Professional Documents
Culture Documents
Orit Bart, Yair Bar-Haim, Einat Weizman, Avi Sadeh & Matti Mintz Tel Aviv University Israel
Aims
Methods
Participants
Forty-nine children (M=5.6,Range =5.07.0) with balance difficulties (BOTMP) and high level of anxiety (FSSC). Exclusion criteria: tactile difficulties (above clinical cutoff score on the TIE), or psychological or OT treatment during the 3 years preceding study onset.
European DCD Conference, 2007
Measures
Balance functions
Bruininks, 1978)
Measures
Anxiety
Fear Survey Schedule for Children (FSSC; Anxiety/Depression subscale of the Child
Behavior Checklist (CBCL; Achenbach, 1991)
Ollendick, 1983)
Measures
Self-esteem
Methods
Procedure
The treatment group (n=25; 3 girls) and the control group (n=24; 3 girls) did not differ in age, balance function, anxiety, and self-esteem at the time of assignment
Children were assigned to either a balance treatment group, or a waiting-list control group based on first come first served policy
Procedure
Battery assessment to both groups
Balance treatment group 12 weekly sessions Control group
Waiting list
Intervention
flexor and extensor muscle tone training maneuvers requiring balance maintenance in different body postures activity involving vestibular stimulation in different
head and body positions.
10% of the sessions were randomly monitored by other OTs. No deviations from protocol were detected.
European DCD Conference, 2007
Intervention
Results
Treatment Group Pre-treatment Post-control Balance function Balance Vestibular processing Anxiety FSSC Total CBCL Anxious/Depressed Self-esteem Self-Esteem Performance Self-Esteem - Acceptance 30.0 (6.2) 30.7 (6.4) 40.1 (4.1) 36.2 (6.2) 28.5 (4.8) 26.3 (6.5) 28.5 (4.6) 25.3 (5.9) 184.0 (11.3) 16.6 (5.5) 128.1 (9.3) 5.0 (2.4) 187.5 (7.3) 14.2 (4.8) 185.3 (8.9) 15.6 (4.7) 3.3 (1.9) 25.2 (3.9) 14.0 (3.7) 46.4 (2.9) 3.9 (2.2) 26.1 (4.8) 2.9 (2.0) 24.8 (3.7) Control Group Pre-waiting Post-waiting
Results
BALANCE
20
Balance - BOTMP
15 control Treatment
10
0 1 Time 2
Results
ANXIETY
20
Anxiety - CBCL
15 control Treatment
10
0 1 Time 2
Results
SELF- ESTEEM
50
Self-estemm
Discussion
Balance treatment
Improved Balance
Reduced anxiety
Increased self-esteem
Discussion
These results land support to a causal pathway by which balance dysfunction is the driving force of a considerable portion of the variance in anxiety and low self-esteem in children with balance dysfunction
Discussion
Anxiety in 40% of the children in the treatment group were still above the clinical cutoff on the CBCL. The residual anxiety could be associated with non-balance factors:
Discussion
The amelioration of anxiety may be the outcome of a psychological desensitization process that is embedded in the balance treatment The positive and rewarding attitude of the therapist may contributed to reduction in anxiety and increase in self-esteem.
The potential change in parents' understanding of their childs difficulties might have lead to more supportive attitude toward the child
European DCD Conference, 2007
Further studies
To include another control group who will receive another treatment method To assess whether anxiety treatment will improve balance function
Clinical implications
Clinical assessment of anxiety disorders in children should include screening for an underlying balance disorder. If an underlying co-morbid balance disorder is identified then a tailored balance intervention may be integrated into the treatment plan.