Psychomotor Intervention Practices for Children with Autism Spectrum Disorder: a Scoping Review

Improved motor skills in autistic children after three weeks of neurologic music therapy via telehealth: a pilot study

Background

Many autistic children experience motor skill deficits which can impact other areas of functioning, and research on therapeutic interventions for motor skills in autism is in a preliminary stage. Music-based therapies have been used extensively to address motor skills in non-autistic populations. Though a handful of studies exist on the effects of music-based therapies for movement in autistic children, none have investigated the possibility of administering sessions via telehealth. This mixed-methods pilot study investigated whether nine Neurologic Music Therapy (NMT)® sessions via telehealth would improve motor and attention skills in autistic children.

Methods

Five autistic children between five and 10 years of age participated in the study, with support from their caregivers. Motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency second edition, short form (BOT-2 SF), and a selective attention and sustained attention task were taken from the Test of Everyday Attention for Children, Second Edition (TEA-Ch2). Caregivers and the two neurologic music therapists involved in the study provided qualitative input about the perceived effectiveness of telehealth NMT for the children involved. Their responses were analyzed using qualitative content analysis. Caregivers also filled out a Sensory Profile 2 assessment prior to the onset of sessions so that each child's sensory profile could be compared to their motor and attention results.

Results

Statistically significant improvements in motor skills were observed between pre-test assessment and a two-week follow-up assessment. Results from attention test scores were not significant. Caregivers and neurologic music therapists generally perceived sessions positively and noted the importance of having caregivers actively involved. When compared with individual progress on the BOT-2 SF assessment, sensory profile results revealed that children with fewer sensory sensitivities tended to improve the most on motor skills. The improvements in motor skills and positive caregiver and therapist views of telehealth indicate that NMT motor interventions administered via telehealth are a promising avenue of therapeutic support for movement skill development in autistic children.

Clinical stance on response initiation in autistic adults: co-creating an integrative approach based on theory and lived experiences to act from language, via motor movement to wellbeing

Getting 'stuck', literally and figuratively, is a common experience for autistic people. Literally 'stuck' means exhibiting limited response initiation due to immobility with tense muscles and inability to move. Figuratively 'stuck' means loneliness, passivity or captivity in activities that do not offer long-term satisfaction. To further conceptualize this complex phenomenon of limited response initiation in autistic individuals, we performed qualitative interviews and focus groups with autistic people and their family members, followed by brainstorm sessions and a Delphi study with input from a larger panel of experts from multiple backgrounds. We aimed to co-create the outline of an integrative approach to support autistic people in moving away from this 'stuck state' to more flexible, limber 'supple states' in order to live freer, more meaningful, satisfying and peaceful lives. Over time, in interaction with all participants, our shared insight grew. Based on this, we here stipulate a conceptual framework, in which the described 'stuck state' at the micro-level of the muscles/behavior of one individual, probably is caused by feeling/being 'stuck' or 'cramped' at several overarching (i.e., meso and macro) levels. For instance, stuck in relationships with unhealthy dynamics, stuck at home creating short-term calm, trance-like states (e.g., gaming), stuck at an educational level that might fit the individuals' current social-emotional state rather than their potential cognitive level, stuck in a job that pays the bills but does not feel meaningful, nor contributes to a satisfying life with opportunities for personal development. Stuck in a mental/public health care system where ever ongoing changes in policies hinder sustained support to suit care-needs. Stuck in a regulated societal system making it likely to repeatedly get stuck. Is this phenomenon specific to autism? Formally we have only conducted interviews with this population, but in another smaller, related project we also spoke to people from the general population with careers that are considered successful in the general society. These people actually voiced similar experiences. Therefore, we hypothesize that this numbing state of being or feeling 'stuck' may be a prevalent phenomenon that needs to be addressed. In this article, we discuss several types of interventive approaches (i.e., language-based talking therapies, affective experiential expressive therapies, physical therapies and systemic therapies), prevention as well as intervention programs, directed at different primary stakeholders, that can complement and enrich each other in an integrative policy, that leads to tailor-made, personalized trajectories of interdisciplinary support to enable people to live satisfying, meaningful, dignified and peaceful lives.

