Neurodevelopmental treatment for children with hemiplegic cerebral palsy: clinical guidelines for occupational therapists
Conway, Mikayla Diane
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Clinical data supporting the benefit of neurodevelopmental treatment (NDT) for children with hemiplegic cerebral palsy (CP) is limited due to inconsistencies in methodology across studies, including variations in: NDT definitions, intervention protocols, and outcome measures (Butler & Darrah, 2001; Graham et al., 2009; Tsorlakis et al., 2004). This has led to disagreement in the literature regarding the benefit of NDT in children with CP. Several contemporary studies indicate that the NDT approach can be effective as a motor and functional intervention for this patient population (Acar et al., 2016; Tsorlakis et al., 2004; Türker et al., 2015). In contrast, others (Novak et al., 2020) have concluded that NDT is not an effective motor intervention for children with CP and should be discontinued. In order to support consistency of evidence-based NDT service delivery, a clinical guideline project was conducted at Children’s Specialized Hospital in the Toms River, NJ outpatient pediatric center. This project was guided by the Knowledge to Action Framework (Graham et al., 2006) and involved the creation of NDT guidelines, including appraisal of current evidence on NDT for children with hemiplegic CP, the proposal of eight essential components of NDT, and recommendations for evidence-based assessments to track patient progress over the course of NDT intervention. Post-Capstone project feedback indicated that key stakeholders of the project identified the clinical guidelines as useful and practical. Recommendations included the implementation of these guidelines into practice, as well as a continual review process to incorporate future research and clinical experience in NDT effectiveness.