Intensive Neurodevelopmental Treatment Succeeds in Kids with Developmental Delays

Intensive neurodevelopmental treatment (NDT) significantly improves motor function in children with developmental delays, regardless of whether they have cerebral palsy (CP), a Korean study shows.

The study, “Efficacy of Intensive Neurodevelopmental Treatment for Children With Developmental Delay, With or Without Cerebral Palsy,” appeared in the journal Annals of Rehabilitation Medicine.

NDT for children with CP has been widely accepted since 194o — even before acceptance of evidence-based medicine and a thorough understanding of central nervous system development — and forms the basis of CP treatment.

Intensive NDT is more effective because sessions last longer and are more frequent. However, the specific regimen depends on individual hospital settings and family support. Due to the variation in age and severity of CP patients, there is no consensus on which regimen is more effective.

Although previous studies have shown that intensive NDT helps children, these were pilot studies that did not include non-CP children with developmental delays.

This latest study, led by Bum Sun Kwon, MD, of Dongguk University College of Medicine in Goyang, evaluated the effectiveness of in-patient intensive NDT on gross motor function of developmentally delayed children with or without CP.

The group consisted of 42 children whose median age was 5 years old; 24 had CP and 18 did not. None showed much improvement after three months of conventional NDT (once or twice a week for 30 minutes a day). They received intensive NDT three times a week, 60 minutes a day, for three months, followed by conventional NDT for another 3 months.

The researchers assessed gross motor function before the initial conventional NDT, before and after intensive NDT, and after the additional three months of conventional NDT. Unlike previous studies, scientists did not include a rest phase after intensive NDT.

They found that intensive NDT improved gross motor function score, and that the improvement was maintained after the final three months of conventional NDT. Furthermore, researchers observed improvement in kids with and without CP, with similar efficacy.

In addition, the absence rate was lower in intensive NDT than during conventional NDT, “which implies better concentration and compliance to intensive NDT,” researchers said.

Among the study’s limitations was the lack of a control group with conventional NDT for the duration of the study. Nor did researchers control the time and frequency of occupational therapy and functional activity training programs, which may involve NDT and therefore affect gross motor function scores.

Due to the study’s encouraging results, authors “recommend the intensive NDT program by day-hospital centers for children with DD [developmental delay], irrespective of accompanying CP.” They added that intensive NDT should be used “intermittently or periodically when the outpatient treatment is not effective anymore and boring for the patient.”

Finally, the study urged fine-tuning the assessment of NDT efficacy, and determining gross motor function beyond three months of intensive NDT to assess long-term effects.