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B Cunha A, Orlando JM, Alghamdi ZS, Lobo MA. Depth and Quality of Recommendations in Popular Sources About How to Play with Infants: Content Analysis. Phys Occup Ther Pediatr 2024:1-23. [PMID: 38952029 DOI: 10.1080/01942638.2024.2371807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/19/2024] [Indexed: 07/03/2024]
Abstract
AIM Systematically evaluate the depth and quality of play recommendations provided in popular sources for parents of infants in the first year of life. METHODS This represents the second stage of a larger analysis of educational content available to parents. Two coders (>90% agreement) extracted and coded play activities from popular websites, applications, and books screened from a systematic online search. Depth of instruction variables were extracted. Activity quality was rated based on opportunities for child-initiated movement, problem-solving with objects, and responsive communication. RESULTS 4370 play activities from 214 sources were analyzed. Activities were likely to suggest specific ages for infants and that a caregiver be present. Less than half of the activities incorporated toys or provided guidance about how to position or physically support infants. Activity quality was low; most activities did not explicitly encourage parents to provide opportunities for child-initiated movement, problem-solving with objects, or quality communication. CONCLUSIONS Parents may encounter a large number of play activities in popular sources, but the depth of instruction and quality of those activities could be improved. Provision of higher-quality education to parents may enhance parent-child play interactions to positively impact parent and child outcomes, especially for children at risk for delays.
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Affiliation(s)
- Andrea B Cunha
- Department of Physical Therapy, Munroe Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Julie M Orlando
- Department of Physical Therapy and Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
| | - Zainab S Alghamdi
- Department of Physical Therapy and Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
| | - Michele A Lobo
- Department of Physical Therapy and Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
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Duncan AF, Gerner GJ, Neel ML, Burton VJ, Byrne R, Warschausky S. Interventions to improve executive functions in children aged 3 years and under: A systematic review. Child Care Health Dev 2024; 50:e13298. [PMID: 38958229 DOI: 10.1111/cch.13298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/27/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Early executive functioning (EF) skills are foundational capabilities that predict school readiness, academic development and psychiatric risk. Early interventions enhancing these capabilities could have critical import in improving outcomes. However, to develop interventions, it is necessary to identify specific EF skills that will vary with child age. Thus, we aimed to examine the characteristics and efficacy of interventions targeting EF in infancy and early childhood up to age 3. METHODS A comprehensive search of PubMed, Embase, CINAHL and APA PsycINFO databases was performed for studies published before December 2022. Randomized and non-randomized studies of interventions designed to improve at least one EF skill in children ≤3 years were included. EF skills included attentional control, inhibition/self-regulation, activity initiation, working memory, cognitive flexibility, planning ability, problem-solving and performance monitoring. We independently extracted data, used the revised Cochrane Risk-of-Bias tool to assess the quality of the evidence and conducted Synthesis Without Meta-analysis (SWiM). The overall quality of the evidence and the strength of recommendations was determined using elements of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS Thirty-five studies met inclusion criteria (original n = 7467). Studies were highly variable in the EF skill targeted, target subject (i.e., child, parent and teacher), nature and dosage of the intervention, and timing of outcome assessment. Most interventions focused on improving impulse control and self-regulation. The overall quality of evidence was low to moderate with a high risk of bias, though six studies had low risk of bias but yielded mixed findings of efficacy. CONCLUSIONS The relatively small number of early EF intervention studies uses such variable methods that there is currently no converging evidence of efficacy to recommend a specific intervention. Thus, findings support the need for a more systematic, targeted approach to the design and implementation of early EF interventions for target populations.
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Affiliation(s)
- Andrea F Duncan
- Department of Pediatrics, Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Gwyn J Gerner
- Division of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mary Lauren Neel
- Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Vera J Burton
- Division of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Neurology and Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rachel Byrne
- Cerebral Palsy Foundation, New York, New York, USA
| | - Seth Warschausky
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
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Li H, Wang J, Li Z, Cecil KM, Altaye M, Dillman JR, Parikh NA, He L. Supervised contrastive learning enhances graph convolutional networks for predicting neurodevelopmental deficits in very preterm infants using brain structural connectome. Neuroimage 2024; 291:120579. [PMID: 38537766 PMCID: PMC11059107 DOI: 10.1016/j.neuroimage.2024.120579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/15/2024] [Accepted: 03/15/2024] [Indexed: 04/13/2024] Open
Abstract
Very preterm (VPT) infants (born at less than 32 weeks gestational age) are at high risk for various adverse neurodevelopmental deficits. Unfortunately, most of these deficits cannot be accurately diagnosed until the age of 2-5 years old. Given the benefits of early interventions, accurate diagnosis and prediction soon after birth are urgently needed for VPT infants. Previous studies have applied deep learning models to learn the brain structural connectome (SC) to predict neurodevelopmental deficits in the preterm population. However, none of these models are specifically designed for graph-structured data, and thus may potentially miss certain topological information conveyed in the brain SC. In this study, we aim to develop deep learning models to learn the SC acquired at term-equivalent age for early prediction of neurodevelopmental deficits at 2 years corrected age in VPT infants. We directly treated the brain SC as a graph, and applied graph convolutional network (GCN) models to capture complex topological information of the SC. In addition, we applied the supervised contrastive learning (SCL) technique to mitigate the effects of the data scarcity problem, and enable robust training of GCN models. We hypothesize that SCL will enhance GCN models for early prediction of neurodevelopmental deficits in VPT infants using the SC. We used a regional prospective cohort of ∼280 VPT infants who underwent MRI examinations at term-equivalent age from the Cincinnati Infant Neurodevelopment Early Prediction Study (CINEPS). These VPT infants completed neurodevelopmental assessment at 2 years corrected age to evaluate cognition, language, and motor skills. Using the SCL technique, the GCN model achieved mean areas under the receiver operating characteristic curve (AUCs) in the range of 0.72∼0.75 for predicting three neurodevelopmental deficits, outperforming several competing models. Our results support our hypothesis that the SCL technique is able to enhance the GCN model in our prediction tasks.
