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This study aimed to evaluate the effectiveness of a multidisciplinary parent training program, Promoting Holistic Development of Young Kids (Poly Kids), using a single-blind randomized waitlist controlled design. The participants included 218 parents of children with developmental disabilities (DD) (intervention group = 107 and waitlist control group = 111). The primary outcomes were child learning, expressive language, fine and gross motor skills (based on individual assessment by respective blinded professionals), and parental reports of child behavior problems. The parents in the intervention group reported significantly lower child behavior problems ( d = .34), higher child task motivation ( d = .63), and lower parenting stress post-intervention ( d = .25), while the children in the intervention group produced significantly more words post-intervention ( d = .82). McNemar test results were significant for movement out of the clinical range in child behavior problems and cognitive skills in the intervention group, but not the control group. The results provided initial evidence on the effectiveness of this train-the-trainer program in supporting families with preschool children with DD in terms of child behavior problems, expressive language, cognitive skills, task motivation, and parenting stress.

Purpose: To describe the development of the Cognition domain of the Hong Kong Comprehensive Assessment Scales for Toddlers (HKCAS-T). Methods: Participants included 345 toddlers aged 18–41 months, ...

To test the reliability and validity of the gross motor items making up a new instrument, Hong Kong Comprehensive Assessment Scales for Toddlers (HKCAS-T) for quantifying gross motor development among children aged 18 to 42 months.The 37 items were administered to 330 children, including 258 typically developing children and 72 children with gross motor delay.Rasch analyzes indicated that the fit statistics of the 37 items were within the acceptable range. The assessment was found able to differentiate between typically developing children and those with gross motor delay and among children of different ages. The raw score reliability (KR-20) was 0.94.The new instrument is a promising alternative for assessing young children's gross motor development.

To examine reliability and validity of the new Social Motor Function Classification System for Children with Autism Spectrum Disorders (SMFCS-ASD). The SMFCS-ASD reliability was examined on 25 children (62.4 months SD 7.8) with ASD among six physical therapists. The validity study involved 1001 children (57.0 months, SD 9.9) with ASD using the gross motor scale (GMS) of the Peabody Developmental Motor Scales (PDMS-2). The indices of agreement and reliability across six examiners were moderate to substantial (Cohen's κ ≤ 0.65 and ICC 0.90, all p 0.001). The SMFCS-ASD was significantly correlated with the GMS of PDMS-2 (all rho from 0.61 to 0.76, p 0.001). The SMFCS-ASD was reliable and significantly correlated with the GMS of the PDMS-2.

Background Walk tests are commonly used to evaluate walking ability in frail older adults with dementia but their psychometric evidence in this population is lacking. Objectives 1) To examine test-retest and inter-rater reliability, construct and known-group validity, and minimal detectable change at 95% level of confidence (MDC95) of walk tests in frail older adults with dementia, and 2) to examine the feasibility and consistency of a cueing system in facilitating participants in completing walk tests. Design Psychometric study with repeated measures. Setting Day care and residential care facilities. Participants Thirty-nine frail older adults with a mean age 87.1 and a diagnosis of dementia or Alzheimer's disease who were able to walk independently for at least 15 m. Methods The participants underwent a 2-minute walk test (2MWT), 6-minute walk test (6MWT) and 10-meter walk test (10MeWT) on 6 separate occasions under 2 independent assessors using a cueing system. Functional status was measured using the Elderly Mobility Scale (EMS), Berg Balance Scale (BBS) and Modified Barthel Index (MBI). Results Excellent test-retest (ICC = 0.91–0.98) and inter-rater reliability (ICC = 0.86–0.96) were shown in the 2MWT, 6MWT and 10MeWT. The walk tests were strongly correlated with each other (ρ = 0.85–0.94). The correlations between the walk tests and the functional measures were moderate in general (ρ = 0.34–0.55). All the walk tests were able to distinguish between those who could walk outdoor and indoor only (p ≤ .036). The MDC95 were 9.1 m in the 2MWT, 28.1 m in the 6MWT, and.16 m/s in the 10MeWT. The cues provided by the assessors in the walk tests were generally consistent (ICC = 0.62–0.89). Conclusions The 2MWT, 6MWT and 10MeWT are reliable and valid measures in evaluating walking ability in frail older adults with dementia. The MDC95 of the walk tests has been established. The cueing system is feasible and reliable to facilitate the administration of the walk tests in this population group.

