Rehabilitation Therapy

Comparison of Traditional and Innovative

Therapies for Special Needs Children
Traditional vs. Innovative
Traditional Therapy Innovative Therapy

Set guidelines & Speculative therapy

protocols for therapists approach
to follow New, modified therapy
Evidence-based Lack of evidence to
therapy support therapy
Proven effects effectiveness
Includes: Physical, Unproven effects
Occupational, &
Speech therapy
Physical Therapy
Develop, maintain, & restore movement and
functional ability threatened by ageing, injury,
pain, diseases, disorders, conditions or
environmental factors throughout the lifespan
- WCPT

Enhance quality of life by improving physical

capabilities
Prevent/improve functional limitations
Minimize impairments due to disability/condition
Develops interventions/treatment to improve
physical functioning
Enhance independent functioning
Implement modifications to patients life for
better functioning in daily life activities
Traditional Physical
Therapy Approaches
Physical Therapy typically targets gross
motor functioning skills which include
movements of the larger muscle groups
involving whole-body movements
Standing/Sitting
Walking/Running
Skipping/Jumping
Stair climbing
Balance & Stability training
Body awareness & coordination
Muscle strengthening/Improving muscle tone
 Therasuit Method
The purpose of the Therasuit method is to improve
and change proprioception, reduce pathological
reflexes, restore physiological muscle synergies and
load the entire body with weight similar to a reaction
of our muscles to the gravitational forces
- The Therapy Place

Aim is to correct improper pathological reflexes and

movements and employ proper movement patterns for
better physical functionality

Muscle and neurological retraining

Therasuit Method
Intensive program lasting 3 weeks, with 5
sessions per week lasting 3 hours in duration.

Soft dynamic proprioceptive orthotic

Uses elastic bands and bungee cords to

properly align the body in an upright,
vertical standing position with gravity. By
this enforced physical alignment, posture
can be corrected allowing the muscles to
engage in appropriate movement patterns
and strengthen those neglected muscles.
Proposed Benefits
of Therasuit
Afferent proprioceptive input
External stabilization
Improve and correct improper muscle tone.
Proper body alignment/posture
Improve gait pattern
Tactile stimulation
Improvements in muscle strengthening
Better body awareness and coordination
Innovative Physical Therapy:
Therasuit Studies
Comparison of Efficacy of Adeli suit &
Neurodevelopmental Treatments in Children
with Cerebral Palsy
Bar-Haim, S. et al. (2006)

Adeli Suit Treatment Experimental Neurodevelopmental Treatment

Group Comparison Group

Participants placed in the suit Focused on the CNS and

correcting body alignment and neuromuscular system.
restricted limb improper limb Techniques reducing spasticity &
positions. emphasized normal movement
Typical physical therapy patterns.
exercises while in the suit. Walking, standing from sitting
Locomotion exercises.
Walking, stand up from sitting,
ball play while standing, walking
on different surfaces, jumping,
climbing.
Cont.
Each session for both treatment groups lasted 2 hours, 5 days per
week for 4 weeks.
24 Children: 17 males & 7 females
Gross Motor Function Measurements
Neurodevelopmental Group: Significant difference between initial
measurement & 10 month post-treatment measurement: P-value <
0.006
Adeli Suit Treatment Group: Significant difference between initial
measurement & 10 month post-treatment measurement: P-value <
0.037
Conclusion: Both treatments employed greater significant
improvements in gross motor abilities compared to traditional
physical therapy due to intensity of both methods
Effect of modified suit therapy in spastic
diplegic cerebral palsy A single blinded
randomized controlled trial.
Alagesan J., & Shetty, A. (2010).

