Single-case Design Studies in Children with Cerebral Palsy: A Scoping Review

Figures & data

Figure 1. Flowchart of the study selection process.

Table 1. Methodological and statistical approaches of studies.

Study	Design type	Statistical approach(es)
Akerstedt et al.^Citation21 (2010)	A-B design
Angelo^Citation22 (1992)	Alternating-treatments design	Kruskal-Wallis test
Angelo^Citation23 (1993)	Alternating-treatments design
Barbosa et al.^Citation24 (2008)	Withdrawal/reversal (A-B-A) design: A-B-C-A	Celeration Line (CL) Two-standard deviation band method
Beauregard et al.^Citation25 (1998)	Withdrawal/reversal (A-B-A) design	Celeration line
Brien et al.^Citation26 (2010)	Multiple-baseline design	Visual analysis of graphed data Statistical analysis using the two-standard deviation band method Analysis of clinical significance
Brien et al.^Citation27 (2011)	A-B design (including follow-up)	Autocorrelation coefficient to determine serial dependency Visual inspection: summarizing patterns of data on the basis of trend, level, and variability Two-standard deviation band method Computation of the differences between the mean scores at baseline and the mean scores at intervention and follow-up
Chen et al.^Citation28 (2007)	A-B design (including follow-up)	Autocorrelation coefficient to determine serial dependency Two-standard deviation band method Analysis of clinical significance
Coker et al.^Citation29 (2009)	Withdrawal/reversal (A-B-A) design: A-B-A-B
Corn et al.^Citation30 (2003)	A-B design	Linear regression models to determine the line of best fit T-values (difference between the slope of the baseline data and the slope of the intervention and intercept between the last baseline value and the first intervention value (effect))
Costigan et al.^Citation31 (2010)	Withdrawal/reversal (A-B-A) design: A-B-A-B	Changes in mean accurate selections between phases Changes in the level of the dependent variable between phases (i.e., difference in performance between the end of one phase and the beginning of the next phase) The trend of the data (i.e., the direction of the data for the dependent variable in each phase) The strength of the trend (i.e., the slope of the line connecting data points) Percentage of nonoverlapping data (i.e., the percentage of data points in the intervention phase that were greater than the highest data point in the baseline phase)
Crocker et al.^Citation32 (1997)	Withdrawal/reversal (A-B-A) design	Two-standard deviation band method Inter-rater reliability: Pearson correlation coefficients
Dada et al.^Citation33 (2009)	Multiple-baseline design
DeGangi et al.^Citation34 (1983)	Alternating-treatments design	Sign test
Dinomais et al.^Citation35 (2013)	A-B design	‘‘Nonoverlap of all pairs’’ (NAP) method
Do et al.^Citation36 (2016)	Withdrawal/reversal (A-B-A) design	Change in means between all phases.
Durfee et al.^Citation37 (1999)	Withdrawal/reversal (A-B-A) design: A-B-A-B	Least squares regression procedures were used to establish straight-line trends for each treatment phase
Fienup et al.^Citation38 (2013)	Two-phase study: multiple baseline design + changing criterion design
Fragala et al.^Citation39 (2002)	A-B design	Trend line
Ghorbani et al.^Citation40 (2017)	Multiple-baseline design	Percentage of Non-overlapping Data (PND) Split-Middle Method of trend estimation (celeration line)
Goodman et al.^Citation41 (1991)	A-B design	Autocorrelation coefficient to determine serial dependency
Hamill et al.^Citation42 (2007)	Multiple-baseline design
Harris et al.^Citation43 (1986)	Alternating-treatments design
Hartveld et al.^Citation44 (1996)	A-B design
Havstam et al.^Citation45 (2003)	Withdrawal/reversal (A-B-A) design
Hinderer et al.^Citation46 (1988)	A-B design: A-B-A-C design	Linear regression line
Iammatteo et al.^Citation47 (1990)	Withdrawal/reversal (A-B-A) design	Celeration line approach Statistical significance was determined through the use of Bloom’s probability table Autocorrelation coefficient to determine serial dependency
Jelsma et al.^Citation48 (2013)	Multiple-baseline design	Non-overlap of All Pairs (NAP) Repeated measures ANOVA Tukey post-hoc analysis
Johnson et al.^Citation49 (2014)	Multiple-baseline design	Split-middle lines of trend estimation
Kelly et al.^Citation50 (2009)	A-B design (including follow-up)	Two-standard deviation band method
Kenyon et al.^Citation51 (2018)	Withdrawal/reversal (A-B-A) design: A-B-A-B	Two-standard deviation band method
Kinghorn et al.^Citation52 (1996)	Withdrawal/reversal (A-B-A) design	Two-standard deviation band method C statistic
Ko et al.^Citation53 (2015)	A-B design	Two-standard deviation band method Paired t-test
Laessker-Alkema et al.^Citation54 (2016)	A-B design	Two-standard deviation band method Group level: Wilcoxon singed rank test
Lammi et al.^Citation55 (2003)	Multiple-baseline design	Serial dependency between the data points in the baseline using Bartlett’s test Celeration lines Linear regression using the c-statistic Comparison of the mean performance ratings for each phase of the study to the overall mean
Laskas et al.^Citation56 (1985)	Withdrawal/reversal (A-B-A) design	Split-middle technique to calculate the celeration line
Lephart et al.^Citation57 (2015)	Withdrawal/reversal (A-B-A) design	Dependent t tests (to determine whether physiological measures changed within treatment sessions) Split middle analyses (celeration line)
Lewis et al.^Citation58 (2016)	Multiple-baseline design
Lilly et al.^Citation59 (1990)	Alternating-treatments design	Friedman analysis of variance by ranks (modified Friedman test) Analysis of variance (ANOVA) Wilcoxon rank sum test
Lin et al.^Citation60 (2014)	Withdrawal/reversal (A-B-A) design: A-B-A-B	Kolmogorov–Smirnov statistical test
Lin et al.^Citation61 (2015)	Withdrawal/reversal (A-B-A) design: A-B-A-B	Kolmogorov–Smirnov statistical test
Mackey^Citation62 (1989)	Withdrawal/reversal (A-B-A) design	One-way analysis of variance test T-test for group effects
Man et al.^Citation63 (2007)	A-B design: A-B-C-D	Levene’s test
Matthews et al.^Citation64 (2009)	Withdrawal/reversal (A-B-A) design	Inferential statistical analysis: celeration line method
McCarthy et al.^Citation65 (2015)	A-B design
McConnell et al.^Citation66 (2014)	Withdrawal/reversal (A-B-A) design	Two-standard deviation band method
Owen et al.^Citation67 (1992)	Four-phased randomized design	Mann-Whitney U Test
Pinder et al.^Citation68 (1995)	Withdrawal/reversal (A-B-A) design
Pool et al.^Citation69,Citation70 (2014)	Withdrawal/reversal (A-B-A) design	Two-standard deviation band method C-statistic Autocorrelation coefficient to determine serial dependency Group-level: Wilcoxon signed rank tests
Pratt et al.^Citation71 (2016)	Alternating-treatments design	Autocorrelation coefficient to determine serial dependency Percentage of nonoverlapping data (PND) between conditions Celeration line Probability table Effect size
Prosser et al.^Citation72,Citation73 (2012)	A-B design (including follow-up)	Split middle technique: celeration lines Net change scores (subtracting baseline change from treatment change)
Ramani et al.^Citation74 (2014)	Multiple-baseline design
Ray et al.^Citation75 (1983)	Withdrawal/reversal (A-B-A) design	Split-middle technique to calculate celeration lines Autocorrelation coefficient to determine serial dependency
Reid et al.^Citation76 (1999)	Withdrawal/reversal (A-B-A) design	Group level: Repeated measures ANOVA
Retarekar et al.^Citation77 (2009)	Withdrawal/reversal (A-B-A) design	Two-standard deviation band method
Rigby et al.^Citation78 (2001)	Withdrawal/reversal (A-B-A) design
Rintala et al.^Citation79 (1994)	Withdrawal/reversal (A-B-A) design
Rivi et al.^Citation80 (2014)	A-B design
Sakemiller et al.^Citation81 (1998)	Withdrawal/reversal (A-B-A) design
Sheppard et al.^Citation82 (2007)	A-B design: A-B-A-C design	Interrupted time-series analysis (ITSA)
Shumway-Cook et al.^Citation83 (2003)	Multiple-baseline design	Hierarchical linear modelling Repeated measures ANOVAs
Siconolfi-Morris^Citation84 (2012)	A-B design	Two-standard deviation band method C-statistic (converted to a Z score) Improvement rate difference (IRD)
Smelt^Citation85 (1989)	Withdrawal/reversal (A-B-A) design	Auto-correlation coefficient (serial dependency) Standard deviation band (SD-band) C-statistic
Smithers^Citation86 (1991)	Withdrawal/reversal (A-B-A) design	Method of least squares (trend line)
Soto et al.^Citation87 (2008)	A-B design
Stansfield et al.^Citation88 (2015)	A-B design	Two-standard deviation band method
Stewart et al.^Citation89 (1992)	Alternating-treatments design	Two-tailed paired sample t-test for each subject and across all subjects
Stewart et al.^Citation90 (2000)	Withdrawal/reversal (A-B-A) design: A-B-A-C-A
Svedberg et al.^Citation91 (2001)	A-B design: A-B-B	Student’s t-test Linear regression
Symons et al.^Citation92 (2007)	A-B design: A-B-C-D
Thorpe et al.^Citation93 (2002)	Multiple-baseline design	“Sign” test on group level Split-middle method/trend line
Ustad et al.^Citation94 (2009)	Multiple-baseline design: A-B-A-B-A	Two-standard deviation band method Celeration lines
Voulgarakis et al.^Citation95 (2015)	Changing-criterion design
Ward et al.^Citation96,Citation97 (2013 & 2014)	Multiple-baseline design: A-B-C-A	Two-standard deviation band method Dual-criterion method of trend estimation with binomial test Modified Cohen’s d, based on the pooled standard deviation

The letters ‘A’, ‘B’, etc., designate the treatment phases.

Table 2. Risk of bias per item of the RoBiNT Scale, and inter-rater agreement of RoBiNT Scale scores (n = 73).

	Mean (range)						% of agreement
Interval Validity Subscale	3.6 (1–10)						79
External Validity and Interpretation Subscale	7.6 (2–13)						72
Total score	11.2 (4–22)						75
	Score
Item	0 points		1 point		2 points
	Absolute	%	Absolute	%	Absolute	%
Interval Validity Subscale
1. Design with control	27	37.0	29	39.7	17	23.3	74
2. Randomization	63	86.3	0	0.0	10	13.7	93
3. Sampling of behavior	8	11.0	30	41.1	35	47.9	78
4. Blinding of people involved in the intervention	70	95.9	3	4.1	0	0.0	93
5. Blinding of assessor(s)	56	76.7	3	4.1	14	19.2	77
6. Inter-rater agreement	47	64.4	15	20.5	11	15.1	53
7. Treatment adherence	67	91.8	3	4.1	3	4.1	84
External Validity and Interpretation Subscale
8. Baseline characteristics	37	50.7	36	49.3	0	0.0	58
9. Setting	27	37.0	29	39.7	17	23.3	59
10. Dependent variable (target behavior)	0	0.0	13	17.8	60	82.2	78
11. Independent behavior (therapy/intervention)	5	6.8	23	31.5	45	61.6	67
12. Raw data record	12	16.4	43	58.9	18	24.7	68
13. Data analysis	34	46.6	24	32.9	15	20.5	59
14. Replication	25	34.2	20	27.4	28	38.4	89
15. Generalization	71	97.3	0	0.0	2	2.7	99

Table 3. Quality of reporting appraisal, per item of the CENT (n = 72).

