Advances in Rehabilitation of Children with Disabilities

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Nursing".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 12076

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Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Rey Juan Carlos University (URJC), Madrid, Spain
Interests: aquatic therapy; functioning; disability and rehabilitation
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Special Issue Information

Dear Colleagues,

Therapeutic interventions for children and youth with disabilities have evolved substantially over the past 15 years. The paradigm shift has primarily been driven by our addressing the underlying symptoms and impairments to improve function (through unimodal models and therapist-centred approaches), and our focusing on training programs for activities and tasks that are relevant to children in order to target full participation (through multimodal models with child-centred goals, more active practice, and individual adaptations of the task and environment). How are therapeutic approaches for children with disabilities evolving today?

The aim of this Special Issue is to provide a comprehensive and innovative overview of developments in clinical and translational research on new advances in the assessment and treatment of children with disability, promoting the highest standards of care and support for children and their families.

This Special Issue welcomes original studies that enhance our understanding in this challenging field of healthcare science. All childhood disabling conditions can be addressed. We especially welcome studies that have the potential to change clinical care settings and health policy.

Prof. Dr. Javier Güeita Rodríguez
Prof. Dr. Domingo Palacios-Ceña
Guest Editors

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Keywords

  • childhood
  • disability
  • functioning
  • participation
  • training programs
  • healthcare services

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Published Papers (11 papers)

