p < 0.001). CONCLUSIONS: The results show that sensory processing and motor development are related parts of the development of very preterm infants. In the early rehabilitation process, therapists should comprehensively take motor and sensory development into consideration.

Assessment of Participation within the International Classification of Functioning, Disability, and Health (ICF): The Turkish Validity and Reliability of the Participation Scale.

OBJECTIVE: The aim of the study was to investigate the reliability and validity of the Turkish version of the Participation Scale (P-Scale). METHODS: A total of 152 students, with a mean age of 20.27 ± 2.19, participated in the study. Sociodemographic information (age, gender, and family income) was recorded; all participants completed the P-Scale twice with a 15-day interval. Translation and cross-cultural adaptation were performed to analyze the validity and reliability of the P-Scale. Cronbach's alpha and McDonald's alpha were used for scale reliability statistics and explanatory (EFA) and confirmatory (CFA) factor analysis; Mardia's multivariate normality and assumption tests were used for the validity of the scale. The factor extraction methods were minimum rank factor analysis in EFA and weighted least squares mean and variance adjusted estimator polychoric correlation matrix in CFA. RESULTS: Internal consistency of the scale was found good with Cronbach's alpha (0.852) and excellent with McDonald's alpha (0.924). The EFA and CFA resulted in two-factored structure, with the explained variance found to be higher than 30%. CONCLUSIONS: Analysis demonstrated that the P-Scale had a satisfactory level of reliability and validity in Turkish university students.

Home participation, support and barriers among children with attention-deficit/hyperactivity disorder before and during the COVID-19 pandemic.

OBJECTIVES: Few studies have focused on the participation of children with attention-deficit/hyperactivity disorder (ADHD) in daily routine and leisure activities. This study aimed to compare the participation, support and barriers for children with ADHD at home pre-COVID-19 and during the COVID-19 outbreak. METHODS: The study included 55 children with ADHD aged 6-11 years. Participation frequency, involvement, desire for change, supports and barriers at home were assessed using the Participation and Environment Measure for Children and Youth (PEM-CY). RESULTS: During the COVID-19 pandemic compared with the pre-COVID-19 period, the mean frequency of participation of children with ADHD in computer and video games (5.8% vs 5%, respectively), socialising with other people (7% vs 6.2%) and household chores (5.5% vs 4.6%) was shown to be significantly higher (p < 0.05). Mothers of children with ADHD reported higher levels of involvement during the COVID-19 pandemic compared with the pre-COVID-19 period across four areas of home participation, including computer and video games (4.1% vs 3.2%, respectively), arts, crafts, music and hobbies (3.7% vs 3%), household chores (3.6% vs 2.8%) and personal care management (4.2% vs 3.5%) p < 0.05). Mothers of children with ADHD reported that during the pandemic the following two features of the environment made participation easier than pre-COVID-19 (p < 0.05): cognitive demands (36.4% vs 60%, respectively) and social demands (5.5% vs 34.5%). More mothers reported that services (92.7%), supplies (87.3%) and information (85.5%) were available and/or adequate in the COVID-19 period than pre-COVID-19 (p < 0.05). CONCLUSIONS: Mothers of children with ADHD reported that their children were participating more frequently in some of the home-related activities during the COVID-19 pandemic compared to pre-COVID-19. Reduced cognitive and social demands, and more readily available resources in the home environment during the COVID-19 period resulted in increased home participation compared to pre-COVID-19.

Investigating the interchangeability and clinical utility of MVPT-3 and MVPT-4 for 7-10 year children with and without specific learning disabilities.

The aim of our study was to determine the sensitivity and specificity levels of MVPT-3 and MVPT-4 in 7-10 year children with specific learning disabilities (SLD) and to compare the clinical usability of these assessment tools. This study was designed as a case-controlled study. 96 ( study group = 48, control group = 48) 7-10 year children were included. The study occurred three stages. In the first place, MVPT-3 and MVPT-4 tests were examined with reference to the Core Outcome Set(COS) evaluation criteria. In the second step, the similarities and differences of MVPT-3 and MVPT-4 tests observed in clinical practices were examined by taking the feedback of experts. In the last step, in order to examine the sensitivity and specificity levels of the tests, assessments were performed in two groups with 1-week intervals. According to the COS results; MVPT-3 test was examined better than MVPT-4 test under cross-cultural validity title. The sensitivity and specificity of the MVPT-3 test were 0.68 and 0.77, and the sensitivity and specificity of MVPT-4 test were 0.50 and 0.87 respectively. This study will help clinicians working on children aged 7-10 to decide the type of test they will use to evaluate visual perception processes.

