Home-Based, Therapist-Assisted, Therapy for Young Children with Primary Complex Motor Stereotypies

Publication date: Available online 18 May 2018
Source:Pediatric Neurology
Author(s): Harvey S. Singer, Shreenath Rajendran, H. Richard Waranch, E. Mark Mahone
BackgroundComplex motor stereotypies (CMS) typically begin before 3 years, and include rhythmic, repetitive, fixed movements, that last for seconds-minutes, and stop with distraction.ObjectiveTo evaluate the effectiveness of a home-based, parent-provided therapy accompanied by scheduled telephone calls with a therapist, in 5-7 year-olds with primary CMS.MethodsEligible families received an instructional DVD, written instructions, and scheduled telephone contacts with a therapist at baseline (DVD receipt), 1, 3, and 8 weeks later. At each call, parents completed outcome measures and received feedback. Outcome scales (Stereotypy Severity Scale (SSS) Motor and Impairment scales and a Stereotypy Linear Analogue Scale (SLAS) were also completed via the internet (REDCap) - at screening, 1 and 2 months post baseline call. At study conclusion, participants were divided into an Intent-to-Treat (ITT; had at least one call) or a Lost-to-Follow-up (LTF) group.Results38 children (m=6 years ± 11 months) were enrolled. The LTF (n=14) had significantly higher scores, than the ITT (n=24) group, on all ADHD ratings (p<0.01), but not stereotypy severity. Primary outcome scores, acquired by telephone and REDCap, showed a significant reduction in SSS Motor and Impairment scores between the initial and the last completed evaluation (p≤0.001). Calculated change ratios were SSS Motor -0.23/-0.30 (call/REDCap); SSS Impairment -0.31/-0.32; and SLAS -0.54 (REDCap). Clinical improvement was further supported by results from a parent improvement scale and end of study questionnaires.ConclusionHome-based, parent-administered behavioral therapy supplemented by telephone contact with a therapist is effective in reducing complex motor stereotypies in children.



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