Mats Niklasson | Sensorimotor Therapy | Niklasson | Sensorimotor Therapy Mats Sensorimotor Therapy: Sensorimotor Therapy: Assessing Quantitative and Qualitative Expressions Assessing Quantitative and of Physiological and Psychological 2013:20 Qualitative Expressions of Development in Children Physiological and Psychological This thesis had three purposes. (1) to examine whether sensorimotor therapy (SMT) using the training program ”Retraining for Balance” might be a proper Development in Children technique for sensorimotor proficiency. (2) to gain increased understanding of the effects of SMT on physical and psychological development and, (3) to put SMT in a wider perspective by an extension of the theoretical framework. Two naturalistic studies were conducted. Paper I, which was quantitative, comprised Mats Niklasson 232 children who presented attentional and motor difficulties. The cohort was divided into three groups depending on age and results after therapy indicated improvements in all groups. Paper II, a qualitative study, selected records of 8 children from the cohort. Analysis yielded 3 overarching themes, which together formed “the kinesthetic-vestibular developmental model” illustrating how Introductions of exercises pushed the process forward due to Regressions and Transformations. The results were generalized to the remaining 224 children. The tentative conclusion of this thesis was that SMT might constitute a complement to treatment of ADHD, DCD and LD but controlled studies are necessary before decisive conclusions can be drawn. ISBN 978-91-7063-497-0 Faculty of Arts and Social Sciences ISSN 1403-8099 Psychology LICENTIATE THESIS | Karlstad University Studies | 2013:20 LICENTIATE THESIS | Karlstad University Studies | 2013:20 Sensorimotor Therapy: Assessing Quantitative and Qualitative Expressions of Physiological and Psychological Development in Children Mats Niklasson LICENTIATE THESIS | Karlstad University Studies | 2013:20 Sensorimotor Therapy: Assessing Quantitative and Qualitative Expressions of Physiological and Psychological Development in Children Mats Niklasson LICENTIATE THESIS Karlstad University Studies | 2013:20 ISSN 1403-8099 ISBN 978-91-7063-497-0 © The author Distribution: Karlstad University Faculty of Arts and Social Sciences Department of Social and Psychological Studies SE-651 88 Karlstad, Sweden +46 54 700 10 00 Print: Universitetstryckeriet, Karlstad 2013 WWW.KAU.SE This licentiate thesis is dedicated to all persistent children and their brave parents #ho made these studies possible$ %t is also dedicated to Emma #ho made it possible for %rene and me to develop &estibularis. Licentiate thesis: Sensorimotor therapy: Assessing quantitative and qualitative expressions of physiological and psychological development in children. Mats Niklasson, epartment of !sychology, "arlstad #niversity, S$eden. Abstract &e 'rst purpose of this thesis $as to examine $hether sensorimotor therapy utilizing the training program )Retraining for Balance) might %e an appropriate technique for sensorimotor profciency. &e second purpose $as to gain increased understanding of the e*ects of sensorimotor therapy on the physical and psychological development of children and youth. A third purpose $as to put sensorimotor therapy in a $ider perspective through a some$hat novel extension of the theoretical frame$ork. +$o naturalistic studies $ere conducted. !aper , $as quantitative and comprised 232 children /181 boys and 51 girls) divided into three groups /03 a younger group /7 years or younger, n5623, /-3 a middle group /8 to 10 years old, n5803 and, /.3 an older group /00 years old or older, n5463. &e participants presented attentional and motor di9culties before starting therapy. &e treatment period $as in average close to . years. :esults indicated signifcant improvements concerning sensorimotor skills in all age groups. !aper ,, $as a qualitative study, $hich included the records of 1 children /4 boys and 0 girl3 randomly selected from the cohort of -.- children. &e analysis used the ;!!<method and yielded . overarching themes, $hich together formed “the kinesthetic-vestibular developmental model”. &e model illustrated ho$ Introductions of sensorimotor exercises pushed the therapy process for$ard due to periods of Regression and Transformation. &e results $ere generalized to the remaining --= children in the cohort %y comparing each participant>s records $ith ?the kinesthetic-vestibular developmental model”. &e tentative conclusion $as that sensorimotor therapy according to the method “Retraining for Balance” might constitute a complement to treatment of A @ , A and L but controlled studies are necessary %efore more decisive conclusions can be dra$n. "eywords: evelopmental Aoordination isorder, Learning