Investigation on participation, supports and barriers of children with specific learning disabilities.

BACKGROUND: Children with specific learning disabilities (SLD) have been observed to face participation restrictions in their daily life. AIMS: This study aims to examine the participation and environmental features of children with SLD compared to non-disabled children. METHODS AND PROCEDURES: This study was designed as a case-controlled study. Parents of children between 5 and 17 years of age with SLD (n = 90) and those who are non-disabled (n = 88) were included in this study to do the Participation and Environment Measure for Children and Youth (PEM-CY). RESULTS: Differences between groups were found statistically significant in home, school, and community settings between both participation and environmental features (p < 0.05). Children with SLD participated less frequently in school settings and were less involved in activities in home and school settings. Parents of children with SLD desired more change in their child's participation in all settings. Environmental factors were significantly more likely to be identified as barriers in the participation of children with SLD. CONCLUSION AND IMPLICATIONS: This study provides information about participation patterns and environmental factors for many children with SLD. The results provide insights into a rehabilitation program that may improve the participation of children with SLD, and on where greater efforts are needed to support participation and environmental features for children with SLD.

The Effects of Virtual Reality on Motor Functions and Daily Life Activities in Unilateral Spastic Cerebral Palsy: A Single-Blind Randomized Controlled Trial.

Aim: This study was designed to investigate the effects of virtual reality (VR) through Kinect on both gross and fine motor functions and independence in daily living activities in children with unilateral spastic cerebral palsy (USCP). Materials and Methods: This study was designed as a single-blind, randomized, controlled trial. Sixty children with USCP were randomized and split equally between the VR intervention group (10 females and 20 males with a mean age of 10.5 ± 3.62 years) and the traditional occupational therapy (TOT) intervention group (13 females and 17 males with a mean age of 10.06 ± 3.24 years). Both groups were evaluated in terms of motor functioning via the Bruininks-Oseretsky Test of Motor Proficiency-Short Form (BOTMP-SF) and were assessed in accordance with independence in daily activities via the WeeFunctional Independence Measure (WeeFIM). Interventions were conducted for 8 weeks with the main objective of improving motor functions and independence in daily activities. Results: Total motor functions and total independence in daily lives in both groups improved after 8 weeks of intervention. A comparison between groups revealed significantly greater improvements in both gross and fine motor functions and daily activities in the VR group than in the TOT group (P < 0.001). Conclusion: The Kinect-based VR intervention approach is important to improving motor functions and independence in daily activities of children with USCP.

Effectiveness of the virtual reality on cognitive function of children with hemiplegic cerebral palsy: a single-blind randomized controlled trial.

Cerebral palsy is a term covering non-progressive motor and cognitive impairments caused by lesions of the brain. This study aims to evaluate the effectiveness of virtual reality-based rehabilitation program for children with hemiplegic cerebral palsy on cognitive functions. Ninety children (47 boys, 43 girls) with hemiplegic cerebral palsy were randomized to either study (n = 45; 11.18 ± 3.37 years) or control (n = 45; 11.06 ± 3.24 years) groups. The study group received virtual reality intervention in addition to Traditional Occupational Therapy intervention, and the control group received Traditional Occupational Therapy for 20 sessions. Both groups were evaluated by blinded assessors with Dynamic Occupational Therapy Cognitive Assessment for Children to collect information on cognitive functioning. Both groups' cognitive functions were improved after 10 weeks of interventions. The between-group comparison revealed significantly greater improvements in all subtest of cognitive functions in the virtual reality group than in the Traditional Occupational Therapy group (P < 0.001). Our results showed that 10 weeks of virtual reality-based rehabilitation enhanced cognitive functions in children with hemiplegic cerebral palsy. Using virtual reality applications in cognitive rehabilitation was recommended to improve spatial perception, praxis, visuomotor construction and thinking operations in children with cerebral palsy.