Gross Motor Function and Manual Abilities in Cerebral Palsy

The Journal of Child Neurology published research on the relationship between gross motor function and manual ability in cerebral palsy. Three hundred thirty two (332) Canadian children with cerebral palsy were included in the study. There was moderate overall agreement between the Gross Motor Function Classification System and Manual Ability Classification Scale Levels with a strong positive correlation. This agreement varied based on subtype of cerebral palsy and cognitive level.

The following results were seen:

• moderate agreement among children with spastic quadriparesis and dysketic cerebral palsy,
• fair agreement in children with spastic diplegia
• poor agreement in children with spastic hemiplegia. 
• children with cognitive impairment showed a higher correlation than those without cognitive impairment

Reference: Maryam Oskoui, Annette Majnemer, Lynn Dagenais, and Michael I. Shevell The Relationship Between Gross Motor Function and Manual Ability in Cerebral Palsy J Child Neurol 0883073812463608, first published on October 30, 2012 doi:10.1177/0883073812463608 

Technology and Written Productivity

The Canadian Journal of Occupational Therapy published a research review on the effects of technology use to support written productivity in children with learning disabilities.  A search revealed 27 papers that met inclusion criteria.  The evidence in favor of using technology to support written productivity was a moderately low level and inconclusive.  Trends did suggest a positive influence of some technology on children's performance and behavior.  The authors of the study concluded that high quality research with newer technologies is needed.

Reference: Batorowicz, Beata; Missiuna, Cheryl A.; Pollock, Nancy A. Technology supporting written productivity in children with learning disabilities: A critical review. Canadian Journal of Occupational Therapy, Volume 79, Number 4. DOI: http://dx.doi.org/10.2182/cjot.2012.79.4.3  

Paper "Chain of Events"

Download this free template to make the paper "chain of events".  You can get the download at YourTherapySource.com.

Using Metronome Apps to Teach Gross Motor Skills

Lately, I have been using a free metronome app on the iPhone to help teach gross motor skills.  There are several metronome apps so pick the one that works best for you.  I downloaded this one since it was free and it works fine for my purposes.

Basically you can set the beat on the metronome to a fast or slow speed.  The tick tock on the metronome is an excellent way to teach children stop and go, self control, rhythm and motor timing.

After setting the metronome to a slow speed I instruct the student to only step, jump or hop on the beat.   I usually put tape, circles or use a floor ladder to designate where to step or jump.  On each tick they are to jump but only on the tick. It forces the child to listen and to stop and go on a beat.  Sometimes I will also move the iPhone back and forth as it ticks to provide a visual cue along with the auditory cue.  For some children we stay at this level for awhile - practicing different skills (clapping, stepping, jumping, hopping, etc) to the beat encourages motor planning, motor timing, reflexes and self control.  When they master moving to the beat, we progress to higher level skills that require similar motor timing - ie jumping jacks, skipping and jumping rope.  The kids seem to enjoy the predictable rhythm of the metronome.  In my opinion there appears to be immediate carry over of the isolated skill to other functional skills.

Next I plan on trying to use the metronome with gait training in children with cerebral palsy to help increase cadence.  

Have you tried using a metronome to teach gross motor skills?   

Review on Cerebral Palsy

Pediatrics performed a systemic review in order to compile information on the rates of co-occurring impairments, diseases, and functional limitations with cerebral palsy into simple clinical findings. After reviewing 1366 papers 82 were appraised and 30 were included in the meta-analyses.

The results indicated the following for children with cerebral palsy:

• 3 in 4 were in pain
• 1 in 2 had an intellectual disability
• 1 in 3 could not walk
• 1 in 3 had a hip displacement
• 1 in 4 could not talk
• 1 in 4 had epilepsy
• 1 in 4 had a behavior disorder
• 1 in 4 had bladder control problems
• 1 in 5 had a sleep disorder
• 1 in 5 dribbled
• 1 in 10 were blind
• 1 in 15 were tube-fed
• 1 in 25 were deaf.

You can view the entire article here.

Reference: Iona Novak, Monique Hines, Shona Goldsmith and Richard Barclay. Clinical Prognostic Messages From a Systematic Review on Cerebral Palsy. Pediatrics DOI: 10.1542/peds.2012-0924 originally published online October 8, 2012.

November Digital Magazine for Pediatric OT/PT

Here is the latest issue of Your Therapy Source Digital Magazine for Pediatric OT and PT. If you can not view below go to YourTherapySource to download a pdf version.

Open publication - Free publishing

Doodle Diaries

Check out this latest freebie - add to the doodle picture or squiggle and write a story about it.  It is available on dotted line and double line paper.  You can download the freebie at YourTherapySource.

Here is a picture of a completed doodle and story -