Intervention Based on Psychomotor Rehabilitation in Children with Autism Spectrum Disorder ASD: Effect on Postural Control and Sensory Integration

Postural stability and control are essential motor skills for successfully performing various activities of daily living. However, children with autism spectrum disorder (ASD) exhibit significant sensorimotor impairments. The aim of this study was to investigate the efficacy of psychomotricity training on postural control (PC) of children with ASD. We recruited thirty children (age = 8.01 ± 1.2; weight = 31.66 ± 8.1 kg; height = 129.7 ± 10.8 cm) diagnosed with ASD (intellectual quotient > 50) to participate in this study. They were divided into two groups: the experimental group (n = 16) and control group (n = 14). Children in the experimental group were trained with psychomotor activities two times a week for nine weeks. Statistic postural balance was assessed before and after intervention and on different vision conditions. The results showed that the psychomotor training significantly improved PC in standing position under different conditions when compared to the control group, in all parameters (CoPA; CoPLX; CoPLy) (p < 0.01). Our preliminary findings suggest the usefulness of the psychomotor training in children with ASD on static PC.

Bibliometric Analysis of Psychomotricity Research Trends: The Current Role of Childhood

Psychomotricity is a wide broad term, which encompasses different bodily action approaches to support children and adolescents to achieve their highest potential. A search on the Web of Science (WoS) Core Collection database was performed on this topic, using traditional bibliometric laws. Finally, 118 publications (112 articles and 6 reviews) documents were found. Annual publications presented an exponentially growing trend (R² = 84.7%). Spain was the most productive country/region worldwide. Paola Magioncalda, Matteo Martino y Víctor Arufe Giraldez were highlighted as the most prolific co-authors. "Retos Nuevas Tendencias en Educación Física, Deporte y Recreación" was the most productive journal and the "International Journal of Environmental Research and Public Health", was the second most productive; the third in the list was the most productive in the JCR ranking. Thus, research on psychomotricity is experiencing exponential growth, causing this topic to generate great interest among researchers, publishers and journals. The most cited paper was "Neurocognitive Effects of Alcohol Hangover". The author keywords that were first raised together with psychomotricity were related to rehabilitation and psychomotor development, while the current trend was focused on physical activity and early childhood education.

Consensus on the Best Practice Guidelines for Psychomotor Intervention in Preschool Children with Autism Spectrum Disorder

Psychomotor intervention has been used to promote development by the enhancement of psychomotor and socio-emotional competence. However, studies with high-quality evidence, describing psychomotor-intervention processes and outcomes are scarce. Therefore, we aimed to generate expert consensus regarding psychomotor-intervention guidelines to support psychomotor therapists through the design and implementation of interventions for preschool (3−6 years old) children with autism spectrum disorder (ASD). A formal consensus process was carried out, using modified nominal group (phase I) and Delphi survey (phase II) techniques. We recruited 39 Portuguese experts in psychomotor intervention with preschool children with ASD in phase I. Experts participated in at least one of the five online meetings, discussing themes (e.g., objectives, methods, strategies) concerning psychomotor intervention with preschool children with ASD. A deductive thematic analysis from phase I resulted in 111 statements composing round 1 of the Delphi survey. Thirty-five experts completed round 1, and 23 round 2. The experts reached a consensus (agreement > 75%) on 88 statements, grouped under 16 sections, (e.g., intervention source, general setting, intended facilitation-style), reflecting generic psychomotor-intervention guidelines. Consensus guidelines may be used to support transparent and standard psychomotor interventions, although further studies should be undertaken to determine their efficacy.

The Assessment of the Psychomotor Profile in Children: Preliminary Psychometric Analysis of the Portuguese Version of the Batterie d'Evaluation des Fonctions Neuropsychomotrices de L'enfant (NPmot.pt)

Psychomotor assessment is an expanding research field. A deep knowledge of the typical development will allow for better child-centered planning. Due to the scarcity of psychomotor assessment instruments validated in Portugal, our research aims to perform a preliminary analysis of the psychometric properties of the Portuguese version of the Battery for Neuropsychomotor functions evaluation (NPmot.pt). The NPmot.pt was translated and adapted to the Portuguese language/culture and applied to 200 children, 4−12 years old (6 y 10 m ± 0 y 4 m), with (n = 150) and without developmental disorders, attending regular school. For content validity, nine experts classified all items according to their relevance, clarity, simplicity and ambiguity. All indexes (IVC > 0.78) pointed out the representativeness of indicators, corroborated by experts proportion agreement (>0.42), and Cohen’s kappa scores (0.02 > k < 0.95). Reliability was confirmed through internal consistency, with Cronbach alphas/split-half (α > 0.45) and temporal reliability (test-retest technique, 0.45 > r < 0.99). Construct validity was analyzed through domains and domains-total correlations, tending to moderate to strong (0.31 > r < 0.92); exploratory factor analysis pointed out an eight-factor solution, explaining 88.5% of the total variance. For discriminant validity, we conducted a comparative study between children with and without developmental disorders that revealed significant differences (p < 0.05). The NPmot.pt seems to confirm validity and reliability for Portugal; however, more studies are needed.