Is this the best PhD dissertation produced by a Swede in the last 20 years?


The doctoral dissertation that the title asks for has recently been published on Research Gate and can also be downloaded here. I, who stick out my chin here and dare to say that it is actually so, have had the great honor of being the head supervisor for Mats Niklasson. It should be acknowledged that I am absolutely buzzing with pride for having been involved in this adventure.



During my time as professor of Experimental Psychology at Karlstad University I heard rumors that the husband and wife Mats and Irene Niklasson (then working in Mönsterås, now in Kalmar) successfully managed to treat children with various forms of motor problems. The treatment also produced positive results for children diagnosed with a variety of other disabilities. Professionally, they were trained in physical education. That's why I thought it would be interesting to invite the couple for a discussion at one of our seminars for doctoral students.


Mr. Niklasson accepted the challenge and gave a particularly interesting lecture on the spouses' activities at their company Vestibularis. It turned out that they received no support from the established care of children and adolescents psychiatry (BUP) or from physiotherapists despite the many promising anecdotal resultsThe parents had to pay for their children’s treatment themselves.


In addition, Mr. Niklasson told us also that they had built up a medical record system of over 200 treated children in collaboration with a European certified registry system that makes recurring checks that everything is handled properly. It also emerged that they used three established tests before and after treatment: Teacher Rating Scale (TRS), Parents Symptom Questionnaire (PSQ), and Keystone Visual Skills test (KVS). But they did not know how to evaluate them. Add to that that there was a wealth of data on a large number of so-called primitive reflexes with measurement results before and after!


As you understand, the hair on my arms rose. Here we talk about a database of very large potential value!


Mr. Niklasson must read psychology!

Immediately after the lecture, I had a private meeting with Mr. Niklasson. I offered him the opportunity to read psychology. He seemed a little interested (hurray!) although he also hesitated and strongly emphasized that he must prioritize the business at Vestibularis.


After negotiations, we came to the conclusion that he could borrow all needed literature that would cover the requirements for A- to C-levels (beginner to BA). A prerequisite was also that he had to make the trip up to Karlstad on a few occasions to test his knowledge in different parts of the curriculum for me personally.


A requirement on my part, and a prerequisite for me to continue my interest in the project, was that he must write a C-thesis (i.e. Bachelor Thesis) and that it should conveniently be designed as a psychometric report on the activities at Vestibularis. Then we shook hands!


The Quantitative Bachelor Thesis

The C-level essay became a sensation in itself. On the basis of the above three established tests and three new ones (Physiological test; Orientation and Balance test; Audiometric test) it became clear that the spouses Mats and Irene Niklasson conducted a very successful operation at the Vestibularis clinic.


The report had such a high level and was so important that it simply had to be translated into English and submitted to a scientific journal. So it became [Niklasson, M., Niklasson, I., & Norlander, T. (2009). Sensorimotor therapy: Using stereotypic movements and vestibular stimulation to increase sensorimotor proficiency of children with attentional and motor difficulties. Perceptual and Motor Skills, 108, 643-669].


The qualitative (and quantitative) Master Thesis

As you understand, the three musketeers, Mats-Irene-myself, craved for more after the success of the first report. First I tried to get Mr. Niklasson to follow a graduate student track, but there he was not interested ("there is no chance, I have neither the time, desire or finances"). Mr. Niklasson thought it was enough to make new reports and I simply had to accept that. But after many attempts at persuasion, I managed to get him to enroll at the D-level course (Master of Science) on the condition that the arrangements were the same as for the C-level. We also agreed that he must do a D-essay.


When it was time to write the D-essay, it came to be about an interesting phenomenon that the Niklassons had identified. It seemed that the physical exercises that were carried out led to the children getting psychological regressions, which is, by the way, a common phenomenon for many psychological treatment methods. On the basis of the same cohort used during the C-thesis, eight random entries were analyzed using a phenomenological method (the EPP method) after a random procedure.


It turned out that it was possible to describe the phenomenon in the form of a model with an upward curve with three distinctive regression phases. The model inspired Irene and Mats Niklasson to dig into and analyze the entire cohort in comparison with the qualitative result and they found that it was possible to quantitatively determine that the model broadly applied to the entire cohort, a result that, incidentally, could be shown in recent reports.


Sensorimotor therapy could no longer be dismissed as something that had nothing to do with psychology. Previously, I had received objections like "Why are you fiddling with PE teachers, that it is not psychology!". Of course the report also appeared as an article in a reputable psychological magazine [Niklasson, M., Niklasson, I., & Norlander, T. (2010). Sensorimotor therapy: Physical and Psychological regressions contribute to improved kinesthetic and vestibular capacity in children and adolescents with motor difficulties and concentration problems. Social Behavior and Personality, 38, 327-346].


University of Bolton

Because I left Karlstad University to become an affiliated Professor of Medical Psychology at the Karolinska Institute with my activity taking place in the research and education company Evidens (by the way, now recognized by the Swedish Higher Education Authority (UKÄ) as Evidens University College) we partially left each other. Despite this, we continued to compose reports from time to time, following Swedish ethics legislation with, among others, support from the Regional Ethics Committee in Uppsala. A leading Swedish physician and pediatric neurologist, MD, PhD, Associate Professor Peder Rasmussen from the Sahlgrenska Academy, joined the author group.


It was only after we had published five articles (four indexed in Webb of Science and Scopus and one in MedLine) that we found a way for Mats to write a Critical Commentary (called a “kappa” in Swedish) and get it presented at a university. The Viva took place recently with the help of Skype (because of the British lockdown following the Corona virus) at Bolton University where I have an affiliation.


In the British system there is a special route to PhD which is called Doctor of Philosophy by Publication: Retrospective Route. In short, this means that you present your published work to the university and if it is considered to be of quality, you can apply for doctoral studies, and if accepted you start work on your “kappa”. However, a prerequisite is that a professor that is well-known for the university has been helpful with article production. You will find more details on this in the Thesis.


Below you can download Dr. Niklasson's Critical Commentary (“kappa”), which in itself will become a classic: 


Niklasson, M. (2020). The importance of grounded assessments and interventions: Towards a new framework for Developmental Coordination Disorder. Bolton, UK: PhD by publication, University of Bolton.