Purpose: To evaluate the feasibility of implementation, acceptance, and perceived efficacy of a joystick-operated ride-on-toy intervention to promote upper extremity (UE) function in 3-to 14-year-old children with hemiplegic cerebral palsy. Methods: Exit questionnaires were collected from children, caregivers, and clinicians/camp staff following a 3-week ride-on-toy training program incorporated within a summer camp for children with hemiplegic cerebral palsy. Training encouraged children to use their affected UE to maneuver the ride-on-toy. Questionnaires included Likert scale and open-ended questions to assess enjoyment, acceptance, feasibility, and perceived efficacy of the training. Results: All stakeholder groups indicated that the training was enjoyable. Clinicians/staff and caregivers indicated that the training increased children's motivation to use their affected UE and reported perceived improvements in UE movement control and function following training. Conclusions: Our promising preliminary findings call for future research to systematically assess the efficacy of ride-on-toys to promote UE control and function in children with hemiplegic cerebral palsy.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting multiple developmental domains including social communication, behavioral-affective, sensorimotor, and cognitive systems. There is growing evidence for the use of holistic, whole-body, Creative Movement Therapies (CMT) such as music, dance, yoga, theater, and martial arts in addressing the multisystem impairments in ASD. We conducted a comprehensive quantitative and qualitative review of the evidence to date on the effects of CMT on multiple systems in individuals with ASD. The strongest evidence, both in terms of quantity and quality, exists for music and martial arts-based interventions followed by yoga and theater, with very limited research on dance-based approaches. Our review of 72 studies (N = 1,939 participants) across participants with ASD ranging from 3 to 65 years of age suggests that at present there is consistent evidence from high quality studies for small-to-large sized improvements in social communication skills following music and martial arts therapies and medium-to-large improvements in motor and cognitive skills following yoga and martial arts training, with insufficient evidence to date for gains in affective, sensory, and functional participation domains following CMT. Although promising, our review serves as a call for more rigorous high-quality research to assess the multisystem effects of CMT in ASD. Based on the existing literature, we discuss implications of our findings for autism researchers and also provide evidence-based guidelines for clinicians to incorporate CMT approaches in their plan of care for individuals with ASD.

Our research aims to evaluate the utility of joystick-operated ride-on-toys (ROTs) as therapeutic adjuncts to improve upper extremity (UE) function in children with hemiplegic cerebral palsy (HCP). This study assessed changes in affected UE use and function following a three-week ROT navigation training incorporated into an existing constraint-induced movement therapy (CIMT) camp in 11 children (3–14 years old) with HCP. We report changes in scores on the standardized Shriners Hospital Upper Extremity Evaluation (SHUEE) from pretest-to-posttest and changes from early-to-late sessions in percent time spent by the affected arm in: (a) “moderate-to-vigorous activity”, “light activity” and “no activity” bouts based on accelerometer data and (b) “independent”, “assisted”, and “no activity” bouts based on video data. We also explored relationships between standardized measures and training-specific measures of affected UE activity. We found small-to-medium improvements in the SHUEE scores. Between 90 and 100% of children also showed medium-to-large improvements in affected UE activity from early-to-late sessions using accelerometers and small improvements via video-based assessments. Exploratory analyses suggested trends for relationships between pretest-posttest and training-specific objective and subjective measures of arm use and function. Our pilot data suggest that single joystick-operated ROTs may serve as motivating, child-friendly tools that can augment conventional therapies such as CIMT to boost treatment dosing, promote affected UE movement practice during real-world navigation tasks, and ultimately improve functional outcomes in children with HCP.

Individuals with developmental disabilities present with perceptuo-motor, social communication, and cognitive impairments that often relate to underlying atypical brain structure and functioning. Physical activity/movement interventions improve behavioral performance of individuals with and without developmental disabilities. Majority of the evidence on potential neural mechanisms explaining the impact of physical activity/movement interventions is based on studies in individuals with typical development; there is a dearth of systematic reviews synthesizing the neural effects of physical activity/movement interventions in individuals with developmental disabilities. In this systematic review, we have gathered evidence on the neural effects of physical activity/movement interventions from 32 papers reporting substantial neural effects and behavioral improvements in individuals with developmental disabilities. Chronic intervention effects (multiple sessions) were greater than acute intervention effects (single session). Specifically, using electroencephalogram, functional magnetic resonance imaging, diffusion tensor imaging, and functional near-infrared spectroscopy, studies found physical activity/movement intervention-related changes in neural activity, indicating normalization of cortical arousal in individuals with attention-deficit /hyperactivity disorder (ADHD), increased social brain connectivity in individuals with autism spectrum disorder (ASD), and more efficient executive functioning processes in individuals with a wide range of other developmental disabilities. Despite promising results, more research is clearly needed in this area with larger sample sizes, using standardized neuroimaging tools/variables, and across multiple diagnoses to further explore the neural mechanisms underlying physical activity/movement interventions and to replicate findings from the present review.

Background Children with autism spectrum disorder (ASD) demonstrate significant motor impairments in visuomotor and body coordination, agility, and strength. Around 87% of children with ASD are at risk for motor impairments. However, only about 31% of these children receive rehabilitation services to address their motor needs. Objective Our randomized clinical trial assessed the effects of a general movement (GM) intervention compared to a standard-of-care seated play (SP) intervention delivered to children via face-to-face (F2F) and telehealth (TH)–based modes of intervention delivery on motor performance, agility, and locomotor skills in children with ASD. Methods Thirty 5- to 14-year-old children were matched on age, gender, and level of functioning and randomly assigned to the GM or SP groups. Children participated in the study for 10 weeks with pretests and posttests conducted during the first and last weeks and training in the interim 8 weeks with 2 sessions conducted per week. The strength and running speed and agility subtests of Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) and the locomotor subtest of the Test of Gross-motor development (TGMD) were administered at pretest and posttest. In addition, in the GM group, task-specific games involving locomotor skills were assessed during early and late training sessions for changes in movement form or accuracy and the amount of prompting required to complete the actions. Results We found significant improvements in standard scores of the TGMD from pretest to posttest in the GM group (pretest mean 6.1, SE 1.0; posttest mean 8.1, SE 0.9; P<.001) but not the SP group. Within the GM group, there were no significant differences in the rates of improvement for children seen F2F versus via TH (F2F mean 1.8, SE 0.8; TH mean 2.0, SE 1.7; P=.87). On the BOT-2, the GM (pretest mean 36.1, SE 2.6; posttest mean 40.9, SE 3.1; P<.001) but not SP group showed improvements in standard scores on the strength and agility composite. Similar to the trends reported above, there were no differences in the magnitude of improvement for children seen F2F versus via TH (F2F mean 3.7, SD 1.3; TH mean 5.6, SD 1.5; P=.37). On the training-specific test of locomotor skills, children in the GM group improved their movement accuracy (pretest mean 74.4, SE 6.2; posttest mean 86.5, SE 4.7; P<.001) and reduced prompting (pretest mean 22.5, SE 3.5; posttest mean 16.9, SE 4.2; P=.02) required to complete the movements. Both children seen F2F as well as via TH showed similar trends, with no significant differences between the intervention delivery modes. Conclusions Our data suggest that TH is an effective mode of delivery of gross motor interventions and can be used to promote agility and motor coordination in children with ASD. Conflicts of Interest None declared.