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Affiliation(s)
- Hailong Li
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Neurodevelopmental Disorders Prevention Center, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Artificial Intelligence Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Junqi Wang
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Zhiyuan Li
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Computer Science, University of Cincinnati, Cincinnati, OH, USA
| | - Kim M Cecil
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mekibib Altaye
- Neurodevelopmental Disorders Prevention Center, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jonathan R Dillman
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Artificial Intelligence Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Nehal A Parikh
- Neurodevelopmental Disorders Prevention Center, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Lili He
- Imaging Research Center, Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Neurodevelopmental Disorders Prevention Center, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Artificial Intelligence Imaging Research Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Computer Science, University of Cincinnati, Cincinnati, OH, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA; Department of Biomedical Informatics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Delfing D, Chin K, Hentrich L, Rachwani J, Friel KM, Santamaria V, Imms C, Gordon AM. Assessing engagement in rehabilitation: development, validity, reliability, and responsiveness to change of the Rehabilitation Observation Measure of Engagement (ROME). Disabil Rehabil 2024; 46:1888-1897. [PMID: 37161867 DOI: 10.1080/09638288.2023.2208379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE We describe the development of an observational video coding tool, the Rehabilitation Observation Measure of Engagement (ROME), to quantify engagement in rehabilitative settings at the person (internal state of an individual) and between-system (interaction between individuals) level. METHODS Forty-nine children with unilateral spastic cerebral palsy (29 males; Age: M = 9.28 yrs, SD = 3.08 yrs) and their interventionists were videotaped during different activities. Construct validity was examined by correlating the ROME with the Engagement vs. Disaffection with Learning Survey and the Pediatric Rehabilitation Intervention Measure of Engagement - Observation questionnaire. Inter- and intra-rater reliability were examined using two independent raters. The ROME's responsiveness to change was examined by comparing scores across activities. RESULTS For construct validity, results showed a positive correlation for person-level engagement (r = 0.444, p = 0.003). No relationship was found between-system-level engagement. High intrarater (91.8%) and interrater (96.1%) reliability was found. The ROME's responsiveness to change was supported by children exhibiting lower engagement scores during repetitive shaping activities. CONCLUSION These findings provide evidence that the ROME is a reliable tool to objectively examine the construct of engagement within rehabilitation and is valid for quantifying person-level engagement. It provides information that cannot be extracted from questionnaires and can help guide intervention decisions.
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Affiliation(s)
- Dalina Delfing
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY, NY, United States
| | - Karen Chin
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY, NY, United States
| | - Larissa Hentrich
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY, NY, United States
| | - Jaya Rachwani
- Department of Physical Therapy, Hunter College, City University of New York, New York, NY, United States
| | - Kathleen M Friel
- Burke Neurological Institute, Weill Cornell Medicine, White Plains, NY, United States
| | - Victor Santamaria
- Department of Physical Therapy, New York Medical College, NY, United States
| | - Christine Imms
- Healthy Trajectories: A Child and Youth Disability Research Hub, Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | - Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, NY, NY, United States
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Prosser LA, Pierce SR, Skorup JA, Paremski AC, Alcott M, Bochnak M, Ruwaih N, Jawad AF. Motor training for young children with cerebral palsy: A single-blind randomized controlled trial. Dev Med Child Neurol 2024; 66:233-243. [PMID: 37550991 DOI: 10.1111/dmcn.15729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 08/09/2023]
Abstract
AIM To compare the effect of iMOVE (Intensive Mobility training with Variability and Error) therapy with dose-matched conventional therapy on gross motor development and secondary outcomes in young children with cerebral palsy. METHOD This single-blind, randomized controlled trial included repeated assessments of gross motor function (using the Gross Motor Function Measure) and secondary outcomes during a 12- to 24-week intervention phase and at three follow-up points after treatment. Treatment was delivered three times per week in both groups. Forty-two children aged 12 to 36 months were stratified by age and motor function to ensure equivalence between groups at baseline. RESULTS Thirty-six children completed treatment and follow-up phases. Treatment fidelity was high and adherence was equivalent between groups (77.3% conventional therapy, 76.2% iMOVE). There were no group differences on the primary (gross motor function after 12 weeks p = 0.18; after 24 weeks p = 0.94) or any secondary (postural control p = 0.88, caregiver satisfaction p = 0.52, child engagement p = 0.98) measure after treatment or at the follow-up points. However, one-third of total participants exceeded predicted change after 12 weeks and 77% exceeded predicted change after 24 weeks of treatment. INTERPRETATION Our observations indicate a potential dose-response effect of rehabilitation therapy. We further demonstrated that individual therapeutic ingredients can be manipulated. When delivered consistently, both iMOVE and conventional therapy interventions might both be more effective than standard care. WHAT THIS PAPER ADDS Those receiving iMOVE therapy demonstrated more independent practice time, error, and child-initiation than those receiving the dose-matched control. iMOVE therapy was not superior to the control (conventional physical) therapy. Most participants exceeded predicted change after 24 weeks of treatment.
