Karen Harpster

Feasibility and preliminary outcomes for Move-Into-Learning: An arts-based mindfulness classroom intervention

This feasibility study investigated teachers’ assessment of Move-Into-Learning (MIL), an eight-week school-based Mindfulness-based intervention (MBI), designed to reduce stress and improve behavior in at-risk elementary students. MIL was implemented with two classrooms of third-grade students (n = 41) in a low income, urban neighborhood using a pretest to posttest single group design. One of the two classrooms (n = 20) completed a two-month follow-up measure examining sustainability of results. The program included mindfulness meditation, yoga movement with breathing exercises, and Appreciative Inquiry (AI) exercises that invited students to express themselves in the written and visual arts. MIL was evaluated via semi-structured teacher interviews and the Connors’ Behavior Rating Scale. Pre/post intervention showed significant improvement in behaviors, such as hyperactivity (t[1,39 = 3.1; p = 0.002), and highly significant differences in the attention-deficit/hyperactivity disorder index (t[1,39] = 5.42; p < 0.001) and cognitive/inattentiveness (t[1,39] = 5.56; p < 0.001) subscales. Teacher interview data supported these findings suggesting MIL as a feasible and acceptable MBI that can be implemented in a third-grade classroom.

Motor characteristics of young children referred for possible autism spectrum disorder.

Purpose: To examine motor characteristics of children referred for evaluation for autism spectrum disorder (ASD) using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Methods: BSID-III scores were collected through retrospective chart review for 30 children (mean age = 31.57 ± 6 months) admitted to an outpatient autism evaluation clinic. Results: Children referred to an ASD clinic demonstrated a mean delay of 6 months for gross motor skills and 8 months for fine motor skills. There were no differences in total score or item analysis in group comparisons of motor characteristics in young children who did or did not receive a diagnosis of ASD. Conclusions: These results suggest that a delay in fine and gross motor skills at an early age is a characteristic of infants referred to an ASD clinic. Furthermore, the BSID-III may not be sensitive enough to distinguish between referred children with and without ASD.

Functional and structural connectivity of the visual system in infants with perinatal brain injury.

Background:Infants with perinatal brain injury are at risk of later visual problems. Advanced neuroimaging techniques show promise to detect functional and structural alterations of the visual system. We hypothesized that infants with perinatal brain injury would have less brain activation during a visual functional magnetic resonance imaging (fMRI) task and reduced task-based functional connectivity and structural connectivity as compared with healthy controls.Methods:Ten infants with perinatal brain injury and 20 control infants underwent visual fMRI and diffusion tensor imaging (DTI) during natural sleep with no sedation. Activation maps, functional connectivity maps, and structural connectivity were analyzed and compared between the two groups.Results:Most infants in both groups had negative activation in the visual cortex during the fMRI task. Infants with brain injury showed reduced activation in the occipital cortex, weaker connectivity between visual areas and other areas of the brain during the visual task, and reduced fractional anisotropy in white matter tracts projecting to visual regions, as compared with control infants.Conclusion:Infants with brain injury sustained in the perinatal period showed evidence of decreased brain activity and functional connectivity during a visual task and altered structural connectivity as compared with healthy term neonates.

Feasibility of Pediatric Game-Based Neurorehabilitation Using Telehealth Technologies: A Case Report

This case report is the first in a series of reports designed to determine the feasibility of implementing game-based neurorehabilitation using telehealth technologies (GbN+TT) for children with cerebral palsy, evaluate the responsiveness of relevant outcome measures to changes in motor impairment and activity participation after intervention, and identify technological challenges associated with implementation of GbN+TT. The participant completed more than 56 hr of game-based neurorehabilitation over 8 wk using the Timocco platform in his home. The primary measures of motor impairment (Bruininks–Oseretsky Test of Motor Proficiency, Second Edition) and function (Pediatric Motor Activity Log) were both sensitive to change. Results indicate that it is feasible to administer GbN+TT to a child with cerebral palsy and monitor outcomes using standardized assessments.

Changes of White Matter Diffusion Anisotropy in Response to a 6-Week iPad Application-Based Occupational Therapy Intervention in Children with Surgically Treated Hydrocephalus: A Pilot Study

Objective Our aims were (1) to test whether diffusion tensor imaging (DTI) could detect underlying white matter (WM) changes after a 6-week iPad application-based occupational therapy (OT) intervention in children with surgically treated hydrocephalus (HCP); and (2) to explore the association between WM changes and performance outcomes. Methods Five children (age range: 6.05-9.10 years) with surgically treated HCP completed an intensive iPad-based OT intervention targeting common domains of long-term deficits in children with HCP. The intervention included 6 weekly sessions in an OT clinic supplementing home-based program (1 hour/day, 4 days/week). DTI and neuropsychological assessments were performed before and after the intervention. Observation After the therapy, significant increases in fractional anisotropy (FA) and/or decreases in radial diffusivity were found in extensive WM areas. All participants demonstrated an increased perceptual reasoning index (PRI, Wechsler Abbreviated Scale of Intelligence: 2nd edition, PRI gains = 14.20 ± 7.56, p = 0.014). A significant positive correlation was found between PRI increase and the increase of FA in the right posterior limb of the internal capsule and the right external capsule (both p < 0.05). Conclusion This study provides initial evidence of DTIs sensitivity to detect subtle WM changes associated with performance improvements in response to a 6-week OT intervention in children with HCP.

Sensory Features of Toddlers at Risk for Autism Spectrum Disorder

OBJECTIVE We observed sensory features in toddlers ages 12-24 mo with risk factors for autism spectrum disorder (ASD) and explored their relationship to general development and early signs of ASD. METHOD Participants (N = 46) included toddlers with higher risk for ASD. All participants were administered standardized assessments of sensory features, early signs of ASD, and general development at a single study visit. RESULTS Sensory features in toddlers were characterized as either adaptive or reactive. Toddlers with more difficulties in oral sensory processing displayed more early signs of ASD. Typical oral and auditory processing were associated with higher cognitive function, and toddlers with fewer sensory features overall had more mature language skills. CONCLUSION Specific sensory features were associated with both early signs of ASD and less mature general development. Replication of this preliminary study is required.