TY - JOUR
T1 - Compressive garments in individuals with autism and severe proprioceptive dysfunction
T2 - A retrospective exploratory case series
AU - Guinchat, Vincent
AU - Vlamynck, Elodie
AU - Diaz, Lautaro
AU - Chambon, Coralie
AU - Pouzenc, Justine
AU - Cravero, Cora
AU - Baeza-Velasco, Carolina
AU - Hamonet, Claude
AU - Xavier, Jean
AU - Cohen, David
N1 - Funding Information:
All participants were treated in strict compliance with the Declaration of Helsinki. CGs are currently funded by the French healthcare system in the indication of EDS. Patients with both ASD and EDS who present severe challenging behaviors may officially benefit from CGs. Other patients were able to obtain CGs as a gracious gift from Novatex Medical for the SPD indication. As we employed a retrospective design for this case series, no external review board was required [53]. However, given the compassionate nature of the intervention, written informed consent was obtained from the parents of all participants when CGs were proposed. In addition, as requested by French regulation rules, all patients/families were contacted for inclusion of the data in a retrospective study; in particular, the database was approved by the Commission Nationale Informatique et Liberté (CNIL or National Informatics and Freedom Commission) under the number No. 1256552.
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/7
Y1 - 2020/7
N2 - (1) Background: Compression garments (CGs) are an adjuvant treatment for generalized joint hypermobility (GJH), including the Ehlers–Danlos syndrome/hypermobility types. The effects of CGs are likely to be related to better proprioceptive control. We aimed to explore the use of CGs in individuals with autism and severe proprioceptive dysfunction (SPD), including individuals with GJH, to control posture and challenging behaviors. (2) Methods: We retrospectively described 14 patients with autism and SPD, including seven with comorbid GJH, who were hospitalized for major challenging behaviors with remaining behavioral symptomatology after the implementation of multidisciplinary approaches, including medication, treatment of organic comorbidities, and behavioral restructuring. Each patient received a CG to wear for at least 1 h (but most often longer) per day for six weeks. We assessed challenging behaviors in these participants with the Aberrant Behavior Checklist (ABC), sensory integration with the Dunn questionnaire, and postural sway and motor performance using a self-designed motricity path at baseline, two weeks, and six weeks. (3) Results: We observed a significant effect on most ABC rating scores at two weeks, which persisted at six weeks (total score, p = 0.004; irritability, p = 0.007; hyperactivity, p = 0.001; lethargy, p = 0.001). Postural control in dorsal and profile positions was significantly improved between before and after wearing the CGs (p = 0.006 and 0.007, respectively). Motor performance was also significantly improved. However, we did not observe a significant change in Dunn sensory scores. During the six-week duration, the treatment was generally well-tolerated. A comorbid GJH diagnosis was not associated with a better outcome. (4) Conclusions: CGs appear to be a promising adjuvant treatment for both behavioral and postural impairments in individuals with autism and SPD.
AB - (1) Background: Compression garments (CGs) are an adjuvant treatment for generalized joint hypermobility (GJH), including the Ehlers–Danlos syndrome/hypermobility types. The effects of CGs are likely to be related to better proprioceptive control. We aimed to explore the use of CGs in individuals with autism and severe proprioceptive dysfunction (SPD), including individuals with GJH, to control posture and challenging behaviors. (2) Methods: We retrospectively described 14 patients with autism and SPD, including seven with comorbid GJH, who were hospitalized for major challenging behaviors with remaining behavioral symptomatology after the implementation of multidisciplinary approaches, including medication, treatment of organic comorbidities, and behavioral restructuring. Each patient received a CG to wear for at least 1 h (but most often longer) per day for six weeks. We assessed challenging behaviors in these participants with the Aberrant Behavior Checklist (ABC), sensory integration with the Dunn questionnaire, and postural sway and motor performance using a self-designed motricity path at baseline, two weeks, and six weeks. (3) Results: We observed a significant effect on most ABC rating scores at two weeks, which persisted at six weeks (total score, p = 0.004; irritability, p = 0.007; hyperactivity, p = 0.001; lethargy, p = 0.001). Postural control in dorsal and profile positions was significantly improved between before and after wearing the CGs (p = 0.006 and 0.007, respectively). Motor performance was also significantly improved. However, we did not observe a significant change in Dunn sensory scores. During the six-week duration, the treatment was generally well-tolerated. A comorbid GJH diagnosis was not associated with a better outcome. (4) Conclusions: CGs appear to be a promising adjuvant treatment for both behavioral and postural impairments in individuals with autism and SPD.
KW - Autism
KW - Challenging behaviors
KW - Compression garment
KW - Ehlers–Danlos syndrome
KW - Intellectual disability
KW - Joint hypermobility
KW - Pressure therapy
KW - Proprioceptive dysfunction
UR - http://www.scopus.com/inward/record.url?scp=85116205502&partnerID=8YFLogxK
U2 - 10.3390/children7070077
DO - 10.3390/children7070077
M3 - Article
AN - SCOPUS:85116205502
SN - 2227-9067
VL - 7
JO - Children
JF - Children
IS - 7
M1 - 77
ER -