PDF(Pubmed)
Abstract：
BACKGROUND: Children with motor delays are at increased risk for delayed means-end problem-solving (MEPS) performance.
OBJECTIVE: To evaluate children with motor delays: 1) the impact of motor delay severity and MEPS mastery timing on developmental trajectories of MEPS; and 2) the effectiveness of Sitting Together And Reaching To Play (START-Play) intervention for improving MEPS.
METHODS: This represents a secondary analysis from a multi-site randomized controlled trial, with blinded assessors and prospective registration. Children with mild or significant motor delays (n = 112, mean age=10.80, SD=2.59 months at baseline) were randomly assigned to START-Play or usual care early intervention (UC-EI) and assessed at five visits across one year using the Means-End Problem-Solving Assessment Tool that included three 30-second MEPS trials per visit. Task mastery occurred at the first visit the child achieved the highest level of performance in at least two of the three trials. Multilevel analyses evaluated trajectories of MEPS outcomes dependent upon the timing of MEPS mastery, motor delay severity, and intervention group.
RESULTS: At baseline, children with mild motor delays demonstrated better MEPS than children with significant delays, but this difference was only observed for children who achieved mastery late. Children with significant delays demonstrated greater improvements in MEPS in the post-intervention phase compared to children with mild delays. No MEPS differences were found between START-Play and UC-EI.
CONCLUSIONS: Motor delay severity and timing of task mastery impacted MEPS trajectories, whereas START-Play intervention did not impact MEPS for children with motor delays.
UNASSIGNED: NCT02593825 (https://clinicaltrials.gov/ct2/show/NCT02593825).
OBJECTIVE: To evaluate children with motor delays: 1) the impact of motor delay severity and MEPS mastery timing on developmental trajectories of MEPS; and 2) the effectiveness of Sitting Together And Reaching To Play (START-Play) intervention for improving MEPS.
METHODS: This represents a secondary analysis from a multi-site randomized controlled trial, with blinded assessors and prospective registration. Children with mild or significant motor delays (n = 112, mean age=10.80, SD=2.59 months at baseline) were randomly assigned to START-Play or usual care early intervention (UC-EI) and assessed at five visits across one year using the Means-End Problem-Solving Assessment Tool that included three 30-second MEPS trials per visit. Task mastery occurred at the first visit the child achieved the highest level of performance in at least two of the three trials. Multilevel analyses evaluated trajectories of MEPS outcomes dependent upon the timing of MEPS mastery, motor delay severity, and intervention group.
RESULTS: At baseline, children with mild motor delays demonstrated better MEPS than children with significant delays, but this difference was only observed for children who achieved mastery late. Children with significant delays demonstrated greater improvements in MEPS in the post-intervention phase compared to children with mild delays. No MEPS differences were found between START-Play and UC-EI.
CONCLUSIONS: Motor delay severity and timing of task mastery impacted MEPS trajectories, whereas START-Play intervention did not impact MEPS for children with motor delays.
UNASSIGNED: NCT02593825 (https://clinicaltrials.gov/ct2/show/NCT02593825).
摘要：
背景：患有运动延迟的儿童在延迟的手段最终解决问题（MEPS）表现方面的风险增加。
目的：评估运动迟缓儿童：1）运动迟缓严重程度和MEPS掌握时间对MEPS发育轨迹的影响；2）坐在一起并达到游戏（START-Play）干预改善MEPS的有效性。
方法：这是一项来自多中心随机对照试验的二次分析，与盲目的评估和预期注册。将轻度或显着运动延迟的儿童（n=112，平均年龄=10.80，基线时SD=2.59个月）随机分配到START-Play或常规护理早期干预（UC-EI），并在一年的五次访问中进行评估使用Means-End问题解决评估工具，每次访问包括三个30秒的MEPS试验。任务掌握发生在第一次访问时，孩子在三个试验中的至少两个试验中达到了最高水平的表现。多层次分析评估MEPS结果的轨迹取决于MEPS掌握的时间，电机延迟严重程度，干预组。
结果：在基线时，轻度运动延迟的儿童表现出比显著延迟的儿童更好的MEPS，但是这种差异只在掌握较晚的孩子身上观察到。与轻度延误儿童相比，严重延误儿童在干预后阶段表现出更大的MEPS改善。在START-Play和UC-EI之间没有发现MEPS差异。
结论：运动延迟严重程度和任务掌握时间影响了MEPS轨迹，而START-Play干预对运动迟缓儿童的MEPS没有影响.
■NCT02593825(https://clinicaltrials.gov/ct2/show/NCT02593825)。
目的：评估运动迟缓儿童：1）运动迟缓严重程度和MEPS掌握时间对MEPS发育轨迹的影响；2）坐在一起并达到游戏（START-Play）干预改善MEPS的有效性。
方法：这是一项来自多中心随机对照试验的二次分析，与盲目的评估和预期注册。将轻度或显着运动延迟的儿童（n=112，平均年龄=10.80，基线时SD=2.59个月）随机分配到START-Play或常规护理早期干预（UC-EI），并在一年的五次访问中进行评估使用Means-End问题解决评估工具，每次访问包括三个30秒的MEPS试验。任务掌握发生在第一次访问时，孩子在三个试验中的至少两个试验中达到了最高水平的表现。多层次分析评估MEPS结果的轨迹取决于MEPS掌握的时间，电机延迟严重程度，干预组。
结果：在基线时，轻度运动延迟的儿童表现出比显著延迟的儿童更好的MEPS，但是这种差异只在掌握较晚的孩子身上观察到。与轻度延误儿童相比，严重延误儿童在干预后阶段表现出更大的MEPS改善。在START-Play和UC-EI之间没有发现MEPS差异。
结论：运动延迟严重程度和任务掌握时间影响了MEPS轨迹，而START-Play干预对运动迟缓儿童的MEPS没有影响.
■NCT02593825(https://clinicaltrials.gov/ct2/show/NCT02593825)。
