The purpose of this paper was to examine and integrate the findings of empirical research on the effectiveness of basic motor skills instruction for children with neuromotor delays. Twenty-eight studies were identified. The methodology and effectiveness of the specific training approaches implemented in each study were analyzed. Training approaches were classified into one of four frameworks: neuromotor interventions, sensory integration techniques, behavioral programming, and naturalistic programming. Analysis of study findings indicate that progress in developing and conducting rigorous empirical investigations to address questions of effectiveness of motor intervention techniques is occurring, albeit slowly. The area with the strongest research base is behavioral programming. All approaches, however, lack comprehensive assessment of generalization and maintenance, especially in terms of response generalization, generalization to the natural environment, and maintenance. In fact, the issue of generalization appears to be central to this body of literature, in terms of both directions for future research and implications for current practice.
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References
1.
Alberto, P.A., & Troutman, A. (1986). Applied behavior analysis for teachers. (2nd ed.). Columbus, OH: Merrill.
2.
Ayllon, T., & Azrin, N.H. (1964). Reinforcement and instructions with mental patients. Journal of Experimental Analysis of Behavior, 7, 327–331.
3.
Ayres, A.J. (1972). Sensory integration and learning disorders. Los Angeles: Western Psychological Services.
4.
Bagnato, S.J., & Neisworth, J.T. (1985). Efficacy of inter-disciplinary assessment and treatment for infants and preschoolers with congenital and acquired brain injury. Analysis and Intervention in Developmental Disabilities, 5, 107–128.
5.
Baer, D.M., Wolf, M.M., & Risley, T.R. (1968). Some current dimensions of behavior analysis. Journal of Applied Behavior Analysis, 1, 91–97.
6.
Ball, T.S., McCrady, R.E., & Hart, A.D. (1975). Automated reinforcement of head posture in two cerebral palsied retarded children. Perceptual and Motor Skills, 40, 619–622.
7.
Bax, M.C. (1964). Terminology and classification of cerebral palsy. Developmental Medicine and Child Neurology, 6, 295–297.
8.
Bigge, J.L., & O'Donnell, P.A. (1976). Teaching individuals with physical and multiple disabilities. Columbus, OH: Merrill.
9.
Bobath, K. (1980). A neurophysiological basis for the treatment of cerebral palsy. London: William Heinemann Medical Books.
10.
Bobath, K., & Bobath, B. (1972). Cerebral palsy, part 1 and the neurodevelopmental approach to treatment, part 2. In P. Pearson & C. Williams (Eds.), Physical therapy services in the developmental disabilities (pp. 31–185). Springfield, IL: Thomas.
11.
Bragg, J.H., Houser, C., & Schumaker, J. (1975). Behavior modification: Effects on reverse taylor sitting in children with cerebral palsy. Physical Therapy, 55, 860–868.
12.
Breen, C., Haring, T., Pitts-Conway, V., & Gaylord-Ross, R. (1985). The training and generalization of social interaction during breaktime at two job sites in the natural environment. Journal of the Association for Persons with Severe Handicaps, 10(1), 41–50.
13.
Campbell, D.T., & Stanley, J.C. (1966). Experimental and quasi-experimental designs for research. Chicago: Rand McNally.
14.
Campbell, P. (1987). Programming for students with dysfunction in posture and movement. In M. Snell (Ed.), Systematic instruction of persons with severe handicaps (pp. 188–212). Columbus, OH: Merrill.
15.
Campbell, P.H., McInerney, W.F., & Cooper, M.A. (1984). Therapeutic programming for students with severe handicaps. American Journal of Occupational Therapy, 38, 594–602.
16.
Campbell, P., & Stewart, B. (1986). Measuring changes in movement skills with infants and young children with handicaps. Journal of the Association for Persons with Severe Handicaps, 11(3), 153–161.
17.
Cannon, S.E., Rues, J., Melnick, M.E., & Guess, D. (1987). Head-erect behavior among three preschool-aged children with cerebral palsy. Physical Therapy, 67, 1198–1204.
18.
Carlsen, P. (1975). Comparison of two occupational therapy approaches for treating the young cerebral-palsied child. American Journal of Occupational Therapy, 29, 267–272.
Clark, F.A., Miller, L.R., Thomas, J.A., Kucherawy, D.A., & Azen, S.P. (1978). A comparison of operant and sensory integrative methods on developmental parameters in profoundly retarded adults. American Journal of Occupational Therapy, 32, 86–92.
21.
Craft, M. (1979). Tregold's mental retardation. London: Baillière Tindall.
22.
Csapo, M. (1981). Comparison of two prompting procedures to increase response fluency among severely handicapped learners. Journal of the Association for the Severely Handicapped, 6(1), 39–47.
23.
DeGangi, G., Hurley, L., & Linschield, T. (1983). Towards a methodology of the short term effects of NDT. American Journal of Occupational Therapy, 37, 479–488.
24.
de Quiros, J. (1976). Diagnosis of vestibular disorders in the learning disabled. Journal of Learning Disabilities, 9, 39–47.
25.