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18 pages, 3716 KiB  
Article
Comparing Anxiety Levels during the COVID-19 Pandemic among Mothers of Children with and without Neurodevelopmental Disorders
by Ivana Bogavac, Ljiljana Jeličić, Jelena Đorđević, Ivana Veselinović, Maša Marisavljević and Miško Subotić
Children 2023, 10(8), 1292; https://doi.org/10.3390/children10081292 - 27 Jul 2023
Cited by 2 | Viewed by 1455
Abstract
The COVID-19 pandemic undoubtedly burdened families, perhaps even more for parents of children with neurodevelopmental disabilities. This research aims to determine the anxiety levels in mothers of children with neurodevelopmental disorders (autism spectrum disorder and specific language impairment) and mothers of typically developed [...] Read more.
The COVID-19 pandemic undoubtedly burdened families, perhaps even more for parents of children with neurodevelopmental disabilities. This research aims to determine the anxiety levels in mothers of children with neurodevelopmental disorders (autism spectrum disorder and specific language impairment) and mothers of typically developed children. The cross-sectional study comprised 280 mothers from the period of the COVID-19 pandemic in Serbia. A confidential survey included main demographic data and the State-Trait Anxiety Inventory (STAI). Results revealed that the mean levels of STAI-S and STAI-T are elevated in the observed sample of mothers in the first pandemic wave; the STAI-S level is in the high category (STAI-S mean = 46.69), while STAI-T is in the intermediate category near the cut-off value for the high level (STAI-T mean = 43.04). A statistically significant strong positive correlation between STAI-S and STAI-T is seen (r = 0.802, p = 0.001). GLMM analysis revealed that interactions, rather than independent variables, significantly impact anxiety, implying a complex relationship between the observed variables and STAI. Compared with the results from the pre-pandemic study, our findings reveal that COVID-19 affects mothers of children with and without neurodevelopmental disorders in a complex manner, imposing a need for psychological support, which may positively affect mothers’ mental health and the development of their offspring. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
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13 pages, 253 KiB  
Article
Experiences of Hearing Parents of Children with Hearing Loss: A Qualitative Study
by Gül Dikeç, Eda Türk, Esin Yüksel, Kübra Çelebi and Meltem Özdemir
Children 2023, 10(7), 1129; https://doi.org/10.3390/children10071129 - 29 Jun 2023
Cited by 1 | Viewed by 2513
Abstract
This qualitative study was carried out with a phenomenological design to determine the life experiences of the parents of children with hearing loss. The study sample consisted of twenty parents, who did not have hearing loss, of children with hearing loss registered in [...] Read more.
This qualitative study was carried out with a phenomenological design to determine the life experiences of the parents of children with hearing loss. The study sample consisted of twenty parents, who did not have hearing loss, of children with hearing loss registered in a special education and rehabilitation center. The data were collected through in-depth interviews in Istanbul between December and January 2022. Colaizzi’s phenomenological interpretation method was used for qualitative data analysis. It was determined that parents of children with hearing loss experienced anxiety, sadness, and happiness during diagnosis. They needed more information at first, but then they gained knowledge in the process, and it took work to accept this process. They stated that having a child with hearing loss requires more time, responsibility, and effort than other children. This situation affects their social life, and they experience interpersonal conflicts. When parents were asked how they coped, they said they did it through prayer, social support, or time to themselves. It can be recommended to apply psychosocial intervention programs to the parents of children with hearing loss, especially their mothers, from the first diagnosis process. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
10 pages, 1441 KiB  
Article
Efficacy of Intensive Inpatient Therapy in Infants with Congenital Muscular Torticollis Involving the Entire Sternocleidomastoid Muscle
by Dong Rak Kwon and Sung Cheol Cho
Children 2023, 10(6), 1088; https://doi.org/10.3390/children10061088 - 20 Jun 2023
Cited by 2 | Viewed by 2272
Abstract
The efficacy and frequency of physiotherapy in the prognosis of congenital muscular torticollis (CMT) that involves the entire sternocleidomastoid (SCM) muscle continues to be unclear. This study investigated the therapeutic effect of intensive inpatient therapy given to infants with CMT that involves the [...] Read more.
The efficacy and frequency of physiotherapy in the prognosis of congenital muscular torticollis (CMT) that involves the entire sternocleidomastoid (SCM) muscle continues to be unclear. This study investigated the therapeutic effect of intensive inpatient therapy given to infants with CMT that involves the whole SCM using clinical measurements and ultrasound (US). This study included 54 infants (27 boys and 27 girls; mean corrected age of 18.57 days) evaluated for CMT at our outpatient clinic from January 2014 to May 2021. The included patients were divided into three groups (groups 1, 2, and 3). Patients in group 1 underwent outpatient treatment 12 times. Patients in groups 2 and 3 underwent therapeutic exercise followed by US diathermy with microcurrent twice daily for 1 or 2 weeks, respectively. Passive range of motion of the cervical rotation (PCRROM) and SCM thickness were evaluated pre- and post-treatment. Among the three groups, the demographic data at baseline were not significantly different, SCM thickness and PCRROM were significantly decreased/increased at post-treatment compared to pre-treatment (p < 0.05), mean PCRROM change was significantly greater in group 3 (p < 0.05), and mean SCM thickness reduction between pre-treatment and 3 months post-treatment was significantly greater in groups 2 and 3 (p < 0.05). Therefore, intensive inpatient therapeutic exercise and US diathermy with microcurrent may enhance the prognosis of CMT involving the entire SCM muscle. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
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13 pages, 648 KiB  
Article
Clinical and Functional Characteristics of a New Phenotype of SMA Type I among a National Sample of Spanish Children: A Cross-Sectional Study
by Beatriz de-Andrés-Beltrán, Javier Güeita-Rodríguez, Domingo Palacios-Ceña and Ángel Luis Rodríguez-Fernández
Children 2023, 10(5), 892; https://doi.org/10.3390/children10050892 - 16 May 2023
Cited by 6 | Viewed by 2912
Abstract
Spinal Muscular Atrophy (SMA) type I has classically presented extremely severe clinical features. New pharmacological treatments have led to a new phenotype of SMA. The aim of this study was to describe the current health and functional status of children with SMA. A [...] Read more.
