The Efficacy of Neurodevelopmental Treatment in Paediatrics: A Systematic Review

Abstract

Neurodevelopmental treatment (NDT) is widely used by clinicians when working with children diagnosed with neurological dysfunction, such as cerebral palsy, high-risk/low-birthweight infants or traumatic brain injury. The objective of this project was to determine the efficacy of NDT, used with a group of paediatric subjects diagnosed with a neurological dysfunction, through the completion of a systematic search and review of the relevant published research literature. Using a computerised literature search strategy of nine databases, expert consultation, and a hand search of 14 relevant journals and reference lists, 147 relevant citations were identified for consideration. Of the 147 articles reviewed, 17 met the inclusion criteria for further review. These studies were assessed for concealment of treatment allocation (Shulz et al 1995), quality assessment of randomised clinical trial using the Jadad scale (Jadad et al 1996) and level of evidence using the Sackett scale (Sackett 1989). A level of agreement between the two independent reviewers was calculated for each step of the systematic review process using the kappa statistic (κ). Tables containing the details and status of the 17 studies are included. Overall, the results regarding the efficacy of NDT were largely inconclusive since there were a similar number of published research studies supporting the benefit of NDT intervention (n=6) as compared with no benefit (n=9). One study did not specifically address the efficacy of NDT, while another study was unclear as to whether or not NDT was beneficial. The studies that included the use of NDT with paediatric subjects diagnosed with cerebral palsy also had inconsistent results regarding the efficacy of NDT. The studies that included the use of NDT with high-risk/low-birthweight infants did not support the usefulness of NDT with this paediatric client group. A detailed description of the systematic review process used in the completion of this paper is also included.