Complex Neurodevelopmental Disorder
Conditions
Keywords
Complex neurodevelopmental disorder, Intensive rhythmic rehabilitation, Cognition, SCED, Children
Brief summary
In the wide range of studies carried out on neurodevelopmental disorders (NDD), rhythm disorders have been identified as a major cross-cutting component. The aim of our research is to evaluate the effect of intensive rhythm-based rehabilitation on rhythmic abilities and its generalization to attentional, executive and reading skills.
Detailed description
Current knowledge of impaired rhythmic skills in NDD is based on a number of studies, mainly carried out with groups of children presenting either Attention Deficit Disorder with or without Hyperactivity (ADHD), Developmental Coordination Disorder (DCD) or Learning to Read Disorder (dyslexia, DYS). The authors highlighted an impairment of the temporal sphere, and more specifically a timing deficit. A few studies have already evaluated the effect of rhythm-based rehabilitation in children with isolated NDD (Flaugnacco et al., 2015; Habib et al., 2013; Jamey et al., 2024; Puyjarinet et al., 2020) and show an improvement in certain untrained cognitive functions (reading skills, phonological awareness, attention, working memory, inhibition). The intervention, in groups of 6 children, takes place face-to-face, during a school vacation period over 5 consecutive days, 4 hours per day. The sessions are based on specific multimodal training and motor response using the djembe. After an inclusion visit, all patients undergo a full neuropsychological assessment, which is repeated 2 months later (before-after design). These measurements will take place over one day at the Toulouse University Hospital, in person. In the meantime, measurements of the assessment criteria are repeated daily before, during and after the intervention, according to a Single Case Experimental Design (SCED). Daily assessments, excluding weekends, will be performed and recorded via the Toulouse University Hospital's TéléO tool. A 5-days final evaluation phase will be carried out 3 months after the intervention to assess long-term effects.
Interventions
BEHAVIORALIntensive rhythmic musical training
Participants undergo an intensive rhythmic training program using percussion instruments. The program takes place over one week, with daily sessions focused on rhythmic exercises. It focuses on developing motor coordination, timing, and cognitive skills through group-based rhythmic exercises and activities. Sessions include guided percussion practice designed to improve sensorimotor integration and enhance cognitive-motor performance.
Sponsors
University Hospital, Toulouse
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
8 Years to 126 Months
Healthy volunteers
No
Inclusion criteria
* Diagnosis of neurodevelopmental disorder involving at least two impairments (ADHD + DCD, ADHD + Dyslexia, Dyslexia + DCD, ADHD + Dyslexia + DCD), according to DSM-5 criteria (2015), established at the Language and Learning Disorders Reference Center (CRTLA) of Toulouse University Hospital. * Aged between 8 years and 10 years 6 months. * Enrolled in elementary school. * Visual, auditory (with permitted aids), motor, oral and written expression and comprehension abilities sufficient, according to the investigator physician's assessment, to perform cognitive tests and follow the intervention. * Patient beneficiary/affiliate of the French Social Security system. * Signed informed consent from parent(s) / legal guardian(s) in accordance with French law and Good Clinical Practice, along with minor's assent. * Authorization for image and sound recording.
Exclusion criteria
* Practice of a musical instrument during the current year (in a music school or leisure activity). * Behavioral disorder making group practice difficult (e.g., oppositional defiant disorder) according to the investigator's opinion. * Patient diagnosed with autism spectrum disorder or intellectual developmental disorder (IQ \< 70). * Patient with epilepsy (with or without treatment). * Uncorrected hearing or visual impairment. * Current treatment with psychostimulants or psychotropic drugs (notably methylphenidate, antidepressants). * Patient lacking access to a stable internet connection required for teleconsultation assessments. * Any family or sociological condition preventing compliance with the procedures outlined in the study protocol, according to the investigator's opinion. * Patient participating in another human research study involving experimental treatment or behavioral therapy. * Ongoing rehabilitative care is not an exclusion criterion for the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Rhythmic structure reproduction task (Stambak-type test) | From week 2 after enrollment to week 14 |
Secondary
| Measure | Time frame |
|---|---|
| Behavioral observation grid in ecological settings (SCED methodology) | From week 2 after enrollment to week 14 |
| Text reading task (speed/accuracy ratio) (SCED methodology) | From week 2 after enrollment to week 14 |
| Line orientation judgment task (SCED methodology) | From week 2 after enrollment to week 14 |
| Explicit sensorimotor timing: Synchronization tapping task with a metronome | Week 1 and week 17 |
| Explicit perceptual timing: Beat alignment task | Week 1 and 17 |
| Implicit motor timing (emergent timing): DALS (Draw A Line Slowly) | Week 1 and week 17 |
| Implicit motor timing (emergent timing): WALS (Walk A Line Slowly) | Week 1 and week 17 |
| Selective visual attention: Barre-Joe Test | Week 1 and week 17 |
| Auditory attention: Auditory attention and associated response test | Week 1 and week 17 |
| Planning: 8 Maze Test or Rey-Osterrieth Complex Figure with planning instructions | Week 1 and week 17 |
| Cognitive flexibility: Children's Card Sorting Test - KCST | Week 1 and week 17 |
| Inhibition: Child Tapping Test | Week 1 and week 17 |
| Spontaneous tempo tapping task (SCED methodology) | From week 2 after enrollment to week 14 |
| Visuospatial: Spatial memory task | Week 1 and week 17 |
| Pseudoword reading: Evaléo (ages 6-15) | Week 1 and week 17 |
| Text reading: Evaléo (ages 6-15), Forms A and B | Week 1 and week 17 |
| Test assessing passive lexical knowledge: Evaléo (ages 6-15) | Week 1 and week 17 |
| Rapid color naming task: Evaléo (ages 6-15) | Week 1 and week 17 |
| Tapping subtest from NEPSY-II | Week 1 and week 17 |
| Manual dexterity (MABC-2) | Week 1 and week 17 |
| Temporal questionnaire for children (QTE) | Week 1 and week 17 |
| MDI-C (Children's Depression Inventory: Self-esteem subscale, ages 8-17) | Week 1 and week 17 |
| Parent questionnaire: Strengths and Difficulties Questionnaire (SDQ-Fra) | Week 1 and week 17 |
| Child self-assessment from a predefined list of daily activities that may pose difficulties (ecological assessment) | Week 1 and week 17 |
| Likert scale assessing satisfaction across various criteria | Week 17 after enrollment |
| Auditory-verbal: Digit Span Task | Week 1 and week 17 |
Countries
France
Contacts
Primary ContactCéline CHIGNAC
Outcome results
None listed