Spinal Muscular Atrophy (SMA) type I has classically presented extremely severe clinical features. New pharmacological treatments have led to a new phenotype of SMA. The aim of this study was to describe the current health and functional status of children with SMA. A cross-sectional study was conducted based on the STROBE guidelines. Patient questionnaires and standardized tools were used. A descriptive analysis was conducted establishing the proportions of subjects for each of the characteristics of interest. In total, 51 genetically confirmed SMA type I subjects were included. Fifty-seven percent received oral feeding, 33% received tube feeding and 10% combined both. Moreover, 21.6% had tracheostomies, and 9.8% needed more than 16 h/d ventilatory support. Regarding orthopedic status, 66.7% had scoliosis, and 68.6% had hip subluxation or dislocation. Up to 67% were able to sit independently, 23.5% walked with support and one child walked independently. Current SMA type I is a different entity from the classic phenotype but also from types II and III. In addition, no differences were found between SMA type I subgroups. These findings may enable the professionals involved in the care of these patients to improve their interventions in terms of prevention and rehabilitation measures for these children. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
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15 pages, 621 KiB  
Article
The Emotional Experience of Caring for Children in Pediatric Palliative Care: A Qualitative Study among a Home-Based Interdisciplinary Care Team
by Patricia Rico-Mena, Javier Güeita-Rodríguez, Ricardo Martino-Alba, Marina Castel-Sánchez and Domingo Palacios-Ceña
Children 2023, 10(4), 700; https://doi.org/10.3390/children10040700 - 9 Apr 2023
Cited by 10 | Viewed by 3398
Abstract
The healthcare providers caring for children with life-threatening illnesses experience considerable compassion fatigue. The purpose of this study was to describe the feelings and emotions of professionals working in an interdisciplinary pediatric palliative home care team. A qualitative case study was conducted, comprising [...] Read more.
The healthcare providers caring for children with life-threatening illnesses experience considerable compassion fatigue. The purpose of this study was to describe the feelings and emotions of professionals working in an interdisciplinary pediatric palliative home care team. A qualitative case study was conducted, comprising 18 participants. A purposeful sampling technique approach was used including the home-based interdisciplinary pediatric palliative team. Data were collected via semi-structured interviews and researchers’ field notes. A thematic analysis was performed. Two themes emerged: (a) changing life for the better, which described how professionals value life more and helping children and families provides compassion satisfaction, which is comforting and explains their dedication to care; (b) adverse effects of work highlighted the emotional burden of caring for children with life-limiting or life-threatening illnesses, which can affect their job satisfaction and may lead to burnout, showing how experiencing in-hospital child deaths with suffering leads professionals to develop an interest in specializing in pediatric palliative care. Our study provides information on possible causes of emotional distress in professionals caring for children with life-threatening illnesses and highlights strategies that can help them to reduce their distress. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
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12 pages, 311 KiB  
Article
Effectiveness of a Telecare Physical Therapy Program in Improving Functionality in Children and Adolescents with Cerebral Palsy: A Cases Study
by Isabel Rodríguez-Costa, Vanesa Abuín-Porras, Paula Terán-García, Andrea Férez-Sopeña, Victoria Calvo-Fuente, Concepción Soto-Vidal and Soraya Pacheco-da-Costa
Children 2023, 10(4), 663; https://doi.org/10.3390/children10040663 - 31 Mar 2023
Viewed by 1896
Abstract
Cerebral palsy (CP) is the most common physical disability in childhood and results in motor impairment that is often associated with other disorders. The aim of this study was to assess whether a telecare intervention consisting of Action Observation Therapy with a family-center [...] Read more.
Cerebral palsy (CP) is the most common physical disability in childhood and results in motor impairment that is often associated with other disorders. The aim of this study was to assess whether a telecare intervention consisting of Action Observation Therapy with a family-center approach produces improvements in functionality in children and adolescents with CP. Seven girls with CP ages between 6 and 17 participated in this case series study that lasted 12 weeks: 6 weeks of telecare program with a total of six sessions; and a follow-up period of 6 weeks. The outcome variables were Gross Motor Function (Spanish version of the Gross Motor Function Measure), balance (Spanish version of the Pediatric Balance Scale), walking endurance (6-min walk test) and walking speed (10-m walk test). The variables were measured before starting the study, after 6 weeks of intervention and after the 6-week follow-up period. Results showed statistically significant improvements in gross motor function (p = 0.02) after the intervention. After the follow-up period, gross motor function remained statistically significant (p = 0.02), as well as balance (p = 0.04) and walking endurance (p = 0.02). These results show that a telecare program has been beneficial in improving functionality with enhancements in gross motor function, balance and endurance in children and adolescents with CP that will facilitate participation. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
11 pages, 896 KiB  
Article
Tele-Coaching Korean Parents for Improving Occupational Performance of Toddlers: Three Case Reports
by Dabin Choi, Aeri Yu, Misun Kim and Eun Young Kim
Children 2023, 10(3), 492; https://doi.org/10.3390/children10030492 - 2 Mar 2023
Cited by 2 | Viewed by 2214
Abstract
Telehealth has been applied to occupational therapy practice since the COVID-19 pandemic, but no research has been conducted on the use of telehealth to improve the occupational performances of Korean children and parents. This study explored the possibility of tele-coaching parents to improve [...] Read more.
Telehealth has been applied to occupational therapy practice since the COVID-19 pandemic, but no research has been conducted on the use of telehealth to improve the occupational performances of Korean children and parents. This study explored the possibility of tele-coaching parents to improve toddlers’ occupational performance and parenting competence in Korea. Three mothers of toddlers received Occupational Performance Coaching (OPC) via videoconference. The Canadian Occupational Performance Measure (COPM) and the Parenting Sense of Competence Scale (PSOC) were used pre- and post-intervention to measure the occupational performances of the toddlers and parents and parenting competence. Post-intervention interviews were conducted to explore the parents’ experiences with the tele-coaching and analyzed by content analysis. Most of the COPM scores showed a significant increase. The PSOC scores also increased. The mothers reported their learning, the changes in their children, the appropriateness of the coaching, and the usefulness of the tele-coaching delivery. The findings demonstrate the potential of tele-coaching as a practical intervention for Korean children and parents. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
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12 pages, 1350 KiB  
