Objective: This study aims to statistically clarify the association between disability characteristics and school refusal in school-aged children with Autism Spectrum Disorder (ASD).Methods: The subjects were 158 school-aged children with ASD who were prescribed rehabilitation at Narita Hospital of International University of Health and Welfare. The following information was collected from medical records: presence or absence of school refusal, age, gender, the Autism Screening Questionnaire (ASQ) scores, result of the Wechsler Intelligence Test 4th version, the Sensory Profile (SP) scores, the Liebowitz Social Anxiety Scale for Children and Adolescents scores, decline in family functions, bullying, and enrolled class. Poisson regression analysis was conducted using both crude and adjusted models. School refusal was the dependent variable, while ASQ and SP subcategories were the independent variables. Age and other factors were used as covariates in the adjusted model.Results: The “sensory avoidance” of the SP subcategory was significantly associated with school refusal in both the crude and adjusted models (odds ratio, 95% confidence interval: 1.03, 1.01-1.05, 1.03, 1.00-1.05, respectively).Conclusion: Analysis of the association between disability characteristics and school refusal in school-aged children with ASD suggests that sensory processing deficits are associated with school refusal.

Objective: This study aims to statistically clarify the association between disability characteristics and school refusal in school-aged children with Autism Spectrum Disorder (ASD).Methods: The subjects were 158 school-aged children with ASD who were prescribed rehabilitation at Narita Hospital of International University of Health and Welfare. The following information was collected from medical records: presence or absence of school refusal, age, gender, the Autism Screening Questionnaire (ASQ) scores, result of the Wechsler Intelligence Test 4th version, the Sensory Profile (SP) scores, the Liebowitz Social Anxiety Scale for Children and Adolescents scores, decline in family functions, bullying, and enrolled class. Poisson regression analysis was conducted using both crude and adjusted models. School refusal was the dependent variable, while ASQ and SP subcategories were the independent variables. Age and other factors were used as covariates in the adjusted model.Results: The “sensory avoidance” of the SP subcategory was significantly associated with school refusal in both the crude and adjusted models (odds ratio, 95% confidence interval: 1.03, 1.01-1.05, 1.03, 1.00-1.05, respectively).Conclusion: Analysis of the association between disability characteristics and school refusal in school-aged children with ASD suggests that sensory processing deficits are associated with school refusal.

Objective: To evaluate the reliability and validity of this new measure, called the caregivers’ fear of falling index (CFFI). Methods: The study surveyed home-based rehabilitation patients with fall-related fracture, and their primary caregivers. The characteristics of these patients were evaluated, and the caregivers were surveyed using the CFFI and Falls Efficacy Scale-International (FES-I). The reliability of the CFFI was assessed using item-total correlation, while the validity of the CFFI was evaluated through correlation coefficients calculated between the CFFI and the FES-I. Results: The participants were 51 patient-caregiver pairs. The internal consistency of the CFFI showed an alpha coefficient of 0.904. No items were excluded in the corrected item-total correlations. The CFFI showed a moderate correlation with FES-I (r=0.432, p=0.002). Conclusion This study found the CFFI to be a reliable and valid tool for measuring the primary caregivers’ fear. The CFFI may be a useful tool for healthcare professionals to identify and supporting these primary caregivers.

Background : The aim of this study was to assess the effects of repeated injections of botulinum toxin type A (BoNT-A) combined with a rehabilitative program for treating spastic upper limb hemiparesis after stroke. Subjects and methods: Subjects were 112 poststroke hemiparetic patients with spastic upper limb (mean age : 55.5±11.6 years ±SD, mean period between onset and first injection : 5.1±3.5 years). For each patient, BoNT-A (maximum dose of each injection : 240 units) was injected in the spastic muscles of the affected upper limb twice with a minimum interval of 3 months. Following each injection, detailed one-to-one instructions for homebased functional training was provided. At the baseline (before injection) and at 1 and 3 month follow-ups after each injection, the patient's modified Ashworth scale (MAS), the range of motion (ROM) and Fugl-Meyer Assessment (FMA) were evaluated. Results : The total score for the upper limb and the scores of categories A and B of the FMA increased significantly not only after the first injection but after the second injection compared with the second baseline, while the FMA score for category D increased significantly only after the second injection. MAS also decreased significantly not only after the first injection but after the second injection compared to the second baseline. Conclusion : A more significant improvement was found not only in muscle spasticity but also in upper limb motor function after two BoNT-A injections. It is suggested that repeated BoNT-A injections followed by a comprehensive rehabilitative program would be an effective treatment for limb spasticity after a stroke.