Yee-Pay Wuang

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.

Profiles and Cognitive Predictors of Motor Functions among Early School-Age Children with Mild Intellectual Disabilities.

BACKGROUND The purpose of the study was to describe sensorimotor profile in children with mild intellectual disability (ID), and to examine the association between cognitive and motor function. METHODS A total of 233 children with mild ID aged 7 to 8 years were evaluated with measures of cognitive, motor and sensory integrative functioning. RESULTS Children with mild ID performed significantly less well on all test measures. 44.2% of children scored in the impaired range on seven out of 22 sensorimotor measures. They had weaker fine motor skills than gross motor skills. Sensory integrative functions were only mildly impaired. Total IQ substantially predicted overall performance on each motor test. Specifically, verbal comprehension and processing speed indexes were significant predictors of gross and fine motor function. CONCLUSIONS Sensorimotor dysfunctions were found to be very frequent in children with mild ID. Early identification of sensorimotor impairments is essential to prompt early intervention and facilitate better integration into regular school settings.

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.

Strength and Agility Training in Adolescents with Down Syndrome: A Randomized Controlled Trial.

The purpose of this study was to investigate the effects of a proposed strength and agility training program of adolescents with Down syndrome. Ninety-two adolescents were recruited and evenly randomized to two intervention groups (exercise group vs. control group). The mean age for the exercise and the control group was 10.6±3.2 and 11.2±3.5 respectively. The exercise training program consisted of a 5-min treadmill exercise and one 20-min virtual-reality based activity administered three times a week for 6 weeks. Pre- and post-test measures were taken for muscle strength and agility performance. The measured muscle included hip extensor, hip flexor, knee extensor, knee flexors, hip abductors, and ankle plantarflexor. A handheld dynamometer was used to measure the lower extremities muscle strength, and agility performance was assessed by the strength and agility subtests of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition. The exercise group had significant improvements in agility (p=0.02, d=0.80) and muscle strength of all muscle group (all ps<0.05, d=0.51-0.89) assessed in comparison to the control group after the 6-week intervention. Knee muscle groups including both flexors and extensors had the greatest gains among all the muscles measured. A short-term exercise training program used in this study is capable of improving muscle strength and agility performance of adolescents with DS.

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.

Psychometric comparisons of three measures for assessing motor functions in preschoolers with intellectual disabilities

BACKGROUND Deficit in motor performance is common in children with intellectual disabilities (ID). A motor function measure with sound psychometric properties is indispensable for clinical and research use. The purpose of this study was to compare the psychometric properties of three commonly used clinical measures for assessing motor function in preschoolers with ID: the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, the Movement Assessment Battery for Children-Second Edition and the Peabody Developmental Motor Scale-Second Edition (PDMS-2). METHOD One hundred and ninety-one children aged 3-6 years with ID were evaluated with the three measures at three time points: two baseline measurements with a 1-week interval before the intervention, and a follow-up measurement after 6 months of paediatric rehabilitation programme. One hundred and forty-one participants completed all of the assessments. The distribution (ceiling and floor effects) and reliability (internal consistency and test-retest reliability) of each measure were examined. Concurrent validity, predictive validity, and responsiveness were examined as well. RESULTS All measures, except for the PDMS-2, had significant floor effects or ceiling effects at one or more time points. The three measures had good internal consistency (Cronbach α ≥ 0.86) and test-retest reliability (intraclass correlation coefficient ≥ 0.96). The Spearman ρ correlation coefficient for each pair of the three measures was ≥ 0.80, indicating high concurrent validity. The predictive validity of the three measures was satisfactory (Spearman ρ ≥ 0.52). The responsiveness of the three measures was moderate (0.47 ≤ effect size ≤ 0.74). The minimal detectable changes of the three measures were satisfactory. CONCLUSIONS All three measures showed sufficient reliability, validity and responsiveness in preschoolers with ID, but the PDMS-2 is recommended for its superior psychometric properties.