isorder, Attention efcit @yperactivity isorder, !rimary refexes, Cestibular stimulation, !sychological development, :egression, :etraining for Dalance. I Licentiatsuppsats: Sensomotorisk terapi: CErdering av kvantitativa och kvalitativa yttringar av barns fysiologiska och psykologiska utveckling. Mats Niklasson, avdelningen fFr psykologi, "arlstads universitet, Sverige. Sammanfattning enna licentiatuppsats fFrsta syfte var att undersöka om sensomotorisk terapi enligt metoden “Retraining for Balance” utvecklar sensomotoriska fErdigheter. Andra syftet var att nG Fkad fFrståelse fFr hur sensomotorisk terapi påverkar %arn och ungdomar. ;tt tredHe syfte var att sEtta in sensomotorisk terapi i ett större och delvis nytt teoretiskt perspektiv. +vG naturalistiska studier genomfFrdes. !aper , var en kvantitativ studie med 232 barn /181 poHkar och 51 fickor3 vilka delades in i tre grupper /03 en yngre grupp /4 Gr eller yngre, n5623, /-3 en mellangrupp /1 till 07 Gr, n5803 och /.3 en Eldre grupp /00 Gr och Eldre, n5463. Samtliga deltagare hade fFre trEningens start uppmErksamhetsproblem och motoriska svGrigheter. +rEningstiden var i genomsnitt ungefEr tre Gr. :esultaten indikerade signifkanta sensomotoriska fFr%Ettringar i samtliga tre grupper. !aper ,, var kvalitativ och inbegrep anteckningar frGn Gtta %arn /4 pojkar och 0 Bicka3 som slumpats ur den större gruppen av -.- barn. Analysen gjordes med ;!!< metoden och resulterade i tre teman som tillsammans bildade ‘den kinestetisk-vestibulära utvecklingsmodellen . Modellen illustrerade hur Introduktion av sensomoriska Fvningar gav fart Gt en terapeutisk process med såvEl Regression som Transformation. Studiens resultat kunde generaliseras till de resterande --= barnen i gruppen med avseende på modellanpassning. enna uppsats tentativa slutsats blev att sensomotorisk terapi enligt metoden “Retraining for Balance” skulle kunna utgöra ett komplement till redan %efntlig behandling av såvEl AD@ som A och inlErningssvGrigheter men kontrollerade studier Er nFdvEndiga innan avgörande slutsatser kan dras. Nyckelord: evelopmental Aoordination isorder, ,nlErningssvGrigheter, Attention e'cit @yperactivity isorder, !rimEra refexer, CestibulEr stimulering, !sykologisk utveckling, :egression, :etraining for Dalance. II &is thesis is based on the follo$ing two papers, $hich $ill be referred to in the text %y their :oman numerals: , Niklasson, M., Niklasson, I., I Norlander +. /-7783. Sensorimotor therapy: #sing stereotypic movements and vestibular stimulation to increase sensorimotor profciency of children $ith attentional and motor di9culties. !erceptual and "otor #kills, $%&, 6=.<669. ,, Niklasson, M., Niklasson, I., I Norlander +. /-7073. Sensorimotor therapy: !hysical and psychological regressions contribute to an improved kinesthetic and vestibular capacity in children and adolescents $ith motor di9culties and concentration problems. #ocial Behavior and !ersonality, (&/.3, .-4<346. :eprints $ere made $ith kind permission from the publishers. III )ckno*ledgements &e supervisors. Jirst , $ish to express my deep gratitude to my main supervisor during this scientifc adventure !rofessor +orsten Norlander, epartment of Alinical Neuroscience, "arolinska ,nstitutet, Solna. @earty and sincere thanks for your courage to take me on, for your excellent teaching and for your inspiringly positive attitude – al$ays! Also, , $ould like to thank my assistant supervisor Associate !rofessor !eder :asmussen, the Sahlgrenska Academy, Mothenburg. Many thanks for being there for me, for your humility and for sharing your kno$ledgeL &e supporters. &anks to !rofessor Anette "jellgren and !rofessor Arto @iltunen, both from "arlstad #niversity, for helpful support and encouragement. M. Do Ahrenfelt, thanks for all inspiration and for giving me valuable insights. !rofessor emeritus Matti DergstrFm, @elsingfors #niversity, thanks for being such a reliable friend and inspiring teacher. .D.A. Mats Lindgren, "airos Juture Mroup, Stockholm, thanks for starting me up not the least through the preparation of my 'rst ;xcel<sheet. La$yer and chairman of Cestibularis, Munnar Silf$ersvErd, thanks for your honesty, friendship and for asking all those important questions. !h. @anna ;debol and !sychologist Nla Lindgren, thanks for your friendship and for interesting conversations. Monika @Fgman thanks for your hospitality during my years at "arlstad #niversity. &e family. &anks to my big and loving family for all the joy you bring. Special thanks to ,rene my $ife and companion -=<4<365. Oou are al$ays here for me, Pfor richer for poorer+ in sickness and in health>. I love youL IV Aontents 1. ,ntroduction..................................................................................................................... 0 1.1