30 Children diagnosed with Spastic Diplegia

Experimental Group wore therapy suit while receiving
traditional physical therapy
Control Group did not wear the therapy suit, but still
did receive traditional physical therapy
Both groups participated in 2-hour therapy sessions for
3 weeks
Cont.
Therapy Sessions Included:
Muscle strengthening
Weight-bearing exercises
Weight shifting
Posture corrections & control exercises
Stability exercises & balance training
Climbing exercises
Gait training.
Cont.
Both groups had significant improvements
demonstrated by p-value less than 0.001
Significant difference between the two groups as
represented by a p-value = 0.030 & z = 2.293
Conclusion: Experimental group involving the therapy suit
during therapy sessions had more significant gains in gross
motor functioning than the control group not wearing the
therapy suit.
Occupational
Therapy
The purpose of Occupational Therapy is to assist
patients across the lifespan to participate in the
things they want and need to do through the therapeutic
use of everyday activities (occupations) AOTA
Individualized interventions to improve quality of
life
Improve ability to perform daily activities/tasks
Implement assistive devices/therapeutic tools to
enhance daily functioning
Develop an adaptable environment for patients in
their homes, schools, social networks &
communities
Emphasize independence & less reliance on others
Traditional Occupational
Therapy Approaches
Occupational Therapy typically involves fine motor skills
(perceptual motor skills) that utilized small muscles for
precise, controlled movements.
Activities of Daily Living (dressing, personal hygiene, etc.)
Handwriting, cutting
Sensory integration
Object Manipulation
Grasping/pinching
Bilateral transfer
Innovative Occupational
Therapy Studies
Using the Virtual Reality-Cognitive Rehabilitation
Approach to Improve Contextual Processing in
Children with Autism
Wang, M., & Reid, D. (2013).

Virtual Reality-Cognitive Approach: Child could view his/her self-

participation in the virtual reality program via motion-tracking
camera
Abstraction: the ability to identify the context by extracting the
relevant qualities and relationships within the environment

Cognitive flexibility: the ability to switch between multiple

mental representations of a single object in response to changing
contextual factors.

Object classification based on: perceptual, spatial, & functional

Cont.

Using the Virtual Reality-Cognitive Rehabilitation

Approach to Improve Contextual Processing in
Children with Autism
Wang, M., & Reid, D. (2013).

All 4 autistic children in the study showed improvements

in cognitive flexibility
Child 1 showed a 18% increase post-training and a 45% increase
at follow-up.
Child 3 increased his score by 9% and maintained this at follow-
up.
Child 2 doubled her score by follow-up
Child 4 tripled his score at post-training and maintained his score
at follow-up.
Interactive Metronome
Interactive Metronome therapy involves the use of the
computer in which the patient to listens to the ticking sounds
of the device and utilizes a trigger to match the rhythm of the
beats

Improvements In:
Brain timing
Attention
Motor coordination
Language processing
Self-control of impulses.
Interactive Metronome Research
Shaffer et al. (2001)

56 male participants diagnosed with ADHD

3 Groups: Interactive Metronome experimental group (19
participants), Video game comparison group, & no
intervention comparison group
Interactive Metronome & Video game groups received 1
hour of training for 5 days per week over a 3-5 week period
(total 15 hours of training)
Shaffer et al. (2001) Cont.
Interactive Metronome Experimental
Video Game Control Group
Group
Different tapping exercises The video game intervention group
including:
Clapping consisted of 5 games that involved:
Finger tapping
Eye-hand coordination
Altering toe tap/heel tap
Tapping one toe or heel Advanced mental planning
Alternating tapping one hand &
toe Multiple task sequencing.
Balancing on one foot while
taping other toe.
According to tap accuracy, the
pitch and location of the sound
changed.
Shaffer et al. (2001)
Cont.
Post-training Pre-training Mean Difference
Interactive Metronome = 0.473
Increased performance
Video game = -0.054
No intervention group = -0.278
Negative values = Decrease performance
The Interactive Metronome group also improved in
attention abilities, motor control, language processing,
reading, and aggression regulation.
ARKs Tran-Quill Pencil
Pencil utensil providing vibration, texture & weighted
sensory input without affecting writing/drawing ability
for those with decreased fine motor control and sensory
needs/issues
Benefits Include:
Increase focus and concentration
Improve muscle memory
Correct writing speed
Improve hand strength and dexterity
Decrease the grip force
Speech Therapy
The purpose of Speech Therapy is to prevent, assess, diagnose,
and treat speech, language, social communication, cognitive-
communication, and swallowing disorders in children and adults
- American Speech-Language-Hearing Association
Improve receptive/expressive language
Improve language forms such as phonology, morphology, & syntax
Improve semantics and/or pragmatics of language
Enhance social communication among verbal & non-verbal patients
Aid cognitive communication involving: attention & memory
abilities, planning, problem-solving
Employ techniques to correct/improve swallowing and feeding
strategies
Traditional Speech
Therapy
Language articulation, Language processing,
Chewing/swallowing/feeding, Pre-literacy
3 Phases of Treatment Approach:
1. Establishment Phase: Voluntarily eliciting target behaviors &
stabilizing production
2. Generalization Phase: Encouraging sound productions in
various areas at challenging levels
3. Maintenance Phase: Stabilize target behaviors, automatic
sound production; Self-monitoring & self-correction
Traditional Speech
Therapy Methods
Contrast Therapy: use of contrasting word pairs.
Includes minimal opposition, maximal opposition, empty set and
multiple opposition
Cycle Approach: correct phonological pattern errors to lead to
a more typical phonological development process
Distinctive Feature Therapy: focuses on elements of
phonemes missing
Children needing this type of therapy may substitute one sound
for another
Speech Sound Perception Training: stable representation of
particular phoneme or phonological structure
1. Auditory bombardment
2. Identification tasks
Innovative Speech
Therapy Studies
A comparison of communication
using the apple iPad & a picture-
based system
Flores et al. (2012)

