Chwen-Yng Su

Effectiveness of virtual reality using Wii gaming technology in children with Down syndrome.

This quasi-experimental study compared the effect of standard occupational therapy (SOT) and virtual reality using Wii gaming technology (VRWii) on children with Down syndrome (DS). Children (n = 105) were randomly assigned to intervention with either SOT or VRWii, while another 50 served as controls. All children were assessed with measures of sensorimotor functions. At post-intervention, the treatment groups significantly outperformed the control group on all measures. Participants in the VRWii group had a greater pre-post change on motor proficiency, visual-integrative abilities, and sensory integrative functioning. Virtual reality using Wii gaming technology demonstrated benefit in improving sensorimotor functions among children with DS. It could be used as adjuvant therapy to other proven successful rehabilitative interventions in treating children with DS.

Reliability and responsiveness of the Movement Assessment Battery for Children–Second Edition Test in children with developmental coordination disorder

Aim  To examine the internal consistency, test–retest reliability, and responsiveness of the Movement Assessment Battery for Children–Second Edition (MABC‐2) Test for children with developmental coordination disorder (DCD).

Reliability and responsiveness of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition in children with intellectual disability

We examined the internal consistency, test-retest reliability, and the responsiveness of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) for children with intellectual disabilities (ID). One hundred children with ID aged 4-12 years tested on 3 separate occasions: two baseline measurements with a 2-week interval before the intervention, and a follow-up measurement after 4 months of pediatric rehabilitation program. The test-retest reliability and internal consistency of the total scale were excellent, with an ICC of 0.99 (95% confidence interval) and alpha of 0.92. Responsiveness was acceptable for all BOT-2 measures except the balance subtest. The minimal detectable change (MDC) and the minimal important difference (MID) values yielded a lower sensitivity level but a higher specificity level. Implications for interpreting these responsiveness indices are discussed.

Patterns of Participation and Enjoyment in Adolescents with Down Syndrome.

This study aimed to determine participation and enjoyment in young people with Down syndrome (DS) in Taiwan and to assess how participation varies across gender, cognitive, and motor function variables. Using the Childrens Assessment of Participation and Enjoyment, data on participation were collected from 997 adolescents with DS and their families. Findings indicated limited diversity and intensity of participation, with proportionately greater involvement in informal activities. Youth with better cognitive and motor functions participated more often in activities and reported higher enjoyment and social engagement with these. These findings provide a foundation for an improved understanding of activity participation of youth with DS. Service providers and families could provide and plan activities to ensure more satisfying and meaningful participation.

Rasch analysis of the Bruininks–Oseretsky Test of Motor Proficiency-Second Edition in intellectual disabilities

The Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) is widely used to assess motor skills for both clinical and research purposes; however, its validity has not been adequately assessed in intellectual disabilities (ID). This study used partial credit Rasch model to examine the measurement properties of the BOT-2 among 446 children and adolescents with ID aged 4-18 years. Seventeen items were identified as problematic in the Rasch modeling. After removal of these items, the appropriateness of the response categories was examined in the 36 remaining items. Where the item response categories failed to express an increasing level of the trait (disordered thresholds), collapsing adjacent categories was performed to address this issue. After rescoring most items, items in each composite of the revised BOT-2 showed good fit to the Rasch model and demonstrated excellent reliability (range 0.90-0.97). No differential item functioning was detected with respect to age and gender. The ability of the revised composites to differentiate between mild versus moderate to severe ID was better than those of the original BOT-2. Items from the manual coordination and strength and agility composites were well targeted to the sample, whereas items from fine manual control and body coordination composites were mostly targeted at the lower levels of ability in these domains. Items of higher difficulty may be supplemented to increase the range of ability levels of the people to whom these two composites can be applied with precision.