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Affiliation(s)
- Laura A Prosser
- Division of Rehabilitation Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Samuel R Pierce
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Julie A Skorup
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Athylia C Paremski
- Division of Rehabilitation Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Morgan Alcott
- Department of Physical Therapy, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Meghan Bochnak
- Department of Physical Therapy, Rady Children's Hospital, San Diego, CA, USA
| | - Noor Ruwaih
- Division of Rehabilitation Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Abbas F Jawad
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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De Campos AC, Hidalgo-Robles Á, Longo E, Shrader C, Paleg G. F-words e ingredientes das intervenções precoces para crianças com paralisia cerebral não deambuladoras: uma revisão de escopo. Dev Med Child Neurol 2024; 66:e12-e22. [PMID: 37491829 DOI: 10.1111/dmcn.15717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 07/27/2023]
Abstract
Cuidados centrados na família (incluindo coaching e intervenções fornecidas pelo cuidador) e treinamento parental formal são estratégias eficazes para crianças nos níveis IV e V do GMFCS. Os ingredientes de tecnologia assistiva podem promover várias F-words (funcionalidade, saúde, família, diversão, amigos e futuro). O menor nível de evidência foi encontrado para diversão, amigos e futuro. Outros fatores (prestação de serviços, treinamento profissional, dose de terapia, modificações ambientais) são relevantes para crianças pequenas nos níveis IV e V do GMFCS. Esta revisão de escopo identificou os ingredientes de intervenções precoces para crianças com paralisia cerebral em risco de não serem deambuladoras, e os mapeou-os de acordo com a estrutura das F-words. O treinamento formal dos pais e a tecnologia assistiva se destacaram como estratégias para abordar com várias F-words.
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Affiliation(s)
| | | | - Egmar Longo
- Departamento de Fisioterapia em Pediatria, Universidade Federal da Paraíba, PB, Brasil
| | - Claire Shrader
- HMS School for Children with Cerebral Palsy, Philadelphia, PA, USA
| | - Ginny Paleg
- Montgomery County Infants and Toddlers Program, Rockville, MD, USA
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Smythe T, Chen S, Rotenberg S, Unger M, Miner E, Seghers F, Servili C, Kuper H. Do children with disabilities have the same opportunities to play as children without disabilities? Evidence from the multiple indicator cluster surveys in 38 low and middle-income countries. EClinicalMedicine 2024; 67:102361. [PMID: 38169717 PMCID: PMC10758749 DOI: 10.1016/j.eclinm.2023.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
Background Play is essential for the cognitive, social, and emotional development of all children. Disparities potentially exist in access to play for children with disabilities, and the extent of this inequity is unknown. Methods Data from 212,194 children aged 2-4 years in 38 Low and Middle-Income Countries were collected in the UNICEF supported Multiple Indicator Cluster Survey (2017-2020). Disability was assessed by the Washington Group-Child Functioning Module. Logistic regression models were applied to investigate the relationship between disability and play opportunities, controlling for age, sex, and wealth status. Meta-analysis was used to pool the estimates (overall, and disaggregated by sex), with heterogeneity assessed by Cochran's Q test. Findings Children with disabilities have approximately 9% fewer play opportunities than those without disabilities (adjusted RR [aRR] = 0.88, 95% CI = 0.82-0.93), and this varied across countries. Mongolia and Democratic Republic of São Tomé and Príncipe had the lowest likelihood of play opportunities for children with disabilities ((aRR = 0.26, 95% CI = 0.09-0.75; aRR = 0.46, 95% CI = 0.23-0.93, respectively). Moreover, children with disabilities are 17% less likely to be provided with opportunities to play with their mothers (aRR = 0.83, 95% CI: 0.73-0.93), which is further reduced for girls with disabilities (aRR = 0.74, 95% CI: 0.60-0.90) compared to their peers without disabilities. The associations varied by impairment type, and children with communication and learning impairments are less likely to have opportunities for play with aRR of 0.69 (95% CI: 0.60-0.79) and 0.78 (95% CI: 0.71-0.86), compared to those without disabilities, respectively. Interpretation Children with disabilities are being left behind in their access to play and this is likely to have negative impacts on their overall development and well-being. Funding HK and TS are funded by HK's NIHR Global Research Professorship (NIHR301621). SR is funded by a Rhodes Scholarship. This study was funded by the Programme for Evidence to Inform Disability Action (PENDA) grant from the UK Foreign, Commonwealth and Development Office.
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Affiliation(s)
- Tracey Smythe
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel st, WC1E 7HT, London, UK
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, 8000, South Africa
| | - Shanquan Chen
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel st, WC1E 7HT, London, UK
| | - Sara Rotenberg
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, OX2 6GG, UK
| | - Marianne Unger
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Stellenbosch University, Cape Town, 8000, South Africa
| | - Emily Miner
- Clinton Health Access Initiative, Boston, MA, 02127, USA
| | | | - Chiara Servili
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel st, WC1E 7HT, London, UK
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De Campos AC, Hidalgo-Robles Á, Longo E, Shrader C, Paleg G. F-words and early intervention ingredients for non-ambulant children with cerebral palsy: A scoping review. Dev Med Child Neurol 2024; 66:41-51. [PMID: 37381598 DOI: 10.1111/dmcn.15682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023]
Abstract
AIM To explore the ingredients of early interventions provided to young children with cerebral palsy (CP) who are classified in Gross Motor Function Classification System (GMFCS) levels IV and V, and to identify the 'F-words' addressed by the interventions. METHOD Searches were completed in four electronic databases. Inclusion criteria were the original experimental studies that fitted the following PCC components: population, young children (aged 0-5 years, at least 30% of the sample) with CP and significant motor impairment (GMFCS levels IV or V, at least 30% of the sample); concept, non-surgical and non-pharmacological early intervention services measuring outcomes from any of the International Classification of Functioning, Disability and Health domains; and context, studies published from 2001 to 2021, from all settings and not limited to any specific geographical location. RESULTS Eighty-seven papers were included for review, with qualitative (n = 3), mixed-methods (n = 4), quantitative descriptive (n = 22), quantitative non-randomized (n = 39), and quantitative randomized (n = 19) designs. Fitness (n = 59), family (n = 46), and functioning (n = 33) ingredients were addressed by most experimental studies, whereas studies on fun (n = 6), friends (n = 5), and future (n = 14) were scarce. Several other factors (n = 55) related to the environment, for example, service provision, professional training, therapy dose, and environmental modifications, were also relevant. INTERPRETATION Many studies positively supported formal parent training and use of assistive technology to promote several F-words. A menu of intervention ingredients was provided, with suggestions for future research, to incorporate them into a real context within the family and clinical practice. WHAT THIS PAPER ADDS Family-centred care (including coaching and caregiver-delivered interventions) and formal parental training are effective strategies for children in GMFCS levels IV and V. Assistive technology ingredients (power, mobility, supported, sitting, stepping, and standing) may promote several 'F-words' (functioning, fitness, family, fun, friends, and future). The lowest level of evidence was found for fun, friends, and future. Other factors (service provision, professional training, therapy dose, environmental modifications) are relevant for young children in GMFCS levels IV and V.
