Sensorimotor Training to Affect Balance, Engagement and Learning in Children with

项目摘要/摘要 RFA-MH-09-161：神经发育障碍的新干预措施R21/R33 产前接触酒精会增加终生神经行为问题的风险，以及 属于胎儿酒精谱系障碍(FASD)总称的发育障碍。穷 感觉运动功能，特别是平衡缺陷，是神经发育障碍的一个方面。 在患有FASD的儿童中。有效的平衡和姿势控制是参与的重要基础 更高级别的功能技能，如保持注意力、驾驭环境、控制复杂环境 运动，参加儿童活动，促进身体和行为健康，以及 发展。平衡是一个涉及整合感觉信息和协调的复杂过程 神经肌肉反应。尽管有证据表明，患有平衡缺陷的儿童存在问题 FASD和初步报告称，感觉运动整合不良是可疑的，这些平衡的性质和 姿势控制缺陷还没有被完全理解。也没有干预措施来改善日常功能和行为 通过修复潜在的感觉运动缺陷，在这一人群中进行了考虑和测试， 然而，来自酒精暴露动物模型的证据表明，神经可塑性、运动学习、 并在复杂的康复训练后改善运动能力。因此，最重要的目标是 这项R21/R33联合建议旨在确定感觉运动干预的初步有效性 改善FASD儿童的平衡及相关的功能和行为结果。我们的建议 干预将使用虚拟现实计算机技术来训练体重和重新体重的能力 由模拟的感觉冲突条件引起的平衡扰动期间的感觉信息。作为第一次 这项研究(R21)建议更全面地描述平衡障碍和随后的功能障碍 感觉运动问题对FASD儿童的影响。这将通过比较以下各项的性能实现 患有FASD的7.0-14.9岁儿童与一组在电池上有典型发育的匹配儿童 和一种新的评估系统，专门检查视力、前庭和 身体感觉信息在平衡过程中被使用。这些数据将塑造我们建议的 感觉运动干预技术和初步干预方案，这将用一个小的测试 一组患有FASD的儿童，评估最初的可行性和反应性。来自R21的数据将为 为下一阶段的研究(R33)奠定基础，该研究旨在完善平衡的感觉运动训练 干预技术，并建立和测试通过短期干预提供的干预的有效性 强化实验室方案或更长期的基于家庭的方案。总的来说，这些研究奠定了基本的 为一项更大规模的多点疗效研究奠定基础，以确定干预的有效性 FASD儿童样本和其他神经发育障碍儿童组。

Project Summary / Abstract RFA-MH-09-161: Novel Interventions for Neurodevelopmental Disorders R21/R33 Prenatal exposure to alcohol can increase the risk for lifelong neurobehavioral problems, as well as developmental disabilities that fall under the umbrella term of fetal alcohol spectrum disorders (FASD). Poor sensorimotor function, specifically balance deficits, is one area of neurodevelopmental impairment described among children with FASD. Efficient balance and postural control are important foundations for engagement in higher level functional skills such as maintaining attention, navigating an environment, controlling complex movements, and participating in childhood activities that promote physical and behavioral health and development. Balance is a complex process involving the integration sensory information and the coordination of neuromuscular responses. Despite evidence that balance deficits are problematic among children with FASD and preliminary reports that poor sensorimotor integration is suspect, the nature of these balance and postural control deficits are not fully understood. Nor have interventions to improve daily function and behavior through the remediation of underlying sensorimotor deficits been considered and tested among this population, Yet, evidence from alcohol exposed animal models indicates the capacity for neural plasticity, motor learning, and improved motor performance following complex rehabilitative training. Therefore, the overarching goal of this combined R21/R33 proposal is to determine the preliminary effectiveness of a sensorimotor intervention to improve balance and related functional and behavioral outcomes among children with FASD. Our proposed intervention will employ the use of virtual reality computer technology to train the ability to weight and reweight sensory information during balance perturbations invoked by simulated conditions of sensory conflict. As a first step, this research (R21) proposes to more fully describe balance impairments and subsequent functional impact of sensorimotor problems in children with FASD. This will be done by comparing the performance of children with FASD ages 7.0-14.9 years to a matched group of children with typical development on a battery of clinical tests and a novel assessment system that specifically examines how visual, vestibular and somatosensory information is used during balance. This data will shape the development of our proposed sensorimotor intervention technology and preliminary intervention protocol, which will be tested with a small group of children with FASD to gauge initial feasibility and responsiveness. Data from the R21 will lay the groundwork for the next phase of research (R33) that aims to refine the sensorimotor training for balance intervention technology and establish and test the effectiveness of the intervention delivered via a short-term intensive laboratory protocol or a longer term home-based protocol. Collectively, these studies lay the essential groundwork for a larger multisite efficacy study to determine the effectiveness of the intervention with a larger sample of children with FASD and other groups of children with neurodevelopmental disabilities.