PubMed · 13252661
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L L ANDERSON. 1955. A mobile unit speech therapy program.. https://doi.org/10.1044/jshd.2003.304
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Developmental disabilities (DDs) are chronic conditions that initially manifest in persons aged < or =18 years and result in impairment of physical health, mental health, cognition, speech, language, or self-care. The majority of persons with DDs require long-term supportive care or services. In 2003, RTI International (Research Triangle Park, North Carolina) and CDC analyzed data from multiple surveys and reports to estimate the direct and indirect economic costs associated with four DDs in the United States. On the basis of that analysis, estimated lifetime costs in 2003 dollars are expected to total 51.2 billion dollars for persons born in 2000 with mental retardation, 11.5 billion dollars for persons with cerebral palsy, 2.1 billion dollars for persons with hearing loss, and 2.5 billion dollars for persons with vision impairment. These estimates underscore the need for effective primary and secondary prevention measures (e.g., newborn screening for hearing and metabolic disorders and smoking-cessation counseling for pregnant women) to reduce the costs associated with DDs.
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OBJECTIVE: Occupational therapy (OT) for cerebral palsy focuses on the development of skills necessary for the performance of activities of daily living. The aim of this systematic review was to determine whether OT interventions improve outcome for children with cerebral palsy (CP). METHODS: An extensive search in MEDLINE, CINAHL, EMBASE, AMED and SCISEARCH was performed. Studies with controlled and uncontrolled designs were included. Six intervention categories were distinguished and individually analysed using a best-evidence synthesis. This synthesis is based on the type of design, the methodological quality, the type of outcome measures and the statistical significance of the findings. RESULTS: Seventeen studies were included in this review, seven of which were randomized controlled trials (RCTs). One RCT had a high methodological quality. The analyses resulted in insufficient evidence of the efficacy of occupational therapy in all intervention categories, due to the low methodological quality of studies presenting statistically nonsignificant results. CONCLUSION: Despite the reasonable number of studies identified, the inconclusive findings regarding the efficacy of occupational therapy for children with cerebral palsy may be a reflection of the difficulties in efficacy research in OT for children with CP. Future research should critically reflect on methodological issues.