EXPLORATORY BEHAVIORAL VIDEO CODING OF A TRADITIONAL HAND-ARM BIMANUAL INTENSIVE TRAINING (HABIT) CAMP

Purpose: To explore if participant behaviors were congruent with the intervention principles of a traditional HABIT camp through behavioral coding.

Hypothesis: Children who participated in a traditional HABIT program would demonstrate bimanual behaviors and social engagement with peers.

Subjects: Five children(2 males) with unilateral cerebral palsy(CP), classified at GMFC levels I-II and MACS levels I-III(Mean age=8.8, SD=1.6)

Methods: The HABIT program was administered for 4 hrs/day , five days/week, over 2 weeks. Interventionists and volunteers emphasized intensive, child-active, repetitive practice of bimanual activities and facilitated social engagement among participants. Interrater reliability among coders was established( < 85%), and one random 30-minute portion of the intervention video was coded per participant to measure bimanual contacts, ventral contacts, open-handed contacts, bimanual manipulation, and social engagement. Outcomes were calculated as a percentage of time(per duration of video).

Results: Children spent more time bimanually contacting objects(Mean=53.2%, SD=25.6), with the impaired hand being open and ventral(Mean=43.5%, SD= 21.8), but less time on bimanual manipulation(Mean=9.9%, SD= 12.4). Children were socially engaged during activities(Mean=41.7%, SD= 15.5).

Conclusions: Findings suggested that during a traditional HABIT camp, participants were performing gross motor, bimanual, tasks with open and ventral hand contacts using their involved extremity but were not as engaged in bimanual manipulative tasks. Social engagement was evident, not dominant in the samples.

Clinical Relevance: This use of video coding provided information about the participant's behaviors related to bimanual activities and social engagement with peers. It may be helpful to understand and develop fidelity outcomes in HABIT programs in future studies.