Article
Validation and Determination of Physical Activity Intensity GT3X+ Cut-Points in Children and Adolescents with Physical Disabilities: Preliminary Results in a Cerebral Palsy Population
by Carmen Matey-Rodríguez, Susana López-Ortiz, Saúl Peñín-Grandes, José Pinto-Fraga, Pedro L. Valenzuela, Mónica Pico, Carmen Fiuza-Luces, Simone Lista, Alejandro Lucia and Alejandro Santos-Lozano
Children 2023, 10(3), 475; https://doi.org/10.3390/children10030475 - 27 Feb 2023
Cited by 1 | Viewed by 1789
Abstract
Background: Children and adolescents with disabilities engage in low levels of moderate-to-vigorous intensity physical activity (MVPA), which may create the onset of a sedentary lifestyle. In light of this, MVPA levels must be quantified with a valid tool such as accelerometry. This study [...] Read more.
Background: Children and adolescents with disabilities engage in low levels of moderate-to-vigorous intensity physical activity (MVPA), which may create the onset of a sedentary lifestyle. In light of this, MVPA levels must be quantified with a valid tool such as accelerometry. This study aimed to: (i) analyze the accuracy of Evenson cut-points by estimating MVPA and sedentary behavior (SB) in children and adolescents with disabilities; (ii) define new equations to estimate energy expenditure (EE) with the GT3X+ accelerometer in this population and particularly in those with cerebral palsy (CP); (iii) define specific GT3X+ cut-points to estimate MVPA in those with CP. Methods: A total of 23 children and adolescents with disabilities (10 ± 3 years; 44%females) participated in the study. GT3X+-counts and oxygen uptake (VO2) were measured in four laboratory walking conditions. Results: (i) Evenson cut-points were accurate; (ii) new equations were defined to effectively predict EE; (iii) specific GT3X+ cut-points (VM ≥ 702 counts·min−1; Y-Axis ≥ 360 counts·min−1) were defined for estimating MVPA levels in children and adolescents with CP. Conclusions: The use of specific cut-points for ActiGraph GT3X+ seems to be accurate to estimate MVPA levels in children and adolescents with disabilities and, particularly, in those with CP, at least in laboratory conditions. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
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14 pages, 462 KiB  
Article
Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study
by Eugène A. A. Rameckers, Roche Crafford, Gillian Ferguson and Bouwien C. M. Smits Engelsman
Children 2023, 10(3), 415; https://doi.org/10.3390/children10030415 - 21 Feb 2023
Cited by 3 | Viewed by 3930
Abstract
Background: Task-oriented approaches are recommended for children with developmental coordination disorder (DCD) to address deficits in motor performance and reduce activity limitations. Although this approach is used in several settings, the efficacy of these approaches in children with in dual-diagnosis of specific learning [...] Read more.
Background: Task-oriented approaches are recommended for children with developmental coordination disorder (DCD) to address deficits in motor performance and reduce activity limitations. Although this approach is used in several settings, the efficacy of these approaches in children with in dual-diagnosis of specific learning disabilities (SLD) and DCD is less widely known. This study aims to determine the effect of a group-based intervention based on neuromotor task training (NTT) principles on the motor performance of children aged 6–10 years with SLD/DCD. Methods: A pre-post-test controlled study design was conducted in children with a primary diagnosis of specific learning disabilities (SLD). DCD status was confirmed based on clinical assessment. Children scoring ≤16th percentile on the Motor Assessment Battery for Children 2nd Edition (MABC-2), who also presented with a functional motor problem, according to the MABC checklist were considered as having DCD. Children were allocated to the NTT intervention group based on teachers’ perceived notion of need and received two 45–60 min training sessions per week for nine weeks. Children allocated to the usual care (UC) group, received their planned occupational therapy and physical education. The MABC-2 was used to assess changes in motor performance. Outcome and Results: Our numbers confirm that it is crucial to identify the presence of motor coordination difficulties in children who have been diagnosed with SLD. A task-oriented training program based on NTT principles, presented in small groups, has a positive effect on the motor performance in learners with neurodevelopmental disorders and this effect was larger than in the usual care group. Conclusion and Implications: Although using a small group format in children with multiple neurodevelopmental disorders may be challenging for the therapists, it may be a way of delivering services to children in schools for special education. What this paper adds: Children with DCD plus LSD show improvement in their motor skills by performing group-based NTT in the school environment. Group-based NTT shows a significant improvement in the TSS score of the MABC-2 compared to usual care. Children with DCD plus SLD show equal effect sizes after NTT intervention as DCD without SLD. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
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11 pages, 292 KiB  
Article
“Your Life Turns Upside Down”: A Qualitative Study of the Experiences of Parents with Children Diagnosed with Phelan-McDermid Syndrome
by Cristina García-Bravo, Domingo Palacios-Ceña, Elisabet Huertas-Hoyas, Jorge Pérez-Corrales, Sergio Serrada-Tejeda, Marta Pérez-de-Heredia-Torres, Javier Gueita-Rodríguez and Rosa Mª Martínez-Piédrola
Children 2023, 10(1), 73; https://doi.org/10.3390/children10010073 - 30 Dec 2022
Cited by 3 | Viewed by 1929
Abstract
(1) Background: Parents of children with rare diseases experience great uncertainty and employ different strategies to care for their children and cope with the disease. The purpose of the present study was to describe the perspective of parents with children with Phelan McDermid [...] Read more.
(1) Background: Parents of children with rare diseases experience great uncertainty and employ different strategies to care for their children and cope with the disease. The purpose of the present study was to describe the perspective of parents with children with Phelan McDermid Syndrome (PMS). (2) Methods: A non-probabilistic purposeful sampling was used to perform this qualitative descriptive study. Thirty-two parents with children with PMS were interviewed. In-depth interviews and research field notes were analyzed using an inductive thematic analysis. (3) Results: Four themes emerged from the data. “Understanding and accepting the disease” described how parents experienced their child’s diagnosis and the lack of information. The second theme, called “Living day by day”, highlighted the daily difficulties faced when caring for a child with PMS. The third theme, “Expectations versus reality”, was based on the parents’ expectations of parenthood and the reality they face. Expectations for the future are also included. Finally, “Pain and happiness” describes how parents alternate feelings of distress and suffering but also joy with what they learn from these experiences. (4) Conclusions: Health professionals can use these results to support parents. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)

