Studying the Effectiveness of a Family-Centered Comprehensive Program of Enhancing Sensory-Motor Integrity on Motor Skills of Children with Down Syndrome

Children are a large part of the world's population. Every country pays special attention to the health of children and adolescents, and the emphasis on their mental health can help them play their social roles better. Children with Down syndrome have low cognitive ability, motor processing, sensory integrity, and limited motor skills that impair their everyday functions. Sensory and motor control problems can be normalized and improved. Given the high prevalence of Down syndrome and their well response to rehabilitation (due to their ability to grow appropriately), caring for these children and proper planning to improve their physical, mental, and social health is very important. Despite processing problems in motor–sensory functions of these children, its effect on motor development is appearent. This study aimed to evaluate the effectiveness of a family–centered comprehensive program to enhance sensory and motor functions and motor skills in children with Down syndrome.

The method of this study was quasi–experimental with a pretest–posttest design, a control group and a one–month follow–up. The study's statistical population comprised all children with Down syndrome and their registered parents referred to Saadat and Ava Rehabilitation Clinics in Kashmar City, Iran, in 2019–2018. According to the officials of these centers, they were 60 parents in total. The sample was selected in a multi–stage manner in which all children with Down syndrome were first assessed using Peabody Developmental Motor Scales (PDMS) (parent form) (Folio & Fewell, 1983). Then, from those whose children received low scores (Score ranging from 0 to 2), 20 parents were selected based on the research limit and the number of people referred to the centers. Based on the available sampling method, they voluntarily entered the study and were randomly assigned to experimental and control groups (experimental and control groups of 10 parents each). The inclusion criteria included having 4 to 7 years old children with Down Syndrome, not receiving any educational and psychological services by the parents and their children during the intervention period, parents having sufficient literacy to use educational services, and expressing written consent to participate in the research. The exclusion criteria were parents not regularly participating in the intervention program or using other centers for their children's rehabilitation services. The experimental group underwent intervention, but the control group did not receive any intervention. The experimental group (parents with a child with Down Syndrome) underwent family–centered sensory–motor function training sessions to strengthen the children's motor skills. Their children were examined in three stages of pretest, posttest, and follow–up using Peabody Developmental Motor Scales (PDMS) (Folio & Fewell, 1983). The collected data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (repeated measures analysis of variance and Bonferroni post hoc test) in SPSS software version 22. The significance level of statistical tests was 0.05.

The results showed that the effect of time (p<0.001), group (p<0.001), and time * group (p<0.001) on gross and fine motor skills were significant. Also, in the experimental group, the mean scores of gross motor skills (p<0.001) and fine motor skills (p<0.001) in the posttest and follow–up stages were significantly different from the pretest. Besides, the effect of intervention persisted up to the follow–up stage for variables of gross motor skills (p=0.812) and fine motor skills (p=0.795).

According to findings, the comprehensive program to enhance sensory–motor functions significantly increases the level of gross and fine motor skills of children with Down syndrome. Therefore, it seems that the application of therapeutic methods such as family–centered enhancing motor–sensory training will positively improve motor skills.