Pediatric Physical Therapy:
Abstracts: Abstracts of Platform and Poster Presentations for the 2006 Combined Sections Meeting: Platform Presentations
1Physical Therapy Education, Suny Upstate Medical, Syracuse, NY, USA
To investigate the effects of 3 seating options: chairs, therapy balls, & air cushions on the in-seat behavior & word productivity of students with ADHD. Social validity was assessed to evaluate teacher & student perspectives regarding the intervention.
Number of Subjects:
2 teachers & 47 students from 2 fifth grade classrooms participated in this study. Target study participants were 5 students with a diagnosis of ADHD.
A single subject multiple treatments withdrawal design was used that consisted of 9 phases over 6 months. Phases included: 4 A phases (chairs), 2 B phases (balls), 2 C phases(cushions), & 1 D phase (choice). In-seat data were collected via momentary real time sampling by 2 observers independently & simultaneously. Legible word productivity was defined as the percentage difference between target students word production & the class mean. Data were collected via a word count performed on daily in-class assignments. Social validity was examined via questionnaires completed by teachers & students at the end of the third A phase & at the conclusion of the study. Data were graphed & visually analyzed for differences between phases.
Results indicate improvements in in-seat behavior & word production during use of either one or both of the dynamic seating devices. All 5 participants with a diagnosis of ADHD demonstrated immediate improvement in in-seat behavior when seated on 1 or both forms of dynamic seating (ball or cushion). Word productivity also increased during use of dynamic seating, as demonstrated by all 5 participants with ADHD surpassing the class mean on 1 or more assignments. Students with ADHD not only reported a preference for the balls, but indicated perceived improvements in attention, productivity and comfort. Of the 45 students without ADHD, the majority preferred dynamic seating. Likewise, both teachers preferred dynamic seating & requested continued access to both devices.
This study suggests that dynamic seating in the classroom, increases in-seat behavior & word productivity for children with ADHD. However no one type of seating was found appropriate for all children either with or without ADHD. For some forms of challenging behavior, the use of dynamic seating appears proactive, serving as a positive behavior support strategy to assist in creating an opportunity for learning.
School-based therapists are seeing an increasing number of children with ADHD, many of whom have sensory-motor issues that impact school participation & success. Though therapists often employ sensory-based interventions outcome studies have not been available to validate their effectiveness. Knowledge from this study will advance the practice of school-based therapy by providing data to support evidence based practice & demonstrate how research can be conducted in a natural setting. This study also demonstrates how therapists can use single subject research methods in clinical practice to evaluate if and under what conditions specific interventions are effective for individual children.