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22 pages, 708 KiB  
Systematic Review
Healthcare Professionals’ Knowledge about Pediatric Chronic Pain: A Systematic Review
by Mónica Pico, Carmen Matey-Rodríguez, Ana Domínguez-García, Héctor Menéndez, Simone Lista and Alejandro Santos-Lozano
Children 2023, 10(4), 665; https://doi.org/10.3390/children10040665 - 31 Mar 2023
Cited by 1 | Viewed by 1943
Abstract
Pediatric chronic pain is a common public health problem with a high prevalence among children and adolescents. The aim of this study was to review the current knowledge of health professionals on pediatric chronic pain between 15–30% among children and adolescents. However, since [...] Read more.
Pediatric chronic pain is a common public health problem with a high prevalence among children and adolescents. The aim of this study was to review the current knowledge of health professionals on pediatric chronic pain between 15–30% among children and adolescents. However, since this is an underdiagnosed condition, it is inadequately treated by health professionals. To this aim, a systematic review was carried out based on a search of the electronic literature databases (PubMed and Web of Science), resulting in 14 articles that met the inclusion criteria. The analysis of these articles seems to show a certain degree of heterogeneity in the surveyed professionals about the awareness of this concept, especially regarding its etiology, assessment, and management. In addition, the extent of knowledge of the health professionals seems to be insufficient regarding these aspects of pediatric chronic pain. Hence, the knowledge of the health professionals is unrelated to recent research that identifies central hyperexcitability as the primary factor affecting the onset, persistence, and management of pediatric chronic pain. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)
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