			Sufficient reporting		Insufficient reporting		Not applicable
	No.	Item	Absolute	%	Absolute	%	Absolute	%
Title and abstract
	1a	Identify as an “N-of-1 trial” in the title	17	23.6	55	76.4	0	0.0
	1b	Structured summary of trial design, methods, results, and conclusions (for specific guidance, see CENT guidance for abstracts)	0	0.0	71	98.6	1	1.4
Introduction
Background and objectives	2a.1	Scientific background and explanation of rationale	68	94.4	4	5.6	0	0.0
	2a.2	Rationale for using N-of-1 approach	21	29.2	51	70.8	0	0.0
	2b	Specific objectives or hypotheses	54	75.0	18	25.0	0	0.0
Methods
Trial design	3a	Describe trial design, planned number of periods, and duration of each period (including run-in and wash out, if applicable) In addition for series: Whether and how the design was individualized to each participant, and explain the series design	43	59.7	29	40.3	0	0.0
	3b	Important changes to methods after trial start (such as eligibility criteria), with reasons	19	26.4	53	73.6	0	0.0
Participant(s)	4a	Diagnosis or disorder, diagnostic criteria, comorbid conditions, and concurrent therapies. For series: Eligibility criteria for participants	64	88.9	8	11.1	0	0.0
	4b	Settings and locations where the data were collected	19	26.4	53	73.6	0	0.0
	4c	Whether the trial(s) represents a research study and if so, whether institutional ethics approval was obtained	27	37.5	45	62.5	0	0.0
Interventions	5	The interventions for each period with sufficient details to allow replication, including how and when they were actually administered	38	52.8	34	47.2	0	0.0
Outcomes	6a.1	Completely defined pre-specified primary and secondary outcome measures, including how and when they were assessed	55	76.4	17	23.6	0	0.0
	6a.2	Description and measurement properties (validity and reliability) of outcome assessment tools	10	13.9	62	86.1	0	0.0
	6b	Any changes to trial outcomes after the trial commenced, with reasons	11	15.3	61	84.7	0	0.0
Sample size	7a	How sample size was determined	0	0.0	72	100	0	0.0
	7b	When applicable, explanation of any interim analyses and stopping guidelines	0	0.0	72	100	0	0.0
Randomization
Sequence generation	8a	Whether the order of treatment periods was randomized, with rationale, and method used to generate allocation sequence	4	5.6	68	94.4	0	0.0
	8b	When applicable, type of randomization; details of any restrictions (such as pairs, blocking)	0	0.0	10	13.9	62	86.1
	8c	Full, intended sequence of periods	60	83.3	12	16.7	0	0.0
Allocation concealment mechanism	9	Mechanism used to implement the random allocation sequence (such as sequentially numbered containers), describing any steps taken to conceal the sequence until interventions were assigned	0	0.0	9	12.5	63	87.5
Implementation	10	Who generated the random allocation sequence, who enrolled participants, and who assigned participants to interventions	2	2.8	9	12.5	61	84.7
Blinding	11a	If done, who was blinded after assignment to interventions (for example, participants, care providers, those assessing outcomes) and how	13	18.1	59	81.9	0	0.0
	11b	If relevant, description of the similarity of interventions	2	2.8	3	4.2	67	93.1
Statistical methods	12a	Methods used to summarize data and compare interventions for primary and secondary outcomes	52	72.2	20	27.8	0	0.0
	12b	For series: If done, methods of quantitative synthesis of individual trial data, including subgroup analyses, adjusted analyses, and how heterogeneity between participants was assessed, (for specific guidance on reporting syntheses of multiple trials, please consult the PRISMA Statement)	8	11.1	46	63.9	18	25.0
	12c	Statistical methods used to account for carryover effect, period effects, and intra-subject correlation	9	12.5	63	87.5	0	0.0
Results
Participant flow	13a.1	Number and sequence of periods completed, and any changes from original plan with reasons	53	73.6	19	26.4	0	0.0
	13a.2	For series: The number of participants who were enrolled, assigned to interventions, and analysed for the primary outcome	50	69.4	4	5.6	18	25.0
	13b	For series: losses or exclusions of participants after treatment assignment, with reasons, and period in which this occurred, if applicable	43	59.7	10	13.9	19	26.4
Recruitment	14a	Dates defining the periods of recruitment and follow-up	4	5.6	68	94.4	0	0.0
	14b	Whether any periods were stopped early and/or whether trial was stopped early, with reason(s).	10	13.9	62	86.1	0	0.0
Baseline data	15	A table showing baseline demographic and clinical characteristics	28	38.9	44	61.1	0	0.0
Numbers analysed	16	For each intervention, number of periods analysed. In addition for series: if quantitative synthesis was performed, number of trials for which data were synthesized	64	88.9	8	11.1	0	0.0
Outcomes and estimation	17a.1	For each primary and secondary outcome, results for each period; an accompanying figure displaying the trial data is recommended.	59	81.9	13	18.1	0	0.0
	17a.2	For each primary and secondary outcome, the estimated effect size and its precision (such as 95% confidence interval) In addition for series: if quantitative synthesis was performed, group estimates of effect and precision for each primary and secondary outcome	3	4.2	67	93.1	2	2.8
	17b	For binary outcomes, presentation of both absolute and relative effect sizes is recommended	1	1.4	0	0.0	71	98.6
Ancillary analyses	18	Results of any other analyses performed, including assessment of carryover effects, period effects, intra-subject correlation In addition for series: If done, results of subgroup or sensitivity analyses	14	19.4	3	4.2	55	76.4
Harms	19	All harms or unintended effects for each intervention	11	15.3	61	84.7	0	0.0
Discussion
Limitations	20	Trial limitations, addressing sources of potential bias, imprecision, and, if relevant, multiplicity of analyses	40	55.6	32	44.4	0	0.0
Generalizability	21	Generalizability (external validity, applicability) of the trial findings	42	58.3	30	41.7	0	0.0
Interpretation	22	Interpretation consistent with results, balancing benefits and harms, and considering other relevant evidence	45	62.5	27	37.5	0	0.0
Other information
Registration	23	Registration number and name of trial registry	0	0.0	72	100	0	0.0
Protocol	24	Where the full trial protocol can be accessed, if available	0	0.0	72	100	0	0.0
Funding	25	Sources of funding and other support (such as supply of drugs), role of funders	35	48.6	37	51.4	0	0.0

Figure 2. Development of SCD studies over time (including linear least squares trend lines).