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Affiliation(s)
- Ana Carolina De Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos-, SP, Brazil
| | | | - Egmar Longo
- Department of Physical therapy in Pediatrics, Federal University of Paraíba, João Pessoa-, PB, Brazil
| | - Claire Shrader
- HMS School for Children with Cerebral Palsy, Philadelphia, PA, USA
| | - Ginny Paleg
- Montgomery County Infants and Toddlers Program, Rockville, MD, USA
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De Campos AC, Hidalgo-Robles Á, Longo E, Shrader C, Paleg G. F-Wörter und Interventionsinhalte in der Frühförderung nicht gehfähiger Kinder mit Cerebralparese: eine umfangreiche Literaturübersicht. Dev Med Child Neurol 2024; 66:e23-e34. [PMID: 37740649 DOI: 10.1111/dmcn.15756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
AbstractZielUntersuchung der Inhalte von Frühfördermaßnahmen für Kleinkinder mit Cerebralparese (CP) mit Gross Motor Function Classification System (GMFCS) Level IV und V und die Identifikation von „F‐Wörtern“, die von den Maßnahmen adressiert werden.MethodeRecherche in vier elektronischen Datenbanken. Einschlusskriterien: experimentelle Originalstudien, die die folgenden PCC‐Komponenten erfüllten: Population: Kleinkinder (im Alter von 0–5 Jahre, mindestens 30% der Stichprobe) mit CP und erheblicher motorischer Beeinträchtigung (GMFCS‐Levels IV oder V, mindestens 30% der Stichprobe); Konzept: nicht‐chirurgische und nicht‐pharmakologische Leistungen der Frühförderung, die Ergebnisse aus einem der Bereiche der Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) messen; und Kontext: Studien, die zwischen 2001 und 2021 veröffentlicht wurden, in allen Konstellationen und nicht auf einen bestimmten geografischen Ort beschränkt.Ergebnisse87 Studien wurden in dieser Literaturübersicht berücksichtigt, mit qualitativen (n = 3), Mixed Methods (n = 4), quantitativ deskriptiven (n = 22), quantitativ nicht‐randomisierten (n = 39) und quantitativ randomisierten (n = 19) Designs. Die meisten experimentellen Studien befassten sich mit Fitness (n = 59), Familie (n = 46) und Funktion (n = 33), während es nur wenige Studien zu den Bereichen Spaß (n = 6), Freunde (n = 5) und Zukunft (n = 14) gab. Verschiedene Umweltfaktoren (n = 55) waren ebenfalls bedeutsam, z. B. das Angebot an Dienstleistungen, Berufsausbildung, Therapiedosis und Umweltanpassungen.InterpretationViele Studien unterstützen Elternschulungen und den Einsatz assistiver Technologien zur Förderung verschiedener F‐Wörter. Ein „Menü“ von Inhalten der Frühförderung wurden ermittelt, mit Vorschlägen für weitere Forschung, um diese in der klinischen Praxis mit Familien umzusetzen.Was dieser Artikel beiträgt
Familienzentrierte Angebote (einschließlich Beratung von und Intervention durch die Bezugspersonen) und strukturiertes Elterntraining sind wirksame Strategien für Kinder in den GMFCS‐Levels IV und V.
Hilfsmittel (Elektromobilität, unterstütztes Sitzen, Stehen und Gehen) können verschiedene „F‐Wörter“ fördern (Funktion, Fitness, Familie, Spaß, Freunde und Zukunft).
Die geringste Menge an Evidenz wurde für Spaß, Freunde und Zukunft gefunden.
Andere Faktoren (Angebot an Dienstleistungen, Berufsausbildung, Therapiedosis, Umweltanpassungen) sind relevant für Kleinkinder der GMFCS‐Levels IV und V.
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Affiliation(s)
- Ana Carolina De Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - Egmar Longo
- Department of Physical therapy in Pediatrics, Federal University of Paraíba, João Pessoa, PB, Brazil
| | - Claire Shrader
- HMS School for Children with Cerebral Palsy, PA, Philadelphia, USA
| | - Ginny Paleg
- Montgomery County Infants and Toddlers Program, Early Childhood Services, MD, Rockville, USA
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de Campos AC, Hidalgo-Robles Á, Longo E, Shrader C, Paleg G. F-words e ingredientes de las intervenciones tempranas dirigidas a niños no ambulantes con parálisis cerebral: Una revisión exploratoria. Dev Med Child Neurol 2024; 66:e1-e11. [PMID: 37491808 DOI: 10.1111/dmcn.15716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
La atención centrada en la familia (incluyendo coaching e intervenciones realizadas por los cuidadores) y el entrenamiento formal de los padres son estrategias efectivas para los niños con niveles IV y V de la GMFCS. Los ingredientes de la tecnología de apoyo pueden promover varias "F-words" (funcionamiento, estado físico, familia, diversión, amigos y futuro). Se encontró el nivel más bajo de evidencia para diversión, amigos y futuro. Otros factores (provisión de servicios, formación profesional, dosis de terapia, modificaciones del entorno) son relevantes para los niños pequeños con niveles IV y V de la GMFCS. Ingredientes de la intervención y F-words en intervenciones tempranas dirigidas a niños no ambulantes con parálisis cerebral.
