Efficacy of parent-delivered behavioral therapy for primary complex motor stereotypies

Aim: Primary complex motor stereotypies (CMS) are persistent, patterned, repetitive, rhythmic movements in young people with typical development. This study evaluated the efficacy of an instructional DVD as a home-based, parent-administered, behavioral therapy for primary CMS. Method: Eighty-one children with primary CMS were enrolled. Primary outcome measures included the Stereotypy Severity Scale (SSS) – Motor and Impairment scores, and Stereotypy Linear Analog Scale (SLAS). Mean CMS onset was 13.4 months (SD 13.1). Eligibility required observed CMS. Psychiatric disorders were not exclusionary and a stable medication regimen was required. Intellectual disability, neurological disorder, autism spectrum disorder, and tics were exclusionary. Initial assessments were completed via REDCap before receipt of the DVD. Fifty-four of the 81 children (34 male, 20 female; mean age 8y 2mo, SD 1.42, range 7–14y) completed assessments at 1, 2, or 3 months after receiving the DVD. Results: Reductions (baseline to last assessment) in SSS Motor, SSS Impairment, and SLAS scores (all p<0.001) represented change ratios of −15%, −24%, and a −20% respectively. Greatest relative treatment benefit was observed by younger children (ages 7–8y), and by 1 month after receipt of DVD, while a parent global assessment scale showed progressive improvement throughout the study. Interpretation: An instructional DVD for parent-delivered behavioral therapy was a safe, effective intervention for primary CMS.