Table

Study	Country	Aim of the study	Study sample	Outcomes	Interventions^a
					ICF level	Treatment approach	Specified
Akerstedt et al.^Citation21 (2010)	Sweden	To evaluate single event multilevel surgery (SEMLS) and rehabilitation using clinical- and self-reported functional measures and HRQOL in youth with CP.	n = 11 Children with CP: 2 Adolescents with CP: 9 Gender: 10 male, 1 female Age: mdn 15y (range 9–18y) Type of CP: 11 spastic TD of CP: 1 hemiplegia, 10 bilateral	Energy cost: Physical Cost Index (PCI) Gross motor capacity: Gross Motor Function Measure (GMFM-66) Walking ability: Classification of Function, Disability and Health (ICF) Maximum outdoor gait distance: estimated in meters Health-related quality of life: Child Health Questionnaire (CHQ) Satisfaction of care: questions regarding fulfilment of expectations and worth of effort; questionnaire regarding estimated time for training and activities for daily life (ADL) during a week; estimated perceived physical and mental effort of the overall rehabilitation-process for the moment	BFS + A	Single event multilevel surgery with therapy	Active and passive movements, muscle strength, stretching, balance and gait towards more complex functional tasks
Angelo^Citation22 (1992)	USA	To compare the three basic modes of scanning -automatic, inverse, and step- regarding accuracy in adolescents with CP.	n = 6 Adolescents with CP: 6 Gender: NS Age: range 18–20y Type of CP: 3 spastic, 3 dyskinetic TD of CP: NS	Accuracy	A	Alternative and augmentative communication	Regular scanning
					A	Alternative and augmentative communication	Inverse scanning
					A	Alternative and augmentative communication	Step scanning
Angelo^Citation23 (1993)	USA	To determine the effect of tilt-in-space on head control for a child with cerebral palsy.	n = 1 Children with CP: 1 Gender: 1 female Age: 9y Type of CP: NS TD of CP: NS	Head control: Time sample recording (percentage of time the subject directly faced the activity)	A + P	Seating and positioning	Zero degrees
					A + P	Seating and positioning	Fifteen degrees
					A + P	Seating and positioning	Thirty degrees
Barbosa et al.^Citation24 (2008)	Brazil	To document the effects of electrical stimulation applied to the wrist muscles of hemiplegic children on hand function.	n = 2 Children with CP: 1 Adolescents with CP: 1 Gender: 1 male, 1 female Age: mdn 9.3y (range 6.9–11.7y) Type of CP: NS TD of CP: 2 hemiplegia	Active wrist extension range of movement (ROM): Goniometer Hand function: three tasks based in the Jebsen Taylor Hand Function Test	BFS	Electrical stimulation (ES, NMES, FES)	Neuromuscular electrical stimulation (FESMED dual-channel NMES unit): wrist extensors
					BFS	Electrical stimulation (ES, NMES, FES)	Neuromuscular electrical stimulation (FESMED dual-channel NMES unit): alternately wrist extensors and flexors
Beauregard et al.^Citation25 (1998)	USA	To examine the reaching movement in two children with CP and upper extremity movement dysfunction while they were playing a game and while performing a rote movement.	n = 2 Children with CP: 2 Gender: 2 female Age: mdn 4y 8mo (range 4y 4mo – 4y 11mo) Type of CP: 2 spastic TD of CP: 2 diplegia	Quality of reach: movement time, movement units, displacement, peak velocity, and the percentage of reach at which peak velocity occurred	BFS	Other	Reaching: Rote movement
					BFS	Other	Reaching: Playing a game
Brien et al.^Citation26 (2010)	Canada	To evaluate an intensive short-duration virtual reality (VR) intervention for balance and functional mobility in adolescents with cerebral palsy (CP) in Gross Motor Functional Classification System (GMFCS) Level I.	n = 4 Adolescents with CP: 4 Gender: 4 male Age: range 13y – 18y Type of CP: 3 spastic, 1 dyskinetic TD of CP: 3 diplegia, 2 NS	Community Balance and Mobility Scale (CB&M) 6-minute walk test (6MWT) Gross Motor Function Measure (GMFM)-Dimension E	BFS + A	Interactive video gaming or virtual reality
Brien et al.^Citation27 (2011)	Canada	To examine the effect of an intensive virtual reality (VR) training program on functional balance and mobility in 13- to 18-year-old adolescents with CP classified at GMFCS level I.	n = 4 Adolescents with CP: 4 Gender: 4 male Age: mdn 15y 10mo (range 13y 9mo – 18y 9mo) Type of CP: 3 spastic, 1 dyskinetic TD of CP: 3 diplegia, 1 NS	Community Balance and Mobility Scale (CB&M) 6-Minute Walk Test (6MWT) Timed Up and Down Stairs (TUDS) GMFM Dimension E	BFS + A	Interactive video gaming or virtual reality
Chen et al.^Citation28 (2007)	Taiwan	To investigate the training effects of a VR intervention on reaching behaviors in children with spastic CP.	n = 4 Children with CP: 4 Gender: 3 male, 1 female Age: mdn 5y 10mo (range 4y 8mo – 8y 6mo) Type of CP: 4 spastic TD of CP: 1 hemiplegia, 3 quadriplegia	Reaching kinematics: movement time (MT), path length (PATH), peak velocity (PV), and movement units (MUs) Fine Motor Domain of the Peabody Developmental Motor Scales–Second Edition (PDMS-2)	BFS + A	Interactive video gaming or virtual reality
Coker et al.^Citation29 (2009)	USA	To evaluate the effectiveness of a mCIMT program for a child less than one year of age diagnosed with congenital hemiplegic cerebral palsy.	n = 1 Children with CP: 1 Gender: 1 male Age: 5mo Type of CP: NS TD of CP: 1 hemiplegia	Peabody Developmental Motor Scales-2 (PDMS-2) Gross Motor Function Measure-88 (GMFM-88)	A	CIMT (Constrained Induced Movement Therapy)	Modified CIMT
Corn et al.^Citation30 (2003)	Australia	To investigate the effectiveness of Second Skin lycra splints to improve the quality of upper limb movement for children with spasticity.	n = 4 Children with CP: 1 Adolescents with CP: 1 Other: 2 Gender: 1 male, 1 female Age: mdn 12y (range 8y – 16y) Type of CP: 2 spastic TD of CP: 2 quadriplegia	Quality of upper limb movement (Melbourne Assessment)	BFS + A	Orthotics (splints)	Lycra splints
Costigan et al.^Citation31 (2010)	USA	To investigate the effect of seated position on the accuracy and efficiency of upper-extremity access to AAC for a child with CP.	n = 1 Children with CP: 1 Gender: 1 male Age: 5y Type of CP: NS TD of CP: 1 quadriplegia	Frequency of Accurate Selection Response Time to Accurate Selection	A	Seating and positioning	Typical seating
					A	Seating and positioning	Conventions of functional seating
Crocker et al.^Citation32 (1997)	Canada	To determine the effect of restriction of the less-involved upper extremity on spontaneous use of the more-involved upper extremity in children with spastic cerebral palsy.	n = 2 Children with CP: 2 Gender: 1 male, 1 female Age: mdn 2.5y (range 2y – 3y) Type of CP: 2 spastic TD of CP: 2 hemiplegia	Specific upper-extremity behaviors (videotaping): Stabilization and weight bearing; grasp and release; sensory exploration; bimanual assist; index finger use in isolation; push and pull; communication and gesture Use of the more-involved extremity for fine motor tasks: The Peabody Developmental Fine Motor Scale (PDMS-F). Daily log (feeding task)	A	Forced-use therapy (FUT)	Custom resting splint, to be worn for most of the waking hours.
							Regular therapy sessions
Dada et al.^Citation33 (2009)	South Africa	To evaluate the effect of an aided language stimulation program on the acquisition of target vocabulary items in children with LNFS (little or no functional speech).	n = 4 Children with CP: 2 Adolescents with CP: 2 Other: 1 Gender: 1 male, 2 female Age: mdn 8.5y (range 8.1y – 10.1y) Type of CP: NS TD of CP: 3 hemiplegia	Acquisition of the target vocabulary items (probe test)	A	Alternative and augmentative communication	Aided language stimulation (simultaneously pointing to symbols on a communication board in conjunction with providing ongoing spoken language stimulation) Three activities: arts and crafts, food preparation, and story time
DeGangi et al.^Citation34 (1983)	USA	To measure the effects of NDT compared to nonspecific play on qualitative motor performance (immediately after a therapy session), in children with CP.	n = 4 Children with CP: 4 Gender: 4 female Age: mdn 18mo (range 10mo – 22mo) Type of CP: 2 spastic, 2 NS TD of CP: 1 hemiplegia, 1 diplegia, 1 quadriplegia, 1 NS	Postural tone Weight shift and weight bearing in developmental postures Transitional movements Functional gains		Neurodevelopmental therapy (NDT, Bobath)
						Play therapy
Dinomais et al.^Citation35 (2013)	France	To examine the ‘‘clinical utility’’ of a virtual rehabilitation tool on upper-limb function in patients with cerebral palsy (CP).	n = 2 Adolescents with CP: 2 Gender: 2 male Age: 16y Type of CP: 2 spastic TD of CP: 2 hemiplegia	Hand function: Box and Block Test (BBT) Hand function: Jebsen–Taylor test (JTT)	A	Interactive video gaming or virtual reality	Training of both upper extremities
Do et al.^Citation36 (2016)	South Korea	To evaluate the effect of virtual reality based bilateral upper limb exercise on upper limb functions and bilateral hand coordination ability in hemiplegic cerebral palsy children.	n = 3 Children with CP: 3 Gender: 2 male, 1 female Age: mdn 6y (range 5y – 7y) Type of CP: 3 spastic TD of CP: 3 hemiplegia	Hand movement ability with complicated movement tasks: Wolf Motor Function Test (WMFT) Independent use of affected upper limb: Pediatric Motor Activity Log (PMAL) Bilateral hand coordination ability: putting a basketball through the hoop Bilateral hand coordination ability: moving large lightweight boxes	A	Interactive video gaming or virtual reality	Training of both upper extremities
Durfee et al.^Citation37 (1999)	USA	To compare the effect of the Touch Window versus the mouse with an enlarged on-screen arrow and cursor when matching upper-case letters of the alphabet for a child with both motor control impairments and visual impairments.	n = 1 Children with CP: 1 Gender: 1 male Age: 9y Type of CP: 1 spastic TD of CP: 1 quadriplegia	The percentage of letters correctly matched per session The total number of correct matches per letter Rate, expressed as the number of letters per minute accurately matched	A	Computer training	Touch Window
					A	Computer training	Mouse
Fienup et al.^Citation38 (2013)	USA	To compare the effect of two interventions targeting money-counting in a student with brain injury.	n = 1 Adolescents with CP: 1 Gender: 1 male Age: 15y Type of CP: NS TD of CP: NS	Counting accuracy: correctly stating the total value of multiple coins or bills Sorting accuracy: organizing bills and coins based on their denomination in a decreasing order Sequential counting: counting bills and coins in descending values	A	Education (money counting skills)	Education as usual
					A + P	Education (money counting skills)	Pre-teaching organization and error-correction
Fragala et al.^Citation39 (2002)	USA	To examine the effect of BtA injections (botox A injections) on impairment, spasticity, disability and parent satisfaction in children with cerebral palsy and lower-extremity spasticity.	n = 7 Children with CP: 5 Adolescents with CP: 2 Gender: 6 male, 1 female Age: mdn 4y 7mo (range 2y 9mo – 11y 10mo) Type of CP: 7 spastic TD of CP: 3 hemiplegia, 4 diplegia	Passive range of motion (hip flexion, extension, and abduction; popliteal angle; knee flexion and extension; ankle dorsiflexion): goniometry Spasticity (hip flexors, extensors and adductors; knee flexors and extensors; and ankle plantar flexors): MAS Disability: COPM Performance score Parents satisfaction: COPM Satisfaction score	BFS + A	Botulinum toxin (BoNT-A)	BoNT-A in the lower extremity
Ghorbani et al.^Citation40 (2017)	Iran	To investigate whether the CO-OP approach leads to motor-based, occupational performance goal achievement and improvement in motor skills in children with CP.	n = 6 Children with CP: 6 Gender: NS Age: mdn 7y 5mo (range 7y – 9y) Type of CP: 3 spastic, 1 dyskinetic, 1 NS TD of CP: 3 hemiplegia, 1 triplegia, 1 NS	Motor skills including gross motor, fine motor, and a combination of both: Bruininks-Oseretsky Test of Motor Proficiency Measure (BOTMP) Change in performance and satisfaction of personal goals: Canadian Occupational Performance Measure (COPM); Goal Attainment Scale (GAS)	A and P	Other	Cognitive Orientation to daily Occupational Performance (CO-OP)