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Affiliation(s)
- Ana Carolina de Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, -SP, Brazil
| | | | - Egmar Longo
- Department of Physical therapy in Pediatrics, Federal University of Paraíba, João Pessoa, -PB, Brazil
| | - Claire Shrader
- HMS School for Children with Cerebral Palsy, Philadelphia, PA, USA
| | - Ginny Paleg
- Montgomery County Infants and Toddlers Program, Rockville, MD, USA
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11
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Cunha AB, Babik I, Choi D, Koziol N, Harbourne RT, Dusing SC, McCoy SW, Willett SL, Bovaird JA, Lobo MA. The impact of severity of motor delay, timing of task mastery, and START-play intervention on the development of means-end problem solving in young children. Braz J Phys Ther 2024; 28:100590. [PMID: 38359542 PMCID: PMC10877108 DOI: 10.1016/j.bjpt.2024.100590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/25/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Children with motor delays are at increased risk for delayed means-end problem-solving (MEPS) performance. OBJECTIVES To evaluate children with motor delays: 1) the impact of motor delay severity and MEPS mastery timing on developmental trajectories of MEPS; and 2) the effectiveness of Sitting Together And Reaching To Play (START-Play) intervention for improving MEPS. METHODS This represents a secondary analysis from a multi-site randomized controlled trial, with blinded assessors and prospective registration. Children with mild or significant motor delays (n = 112, mean age=10.80, SD=2.59 months at baseline) were randomly assigned to START-Play or usual care early intervention (UC-EI) and assessed at five visits across one year using the Means-End Problem-Solving Assessment Tool that included three 30-second MEPS trials per visit. Task mastery occurred at the first visit the child achieved the highest level of performance in at least two of the three trials. Multilevel analyses evaluated trajectories of MEPS outcomes dependent upon the timing of MEPS mastery, motor delay severity, and intervention group. RESULTS At baseline, children with mild motor delays demonstrated better MEPS than children with significant delays, but this difference was only observed for children who achieved mastery late. Children with significant delays demonstrated greater improvements in MEPS in the post-intervention phase compared to children with mild delays. No MEPS differences were found between START-Play and UC-EI. CONCLUSION Motor delay severity and timing of task mastery impacted MEPS trajectories, whereas START-Play intervention did not impact MEPS for children with motor delays. CLINICAL TRIALS REGISTRY IDENTIFIER NCT02593825 (https://clinicaltrials.gov/ct2/show/NCT02593825).
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Affiliation(s)
- Andrea B Cunha
- Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA
| | - Iryna Babik
- Department of Psychological Science, Boise State University, Boise, ID, USA
| | - Dongho Choi
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Natalie Koziol
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Regina T Harbourne
- Department of Physical Therapy, Duquesne University, Pittsburgh, PA, USA
| | - Stacey C Dusing
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, USA
| | - Sarah W McCoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Sandra L Willett
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - James A Bovaird
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Michele A Lobo
- Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA.
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12
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Babik I, Cunha AB, Srinivasan S. Biological and environmental factors may affect children's executive function through motor and sensorimotor development: Preterm birth and cerebral palsy. Infant Behav Dev 2023; 73:101881. [PMID: 37643499 DOI: 10.1016/j.infbeh.2023.101881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
Disruptive biological and environmental factors may undermine the development of children's motor and sensorimotor skills. Since the development of cognitive skills, including executive function, is grounded in early motor and sensorimotor experiences, early delays or impairments in motor and sensorimotor processing often trigger dynamic developmental cascades that lead to suboptimal executive function outcomes. The purpose of this perspective paper is to link early differences in motor/sensorimotor processing to the development of executive function in children born preterm or with cerebral palsy. Uncovering such links in clinical populations would improve our understanding of developmental pathways and key motor and sensorimotor skills that are antecedent and foundational for the development of executive function. This knowledge will allow the refinement of early interventions targeting motor and sensorimotor skills with the goal of proactively improving executive function outcomes in at-risk populations.
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Affiliation(s)
- Iryna Babik
- Department of Psychological Science, Boise State University, Boise, ID, USA.
| | - Andrea B Cunha
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sudha Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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13
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Scott K, Sakzewski L, Ziviani J, Heathcock JC, Boyd R. Fidelity of Delivery in a Multisite Randomized Clinical Trial of Intervention Efficacy for Infants With Unilateral Cerebral Palsy. Pediatr Phys Ther 2023; 35:458-466. [PMID: 37747982 PMCID: PMC10703014 DOI: 10.1097/pep.0000000000001038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
PURPOSE To investigate the reliability of a measure of fidelity of therapist delivery, quantify fidelity of delivery, and determine factors impacting fidelity in the Rehabilitation EArly for Congenital Hemiplegia (REACH) clinical trial. METHODS Ninety-five infants (aged 3-9 months) with unilateral cerebral palsy participated in the REACH clinical trial. The Therapist Fidelity Checklist (TFC) evaluated key intervention components. Video-recorded intervention sessions were scored using the TFC. RESULTS Inter- and intrarater reliability was percentage agreement 77% to 100%. Fidelity of delivery was high for 88.9% of sessions and moderate for 11.1% of sessions. Sessions with moderate scores included infants receiving infant-friendly bimanual therapy and occurred at the intervention midpoint or later. No significant relationships were found for TFC scores and infant age, manual ability, or parent engagement. CONCLUSIONS Fidelity of delivery was high for the REACH trial in most intervention sessions. Standardized therapist training with intervention manuals and monthly peer-to-peer support likely contributed to these results.
