[PI-2] ポスター：発達障害 2

[PI-2-1] A pilot randomized controlled trial of ride-on cars and social function in toddlers with mild and moderate motor delays

Hsiang-Han Huang^1,2, Ching-Ying Hung¹, Yung-Tze Lee¹, Chia-Ling Chen^3,4 (1.Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan, 2.Joint Appointment with Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan, 3.Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan, 4.Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan)

Recent evidence demonstrates the effectiveness of using ride-on cars (ROCs) with a standing posture on psychosocial function in young children with motor delays and their caregivers. To examine the issue of different severity levels, this pilot randomized controlled trial aims to compare the effects of the ROC training on social function and parenting stress levels between toddlers with mild and moderate motor delays. This study was approved by the local Institutional Review Board. Twenty-four toddlers aged 1-to-3-year old were randomly assigned to the four groups: ride-on car training with mild and moderate levels (ROC-mild: n=9, mean age: 17.24 months; ROC-moderate: n=7, mean age: 25.66 months), and conventional therapy with mild and moderate levels (Control-mild: n=5, mean age: 18.83 months; Control-moderate: n=3, mean age: 28.62 months). The whole study duration was 24 weeks, including a 12-week intervention and a 12-week follow-up. All programs included 120 minutes/per session, 2 sessions/per week. Participants continued their regular therapy during the whole study. The applied standardized assessments were Chinese Version of Pediatric Evaluation of Disability Inventory, Bayley Scales of Infant and Toddler Development (3rd edition), and Parenting Stress Index, Short Form-Chinese Version. A two-way repeated measures ANOVA was employed to evaluate the effects of the outcomes among the three groups. There was no significant difference in demographic data, social function and parenting stress levels among the groups at pre-test. There was no significant time × group interaction or group effect for social function and parenting stress levels. However, a main effect of testing session was found for the four groups for social function measures (p<.001) and the post-hoc test showed a significant difference between pretest and posttest scores (p=.001), posttest and follow-up test (p=.001), and pretest to follow-up test (p<.001). The individual data of ROC training showed a trend of more changes for toddlers with mild motor delays, and the conventional therapy was for those with moderate ones. The preliminary findings support the positive effects of applying the ROC-Stand training on social function, particularly for toddlers with mild motor delays. The standing style of a modified ROC requires more postural adjustment skills than the sitting one, which may have fit the participants’ abilities with mild motor delays, and offered just right challenge. Toddlers with moderate delays may benefit more on social function from the conventional therapy program. Sufficient practice dosages and moderate challenging levels from the environment may be two key factors which require further investigations for providing practical guidelines for clinicians and caregivers. To unravel the question of challenging levels, future studies may also consider applying eye-tracking technology to clarify the relationship between person and environmental factors.