Goodman et al.^Citation41 (1991)	USA	To measure the effects of a short thumb opponens splint on hand function and on the underlying aspects of hand function in a child with moderate spastic quadriplegic CP.	n = 1 Children with CP: 1 Gender: 1 female Age: 4y Type of CP: 1 spastic TD of CP: 1 quadriplegia	Active range of motion of the carpometacarpal joint in radial abduction, palmar abduction, and opposition Grip (spherical grasp) strength: Martin Vigorimeter Tip, lateral, and palmar pinch: B&L Pinch Gauge Scores on the Box and Block Test of manual dexterity The average number of I-in. cubes stacked in three trials Observation of qualitative aspects of prehension: the Erhardt Developmental Prehension Assessment and photographs.	BFS + A	Orthotics (splints)	Short thumb opponens splint
Hamill et al.^Citation42 (2007)	USA	To examine the effects of hippotherapy on sitting and parental perception in young children with CP classified in Level V on the Gross Motor Function Classification System (GMFCS).	n = 3 Children with CP: 3 Gender: 2 male, 1 female Age: mdn 3y 6mo (range 2y 3mo – 4y 6mo) Type of CP: 1 dyskinetic, 1 ataxic, 1 mixed TD of CP: 3 quadriplegia	Sitting: Gross Motor Function Measure-88 item version (GMFM-88) Dimension B (Sitting) Gross motor function: Gross Motor Function Measure-88 item version (GMFM-88) Postural control and functional control of arms and hands for different sitting positions: Sitting Assessment Scale (SAS) Anticipated and perceived effects and perceived value of the hippotherapy program: parent questionnaires (Likert scale and open-ended questions)	A	Hippotherapy
Harris et al.^Citation43 (1986)	USA	To examine the effects of inhibitive orthoses on both quantitative and qualitative aspects of independent standing for a child with spastic quadriplegic CP.	n = 1 Children with CP: 1 Gender: 1 male Age: 4.5y Type of CP: 1 spastic TD of CP: 1 quadriplegia	Independent standing balance (timed)			Barefoot
					A	Orthotics (splints)	Inhibitive ankle-foot orthoses
Hartveld et al.^Citation44 (1996)	UK	To examine the effects of Standing balance and weightshifting practice on the Compex board on the standing balance of children with diplegic CP.	n = 4 Children with CP: 2; Adolescents with CP: 2 Gender: 2 male, 2 female Age: mdn 9y (range 5y – 16y) Type of CP: 3 spastic, 1 mixed TD of CP: 4 diplegia	Standing balance (a quantitative test for standing balance after Atwater et al.)			Regular physiotherapy maintenance programme of functional training and some stretching exercises
					BFS	Other	Shifting weight from left to right and forwards and backwards while standing on the current production version of the Compex board, using a variety of games.
Havstam et al.^Citation45 (2003)	Sweden	To examine the ffect of the speech recognition system Dragon Dictate on computer use and speech development in individuals with CP with (severe) dysarthria.	n = 2 Adolescents with CP: 1 Other: 1 Gender: 1 male Age: 12y Type of CP: 1 spastic TD of CP: 1 quadriplegia	Computer access system efficiency (five minute typing test) Perceived performance and comfort (participant rated) Level of success in speech recognition (five-minute test) Speech production (videotape recording) Speech production (word repetition and word naming)	A + P	Alternative and augmentative communication	Original system (a computer, a head switch and the scanning software SAW (Switch Access to Windows) for text entry and other forms of computer access; a Bliss chart and a light pointer attached to the eyeglasses)
					A + P	Alternative and augmentative communication	The speech recognition system Dragon Dictate
Hinderer et al.^Citation46 (1988)	USA	To compare the effects of tone-reducing vs. standard immobilization casts on the gait patterns of children with CP.	n = 2 Children with CP: 2 Gender: 1 male, 1 female Age: mdn 4y 8mo (range 3y 6mo – 5 y 9 mo) Type of CP: 2 spastic TD of CP: 2 diplegia	Gait (footprint data) Fine motor skills (timed performance)			No casting
					BFS + A	Casting	Tone-reducing casts, operationally defined as casts which maintain the ankle at zero degrees and stabilize the toes and foot in neutral alignment by incorporating a footplate which supports the toes and the metatarsal, peroneal and longitudinal arches of the foot
					BFS + A	Casting	Standard casts, defined as casts which hold the ankle at zero degrees but do not include a footplate
Iammatteo et al.^Citation47 (1990)	USA	To examine the effect of techniques used to facilitate mouth closure and swallowing on drooling and bilabial sounds produced in children with CP.	n = 2 Children with CP: 2 Gender: 2 male Age: mdn 2y 9mo (range 2y 7mo – 2y 11mo) Type of CP: 2 spastic TD of CP: 1 diplegia, 1 quadriplegia	Drooling (saliva weight) Bilabial vocalization (counted)			No intervention
					BFS	Oral motor treatment	Techniques used to facilitate mouth closure and swallowing recommended by Morris and Mueller
Jelsma et al.^Citation48 (2013)	South Africa	To compare the effect of a Nintendo Wii Fit intervention compared to conventional physiotherapy on balance and gross motor function in children with spastic hemiplegic CP performing at GMFCS level I or II.	n = 14 Children/adolescents with CP: 14 Gender: 8 male, 6 female Age: mean 11.4y (range 7y – 14y) Type of CP: 14 spastic TD of CP: 14 hemiplegia	Balance and gross motor function: a set of adapted, criterion-referenced activities based on the Bruininks–Oseretsky test of Motor Proficiency 2nd Edition (BOT-2) Balance: Subtests 5 Running speed and agility, RSA: 6 of the BOT-2 Functional mobility: the timed up and down stairs test (TUDS)			Conventional physiotherapy (children continued their standard physiotherapy regimen of twice weekly 30min sessions)
					BFS + A	Interactive video gaming or virtual reality	Nintendo Wii Fit balance board
Johnson et al.^Citation49 (2014)	USA	To evaluate the effects and optimal duration of plyometric training on gross motor abilities in children with CP.	n = 3 Children with CP: 2 Adolescents with CP: 1 Gender: 3 male Age: mdn 9y 11 mo (range 8y 9mo – 10y) Type of CP: 3 spastic TD of CP: 3 hemiplegia	Gross motor ability: GMFM D, E, 66, and percentile rank Running speed: 20-m running-start sprint Agility: 10 × 5-m Sprint Muscle power: basketball throw, broad jump, vertical jump Self-selected goal Safety	BFS + A	Strength training (resistance)	Plyometric training intervention
Kelly et al.^Citation50 (2009)	Canada	To examine the effect of a community-based group aquatic exercise program on energy expenditure and children’s self-reported levels of fatigue in children with CP.	n = 5 Children with CP: 1 Adolescents with CP: 4 Gender: NS Age: mdn 10y (range 9y – 11y) Type of CP: 5 spastic TD of CP: 2 hemiplegia, 2 diplegia, 1 quadriplegia	Energy expenditure: Energy Expenditure Index (EEI) Children’s perception of fatigue: Pediatric Quality of Life Multidimensional Fatigue Scale (PedsQL-Fatigue Scale) Children’s performance and satisfaction ratings of a movement goal: Canadian Occupational Performance Measure (COPM)	BFS + A	Other	Aquatic aerobic exercise program
Kenyon et al.^Citation51 (2018)	USA	To evaluate the impact of power mobility training using an alternative power mobility device with a child who has multiple, severe impairments on the child’s spectrum of EEG activity and mastery motivation.	n = 1 Children with CP: 1 Gender: 1 female Age: 3y 2mo Type of CP: 1 spastic TD of CP: 1 quadriplegia	Mastery motivation: dimensions of mastery questionnaire (DMQ) EEG data collected under various conditions Paediatric evaluation of disability inventory–computer adaptive test (PEDI-CAT) Canadian occupational performance measure (COPM) Assessment of learning powered mobility use (ALP) Maternal interview to determine the mother’s perceptions of her child’s response to power mobility training	A and P	Other	Power mobility training
Kinghorn et al.^Citation52 (1996)	Canada	To investigate the effects of an upper-extremity weight-bearing splint on muscle tone and functional hand skills in a child with CP.	n = 1 Children with CP: 1 Gender: 1 male Age: 20mo Type of CP: 1 spastic TD of CP: 1 quadriplegia	Hand contact with a surface (hand tracing) Arm-hand posture: elbow and hand position (observation rating scale) Hand function: grasping of a 1-in. block cube; batting or trapping of a ball	BFS + A	Other	Weight bearing without splint
					BFS + A	Other	Weight bearing with upper-extremity weight-bearing splint
Ko et al.^Citation53 (2015)	South Korea	To evaluate the effect of AST (Adeli suit treatment) on spatial-temporal gait parameters, 10-meter walking speed, pediatric balance scale (PBS) and GMFM in a child with CP.	n = 1 Children with CP: 1 Gender: 1 female Age: 8y Type of CP: 1 spastic TD of CP: 1 diplegia	Spatial-temporal gait: parameters gait speed, stride time, stride length and stride width Walking speed: 10-meter walking test Motor function: Gross motor functional measure (GMFM) Balance: Pediatric balance scale (PBS)			Regular physical and occupational therapy treatments
					BFS + A	Other	Adeli suit treatment (and regular physical and occupational therapy treatments)
Laessker-Alkema et al.^Citation54 (2016)	Sweden	To examine the efficacy of knee orthoses on extensibility of the hamstrings in children with spastic CP.	n = 10 Children with CP: 4 Adolescents with CP: 6 Gender: 6 male, 4 female Age: mdn 12.0y (range 5.8y −14.7y) Type of CP: NS TD of CP: 4 diplegia, 6 NS	Passive ROM (hamstrings and knee extension): hand-held plastic goniometer Muscle tone (hamstrings): Modified Ashworth Rating Scale (MAS) Gross motor function: Gross Motor Function Measure (GMFM), GMFM-88 version	BFS	Orthotics (splints)	Knee orthoses for both legs (intervention position: sitting, well supported, with the hips up to 90◦ of flexion, the knees extended, and the legs slightly in abduction)
Lammi et al.^Citation55 (2003)	Canada	To determine if occupational therapy intervention, using modified FCFT (Family-Centred Functional Therapy), focused on changing only the task and the environment, could improve the functional performance of preschool aged children with CP.	n = 3 Children with CP: 3 Gender: 2 male, 1 female Age: mdn 3y 6mo (range 3y – 3y 6mo) Type of CP: NS TD of CP: NS	Performance and satisfaction of tasks: Canadian Occupational Performance Measure (COPM) The level of independence of the child: Paediatric Evaluation of Disability Inventory (PEDI); Caregiver Assistance Scale Level of achievement for task performance and the quality of performance: Performance Quality Rating Scale (PQRS)	A + P	Goal-directed training/functional training	Family-Centred Functional Therapy (FCFT)
Laskas et al.^Citation56 (1985)	USA	To examine the effect of particular NDT activities on heel to floor contact and dorsiflexor muscle activity in a child with quadriplegic CP.	n = 1 Children with CP: 1 Gender: 1 male Age: 2.5y Type of CP: 1 spastic TD of CP: 1 quadriplegia	Dorsiflexor muscle activity during three posterior equilibrium reactions: biofeedback Heel contact when coming to a standing position			Routine physical therapy services (once a week)
					BFS + A	Neurodevelopmental therapy (NDT, Bobath)	Routine physical therapy services (once a week) continued during intervention phase
Lephart et al.^Citation57 (2015)	USA	To compare the effects of 2 seating systems used in a school setting on cardiopulmonary functioning (body function and structure), time to activate communicationswitches (activity), and accuracy of answering questions participation) for a young adult with quadriplegic CP and neurological scoliosis.	n = 1 Adolescents with CP: 1 Gender: 1 male Age: 19y Type of CP: 1 spastic TD of CP: 1 quadriplegia	SaO2: digital fingertip pulse oximeter Heart rate (HR): digital fingertip pulse oximeter Respiration rate (RR): number of chest excursions in 1 minute Body temperatoure BT: factory-calibrated noncontact infrared thermometer Activity: the time it took to reach a switch from a standardized starting position after a question was asked Participation: the number of correct answers to 5 questions	BFS + A + P	Seating and positioning	Original chair position (OCP): Contoured Advance Seat
