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Efficacy of parent-delivered behavioral therapy for primary complex motor stereotypies
Matthew W Specht1, E Mark Mahone1,2, Tina Kline1
1Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Insights
A home-based instructional DVD effectively reduced symptoms of complex motor stereotypies (CMS) in children. This parent-administered behavioral therapy showed significant improvements in motor and impairment scores.
Area of Science:
- Pediatric neurology
- Behavioral therapy
- Developmental disorders
Background:
- Primary complex motor stereotypies (CMS) are characterized by persistent, patterned, repetitive, rhythmic movements in typically developing youth.
- Effective, accessible interventions are needed for managing CMS in children.
Purpose of the Study:
- To evaluate the efficacy of an instructional DVD as a home-based, parent-administered behavioral therapy for primary CMS.
- To assess the impact of this intervention on motor symptoms and functional impairment.
Main Methods:
- Eighty-one children diagnosed with primary CMS were enrolled in the study.
- Outcome measures included the Stereotypy Severity Scale (SSS) - Motor and Impairment scores, and Stereotypy Linear Analog Scale (SLAS).
- Fifty-four participants completed assessments at 1, 2, or 3 months post-intervention.
Main Results:
- Significant reductions were observed in SSS Motor (-15%), SSS Impairment (-24%), and SLAS (-20%) scores (p<0.001).
- Younger children (7-8 years) showed the greatest relative treatment benefit.
- Parental global assessments indicated progressive improvement throughout the study duration.
Conclusions:
- An instructional DVD providing parent-delivered behavioral therapy is a safe and effective intervention for primary CMS.
- This home-based approach offers a promising avenue for managing complex motor stereotypies in pediatric populations.
Aim:
Primary complex motor stereotypies (CMS) are persistent, patterned, repetitive, rhythmic movements in young people with typical development. This study evaluated the efficacy of an instructional DVD as a home-based, parent-administered, behavioral therapy for primary CMS.
Method:
Eighty-one children with primary CMS were enrolled. Primary outcome measures included the Stereotypy Severity Scale (SSS) - Motor and Impairment scores, and Stereotypy Linear Analog Scale (SLAS). Mean CMS onset was 13.4 months (SD 13.1). Eligibility required observed CMS. Psychiatric disorders were not exclusionary and a stable medication regimen was required. Intellectual disability, neurological disorder, autism spectrum disorder, and tics were exclusionary. Initial assessments were completed via REDCap before receipt of the DVD. Fifty-four of the 81 children (34 male, 20 female; mean age 8y 2mo, SD 1.42, range 7-14y) completed assessments at 1, 2, or 3 months after receiving the DVD.
Results:
Reductions (baseline to last assessment) in SSS Motor, SSS Impairment, and SLAS scores (all p<0.001) represented change ratios of -15%, -24%, and a -20% respectively. Greatest relative treatment benefit was observed by younger children (ages 7-8y), and by 1 month after receipt of DVD, while a parent global assessment scale showed progressive improvement throughout the study.
Interpretation:
An instructional DVD for parent-delivered behavioral therapy was a safe, effective intervention for primary CMS.
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