Abstract
This is a retrospective study defining routine OT interventions in the treatment of children with somatodyspraxia and examining the effectiveness of those interventions on improving motor skills. Text mining was used to examine narrative data from therapy notes, and pretest–posttest data from a standardized motor assessment were used to examine effectiveness of interventions. Results revealed three common interventions and statistically significant improvement of motor coordination.
Primary Author and Speaker: Aimee Piller
Somatodyspraxia (SD) is a disorder in sensory integration dysfunction that refers to difficulties with motor planning as a result of poor somatosensory processing and body awareness (Cermak et al., 2020). A child with SD usually presents with difficulty completing novel motor tasks, decreased ability to properly sequence and time body movements, clumsiness, and have poor balance and coordination (Parham & Mailloux, 2015). Children with SD frequently receive occupational therapy (OT) services. The purpose of this study is to define OT interventions and examine their effectiveness in improving motor skills for children with SD. This study used a mixed methods retrospective study design. Qualitative methodology of text mining was used to examine de-identified therapy notes to define OT interventions and a quasi-experimental pretest-posttest design examined the effectiveness of intervention on improving motor skills. Participants were de-identified therapy records of children from three outpatient clinics located in the southwest region of the United States for children 7-15 who received a minimum of 10 visits of OT, demonstrated a scaled score of less than 10 on 2 of the 3 subtests of a standardized motor assessment (BOT-2), and had concerns with SD as identified in the initial evaluation. For the qualitative portion, researchers used the method of text mining to identify the most frequently used words/phrases in the objective portion of the daily SOAP note of participants meeting the inclusion criteria. Researchers placed the generated list of words (246) into a table with intervention categories that were predetermined based on interventions for SD as defined in the literature. Definitions of each intervention category were provided with the table to avoid misinterpretations. Cognitive testing was completed prior to dispersing the generated list of words to ensure definitions and format were understandable. A panel of four pediatric OTs with advanced training in sensory integration blinded to the study and to one another, reviewed the generated list of most commonly used words (246) and placed them into defined intervention categories. The quantitative portion examined the change in pre and posttest data from the standardized motor assessment using a Wilcoxon sign ranked test. Results indicated the most frequent interventions utilized by pediatric outpatient OTs treating children with SD used sensory-related interventions for 53.6% of the words defining the intervention. Three or more interventions being addressed within on activity was determined to indicate sensory integration treatment, instead of another sensory-related intervention and accounted for 19.1% of the interventions documented. Outside of sensory-related interventions, task training was the second most common intervention accounting for 22.8% of interventions. Pretest-posttest results revealed statistical significance for bilateral coordination (.005). No significance was indicated for fine motor precision or integration. In conclusion, this study indicated that the most common interventions used in the treatment of SD were sensory-related interventions, including sensory integration, and task training interventions. Significant improvements in motor coordination were indicated, but fine motor skills did not show significant improvements following interventions. In conclusion, this study indicates that in outpatient OT, therapists use sensory intervention and task training as the most commonly used interventions to treatment SD. Further results suggest that OT is an effective intervention to increase motor coordination.
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Parham, L. D., & Mailloux, Z. (2015). Sensory integration. In J. Case-Smith & J. Clifford O’Brien (Eds.). Occupational therapy for children and adolescents (7th ed., pp. 258-303). Mosby Elsevier.