Defining quality of life for individuals with neurodevelopmental disorders: Challenges within an inpatient population

Vestibular function in children with neurodevelopmental disorders: A neglected sense?

OBJECTIVE

The study aimed to explore the vestibular function in children with neurodevelopmental disorders (NDDs).

METHODS

Twenty-eight participants with a NDD (6 girls, 22 boys; 6-13 years; 9;3 ± 2;4 years) were enrolled in this pilot study. Sixteen participants had a single NDD (Autism Spectrum Disorder: n = 7, Developmental Coordination Disorder: n = 3; Attention Deficit/Hyperactivity Disorder: n = 6), the remaining 12 had comorbid NDDs. The integrity of the peripheral vestibular system was evaluated using ocular and cervical Vestibular Evoked Myogenic Potentials (o/cVEMP), and a video Head Impulse Test (vHIT); motor competence was assessed with the Movement Assessment Battery for Children, and the KörperkoordinationsTest für Kinder. Results were compared to an age and sex-matched control group (n = 28; 9;7 ± 1;9 years).

RESULTS

The NDD group exhibited significantly higher interpeak amplitudes on both VEMP tests compared to the control group (p < 0.001). No significant differences were found between the groups on vHIT measurements (p > 0.05). Among the children with NDDs, 11 (39 %) showed atypical vestibular responses, including one child with vHIT correction saccades and three children with reduced or absent otolith responses (n = 3). Additionally, eight children showed abnormally elevated otolith amplitudes (cVEMP > 4.00 µV; oVEMP > 55.00 µV).

CONCLUSIONS

Clinicians are encouraged to recognize the overlap and consider the possibility of vestibular alterations in individuals with NDD.

SIGNIFICANCE

Incorporating vestibular assessments into routine clinical evaluations, particularly in children with NDD who exhibit delayed motor development, balance issues, hearing loss, or vestibular-related symptoms, is strongly recommended.

Putting music to trial: Consensus on key methodological challenges investigating music-based rehabilitation

Major advances in music neuroscience have fueled a growing interest in music-based neurological rehabilitation among researchers and clinicians. Musical activities are excellently suited to be adapted for clinical practice because of their multisensory nature, their demands on cognitive, language, and motor functions, and music's ability to induce emotions and regulate mood. However, the overall quality of music-based rehabilitation research remains low to moderate for most populations and outcomes. In this consensus article, expert panelists who participated in the Neuroscience and Music VII conference in June 2021 address methodological challenges relevant to music-based rehabilitation research. The article aims to provide guidance on challenges related to treatment, outcomes, research designs, and implementation in music-based rehabilitation research. The article addresses how to define music-based rehabilitation, select appropriate control interventions and outcomes, incorporate technology, and consider individual differences, among other challenges. The article highlights the value of the framework for the development and evaluation of complex interventions for music-based rehabilitation research and the need for stronger methodological rigor to allow the widespread implementation of music-based rehabilitation into regular clinical practice.

Systematic Review of Acceptance and Commitment Therapy in Individuals with Neurodevelopmental Disorders, Caregivers, and Staff

The purpose of this review was to quantitatively synthesize studies using acceptance and commitment therapy (ACT) with individuals with neurodevelopmental disorders (NNDs), their parents, and staff members that support them. Thirty studies published in peer-reviewed journals between 2006 and 2020 met inclusion criteria. They were reviewed and coded on variables associated with participants' characteristics, settings, dropouts, design type, ACT procedures and measures, social validity, treatment integrity, and main findings. The What Works Clearinghouse (WWC), the revised Cochrane risk-of-bias tool for randomized trials (RoB2) and the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) were applied to evaluate the quality of the studies. Results indicated that 20 studies used group designs and 10 studies used single-case designs. Participants with NNDs consisted predominantly of those with autism spectrum disorder, attention deficit hyperactivity disorder, and learning disabilities. Group studies reported process and outcome measures exclusively; whereas, single-case studies also incorporated behavioral/direct measures. Overall, results showed mixed improvements across studies using indirect and direct measures. Lastly, quality assessment for group studies presented moderate or serious risk of bias and two single-case studies did not meet WWC evidence of effectiveness. Directions for future research and practice are discussed.