OtherDevelopmental medicine and child neurology2017

Efficacy of parent-delivered behavioral therapy for primary complex motor stereotypies.

Matthew W Specht, E Mark Mahone, Tina Kline and 4 others

PMID 27259464

WHAT IT FOUND

Children with primary complex motor stereotypies whose parents used a DVD-based behavioral home therapy showed lower parent-reported stereotypy severity and impairment over follow-up.

Without a control group or clinician checks, this suggests possible benefit, not proof.

Key findings

01Parent-reported motor stereotypy severity, impairment, and overall stereotypy activity were all significantly lower at the last assessment than at baseline.

02The reported change ratios were 15% for motor severity, 24% for impairment, and 20% for the parent-marked activity scale.

03Improvement was mainly seen between baseline and the 1-month assessment; motor severity improved in both age groups, but impairment and activity improved significantly only in younger children.

STILL TO COME

How it was doneWhat they found

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What it does not show

There was no randomly assigned control group, so the study cannot show what would have happened without the DVD. All outcomes were parent-reported, with no clinician confirmation of symptom change or treatment fidelity. Only 54 of 81 participants who received the DVD completed at least one follow-up assessment; 27 were lost to follow-up. Of those who completed the 1 month assessment, only 70% completed a second and 51% a third evaluation. The DVD taught awareness training, movement logging, and reinforced suppression together, so the contribution of any single component cannot be separated. The sample was 94% Caucasian, so findings may not apply broadly. Participants in the analysed group were aged 7 to 14 years, so the study does not address preschool children.

The easy way to misread this

Do not read the 15%, 24%, and 20% reductions as proven efficacy. There was no control group, all outcomes were parent-reported, and 27 of 81 participants did not complete a follow-up assessment.

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The study

Participants
81 children completed baseline and received the DVD; 54 were analysed as the intent-to-treat group.
Certainty of evidence
Low

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    Cite

    Matthew W Specht, E Mark Mahone, Tina Kline, et al. Efficacy of parent-delivered behavioral therapy for primary complex motor stereotypies. Developmental medicine and child neurology. 2017.

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