					BFS + A + P	Seating and positioning	Custom-molded back (CMB)
Lewis et al.^Citation58 (2016)	Australia	To assess the effect of the dynamic elastomeric fabric orthoses (DEFO) in the management of shoulder instability in children with CP, GMFCS levels IV and V.	n = 3 Children with CP: 1 Adolescents with CP: 2 Gender: 2 male, 1 female Age: mdn 11y (range 6.5y – 16y) Type of CP: 3 dyskinetic TD of CP: 3 quadriplegia	Distance from the tip of acromion process to humeral head (mm) Shoulder passive range of motion Participant/Parent evaluation: rating scale Care and Comfort Hypertonicity Questionnaire A daily log of compliance	BFS	Orthotics (splints)	Dynamic elastomeric fabric orthoses (DEFO)
Lilly et al.^Citation59 (1990)	USA	To measure the effects of NDT and play intervention on dressing skills in children with CP.	n = 2 Children with CP: 2 Gender: 2 female Age: mdn 29.5mo (range 27mo – 32mo) Type of CP: 2 spastic TD of CP: 2 diplegia	Sets of measurement criteria for dressing skills	BFS + A	Neurodevelopmental therapy (NDT, Bobath)
					BFS + A	Play therapy
Lin et al.^Citation60 (2014)	Taiwan	To assess whether physical activities increase by employing MaKey–MaKey-based task systems in kindergarten children with severe CP.	n = 2 Children with CP: 1 Other: 1 Gender: 1 female Age: 5y 9mo Type of CP: NS TD of CP: NS	The number of times the participant applied his/her physical strength to touch any part of the conductive material as a physical activity	A	Interactive multimedia training	MaKey–MaKey-based task systems
Lin et al.^Citation61 (2015)	Taiwan	To assess whether interactive augmented reality using Scratch 2.0 increases physical activitiy in children with developmental disabilities.	n = 3 Children with CP: 2 Other: 1 Gender: 1 male, 1 female Age: mdn 5y (range 3y 11mo – 6y) Type of CP: NS TD of CP: NS	Number of correct movements	A		Evoking of movements without interactive augmented reality
					A	Interactive augmented reality	Scratch 2.0 software
Mackey^Citation62 (1989)	UK	To evaluate the difference in the ability of children with CP to carry out a motor control task whether it is performed with therapist feedback alone or with the addition of computer-assisted feedback.	n = 6 Children with CP: 5 Adolescents with CP: 1 Gender: 4 male, 2 female Age: mdn 7y (range 4y −12y) Type of CP: 6 spastic TD of CP: 2 diplegia, 4 quadriplegia	The amount of time spent pressing down a target	BFS + A	Other	Pressure on a switchbox with only oral feedback by the therapist
					BFS + A	Other	Pressure on a switchbox with visual and auditory cues from the computer feedback in addition to oral feedback by the therapist (computer-assisted feedback)
Man et al.^Citation63 (2007)	China	To compare the effects of various available non hand-held pointer interfaces on communication time, precision and comfort in students with severe disabilities.	n = 2 Adolescents with CP: 2 Gender: 1 male, 1 female Age: mdn 14y (range 13y – 15y) Type of CP: 2 dyskinetic TD of CP: 2 quadriplegia	Movement time and accuracy: WinFitts multidirectional point-and-click test Level of comfort: questionnaire	A	Other	Computer-Access Solution: nonhandheld pointing interfaces (CameraMouseTM)
					A	Other	Computer-Access Solution: ASL Head-Array Mouse Emulator
					A	Other	Computer-Access Solution: CrossScanner
					A	Other	Computer-Access Solution: Quick Glance Eye Gaze Tracker 2SH version 4.2
Matthews et al.^Citation64 (2009)	UK	To identify gait and mobility-related changes in a group of children with CP who had been prescribed DEFO leggings.	n = 8 Children/adolescents with CP: 8 Gender: 4 male, 4 female Age: mdn 5.5y (range 3y – 13y) Type of CP: 8 spastic TD of CP: 8 diplegia	Gait velocity: Ten Metre Walking Test (10MWT) Perceived changes in gait: Visual Analogue Scale (VAS) Energy expenditure during gait: Physiological Cost Index (PCI) Mobility-related functional goal: Patient Specific Functional Scale (PSFS) Perceived salient features of mobility and the total number of hours of orthotic wear each day: daily diary	BFS + A	Orthotics (splints)	Dynamic elastomeric fabric orthotic (DEFO) leggings
McCarthy et al.^Citation65 (2015)	USA	To investigate if providing computerized sounding out, or auditory providing the sound sequences of words through a digitized recording of a human voice, during spelling would increase spelling accuracy for children with CP related dysarthria, who did and did not use AAC.	n = 8 Children with CP: 6 Adolescents with CP: 1 Not specified: 1 Gender: 5 male, 3 female Age: mdn 8y (range 5y 8mo – 11y 3mo) Type of CP: NS TD of CP: NS	Correctly spelled pseudo-words at the whole word level Percentage of correctly used phonology (i.e. sounds in the pseudo-words)	A	Other	Spelling education without computerized sounding out
					A	Other	Spelling education with the computerized sounding out
McConnell et al.^Citation66 (2014)	UK	To evaluate the efficacy of reduced intensity CIMT on unilateral upper limb function in children 8–15 years old with hemiplegic CP and exploring the acceptability of the CIMT protocol from the perspectives of children, parents and education staff.	n = 7 Children with CP: 4 Adolescents with CP: 3 Gender: 4 male, 3 female Age: mdn 9y (range 9y – 11y) Type of CP: 7 spastic TD of CP: 7 hemiplegia	Quality of unilateral UL function: Melbourne Assessment of Unilateral Upper Limb Function (MUUL) Strength: Manual Muscle Testing (MMT) Tone: Modified Ashworth Scale (MAS) Active range of motion (AROM): goniometry Participation: shortened parent-proxy Assessment of Life-Habits (Life-H) questionnaire (version 1.0) adapted for children five to 13 years Interviews	BFS + A + P	CIMT (Constrained Induced Movement Therapy)	Reduced intensity CIMT
Owen et al.^Citation67 (1992)	Australia	To evaluate the usefulness of benztropine on reduction of drooling in school aged children with CP.	n = 3 Children with CP: 2 Adolescents with CP: 1 Gender: NS Age: mdn 9.8y (range 5.11y – 12.6y) Type of CP: NS TD of CP: NS	Saliva volume: observational rating scale 0–2	BFS	Other	Benztropine
							Placebo
Pinder et al.^Citation68 (1995)	USA	To investigate whether treatment for shaping intentional communicative signals could effectively influence the development of intentional communicative signals produced by young children who demonstrated different degrees of motor disability.	n = 4 Children with CP: 4 Gender: 2 male, 2 female Age: mdn 13mo (range 11.5mo – 13.5mo) Type of CP: 2 spastic, 2 mixed TD of CP: 2 diplegia, 2 NS	Communicative signals: in two different context (choice and request opportunities), with toys and with food and drink	A	Early intervention	Treatment for shaping intentional communicative signals
Pool et al.^Citation69,Citation70 (2014)	Australia	To determine the effects of functional electrical stimulation (FES) with the Walk Aide on the main impairments affecting gait and participation (trips and falls) in children with spastic hemiplegic CP.	n = 12 Children with CP: 7 Adolescents with CP: 5 Gender: 7 male, 5 female Age: mdn 9y 4mo (range 4y 10mo – 15y 5mo) Type of CP: 12 spastic TD of CP: 12 hemiplegia	Passive range of motion: goniometer Spasticity: dynamic ROM (Modified Tardieu Scale); Australian Spasticity Assessment Scale Strength: handheld dynamometry; single-limb heel raises Selective Motor Control: assessment as described by Boyd and Graham Balance: single-limb balance assessment Gait: 2D video using the Observational Gait Scale (OGS) Self-reported Toe Drag and Falls: questionnaire	BFS + A	Electrical stimulation (ES, NMES, FES)	A portable Functional electrical stimulation (FES) (the Walk Aide)
Pratt et al.^Citation71 (2016)	USA	To investigate the effect of ADA-compliant versus noncompliant playgrounds on the physical activity of children with ambulatory CPduring playground play.	n = 5 Children with CP: 5 Gender: 4 male, 1 female Age: mdn 8y 1mo (range 7y 4mo – 8y 5mo) Type of CP: 5 spastic TD of CP: 2 hemiplegia, 2 diplegia, 1 quadriplegia	Physical activity (Stride Count and time active): StepWatch activity monitor	A + P	Other	Noncompliant playground
					A + P	Other	ADA-compliant playground
Prosser et al.^Citation72,Citation73 (2012)	USA	To investigate the feasibility, tolerability and effect on motor development of a novel mobility training intervention incorporating infant motor learning and neurorehabilitation principles in toddlers with CP.	n = 5 Children with CP: 5 Gender: NS Age: mdn 17mo (range 13mo – 27 mo) Type of CP: NS TD of CP: 5 bilateral	Motor function: Gross Motor Function Measure (GMFM-66) Feasibility: completion rate (percentage of therapy sessions attended); participation rate (percentage of therapy time that participants were actively engaged in motor activity)			Maintenance of the therapy services they were already receiving
					A	Other	Mobility training by means of an advanced weight support system
Ramani et al.^Citation74 (2014)	India	To study the impact of low vision care intervention on the reading progress of children with multiple disabilities and visual impairment (MDVI) as measured by reading speed, accuracy percentage and fluency.	n = 3 Children with CP: 1 Adolescents with CP: 2 Gender: 3 male Age: mdn 13y (range 9y – 14y) Type of CP: NS TD of CP: NS	Reading speed: read words/letters per minute Reading accuracy: error rate Reading fluency: multidimensional fluency rating scale	BFS + A	Other	Low vision care intervention
Ray et al.^Citation75 (1983)	USA	To determine the effect of facilitating mouth closure on drooling in an adolescent with mental retardation and CP.	n = 1 Adolescents with CP: 1 Gender: 1 male Age: 11y 8mo Type of CP: 1 spastic TD of CP: 1 quadriplegia	Saliva volume: collected by an absorbent bib (in centigrams)			Play
					BFS	Oral motor treatment	Methods described by Mueller to facilitate jaw closure
Reid et al.^Citation76 (1999)	Canada	To evaluate the effect of a rigid pelvic stabilizer compared to a lap belt on task performance and satisfaction in wheelchair-dependent children with CP.	n = 6 Children with CP: 3 Adolescents with CP: 3 Gender: 2 male, 4 female Age: mdn 10.21y (range 8.33y – 12.75y) Type of CP: 6 spastic TD of CP: 1 diplegia, 5 quadriplegia	Self-perception of children and parents of performance and satisfaction relative to problem areas: Canadian Occupational Performance Measure (COPM) The caregivers’ perception of improvement regarding their child’ s performance: a single-item measure which was part of a structured interview developed for this study	A + P	Seating and positioning	Standard single-anchor-point wheelchair lap belt
					A + P	Seating and positioning	Rigid pelvic stabilizer (RPS)
Retarekar et al.^Citation77 (2009)	USA	To evaluate the effects of an aquatic aerobic exercise program on participation, gross motor function, walking endurance, and energy expenditure in an ambulatory child with CP	n = 1 Children with CP: 1 Gender: 1 female Age: 5y Type of CP: 1 spastic TD of CP: 1 diplegia	Mother’s perception of performance and satisfaction in the areas of self-care, productivity, and leisure: Canadian Occupational Performance Measure (COPM) Gross motor function: Gross Motor Function Measure-66 (GMFM-66) Submaximal functional exercise capacity: 6-Minute Walk Test Energy expenditure during walking: Modified Energy Expenditure Index Physical activity: Physical Activity Questionnaire			Usual care only (physical therapy and physical education)
					BFS + A	Other	Aquatic aerobic exercise
Rigby et al.^Citation78 (2001)	Canada	To evaluate task performance and caregiver assistance for children with CPusing a rigid pelvic stabilizer system compared with a lap belt on their adaptive wheelchair seating system.	n = 6 Children/adolescents with CP: 6 Gender: 2 male, 4 female Age: mean 10y 4mo Type of CP: 6 spastic TD of CP: 1 diplegia, 5 quadriplegia	The amount of caregiver assistance required by the child to engage in each of the occupational performance areas identified on the COPM: Caregiver Assistance Scale modified from the PEDI	A + P	Seating and positioning	A seating system lap belt, anchored at two points
