Functional neurological movements in children: Management with a psychological approach

Area of Science:

• Pediatric neurology
• Child psychology
• Rehabilitation medicine

Background:

• Functional Movement Disorder (FMD) is a condition affecting children's motor function.
• Current management often involves multidisciplinary approaches.
• Novel therapeutic strategies are needed to enhance symptom management.

Purpose of the Study:

• To develop and evaluate a cognitive behavioural treatment (CBT) approach for pediatric FMD.
• Incorporate novel attention training components into CBT for FMD symptom management.
• Assess the efficacy of this integrated approach in improving children's functioning.

Main Methods:

• A case series involving 18 children (mean age 13 years) diagnosed with FMD.
• Participants underwent CBT incorporating novel attention training components.
• Treatment outcomes were measured using the Child Global Assessment Scale (CGAS) at baseline and post-treatment.

Main Results:

• Significant improvements in CGAS scores were observed post-treatment (p < 0.001).
• All participants demonstrated significant functional changes based on the Reliable Change Index (RCI).
• Clinically significant changes in functioning were evident across classification boundaries.

Conclusions:

• CBT with attention training shows promise for managing FMD in children.
• Further research with larger trials is needed to optimize treatment components.
• Future studies should incorporate objective measures of interoception and attention.