Correlations of sensory processing and visual organization ability with participation in school-aged children with Down syndrome

Previous work has highlighted delays and differences in cognitive, language, and sensorimotor functions in children diagnosed with Down syndrome (DS). However, sensory processing and visual organization abilities have not been well-examined in DS to date. This study aimed to investigate the developmental profile of sensory processing and visual organization abilities, body functions classified by the World Health Organizations ICF model, and their impacts on participation in DS to guide research and evidence-based practices. Two hundred and six children (101 boys, 105 girls) with DS (age range = 6 years 1 month to 12 years 10 months; mean age = 8 years 1 month) were assessed on measures of sensory processing (Sensory Profile), visual organization ability (Hooper Visual Organization Test), and activity participation (Vineland Adaptive Behavior Scale, School Function Assessment). Our findings characterized the developmental continuum of body functions (sensory processing and visual organization) of children with DS, and revealed their correlations with activity participation. Interventions focused on improving body functions is needed while stressing the acquisition of functional skills that increase participation in age-appropriate activities.

Wisconsin Card Sorting Test Performance in Children with Developmental Coordination Disorder.

The primary purpose of this study was to investigate and compare the executive functions measured by the Wisconsin Card Sorting Test (WCST) between children with developmental coordination disorder (DCD) and age-matched normal controls. A second purpose was to examine the relations between executive functions and school functions in DCD children. Seventy-one children with DCD and 70 children without motor problems were recruited from 14 public schools. Executive functions and school functions were assessed using the WCST, and the School Function Assessment--Chinese Version (SFA-C) respectively. Univariate analyses demonstrated significant between-group differences in five WCST measures. The logistic regression analysis showed differences between two groups on eight SFA-C subscales, and significant correlation between items measured on WCST and SFA-C was also found. The result of the study provides further evidence of impaired sub-domains of executive functions (i.e., mental shifting, flexibility) in children with DCD. The finding also adds to recent investigations into the relationship between executive functions and school functions in DCD. Implications for rehabilitation professionals and recommendations for further research are discussed.

Occupational Therapy Home Program for Children with Intellectual Disabilities: A Randomized, Controlled Trial.

This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, and The Childrens Assessment of Participation and Enjoyment scores at 10 and 20 weeks. The 20-week OTHP produced significant difference in fine motor function, activity participation, and parent satisfaction with performance, compared to those of no OTHP. Pediatricians can advise families to implement 20 weeks of OTHP with an average 15 min per session to facilitate functional changes of children with ID.

A Comparison of Perceptions among Employed and Unemployed Individuals with Psychiatric Disabilities regarding Factors Affecting Employment

This study compared the perspectives of employed and unemployed individuals with psychiatric disabilities regarding factors influencing employment. Ninety-six employed and 113 unemployed individuals completed questionnaires assessing the importance of several factors in successfully maintaining employment. These factors included psychiatric symptoms; the persons ability, work habits, and attitudes; and environmental factors. Exploratory factor analyses supported a unidimensional structure for each of the four subscales, with high internal consistency estimates across all subscales (coefficient alpha values ranging from 0.84 to 0.95). The results indicated no significant differences between the two groups in mean ratings for the items and subscales. Employed people perceived psychiatric symptoms as being more important than the other three subscales; however, in comparison, unemployed people gave the highest mean rating to environmental factors (e.g., employers acceptance, absence of stigma, working in a safe environment, and supportive family). Overall, the two groups had moderate agreement on the most important influences on employment. Implications for services are discussed.

A Rasch-based validation of the Hooper Visual Organization Test in Chinese-speaking children.

The aim of this study was to examine the validation of the Hooper Visual Organization Test (HVOT) for use in children by testing for item fit, unidimensionality, item hierarchy, reliability, and screening capacity. A modified scoring system was devised for the HVOT so that children received some credit for being able to describe the function of objects. The HVOT was administered to 630 typically developing school-aged children and 210 children with Down syndrome matched for age and education. Rasch analysis and receiver operating characteristic curve were applied. Rasch analysis of data from typically developing children showed that twelve items were candidates for deletion due to poor fit to the Rasch model, violation of normality and age-related item bias. Removing these items resulted in a shortened version with 18 items that forms a reliable and strong unidimensional, hierarchical scale. The items were well targeted to the ability level of the children tested. Area under the curve for HVOT-18 was 0.84, indicating very good ability to identify visual integration deficit in children with Down syndrome. The 18-item HVOT can be summed to produce an overall index of visual synthetic ability. Subsequent work is needed to validate its use in other childhood disabilities.