					A + P	Seating and positioning	Rigid pelvic stabilizer (RPS)
Rintala et al.^Citation79 (1994)	NS	To document the effects of a 4-month physical activity program on posture control in children with CP.	n = 8 Children with CP: 3 Adolescents with CP: 5 Gender: 5 male, 3 female Age: mdn 10.5y (range 7y – 11y) Type of CP: NS TD of CP: 5 hemiplegia, 3 diplegia	Postural sway during standing: velocity of the center of pressure during 1) normal bipedal standing; 2) normal bipedal standing with eyes closed; and 3) toe-to-heel standing			No organized physical activities
					BFS + A	Other	Physical activity program, including ball skills, balance, and physical fitness
Rivi et al.^Citation80 (2014)	Italy	To assess the effectiveness of the standing frame on constipation in a chronically constipated child with quadriplegic CP.	n = 1 Children with CP: 1 Gender: 1 male Age: 5y Type of CP: NS TD of CP: 1 quadriplegia	Constipation (including evacuation, induction and pain): daily diary Type of stool: The Bristol Stool Scale Burden on caregivers because of the evacuation management: self-developed questionnaire			No use of the standing frame
					BFS	Other	Use of a standing frame
Sakemiller et al.^Citation81 (1998)	USA	To explore whether a meaningful game would elicit a higher degree of functional vertical neck and back extension than would rote exercises in children with hypotonic CP.	n = 2 Adolescents with CP: 2 Gender: 2 female Age: mdn 10.9y (range 10.6y – 11.2y) Type of CP: NS TD of CP: NS	Neck extension: videotaped two-dimensional biomechanical analysis Back extension: videotaped two-dimensional biomechanical analysis Total extension: videotaped two-dimensional biomechanical analysis	BFS + A	Other	A verbal request to hold the head up.
					BFS + A	Other	Meaningful games to motivate head and back extension
Sheppard et al.^Citation82 (2007)	Australia	To determine whether the treatment approaches NDT versus BIT increased spontaneous hand use and improved upper limb movement patterns in children with hemiplegic CP.	n = 3 Children with CP: 3 Gender: 1 male, 2 female Age: mdn 9y 10mo (range 8y 1mo – 9y 11mo) Type of CP: 3 spastic TD of CP: 3 hemiplegia	Hand use: 1) frequency of use/percentage of time the affected hand was used; 2) absence or presence of movement characteristics (during specified test tasks)			No therapy
					BFS + A		NDT in combination with Bilateral Isokinematic Training (BIT)
					BFS + A	Other	Bilateral Isokinematic Training (BIT)
Shumway-Cook et al.^Citation83 (2003)	USA	To examine the effect of massed practice using a moving platform on recovery of stability in school-age children with CP.	n = 6 Children with CP: 4 Adolescents with CP: 2 Gender: 4 male, 2 female Age: mdn 8y 9mo (range 7y 5mo – 12y 11mo) Type of CP: 6 spastic TD of CP: 2 hemiplegia, 4 diplegia	Reactive balance control: center of pressure area and time to stabilization following a perturbation on a force platform Motor function: GMFM dimension D			Current schedule of therapies
					BFS	Other	Moveable forceplate system to train reactive balance control
Siconolfi-Morris^Citation84 (2012)	USA	To explore the use of a therapist direct, video game based, multi-directional balance training intervention on the balance, strength, GV and activities of children with CP in the home environment.	n = 5 Children with CP: 4 Adolescents with CP: 1 Gender: 3 male, 2 female Age: mdn 8.1y (range 7.0y – 10.4y) Type of CP: 5 spastic TD of CP: 2 hemiplegia, 3 diplegia	Balance, weight bearing symmetry (WBS): assessed using the WiiFit Plus software and Wii balance board (WBB) from the Nintendo Wii gaming console Balance, center of pressure and time to boundary: ground reaction force data was assessed on an Accusway forceplace Balance: timed up and go (TUG) Gait velocity: time to ambulate a 3m distance Isometric strength of the hip abductors: hand-held dynamometer Activities: Activities Scale for Kids, performance version (ASKp) Enjoyment and difficulty of the intervention: Enjoyment and Difficulty Questionnaire (EDQ) (adapted version)			Current therapies received
					BFS + A	Interactive video gaming or virtual reality	Balance training intervention utilizing the WiiFit Plus software and the WBB
Smelt^Citation85 (1989)	USA	To determine the effect of an upper extremity inhibitive weight-bearing mitt in conjunction with NDT, as compared to NDT alone, on the muscle tone and functional performance of a child with spastic CP.	n = 1 Children with CP: 1 Gender: 1 male Age: 17mo Type of CP: 1 spastic TD of CP: 1 hemiplegia	Passive range of motion in the hand: grip circumference Tone: hand weight-bearing surface area Functional performance: the ability to perform several play activities	BFS + A	Neurodevelopmental therapy (NDT, Bobath)	NDT alone
					BFS + A	Orthotics (splints)	Inhibitive weiht-bearing mitt in conjunction with NDT
Smithers^Citation86 (1991)	UK	To evaluate the effect of facilitation techniques on the rolling ability of a boy with athetoid CP and associated learning difficulties.	n = 1 Children with CP: 1 Gender: 1 male Age: 7y Type of CP: 1 dyskinetic TD of CP: NS	Quantity of supine to side-lying rolls: number of successfully completed rolls (frequency ticklist) Quality of supine to side-lying rolls: a modified version of a video-assessment of rolling drawn up by Montgomery and Connolly			No facilitating techniques
					A	Other	Facilitating techniques for rolling
Soto et al.^Citation87 (2008)	USA	To investigate the effect of an intervention program designed to improve the narrative skills of children who use AAC on the narrative performance of a 12-year-old who used AAC.	n = 1 Adolescents with CP: 1 Gender: 1 female Age: 12y Type of CP: 1 dyskinetic TD of CP: 1 quadriplegia	Linguistic Complexity: 1) total number of different words (NDW); 2) number of clauses; and 3) clausal density Story Complexity, 1) cohesiveness of the narratives: the presence of cohesion markers between clauses; 2) story coherence: the use of story grammar elements and the organization of story structure Ecological validity of the intervention: post-treatment interview Social validity of the intervention: a postintervention questionnaire			No intervention
					A + P	Other	A comprehensive narrative intervention program
Stansfield et al.^Citation88 (2015)	USA	To investigate whether the use of motion- based VR gameplay results in improved measures of motor performance in an adolescent with CP.	n = 1 Adolescents with CP: 1 Gender: 1 male Age: 10y Type of CP: NS TD of CP: NS	Speed of reach with the affected upper extremity: motion tracker data Upper extremity skills: the dissociated movement subscale from the Quality of Upper Extremity Skills Test (QUEST) Bilateral integration of the upper extremities in a functional task: the Goal Attainment Scale (GAS) Changes noted in the participant’s overall functioning, upper extremity functioning, mood and demeanor: daily log Satisfaction Rating Scale	BFS + A	Interactive video gaming or virtual reality	A motion-based VR game
Stewart et al.^Citation89 (1992)	Australia	To compare the effect of an isometric joystick and a displacement joystick on response time in wheelchair driving in adolescents with CP.	n = 6 Adolescents with CP: 6 Gender: 3 male, 2 female Age: mdn 18y (range 16y – 20y) Type of CP: 2 spastic, 3 dyskinetic TD of CP: 5 quadriplegia	Speed: tracking task (Skill Evaluator and Trainer) Accuracy: tracking task (Skill Evaluator and Trainer)	A	Other	Wheelchaire controls: isometric joystick
					A	Other	Wheelchaire controls: displacement joystick
Stewart et al.^Citation90 (2000)	Australia	To compare the effect of three different types of symbol selection on speed and accuracy of symbol selection in scanning voice output device users with CP.	n = 3 Children with CP: 2 Adolescents with CP: 1 Gender: 1 male, 2 female Age: mdn 8y 4mo (range 6y 8mo – 10y 2mo) Type of CP: 1 dyskinetic, 2 mixed TD of CP: 3 quadriplegia	Speed: the time in seconds for the subject to complete each sentence Errors: the number of symbols that were incorrectly selected	A + P	Alternative and augmentative communication	No-prediction
					A + P	Alternative and augmentative communication	Regular prediction
					A + P	Alternative and augmentative communication	Internal prediction
Svedberg et al.^Citation91 (2001)	Sweden	To assess acupuncture effects on peripheral skin temperature in children with cold feet associated with CP, progressive encephalopathy or Smith-Lemli-Opitz syndrome.	n = 6 Children with CP: 2 Adolescents with CP: 2 Other: 2 Gender: 4 female Age: mdn 10y (range 4y – 16y) Type of CP: 3 spastic, 1 dyskinetic TD of CP: 2 diplegia, 1 quadriplegia, 1 NS	Skin temperature: at the forehead, the suprasternal fossa, the palm and the dorsal surface of the hand, and the sole and dorsal surface of the foot			Normal continuation of pharmacological and physical treatment only
					BFS	Acupuncture	Acupuncture
Symons et al.^Citation92 (2007)	USA	To compare the effect of low dose methylphenidate, high dose methylphenidate and placebo on disruptive classroom behaviour in school-age children with CPand comorbid ADHD symptoms.	n = 3 Children with CP: 2 Adolescents with CP: 1 Gender: 2 male, 1 female Age: mdn 9y 8mo (range 8y 5mo – 11y 2mo) Type of CP: 2 spastic, 1 NS TD of CP: 1 triplegia, 1 quadriplegia, 1 NS	Stereotyped behavior: video-taped direct classroom observation Disruptive behavior: video-taped direct classroom observation Task-related behavior: video-taped direct classroom observation	A + P	Other	Placebo
					A + P	Other	Low dose of methylphenidate
					A + P	Other	High dose of methylphenidate
Thorpe et al.^Citation93 (2002)	USA	To examine the effects of presenting augmented information to children with CPon the learning of a novel motor gross motor task.	n = 13 Children with CP: 10 Adolescents with CP: 3 Gender: 5 male, 8 female Age: mdn 8.67y (range 6.00y – 12.67y) Type of CP: NS TD of CP: 9 diplegia, 4 quadriplegia	Total backward displacement of the Pedalo, travelled in 10 seconds	A	Other	No augmented information
					A	Other	Knowledge of performance (KP)
					A	Other	Knowledge of performance enhanced by a cognitive strategy (KP+CS)
Ustad et al.^Citation94 (2009)	Norway	To examine effects of intensive physiotherapy on the acquisition of gross motor functional skills compared to standard care in infants with CP.	n = 5 Children with CP: 5 Gender: 4 male, 1 female Age: mdn 7mo 2wk corrected age (range 5mo 3wk – 9mo 2wk) Type of CP: 4 spastic, 1 mixed TD of CP: 4 hemiplegia, 1 bilateral	Gross motor function: Gross Motor Function Measure (GMFM), both versions			Early intervention (physiotherapy as usual)
					A	Early intervention	Intensive physiotherapy (daily)
Voulgarakis et al.^Citation95 (2015)	USA	To examine the effect of an escape extinction and negative reinforcement-based approach to treating food refusal in a child with CP.	n = 1 Children with CP: 1 Gender: 1 male Age: 8y Type of CP: NS TD of CP: NS	Number of bites accepted within 30 minutes	A + P	Other	An escape extinction and negative reinforcement-based approach during mealtime 5 bites required – 7 bites required – 10 bites required – 7 bites required – 12 bites required
Ward et al.^Citation96,Citation97 (2013 & 2014)	Australia	To evaluate the effectiveness of a motor-speech intervention program (Prompts for Restructuring Oral Muscular Phonetic Targets) on perceptual changes in speech production accuracy in children with moderate-to-severe speech impairment associated with CP.	n = 6 Children with CP: 5 Adolescents with CP: 1 Gender: 3 male, 3 female Age: mdn 5y 3mo (range 3y – 11y 9 mo) Type of CP: 5 spastic, 1 dyskinetic TD of CP: 4 hemiplegia, 1 quadriplegia, 1 NS	Accuracy of the targeted motor speech movement pattern (MSMP): speech probes Perceptual accuracy (PA): speech probes			Regular therapy services
					A	Other	Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT)

