WoS İndeksli Yayınlar Koleksiyonu

Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6

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Author: search.filters.author.Balikci, AymenSubject: search.filters.subject.Enriched Environment

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  • Article
    Implementation of the Homeostasis-Enrichment (Hep®) Approach for an Infant at Risk for Autism Spectrum Disorder: A Case Report
    (Necmettin Erbakan Univ, Fac Medicine-Neu Press, 2025) Balikci, Aymen; Balikci, Ayse Firdevs Aracikul; Demirbag, Izgi Miray; Sirma, Gamze Cagla; Beaudry-Bellefeuille, Isabelle; May-Benson, Teresa A.
    Background and Clinical Significance: This case report explicates the implementation and outcomes of the Homeostasis-Enrichment-Plasticity (HEP (R)) Approach in a 10-month-old male infant with an increased risk of Autism Spectrum Disorder (ASD) who exhibited challenges in sensory functioning and motor development. Case Presentation: The intervention was carried out utilizing the eleven-step HEP (R) Approach process. The Peabody Developmental Motor Scale-2 (PDMS-2), Test of Sensory Function in Infants (TSFI), Adaptive Behavior Assessment System-3 (ABAS-3), and Goal Attainment Scale (GAS) were used as outcome measures before and after the intervention. A pediatric physical therapist conducted an hour-long intervention weekly for 10 weeks using the HEP (R) Approach implementation guide. Post-intervention, the infant's fine and gross motor skill scores in the PDMS-2 and General Adaptive Composite in the ABAS-3 exhibited significant improvement, as determined by the 95% confidence interval overlap analysis. The TSFI total score also improved categorically. An overall GAS score of +1.6 corresponded to a t-score of 74.12, indicating significant progress towards the individualized intervention goals. Conclusions: The HEP (R) Approach enhanced motor development, sensory functioning, general adaptive skills, and parental goals in a 10-month-old infant at risk for ASD. The results support further examination of the HEP approach's effectiveness in infants at risk for ASD.
  • Article
    Citation - WoS: 3
    Citation - Scopus: 2
    Hep® (homeostasis-Enrichment Approach Changes Sensory-Motor Development Trajectory and Improves Parental Goals: a Single Subject Study of an Infant With Hemiparetic Cerebral Palsy and Twin Anemia Polycythemia Sequence (taps)
    (Mdpi, 2024) Balikci, Aymen; May-Benson, Teresa A.; Sirma, Gamze Cagla; Ilbay, Gul
    Background: Early intervention (EI) for infants identified as being at high risk for cerebral palsy (CP), or who have been diagnosed with it, is critical for promotion of postnatal brain organization. The aim of this study was to explore the effectiveness of the Homeostasis-Enrichment-Plasticity (HEP) Approach, which is a contemporary EI model that applies the key principles of enriched environment paradigms and neuronal plasticity from experimental animal studies to ecological theories of human development on the motor development, sensory functions, and parental goals of an infant with twin anemia polycythemia sequence (TAPS) and CP. Methods: An AB phase with follow-up single case study design which consisted of multiple baseline assessments with the Peabody Developmental Motor Scales-2 (PDMS-2) and the Test of Sensory Functions in Infants (TSFI) was used. Non-overlapping confidence intervals analysis was used for pre-post PDMS-2 scores. The measurement of progress toward goals and objectives was conducted using the Goal Attainment Scale (GAS). The HEP Approach intervention consisted of 12 one-hour sessions implemented over a period of 3 months, where a physical therapist provided weekly clinic-based parental coaching. Results: Results found a stable baseline during Phase A and improvement in response to the HEP Approach intervention during Phase B in both the PDMS-2 and TSFI according to 2SD Band analysis. The confidence intervals for the PDMS-2 scores also indicated a significant improvement after HEP intervention. The scores for both the PDMS-2 and the TSFI were consistent or showed improvement throughout the Follow-Up phase. A GAS t-score of 77.14 indicated that the infant exceeded intervention goal expectations. Conclusions: Although our findings suggest that the HEP Approach intervention has promise in enhancing sensory functions, motor skill outcomes, and parental goals in an infant with TAPS and CP, further research is required to validate and apply these results more broadly.
  • Article
    Citation - WoS: 6
    Citation - Scopus: 4
    Exploring Effects of the Hep (homeostasis-Enrichment Approach as a Comprehensive Therapy Intervention for an Infant With Cerebral Palsy: a Case Report
    (Georg Thieme verlag Kg, 2022) Balikci, Aymen; Ballkcı, Aymen
    Cerebral palsy (CP) is a common non-progressive neurodevelopmental disorder which causes developmental disabilities in children. Varied interventions for CP exist to address medical and physical needs but with limited effectiveness evidence. Environmental enrichment (EE) is an animal model intervention for many neurodevelopmental disorders, including CP, with considerable positive effects. This case report defines the Homeostasis-Enrichment-Plasticity (HEP) approach, which is based upon principles of EE and ecological theories of development and describes its use to promote the developmental and functional skills of an infant with CP. Parent interviews and assessment data were completed before and after intervention. For the interested parameters data was gathered by developmental history, systematic observation of behaviors in the clinical setting and at home, Beck Anxiety Inventory (BAI), Infant-Toddler Symptom Checklist, the Sensory Profle Infant/Toddler, Peabody Developmental Motor Scales-2, Gross Motor Function Measurement-88 (GMFM-88), the Gross Motor Function Classification System (GMFCS), and Pediatric Evaluation of Disability Inventory (PEDI). The HEP approach intervention was implemented one time per week for 12 months. Following the HEP approach intervention, self-regulation and sensory processing scores improved. GMFM-88 total score improved from 45/264 to 123/264. The Peabody found all gross motor (54-110), fine motor (65-117), and total motor quotient (119-227) scores improved after intervention. Post-intervention observations showed obvious gross motor progress with movement from GMFCS Level IV to Level I. Performance on the Functional Skills Scales and Caregiver Assistance Scales of PEDI also demonstrated notable improvements. BAI scores revealed low anxiety scores for both the mother (13/63 points) and father (14/63) before intervention. These scores did not change after intervention. A definition and detailed description of the HEP approach intervention is presented here for the first time. The case report demonstrated preliminary evidence for the effectiveness of the HEP approach on self-regulation, sensory processing, motor development, functional skills, and caregiver assistance with an infant with CP. Additional studies are needed to validate the findings.