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Affiliation(s)
- Kimberley Scott
- Department of Physical Therapy, Creighton University, Omaha, Nebraska, United States
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Jenny Ziviani
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Jill C. Heathcock
- Division of Physical Therapy, The Ohio State University, Columbus, Ohio, United States
| | - Roslyn Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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14
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Deng W, Anastasopoulos S, deRegnier RA, Pouppirt N, Barlow AK, Patrick C, O’Brien MK, Babula S, Sukal-Moulton T, Peyton C, Morgan C, Rogers JA, Lieber RL, Jayaraman A. Protocol for a randomized controlled trial to evaluate a year-long (NICU-to-home) evidence-based, high dose physical therapy intervention in infants at risk of neuromotor delay. PLoS One 2023; 18:e0291408. [PMID: 37725613 PMCID: PMC10508609 DOI: 10.1371/journal.pone.0291408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION Developmental disabilities and neuromotor delay adversely affect long-term neuromuscular function and quality of life. Current evidence suggests that early therapeutic intervention reduces the severity of motor delay by harnessing neuroplastic potential during infancy. To date, most early therapeutic intervention trials are of limited duration and do not begin soon after birth and thus do not take full advantage of early neuroplasticity. The Corbett Ryan-Northwestern-Shirley Ryan AbilityLab-Lurie Children's Infant Early Detection, Intervention and Prevention Project (Project Corbett Ryan) is a multi-site longitudinal randomized controlled trial to evaluate the efficacy of an evidence-based physical therapy intervention initiated in the neonatal intensive care unit (NICU) and continuing to 12 months of age (corrected when applicable). The study integrates five key principles: active learning, environmental enrichment, caregiver engagement, a strengths-based approach, and high dosage (ClinicalTrials.gov identifier NCT05568264). METHODS We will recruit 192 infants at risk for neuromotor delay who were admitted to the NICU. Infants will be randomized to either a standard-of-care group or an intervention group; infants in both groups will have access to standard-of-care services. The intervention is initiated in the NICU and continues in the infant's home until 12 months of age. Participants will receive twice-weekly physical therapy sessions and caregiver-guided daily activities, assigned by the therapist, targeting collaboratively identified goals. We will use various standardized clinical assessments (General Movement Assessment; Bayley Scales of Infant and Toddler Development, 4th Edition (Bayley-4); Test of Infant Motor Performance; Pediatric Quality of Life Inventory Family Impact Module; Alberta Infant Motor Scale; Neurological, Sensory, Motor, Developmental Assessment; Hammersmith Infant Neurological Examination) as well as novel technology-based tools (wearable sensors, video-based pose estimation) to evaluate neuromotor status and development throughout the course of the study. The primary outcome is the Bayley-4 motor score at 12 months; we will compare scores in infants receiving the intervention vs. standard-of-care therapy.
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Affiliation(s)
- Weiyang Deng
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
| | | | - Raye-Ann deRegnier
- Division of Neonatology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics (Neonatology), Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Nicole Pouppirt
- Division of Neonatology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics (Neonatology), Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Ann K. Barlow
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
| | - Cheryl Patrick
- Division of Rehabilitative Services, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
| | - Megan K. O’Brien
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern Medicine, Chicago, IL, United States of America
| | - Sarah Babula
- Pathways.org, Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
| | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia
| | - John A. Rogers
- Department of Biomedical Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois, United States of America
- Departments of Materials Science and Engineering, Chemistry, Mechanical Engineering, Electrical Engineering and Computer Science, Northwestern University, Evanston, Illinois, United States of America
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Richard L. Lieber
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
- Department of Biomedical Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Evanston, Illinois, United States of America
- Department of Neuroscience, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Jessie Brown Jr., Hines V.A. Medical Center, Hines, Illinois, United States of America
| | - Arun Jayaraman
- Shirley Ryan AbilityLab, Chicago, Illinois, United States of America
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern Medicine, Chicago, IL, United States of America
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
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15
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Kretch KS, Koziol NA, Marcinowski EC, Hsu LY, Harbourne RT, Lobo MA, McCoy SW, Willett SL, Dusing SC. Sitting Capacity and Performance in Infants with Typical Development and Infants with Motor Delay. Phys Occup Ther Pediatr 2023; 44:164-179. [PMID: 37550959 DOI: 10.1080/01942638.2023.2241537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023]
Abstract
AIMS Infants with neuromotor disorders demonstrate delays in sitting skills (decreased capacity) and are less likely to maintain independent sitting during play than their peers with typical development (decreased performance). This study aimed to quantify developmental trajectories of sitting capacity and sitting performance in infants with typical development and infants with significant motor delay and to assess whether the relationship between capacity and performance differs between the groups. METHODS Typically developing infants (n = 35) and infants with significant motor delay (n = 31) were assessed longitudinally over a year following early sitting readiness. The Gross Motor Function Measure (GMFM) Sitting Dimension was used to assess sitting capacity, and a 5-min free play observation was used to assess sitting performance. RESULTS Both capacity and performance increased at a faster rate initially, with more deceleration across time, in infants with typical development compared to infants with motor delay. At lower GMFM scores, changes in GMFM sitting were associated with larger changes in independent sitting for infants with typical development, and the association between GMFM sitting and independent sitting varied more across GMFM scores for typically developing infants. CONCLUSIONS Intervention and assessment for infants with motor delay should target both sitting capacity and sitting performance.