^a for studies in which the baseline condition is not specified, only the experimental intervention(s) is described; NS = not specified; mdn = median; TD = topographical distribution; BFS = body functions and structures level of the International Classification of Functioning, Disability and Health (ICF); A = activity level of the ICF; P = participation level of the ICF.

Akerstedt A, Risto O, Odman P, Oberg B. Evaluation of single event multilevel surgery and rehabilitation in children and youth with cerebral palsy–A 2-year follow-up study. Disabil Rehabil. 2010;32:530–39. doi:10.3109/09638280903180171

 PubMed Web of Science ®Google Scholar

Angelo J. Comparison of three computer scanning modes as an interface method for persons with cerebral palsy. Am J Occup Ther. 1992 official publication of the American Occupational Therapy Association;46:217–22. doi:10.5014/ajot.46.3.217

 PubMed Web of Science ®Google Scholar

Angelo J. Using single-subject design in clinical decision making: the effects of tilt-in-space on head control for a child with cerebral palsy. Assistive Technol. 1993;5:46–49. doi:10.1080/10400435.1993.10132206

 PubMedGoogle Scholar

Barbosa AP, Vaz DV, Gontijo APB, Fonseca ST, Mancini MC. Therapeutic effects of electrical stimulation on manual function of children with cerebral palsy: evaluation of two cases. Disabil Rehabil. 2008;30:723–28. doi:10.1080/09638280701378902

 PubMed Web of Science ®Google Scholar

Beauregard R, Thomas JJ, Nelson DL. Quality of reach during a game and during a rote movement in children with cerebral palsy. Phys Occup Ther Pediatr. 1998;18:67–84. doi:10.1080/J006v18n03_05

 Google Scholar

Brien M, Sveistrup H. An intensive virtual reality program impoves balance and functional mobility of adolescents with cerebral palsy. Arch Phys Med Rehabil. 2010;91:e45. doi:10.1016/j.apmr.2010.07.161

 Google Scholar

Brien M, Sveistrup H. An intensive virtual reality program improves functional balance and mobility of adolescents with cerebral palsy. Pediatr Phys Ther. 2011;23:258–66. doi:10.1097/PEP.0b013e318227ca0f

 PubMed Web of Science ®Google Scholar

Chen YP, Kang LJ, Chuang TY, Doong JL, Lee SJ, Tsai MW, Jeng SF, Sung WH. Use of virtual reality to improve upper-extremity control in children with cerebral palsy: a single-subject design. Phys Ther. 2007;87:1441–57. doi:10.2522/ptj.20060062

 PubMed Web of Science ®Google Scholar

Coker P, Lebkicher C, Harris L, Snape J. The effects of constraint-induced movement therapy for a child less than one year of age. Neuro Rehabili. 2009;24:199–208. doi:10.3233/NRE-2009-0469

 Google Scholar

Corn K, Imms C, Timewell G, Carter C, Collins L, Dubbeld S, Schubiger S, Froude E. Impact of second skin lycra splinting on the quality of upper limb movement in children. Br J Occup Ther. 2003;66:464–72. doi:10.1177/030802260306601005

 Google Scholar

Costigan FA, Light J. Effect of seated position on upper-extremity access to augmentative communication for children with cerebral palsy: preliminary investigation. Am J Occup Ther. 2010;64:596–604. doi:10.5014/ajot.2010.09013

 PubMed Web of Science ®Google Scholar

Crocker MD, MacKay-Lyons M, McDonnell E. Forced use of the upper extremity in cerebral palsy: a single-case design. Am J Occup Ther. 1997 official publication of the American Occupational Therapy Association;51:824–33. doi:10.5014/ajot.51.10.824

 PubMed Web of Science ®Google Scholar

Dada S, Alant E. The effect of aided language stimulation on vocabulary acquisition in children with little or no functional speech. Am J Speech-Lang Pathol. 2009;18:50–64. doi:10.1044/1058-0360(2008/07-0018)

 PubMed Web of Science ®Google Scholar

DeGangi GA, Hurley L, Linscheid TR. Toward a methodology of the short-term effects of neurodevelopmental treatment. Am J Occup Ther. 1983;37:479–84. doi:10.5014/ajot.37.7.479

 PubMed Web of Science ®Google Scholar

Dinomais M, Veaux F, Yamaguchi T, Richard P, Richard I, Nguyen S. A new virtual reality tool for unilateral cerebral palsy rehabilitation: two single-case studies. Dev Neurorehabil. 2013;16:418–22. doi:10.3109/17518423.2013.778347

 PubMed Web of Science ®Google Scholar

Do JH, Yoo EY, Jung MY, Park HY. The effects of virtual reality-based bilateral arm training on hemiplegic children’s upper limb motor skills. Neuro Rehabili. 2016;38:115–27. doi:10.3233/NRE-161302

 Google Scholar

Durfee JL, Billingsley FF. A comparison of two computer input devices for uppercase letter matching. Am J Occup Ther. 1999 official publication of the American Occupational Therapy Association;53:214–20. doi:10.5014/ajot.53.2.214

 PubMed Web of Science ®Google Scholar

Fienup DM, Mudgal D, Pace G. Increasing money-counting skills with a student with brain injury: skill and performance deficits. Brain Inj. 2013;27:366–76. doi:10.3109/02699052.2012.743176

 PubMed Web of Science ®Google Scholar

Fragala MA, O’Neil ME, Russo KJ, Dumas HM. Impairment, disability, and satisfaction outcomes after lower-extremity botulinum toxin a injections for children with cerebral palsy. Pediatr Phys Ther. 2002;14:132–44. doi:10.1097/01.PEP.0000030091.82067.51

 PubMedGoogle Scholar

Ghorbani N, Rassafiani M, Izadi-Najafabadi S, Yazdani F, Akbarfahimi N, Havaei N, Gharebaghy S. Effectiveness of cognitive orientation to (daily) occupational performance (CO-OP) on children with cerebral palsy: A mixed design. Res Dev Disabil. 2017;71:24–34. doi:10.1016/j.ridd.2017.09.007

 PubMed Web of Science ®Google Scholar

Goodman G, Bazyk S. The effects of a short thumb opponens splint on hand function in cerebral palsy: a single-subject study. Am J Occup Ther. 1991 official publication of the American Occupational Therapy Association;45:726–31. doi:10.5014/ajot.45.8.726

 PubMed Web of Science ®Google Scholar

Hamill D, Washington K, White OR. The effect of hippotherapy on postural control in sitting for children with cerebral palsy. Phys Occup Ther Pediatr. 2007;27:23–42. doi:10.1080/J006v27n04_03

 PubMedGoogle Scholar

Harris SR, Riffle K. Effects of inhibitive ankle-foot orthoses on standing balance in a child with cerebral palsy: A single-subject design. Phys Ther. 1986;66:663–67. doi:10.1093/ptj/66.5.663

 PubMed Web of Science ®Google Scholar

Hartveld A, Hegarty J. Frequent weightshift practice with computerised feedback by cerebral palsied children - Four single-case experiments. Physiotherapy. 1996;82:573–80. doi:10.1016/S0031-9406(05)66300-6

 Google Scholar

Havstam C, Buchholz M, Hartelius L. Speech recognition and dysarthria: A single subject study of two individuals with profound impairment of speech and motor control. Logop Phoniatr Vocol. 2003;28:81–90. doi:10.1080/14015430310015372

 PubMedGoogle Scholar

Hinderer KA, Harris SR, Purdy AH, Chew DE, Staheli LT, McLaughlin JF, Jaffe KM. Effects of ‘tone-reducing’ vs. standard plaster-casts on gait improvement of children with cerebral palsy. Dev Med Child Neurol. 1988;30:370–77.

 PubMed Web of Science ®Google Scholar

Iammatteo PA, Trombly C, Luecke L. The effect of mouth closure on drooling and speech. Am J Occup Ther. 1990 official publication of the American Occupational Therapy Association;44:686–91. doi:10.5014/ajot.44.8.686

 PubMed Web of Science ®Google Scholar

Jelsma J, Pronk M, Ferguson G, Jelsma-Smit D. The effect of the Nintendo Wii Fit on balance control and gross motor function of children with spastic hemiplegic cerebral palsy. Dev Neurorehabil. 2013;16:27–37. doi:10.3109/17518423.2012.711781

 PubMed Web of Science ®Google Scholar

Johnson BA, Salzberg C, MacWilliams BA, Shuckra AL, D’Astous JL. Plyometric training: effectiveness and optimal duration for children with unilateral cerebral palsy. Pediatr Phys Ther. 2014;26:169–79. doi:10.1097/PEP.0000000000000012

 PubMed Web of Science ®Google Scholar

Kelly ME, Darrah J, Sobsey R, Haykowsky M, Legg D. Effects of a community-based aquatic exercise program for children with cerebral palsy: a single subject design. J Aquat Phys Ther. 2009;17:1–11.

 Google Scholar

Kenyon LK, Farris JP, Aldrich NJ, Rhodes S. Does power mobility training impact a child’s mastery motivation and spectrum of EEG activity? An exploratory project. Disability Rehabili. 2018;13:665–73. doi:10.1080/17483107.2017.1369587.

 Web of Science ®Google Scholar

Kinghorn J, Roberts G. The effect of an inhibitive weight-bearing splint on tone and function: a single-case study. Am J Occup Ther. 1996 official publication of the American Occupational Therapy Association;50:807–15. doi:10.5014/ajot.50.10.807

 PubMed Web of Science ®Google Scholar

Ko MS, Lee JA, Kang SY, Jeon HS. Effect of Adeli suit treatment on gait in a child with cerebral palsy: a single-subject report. Physiother Theory Pract. 2015;31:275–82. doi:10.3109/09593985.2014.996307

 PubMed Web of Science ®Google Scholar

Laessker-Alkema K, Eek MN. Effect of knee orthoses on hamstring contracture in children with cerebral palsy: multiple single-subject study. Pediatr Phys Ther. 2016;28:347–53. doi:10.1097/PEP.0000000000000267

 PubMed Web of Science ®Google Scholar

Lammi BM, Law M. The effects of family-centred functional therapy on the occupational performance of children with cerebral palsy. Can J Occup Ther. 2003;70:285–97. doi:10.1177/000841740307000505

 PubMedGoogle Scholar

Laskas CA, Mullen SL, Nelson DL, Willson-Broyles M. Enhancement of two motor functions of the lower extremity in a child with spastic quadriplegia. Phys Ther. 1985;65:11–16. doi:10.1093/ptj/65.1.11

 PubMed Web of Science ®Google Scholar

Lephart K, Kaplan SL. Two seating systems’ effects on an adolescent with cerebral palsy and severe scoliosis. Pediatr Phys Ther. 2015;27:258–66. doi:10.1097/PEP.0000000000000163

 PubMed Web of Science ®Google Scholar

Lewis J, Pin T. Dynamic elastomeric fabric orthosis in managing shoulder subluxation in children with severe cerebral palsy: A case series. Dev Med Child Neurol. 2016;58:61.