Ferry, D. (1981). On growing new neurons: Are early intervention programs effective. Pediatrics, 67, 38–41.
26.
Filler, J., & Kasari, C. (1981). Acquisition, maintenance, and generalization of parent taught skills with two severely handicapped infants. Journal of the Association for Persons with Severe Handicaps, 6(1), 30–38.
27.
Garwood, S.G. (1979). Physical and physiological bases of handicaps. In S.G. Garwood (Ed.), Educating young handicapped children: A developmental approach (pp. 51–72). Germantown, MD: Aspen Systems.
28.
Goldenson, R.M. (1978). Disability and rehabilitation handbook. New York: McGraw-Hill.
29.
Grove, D.N., & Dalke, B.A. (1976). Contingent feedback for training children to propel their wheelchairs. Physical Therapy, 56, 815–820.
30.
Hacker, B. (1980). Single subject research strategies in occupational therapy: Part 2. The American Journal of Occupational Therapy, 34(3), 169–176.
31.
Harris, F., Spelman, F., & Hymer, J.W. (1974). Electronic sensory aids as treatment for cerebral palsy children. Physical Therapy, 54, 354–365.
32.
Harris, S. (1981). Effects of neurodevelopmental therapy on improving motor performance in Downs Syndrome infants. Developmental Medicine and Child Neurology, 23, 477–483.
33.
Harris, S. (1988). Early intervention: Does developmental therapy make a difference?Topics in Early Childhood Special Education, 7(4), 20–32.
34.
Hart, B., & Risley, T.R. (1975). Incidental teaching of language in the preschool. Journal of Applied Behavior Analysis, 1, 411–420.
35.
Hersen, M., & Barlow, D. (1976). Single case experimental designs: Strategies for studying behavioral changes. (2nd ed.). New York: Pergamon Press.
36.
Holvoet, J., O'Neill, C., Chazdon, L., Carr, D., & Warner, J. (1983). Hey, do we really have to take data?Journal of the Association for the Severely Handicapped, 8(3), 56–70.
37.
Horn, E.M., & Warren, S.F. (1987). Facilitating the acquisition of sensorimotor behavior with a microcomputer mediated teaching system: An experimental analysis. Journal of the Association for Persons with Severe Handicaps, 12, 205–215.
38.
Horner, R., & McDonald, R. (1982). Comparison of single instance and general case instruction in teaching a generalized vocational skill. Journal of the Association for the Severely Handicapped, 7(3), 7–20.
39.
Horner, R., Williams, J., & Stevely, J. (1985). Acquisition of generalized telephone use by students with moderate and severe mental retardation. Research in Developmental Disabilities, 8, 229–247.
40.
Inge, K. (1987). Normal motor development. In F. Orelove & D. Sobsey (Eds.), Educating children with multiple disabilities: A transdisciplinary approach (pp. 25–41). Baltimore: Brookes.
41.
Ingram, T.T. (1984). A historical review of the definition and classification of the cerebral palsies. In F. Stanley & E. Aberman (Eds.), Clinics in developmental medicine epidemiology of the cerebral palsies (pp. 1–11). Philadelphia: Lippincott.
42.
Kantner, R.M., Clark, D.L., Allen, L.C., & Chase, M. (1976). Effects of vestibular stimulation on nystagmus response and motor performance in the developmentally delayed infant. Physical Therapy, 56, 414–421.
43.
Langley, M.B. (1979). Working with young physically-impaired children. Part A: The nature of physical handicaps. In S.G. Garwood (Ed.), Educating young handicapped children: A developmental approach (pp. 109–149). Germantown, MD: Aspen Systems.
44.
Laskas, C.A., Mullen, S.L., Nelson, D.L., & Willson-Broyles, M. (1985). Enhancement of two motor functions of the lower extremity in a child with spastic quadriplegia. Physical Therapy, 65(1), 11–16.
45.
Lee, J.M., Mahler, T.J., & Westling, D.L. (1985). Reducing occurrences of an ATNR. American Journal of Mental Deficiency, 89, 617–621.
46.
Leiper, C., Miller, A., Lang, J., & Herman, R. (1981). Sensory feedback for head control in cerebral palsy. Physical Therapy, 61, 512–518.
47.
Martin, J., & Epstein, L. (1976). Evaluating treatment effectiveness in cerebral palsy. Physical Therapy, 56, 285–294.
48.
MacLean, W.E., & Baumeister, A.A. (1982). Effects of vestibular stimulation on motor development and stereotyped behavior of developmentally delayed children. Journal of Abnormal Child Psychology, 10, 229–245.
49.
Montgomery, P., & Richter, E. (1977). Effects of sensory integration on the neuromotor development of retarded children. Physical Therapy, 57, 799–806.
50.
Noonan, M.J. (1984). Teaching postural reactions to students with severe cerebral palsy. Journal of the Association for Persons with Severe Handicaps, 9, 111–122.
51.
Norton, Y. (1975). Neurodevelopment and sensory integration for the profoundly retarded multiply handicapped child. American Journal of Occupational Therapy, 29(2), 93–100.