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Affiliation(s)
- Kari S Kretch
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - Natalie A Koziol
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Emily C Marcinowski
- School of Kinesiology, Louisiana State University, Baton Rouge, LA, United States
| | - Lin-Ya Hsu
- Division of Physical Therapy, University of Washington, Seattle, WA, United States
| | - Regina T Harbourne
- Department of Physical Therapy, Duquesne University, Pittsburgh PA, United States
| | - Michele A Lobo
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
| | - Sarah W McCoy
- Division of Physical Therapy, University of Washington, Seattle, WA, United States
| | - Sandra L Willett
- Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, United States
| | - Stacey C Dusing
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
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16
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Orlando JM, Cunha AB, Alghamdi Z, Lobo MA. Information Available to Parents Seeking Education about Infant Play, Milestones, and Development from Popular Sources. Behav Sci (Basel) 2023; 13:bs13050429. [PMID: 37232666 DOI: 10.3390/bs13050429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
Parents commonly seek information about infant development and play, yet it is unclear what information parents find when looking in popular sources. Play, Milestone, and Development Searches in Google identified 313 sources for content analysis by trained researchers using a standardized coding scheme. Sources included websites, books, and apps created by professional organizations, commercial entities, individuals, the popular press, and government organizations/agencies. The results showed that for popular sources: (1) author information (i.e., qualifications, credentials, education/experience) is not consistently provided, nor is information about the developmental process, parents' role in development, or determining an infant's readiness to play; (2) milestones comprise a majority of the content overall; (3) search terminology impacts the information parents receive; (4) sources from the Milestone and Development Searches emphasized a passive approach of observing developmental milestones rather than suggesting activities to actively facilitate learning and milestone development. These findings highlight the need to discuss parents' online information-gathering process and findings. They also highlight the need for innovative universal parent-education programs that focus on activities to facilitate early development. This type of education has potential to benefit all families, with particular benefits for families with children who have unidentified or untreated developmental delays.
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Affiliation(s)
- Julie M Orlando
- Biomechanics & Movement Science Program, University of Delaware, Newark, DE 19713, USA
| | - Andrea B Cunha
- Physical Therapy Department, Munroe Meyer Institute, University of Nebraska Medical Center, Omaha, NE 68106, USA
| | - Zainab Alghamdi
- Biomechanics & Movement Science Program, University of Delaware, Newark, DE 19713, USA
| | - Michele A Lobo
- Biomechanics & Movement Science Program, University of Delaware, Newark, DE 19713, USA
- Physical Therapy Department, University of Delaware, Newark, DE 19713, USA
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17
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Kretch KS, Marcinowski EC, Lin-Ya H, Koziol NA, Harbourne RT, Lobo MA, Dusing SC. Opportunities for learning and social interaction in infant sitting: Effects of sitting support, sitting skill, and gross motor delay. Dev Sci 2023; 26:e13318. [PMID: 36047385 PMCID: PMC10544757 DOI: 10.1111/desc.13318] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/21/2022] [Accepted: 08/15/2022] [Indexed: 12/15/2022]
Abstract
The development of independent sitting changes everyday opportunities for learning and has cascading effects on cognitive and language development. Prior to independent sitting, infants experience the sitting position with physical support from caregivers. Why does supported sitting not provide the same input for learning that is experienced in independent sitting? This question is especially relevant for infants with gross motor delay, who require support in sitting for many months after typically developing infants sit independently. We observed infants with typical development (n = 34, ages 4-7 months) and infants with gross motor delay (n = 128, ages 7-16 months) in early stages of sitting development, and their caregivers, in a dyadic play observation. We predicted that infants who required caregiver support for sitting would spend more time facing away from the caregiver and less time contacting objects than infants who could sit independently. We also predicted that caregivers of supported sitters would spend less time contacting objects because their hands would be full supporting their infants. Our first two hypotheses were confirmed; however, caregivers spent surprisingly little time using both hands to provide support, and caregivers of supported sitters spent more time contacting objects than caregivers of independent sitters. Similar patterns were seen in the group of typically developing infants and the infants with motor delay. Our findings suggest that independent sitting and supported sitting provide qualitatively distinct experiences with different implications for social interaction and learning opportunities. HIGHLIGHTS: During seated free play, supported sitters spent more time facing away from their caregivers and less time handling objects than independent sitters. Caregivers who spent more time supporting infants with both hands spent less time handling objects; however, caregivers mostly supported infants with one or no hands. A continuous measure of sitting skill did not uniquely contribute to these behaviors beyond the effect of binary sitting support (supported vs. independent sitter). The pattern of results was similar for typically developing infants and infants with gross motor delay, despite differences in age.
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Affiliation(s)
- Kari S. Kretch
- Division of Biokinesiology and Physical Therapy, University of Southern California
| | | | - Hsu Lin-Ya
- Division of Physical Therapy, University of Washington
| | - Natalie A. Koziol
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln
| | - Regina T. Harbourne
- Physical Therapy Department, Rangos School of Health Sciences, Duquesne University
| | | | - Stacey C. Dusing
- Division of Biokinesiology and Physical Therapy, University of Southern California
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18
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Koziol NA, Kretch KS, Harbourne RT, Lobo MA, McCoy SW, Molinini R, Hsu LY, Babik I, Cunha AB, Willett SL, Bovaird JA, Dusing SC. START-Play Physical Therapy Intervention Indirectly Impacts Cognition Through Changes in Early Motor-Based Problem-Solving Skills. Pediatr Phys Ther 2023:00001577-990000000-00051. [PMID: 37071882 DOI: 10.1097/pep.0000000000001016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
PURPOSE This study tested whether the Sitting Together and Reaching to Play (START-Play) physical therapy intervention indirectly impacts cognition through changes in perceptual-motor skills in infants with motor delays. METHODS Participants were 50 infants with motor delays randomly assigned to START-Play plus Usual Care Early Intervention (UC-EI) or UC-EI only. Infants' perceptual-motor and cognitive skills were assessed at baseline and 1.5, 3, 6, and 12 months post-baseline. RESULTS Short-term changes in sitting, fine motor skills, and motor-based problem-solving, but not reaching, predicted long-term changes in cognition. START-Play indirectly impacted cognition through motor-based problem-solving but not sitting, reaching, or fine motor skills. CONCLUSIONS This study provided preliminary evidence that early physical therapy interventions that blend activities across developmental domains and are supported by an enriched social context can place infants on more optimal developmental trajectories.