 PubMedGoogle Scholar

Lilly LA, Powell NJ. Measuring the effects of neurodevelopmental treatment on the daily living skills of 2 children with cerebral palsy. Am J Occup Ther. 1990 official publication of the American Occupational Therapy Association;44:139–45. doi:10.5014/ajot.44.2.139

 PubMed Web of Science ®Google Scholar

Lin CY, Chang YM. Increase in physical activities in kindergarten children with cerebral palsy by employing MaKey-MaKey-based task systems. Res Dev Disabil. 2014;35:1963–69. doi:10.1016/j.ridd.2014.04.028

 PubMed Web of Science ®Google Scholar

Lin CY, Chang YM. Interactive augmented reality using Scratch 2.0 to improve physical activities for children with developmental disabilities. Res Dev Disabil. 2015;37:1–8. doi:10.1016/j.ridd.2014.10.016

 PubMed Web of Science ®Google Scholar

Mackey S. The use of computer-assisted feedback in a motor control task for cerebral palsied children. Physiotherapy. 1989;75:143–48. doi:10.1016/S0031-9406(10)62767-8

 Google Scholar

Man DW, Wong MS. Evaluation of computer-access solutions for students with quadriplegic athetoid cerebral palsy. Am J Occup Ther. 2007 official publication of the American Occupational Therapy Association;61:355–64. doi:10.5014/ajot.61.3.355

 PubMed Web of Science ®Google Scholar

Matthews MJ, Watson M, Richardson B. Effects of dynamic elastomeric fabric orthoses on children with cerebral palsy. Prosthet Orthot Int. 2009;33:339–47. doi:10.3109/03093640903150287

 PubMed Web of Science ®Google Scholar

McCarthy JH, Hogan TP, Beukelman DR, Schwarz IE. Influence of computerized sounding out on spelling performance for children who do and do not rely on AAC. Disabil Rehabil. 2015 Assistive technology;10:221–30. doi:10.3109/17483107.2014.883650

 Web of Science ®Google Scholar

McConnell K, Johnston L, Kerr C. Efficacy and acceptability of reduced intensity constraint-induced movement therapy for children aged 9–11 years with hemiplegic cerebral palsy: a pilot study. Phys Occup Ther Pediatr. 2014;34:245–59. doi:10.3109/01942638.2013.866611

 PubMed Web of Science ®Google Scholar

Owen SE, Stern LM. Management of drooling in cerebral palsy: three single case studies. Int J Rehabil Res. 1992;15:166–69.

 PubMedGoogle Scholar

Pinder GL, Olswang LB. Development of communicative intent in young children with cerebral palsy: a treatment efficacy study. Infant-Toddler Intervention. 1995;5:51–69.

 Google Scholar

Pool D, Blackmore AM, Bear N, Valentine J. Effects of functional electrical stimulation in children with spastic hemiplegia. Dev Med Child Neurol. 2014;56:9–10. doi:10.1111/dmcn.12296

 PubMedGoogle Scholar

Pool D, Blackmore AM, Bear N, Valentine J. Effects of short-term daily community walk aide use on children with unilateral spastic cerebral palsy. Pediatr Phys Ther. 2014;26:308–17. doi:10.1097/PEP.0000000000000057

 PubMed Web of Science ®Google Scholar

Pratt B, Hartshorne NS, Mullens P, Schilling ML, Fuller S, Pisani E. Effect of playground environments on the physical activity of children with ambulatory cerebral palsy. Pediatr Phys Ther. 2016;28:475–82. doi:10.1097/PEP.0000000000000318

 PubMed Web of Science ®Google Scholar

Prosser LA, Ohlrich LB, Curatalo LA, Alter KE, Damiano DL. Feasibility and preliminary effectiveness of a novel mobility training intervention in infants and toddlers with cerebral palsy. Dev Neurorehabil. 2012;15:259–66. doi:10.3109/17518423.2012.687782

 PubMed Web of Science ®Google Scholar

Prosser LA, Ohlrich L, Curatalo L, Alter K, Damiano D. Novel mobility training in prewalking toddlers with cerebral palsy. Dev Med Child Neurol. 2012;54:23. doi:10.1111/j.1469-8749.2012.04387.x.

 PubMedGoogle Scholar

Ramani KK, Police SR, Jacob N. Impact of low vision care on reading performance in children with multiple disabilities and visual impairment. Indian J Ophthalmol. 2014;62:111–15. doi:10.4103/0301-4738.111207

 PubMed Web of Science ®Google Scholar

Ray SA, Bundy AC, Nelson DL. Decreasing drooling through techniques to facilitate mouth closure. Am J Occup Ther. 1983;37:749–53. doi:10.5014/ajot.37.11.749

 PubMed Web of Science ®Google Scholar

Reid D, Rigby P, Ryan S. Functional impact of a rigid pelvic stabilizer on children with cerebral palsy who use wheelchairs: users’ and caregivers’ perceptions. Pediatr Rehabil. 1999;3:101–18.  doi:10.1080/136384999289513.

 PubMedGoogle Scholar

Retarekar R, Fragala-Pinkham MA, Townsend EL. Effects of aquatic aerobic exercise for a child with cerebral palsy: single-subject design. Pediatr Phys Ther. 2009;21:336–44. doi:10.1097/PEP.0b013e3181beb039

 PubMed Web of Science ®Google Scholar

Rigby P, Reid D, Schoger S, Ryan S. Effects of a wheelchair-mounted rigid pelvic stabilizer on caregiver assistance for children with cerebral palsy. Assistive Technol. 2001;13:2–11. doi:10.1080/10400435.2001.10132029

 PubMed Web of Science ®Google Scholar

Rintala P, Era P. Posture control in children with cerebral palsy; a pilot study. J Rehabil Sci. 1994;7:9–14.

 Google Scholar

Rivi E, Filippi M, Fornasari E, Mascia MT, Ferrari A, Costi S. Effectiveness of standing frame on constipation in children with cerebral palsy: a single-subject study. Occup Ther Int. 2014;21:115–23. doi:10.1002/oti.1370

 PubMed Web of Science ®Google Scholar

Sakemiller LM, Nelson DL. Eliciting functional extension in prone through the use of a game. Am J Occup Ther. 1998 official publication of the American Occupational Therapy Association;52:150–57. doi:10.5014/ajot.52.2.150

 PubMed Web of Science ®Google Scholar

Sheppard L, Mudie H, Froude E. An investigation of bilateral isokinematic training and neurodevelopmental therapy in improving use of the affected hand in children with hemiplegia. Phys Occup Ther Pediatr. 2007;27:5–25. doi:10.1080/J006v27n01_02.

 PubMedGoogle Scholar

Shumway-Cook A, Hutchinson S, Kartin D, Price R, Woollacott M. Effect of balance training on recovery of stability in children with cerebral palsy. Dev Med Child Neurol. 2003;45:591–602.

 PubMed Web of Science ®Google Scholar

Siconolfi-Morris GC. Use of a video game based balance training intervention on the balance and function of children with developmental disabilities [dissertation]. Lexington (KY): University of Kentucky; 2012.

 Google Scholar

Smelt HR. Effect of an inhibitive weight-bearing mitt on tone reduction and functional performance in a child with cerebral palsy. Phys Occup Ther Pediatr. 1989;9:53–80.

 PubMedGoogle Scholar

Smithers JA. Facilitation of rolling in a child with athetoid cerebral palsy - A single-subject design. Physiotherapy. 1991;77:243–48. doi:10.1016/S0031-9406(10)61742-7

 Google Scholar

Soto G, Yu B, Kelso J. Effectiveness of multifaceted narrative intervention on the stories told by a 12-year-old girl who uses AAC. Augment Altern Commun. 2008;24:76–87. doi:10.1080/07434610701740612

 PubMed Web of Science ®Google Scholar

Stansfield S, Dennis C, Larin H, Gallagher C. Movement-based VR gameplay therapy for a child with cerebral palsy. Annu Rev CyberTher Telemedicine. 2015;13:153–57.

 Web of Science ®Google Scholar

Stewart H, Noble G, Seeger BR. Isometric joystick: A study of control by adolescents and young adults with cerebral palsy. Aust Occup Ther J. 1992;39:33–39. doi:10.1111/j.1440-1630.1992.tb01733.x

 PubMedGoogle Scholar

Stewart H, Wilcock A. Improving the communication rate for symbol based, scanning voice output device users. Technol Disability. 2000;13:141–50. doi:10.3233/TAD-2000-13301

 Google Scholar

Svedberg LE, Nordahl UE, Lundeberg TC. Effects of acupuncture on skin temperature in children with neurological disorders and cold feet: an exploratory study. Complement Ther Med. 2001;9:89–97. doi:10.1054/ctim.2001.0436

 PubMed Web of Science ®Google Scholar

Symons FJ, Tervo RC, Kim O, Hoch J. The effects of methylphenidate on the classroom behavior of elementary school-age children with cerebral palsy: A preliminary observational analysis. J Child Neurol. 2007;22:89–94. doi:10.1177/0883073807299965

 PubMed Web of Science ®Google Scholar

Thorpe DE, Valvano J. The effects of knowledge of performance and cognitive strategies on motor skill learning in children with cerebral palsy. Pediatr Phys Ther. 2002;14:2–15.

 PubMedGoogle Scholar

Ustad T, Sorsdahl AB, Ljunggren AE. Effects of intensive physiotherapy in infants newly diagnosed with cerebral palsy. Pediatr Phys Ther. 2009;21:140–49. doi:10.1097/PEP.0b013e3181a3429e

 PubMedGoogle Scholar

Voulgarakis H, Forte S. Escape extinction and negative reinforcement in the treatment of pediatric feeding disorders: A single case analysis. Behav Anal Pract. 2015;8:212–14. doi:10.1007/s40617-015-0086-8

 PubMed Web of Science ®Google Scholar

Ward R, Leitao S, Strauss G. An evaluation of the effectiveness of PROMPT therapy in improving speech production accuracy in six children with cerebral palsy. Int J Speech Lang Pathol. 2014;16:355–71. doi:10.3109/17549507.2013.876662

 PubMed Web of Science ®Google Scholar

Ward R, Strauss G, Leitao S. Kinematic changes in jaw and lip control of children with cerebral palsy following participation in a motor-speech (PROMPT) intervention. Int J Speech Lang Pathol. 2013;15:136–55. doi:10.3109/17549507.2012.713393

 PubMed Web of Science ®Google Scholar