52.
Nunnally, J.C. (1967). Psychometric theory. New York: McGraw-Hill.
53.
Orelove, F., & Sobsey, D. (1987). Educating children with multiple disabilities: A transdis-ciplinary approach. Baltimore: Brookes.
54.
Ottenbacher, K., Biocca, Z., DeCremer, G., Bevelinger, M., Jedlovec, K.B., & Johnson, M.B. (1986). Quantitative analysis of the effectiveness of pediatric therapy: Emphasis on the neuro-developmental treatment approach. Physical Therapy, 66, 1095–1101.
55.
Ottenbacher, K., & Peterson, P. (1985). A meta-analysis of applied vestibular stimulation research. Physical and Occupational Therapy in Pediatrics, 5(2/3), 119–134.
56.
Ottenbacher, K., Short, M., & Watson, P. (1981). The effects of a clinically applied program of vestibular stimulation on the neuromotor performance of children with severe developmental disability. Physical and Occupational Therapy in Pediatrics, 1, 1–11.
57.
Palmer, F.B., Shapiro, B.K., Wachtel, R.C., Allen, M.C., Hiller, J.E., Harryman, M.S., Mosher, B.S., Meinert, C.L., & Capute, A.J. (1988). The effects of physical therapy on cerebral palsy. New England Journal of Medicine, 318(13), 803–808.
58.
Parette, H.P., & Hourcade, J.J. (1984). How effective are physiotherapeutic programs with young mentally retarded children who have cerebral palsy?Journal of Mental Deficiency Research, 28(3), 167–175.
59.
Pearson, P., & Williams, C. (1972). Physical therapy services in the developmental disabilities. Springfield, IL: Thomas.
60.
Piper, M.C., Kunas, V., Willis, D., Mazer, B.L., Ramsay, M., & Wilver, K.M. (1986). Early physical therapy effects on the high-risk infant: A randomized controlled trial. Pediatrics, 78, 216–224.
61.
Richman, J.S., & Kazlowski, N.L. (1977). Operant training of head control and beginning language development for a severely developmentally disabled child. Journal of Behavior Therapy and Experimental Psychiatry, 8, 437–440.
62.
Rugel, R., Mattingly, J., Eichenger, M., & May, J. (1971). The use of operant conditioning with a physically disabled child. The American Journal of Occupational Therapy, 25(5), 247–249.
63.
Scherzer, A., Mike, V., & Ilson, J. (1976). Physical therapy as a determinant of change in the cerebral palsied infant. Pediatrics, 58, 47–52.
64.
Sellick, K.J., & Over, R. (1980). Effects of vestibular stimulation on motor development of cerebral palsied children. Developmental Medicine and Child Neurology, 22, 476–483.
65.
Skrotzky, K., Gallenstein, J.S., & Osternig, L.R. (1978). Effects of electromyographic feedback training on motor control in spastic cerebral palsy. Physical Therapy, 58, 547–552.
66.
Sommerfeld, D., Fraser, B., Hensinger, R., & Beresford, C. (1981). Evaluation of physical therapy service for severely mentally impaired students with cerebral palsy. Physical Therapy, 61, 338–344.
67.
Stanley, F., & Alberman, E. (Eds.). (1984). Clinics in developmental medicine epidemiology of the cerebral palsies.Philadelphia: Lippin-cott.
68.
Stokes, T.F., & Baer, D.M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349–367.
69.
Stone, C. (1977). Motor skills. In N.G. Haring (Ed.), Developing effective individualized education programs for severely handicapped children and youth (pp. 58–90). Washington, DC: Bureau of Education for the Handicapped.
70.
Tyler, N., & Kahn, N. (1976). A home-treatment program for the cerebral-palsied child. American Journal of Occupational Therapy, 30(7), 437–440.
71.
Umbreit, J. (1983). Physical disabilities and health impairments: An introduction. Columbus, OH: Merrill.
72.
Warren, S.F., & Rogers-Warren, A.K. (1983). A longitudinal analysis of language generalization among adolescents with severely handicapping conditions. Journal of the Association for Persons with Severe Handicaps, 8, 18–31.
73.
Warren, S.F., Rogers-Warren, A., Baer, D.M., & Guess, D. (1976). Assessment and facilitation of language generalization. In W. Sailor, B. Wilcox, & L. Brown (Eds.), Methods of instruction for severely handicapped students (pp. 227–258). Baltimore: Brookes.
74.
White, O.R., & Haring, N.G. (1976). Exceptional teaching: A multimedia training package. Columbus, OH: Merrill.
75.
Wooldridge, C.P., & Russell, G. (1976). Head position training with the cerebral palsied child: An application of biofeedback techniques. Archives of Physical Medical Rehabilitation, 57, 407–414.
76.
Wright, T., & Nicholson, J. (1973). Physiotherapy for the spastic child: An evaluation. Developmental Medicine and Child Neurology, 15, 146–163.
77.
Yin, R.K. (1984). Case study research: Design and methods. Beverly Hills, CA: Sage Publications.