Comparison of 2 communication methods: iPad & Picture based system

5 elementary school-aged children
Both communication methods included 3 hour long sessions for 5 days
per week over a 5-week period.
Tested during snack time: 3 different snacks (pretzels, goldfish, &
cookies).
Picture based system: Laminated color pictures and requests such as I want, &
more were used.
Communicated by: Pointing, Removing card and handing to teacher, or Placing cards in
a sentence.
iPad group: Pick a Word app including color snack pictures and I-Want in a
picture of the American Sign Language hand position on screen with voice-
output
Results: Low study sample = Mixed results with no defined pattern.
Concluded: iPad was an effective alternative to the picture-based system
Increasing functional communication in non-
speaking preschool children: Comparison of PECS
and VOCA
Bock, Stoner, Beck Hanley & Prochnow (2005)

Six non-verbal 4-year olds diagnosed with developmental delay

PECS = Picture Exchange Communication System
VOCA = Voice Output Communication Aid.
GoTalk: digitized device with carrying hand and nine category locations
separated by keyguard.
2-3 sessions per week for 5 weeks in the school setting
Both communication methods involved 3 phases:
1st phase: Child hands over a picture of desired item to communication
partner to receive the item
2nd phase: Child walks over to the communication partner to get his/her
attention and then hand over the picture.
3rd phase: Child discriminates between a desired and a neutral item, then hand
desired item to communication partner to receive the item.
Cont.
Results: PECS was slightly easier for the children to use
compared to the VOCA intervention, because the child had to
place the GoTalk on the table correctly, push the location
category with enough strength to activate the voice output.
However, once this was conquered by the child, both
communication methods proved to be adequate systems to help
non-speaking children communicate.
Arks Y-Chew XXT
Therapeutic tool for children to chew encouraging oral
exploration, input and stimulation while providing a safe
alternative for children who love to chew and explore with
their mouths .
Textures: Smooth, ribbed & bumpy
Benefits:
Enhances jaw strength, jaw stability, & tongue movement
Builds oral tone, strength, mobility, control, coordination, and
endurance
Decreases oral sensitivities, oral defensiveness, and food
aversions
Strengthens the lips, facial muscles, & tongue
Beneficial for feeding and communication skills
Conclusion
Traditional Rehabilitation Therapy: evidence-based
approach with set protocols & guidelines to follow
Innovative Rehabilitation Therapy: highly individualized,
speculative approach with unproven benefits/effects
Physical, Occupational, & Speech therapies treat those of
all ages across the lifespan and are evidenced-based
therapies design to improve quality of life
Innovative therapies are used in all 3 types of therapies
Conclusion
Occupational
Physical Therapy Speech Therapy
Therapy
Improves physical Improves ability to Improve language
functioning complete daily life abilities, language
Involves gross activities processing,
motor skills Involves fine articulation,
(whole-body motor skills feeding abilities
movements) Innovative Innovative
Innovative Examples: Examples:
Example: Virtual Reality iPad
Therasuit Interactive Voice Output
Metronome Communication
ARKs Tran-quill Aids
Pencil ARKs Y-Chew
 Works Cited
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9. Interactive Metronome. Retrieved from https://www.interactivemetronome.com/what-is-im
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vibrating-pencil-kit
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http://www.asha.org/Students/Speech-Language-Pathologists
13. American Speech-Language-Hearing Association. Retrieved from:
http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935321&section=Treatment#Treat
ment_Approaches
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