De normen voor gewasbeschermingsmiddelen in oppervlaktewater worden nog te vaak overschreden. Het tussentijdse doel dat de normen in 2018 vijftig procent minder vaak worden overschreden dan in 2013, is daardoor niet gehaald. Dit doel is een onderdeel van het kabinetsbeleid om de landbouw duurzamer te maken. Het is echter onduidelijk hoe vaak en voor hoeveel stoffen de normen precies worden overschreden. De schadelijkste gewasbeschermingsmiddelen kunnen namelijk niet nauwkeurig genoeg worden gemeten. De waterschappen hebben gemeten of ruim 200 verschillende gewasbeschermingsmiddelen voorkomen in oppervlaktewateren bij landbouwpercelen. Ten minste tweederde van de meetpunten voldoet niet aan de waterkwaliteitsnormen. Volgens berekeningen veroorzaken slechts 4 stoffen 90 procent van de effecten in het oppervlaktewater. Juist deze stoffen zijn moeilijk meetbaar. Daarom beveelt het RIVM aan de monitoring van de waterkwaliteit te verbeteren. Ook blijken de normen voor de beoordeling of stoffen op de markt mogen worden toegelaten, soms minder streng te zijn dan de normen voor de waterkwaliteit, die gelden als de stof eenmaal op de markt is. Aanbevolen wordt deze normen beter op elkaar af te stemmen. Voor 5 gewassen is berekend dat de waterkwaliteit tot ruim 50 procent kan verbeteren door zogeheten geïntegreerde gewasbescherming. Bij deze werkwijze is chemische bestrijding een laatste stap, als andere manieren van plaagbestrijding niet werken. Eerst moeten preventieve maatregelen worden genomen die de landbouw minder kwetsbaar maken voor grote plagen, zoals de aanleg van bloemrijke akkerranden en meer variëren in de teelt van in landbouwgewassen. Het beleid heeft ook doelen voor grondwater en biodiversiteit opgesteld, al zijn die minder concreet. Volgens berekeningen zijn de concentraties van gewasbeschermingsmiddelen in het grondwater gemiddeld 6 procent lager geworden. Om te kunnen aangeven hoe de concentraties zich ontwikkelen, wordt de provincies aanbevolen het grondwater langere tijd te meten en de metingen beter op elkaar af te stemmen. Om te zien of de ingezette beleidsmaatregelen helpen om de achteruitgang van de biodiversiteit te stoppen, zou de biodiversiteit in Nederland langere tijd moeten worden gevolgd.

Purpose: To explore the relationship between segmental trunk control and specific gross motor skills at 4, 8 and 12 months of (corrected) age in young infants.Methods: Thirty-one preterm in...

Objectives 1) To determine if there was a practice effect associated with walk tests performed by frail older adults with and without dementia, 2) to examine the role of systematic cueing in the walk tests for those with dementia, and 3) to make recommendations to testing protocols of the walk tests for frail older adults with and without dementia. Setting Residential and day care facilities. Participants 44 frail older adults with normal cognition (NON-DEM) and 39 older adults with Alzheimer's disease or dementia (DEM) who were able to walk independently for at least 15 m. Methods All the participants completed multiple trials of 2-minute walk test (2MWT), 6-minute walk test (6MWT) and 10-meter walk test (10MeWT) on three separate testing occasions. The DEM group was facilitated to complete the walk tests using a progressive cueing system. Results Significant increases in the walking performance within the same testing occasion were found in the 2MWT (NON-DEM: p = .002; DEM: p ≤ .044) and 6MWT (NON-DEM: p ≤ .004; DEM: p ≤ .002) for both groups but only in the 10MeWT (p ≤ .023) for the DEM group. Significant increases in the walking performance across testing occasions were shown in the 2MWT (p ≤ .047), 6MWT (p ≤ .005) and 10MeWT (p ≤ .039) for the NON-DEM group but not the DEM group (all p > .05). Multivariate regression analyses showed that the cognitive function of the DEM group was independently and inversely associated with the level of cueing provided during the walk tests (p ≤ .007). Conclusion Practice effect associated with the walk tests was found within and across testing occasions for frail older adults with normal cognition, and only within the same testing occasion for those with dementia. Systematic cueing should be provided for those with dementia to complete the walk tests. Testing protocols of the walk tests have been recommended for these two population groups.

Objectives: To investigate the feasibility and potential efficacy of a six-week interactive computer play training on balance and gross motor function in children with moderate cerebral palsy. Design: A pilot single-blinded matched randomized controlled study. Setting: Community. Participants: In total, 18 children with moderate cerebral palsy were recruited, paired according to age and severity of cerebral palsy and randomized into intervention group or control group. Intervention: The intervention group received additional trunk control training using the interactive computer play in sitting four times per week, 20 minutes per session for six weeks. All study children continued their usual physiotherapy programme. Measurements: All study children were assessed at baseline, week 3, week 6 (completion of intervention) and week 12 using the Pediatric Reach Test, Gross Motor Function Measure–66-Item Set and 2-Minute Walk Test. Results: All intervention children completed and enjoyed the training with no reported adverse event. All children were assessed at all time points. No significant difference was found between the two groups in all assessments. In both groups of children, significant improvements were found in the Gross Motor Function Measure–66-Item Set between week 3 (intervention group: mean 53.41, SD 5.34; control group: mean 52.86, SD 8.33) and week 6 (intervention group: mean 55.00, SD 6.32; control group: mean 54.20, SD 8.35). Conclusion: The intervention protocol of a six-week interactive computer play training was feasible and safe for children with moderate cerebral palsy in special school settings. Future studies with larger sample sizes or using single-subject designs are recommended.

supplementary_material for Effectiveness of a multidisciplinary parent training program for children with developmental disabilities: A single-blind randomized waitlist controlled trial by Cynthia Leung, Cynthia Lai, Dustin Lau, Shirley Leung and Tamis W Pin in Journal of Child Health Care

Supplemental material, Supplemental_Material for The effect of interactive computer play on balance and functional abilities in children with moderate cerebral palsy: a pilot randomized study by Tamis W Pin and Penelope B Butler in Clinical Rehabilitation

Purpose This study investigated whether targeted training was feasible with young children younger than 2 years with poor trunk control due to cerebral palsy or developmental delay without using specialized equipment and the overall change in trunk control and functional ability, with the addition of targeted training to standard care physical therapy. Summary of key points Four children younger than 24 months with motor disorders were recruited. No difficulty was identified in using targeted training with this group. Within 3 months of commencing intervention, the 4 children had increased trunk control and functional abilities including independent sitting and bilateral hand use in play. Conclusions and recommendations for clinical practice This form of targeted training was feasible for young children with motor disorders and augmented standard care therapy in enhancing both trunk control and motor skills. Targeted training should be further investigated as a potentially effective treatment.

The 2-min walk test may be more appropriate functional exercise test for young children. This study aimed to examine the 2-min walk test's reliability; validity; and minimal clinically important difference; and to establish norms for children aged 6-12.Sixty-one healthy children were recruited to examine the 2-min walk test's reliability. Forty-six children with neuromuscular disorders (63% cerebral palsy) were recruited to test the validity. The normative study involved 716 healthy children without neuromuscular disorders (male = 51%, female = 49%). They walked at a self-selected speed for 2 min along a smooth, flat path 15 m in length.The mean distance covered in the 2-min walk test was 152.8 m (SD =27.5). No significant difference was found in the children's test-retest results (p 0.05). The intra- and inter-rater reliability were high (all intra-class correlation coefficients0.8). All children, except one with neuromuscular disorders, completed the 2-min walk test, of which the minimal clinically important difference at 95% confidence interval was 23.2 m for the entire group, 15.7 m for children walking with aids, and 16.6 m for those walking independently.The 2-min walk test is a feasible, reliable, and valid exercise test for children with and without neuromuscular disorders aged 6-12. The first normative references and minimal clinically important difference for children with neuromuscular disorders were established for children of this age group. Implications for rehabilitation The 2-min walk test is a feasible, safe, reliable, and valid time-based walk test for children aged 6-12 years. Normative references have been established for healthy children aged 6-12 years. Minimal clinically important difference at 95% confidence interval were calculated for children with neuromuscular disorders who walked without aids (i.e., independent and stand-by supervision) and those who walked with aids equal to 16.6 and 15.7 m, respectively. Distance covered by the healthy children in the 2 min did not correlate with age, gender, height, and weight of the children.