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Affiliation(s)
- Natalie A Koziol
- Nebraska Center for Research on Children, Youth, Families and Schools (Dr Koziol), University of Nebraska-Lincoln, Lincoln, Nebraska; Division of Biokinesiology and Physical Therapy (Drs Kretch and Dusing), University of Southern California, Los Angeles, California; Physical Therapy Department (Dr Harbourne), Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania; Biomechanics and Movement Science Program and Physical Therapy Department (Dr Lobo), University of Delaware, Newark, Delaware; Department of Rehabilitation Medicine (Drs McCoy and Hsu), University of Washington, Seattle, Washington; Rehabilitation and Movement Science (Ms Molinini), Virginia Commonwealth University, Richmond, Virginia; Department of Psychological Science (Dr Babik), Boise State University, Boise, Idaho; University of Nebraska Medical Center (Dr Cunha), University of Nebraska, Omaha, Nebraska; Munroe Meyer Institute (Dr Willett), University of Nebraska Medical Center, Omaha, Nebraska; Department of Educational Psychology (Dr Bovaird), University of Nebraska-Lincoln, Lincoln, Nebraska
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Abstract
Early childhood affords rapid brain development and advancement of the motor system. In High-Risk Infant Follow-Up programs, watchful waiting and monitoring of infants at high risk is shifting toward active surveillance and early diagnosis, followed by immediate targeted very early interventions. Infants with delayed motor skills benefit from developmental care, NIDCAP, and generic or specific motor training. Infants with cerebral palsy benefit from enrichment, targeted skills interventions, and task-specific motor training at high intensity. Infants with degenerative conditions benefit from enrichment but also require accommodations such as powered mobility.
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Affiliation(s)
- Lynda McNamara
- The Children's Hospital Westmead Clinical School, The University of Sydney, Locked Bag 4001, Westmead, Sydney, NSW 2145, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, PO Box 171, Forestville, Sydney, NSW 2006, Australia
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, Specialty of Child and Adolescent Health, Sydney Medical School, The University of Sydney, PO Box 171, Forestville, Sydney, NSW 2006, Australia.
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20
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Duncan AF. Interventions for Executive Function in High-Risk Infants and Toddlers. Clin Perinatol 2023; 50:103-119. [PMID: 36868701 DOI: 10.1016/j.clp.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
This review summarizes the current state of evidence regarding interventions for executive function in high-risk infants and toddlers. Currently, there is a paucity of data in this area, with the interventions that have been studied highly variable in their content, dosage, target, and results. Self-regulation is the executive function construct targeted the most, with mixed results. The few studies that report later child outcomes in prekindergarten/school-aged children are encouraging, overall indicating improved cognition and behavior in the children of parents who received a parenting style intervention.
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Affiliation(s)
- Andrea F Duncan
- Division of Neonatology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, 2nd Floor Main, Philadelphia, PA 19104, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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21
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Longo E, Monteiro R, Hidalgo-Robles Á, Paleg G, Shrader C, De Campos AC. Assigning F-words as ingredients of interventions for children with cerebral palsy functioning at GMFCS IV and V: A scoping review protocol. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1110552. [PMID: 36873816 PMCID: PMC9978822 DOI: 10.3389/fresc.2023.1110552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/12/2023] [Indexed: 02/18/2023]
Abstract
Introduction Children with Cerebral Palsy (CP) functioning at Gross Motor Function Classification System (GMFCS) levels IV and V require "on time" identification and intervention. Interventions offered continue to be a challenge, in high-, but even more so in middle-, and low-income countries. Aim To describe the methods developed to explore the ingredients of published studies on early interventions in young children with cerebral palsy (CP) at highest risk of being non-ambulant based on the "F-words for child development framework" and the design of a scoping review exploring these ingredients. Method An operational procedure was developed through expert panels to identify ingredients of published interventions and related F-words. After sufficient agreement among researchers was reached, a scoping review was designed. The review is registered in the Open Science Framework database. The "Population, Concept and Context" framework was used. Population: young children (0-5 years with CP and at highest risk for being non-ambulant (GMFCS levels IV or V); Concept: non-surgical and non-pharmacological early intervention services measuring outcomes from any ICF domain; Context: studies published from 2001 to 2021. After duplicated screening and selection, data will be extracted and quality will be assessed with the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and Mixed Methods Appraisal (MMAT) tools. Results We present the protocol to identify the explicit (directly measured outcomes and respective ICF domains) and implicit (intervention features not explicitly intended or measured) ingredients. Conclusion Findings will support the implementation of the F-words in interventions for young children with non-ambulant CP.
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Affiliation(s)
- E Longo
- Department of Physical Therapy, Federal University of Paraíba, João Pessoa, PB, Brazil
| | - R Monteiro
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Á Hidalgo-Robles
- Facultad de Educación, Universidad Internacional de La Rioja, Logroño, La Rioja, Spain
| | - G Paleg
- Montgomery County Infants and Toddlers Program, Rockville, MD, USA
| | - C Shrader
- HMS School for Children with Cerebral Palsy, Philadelphia, PA, USA
| | - A C De Campos
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
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22
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Hand-Arm Bimanual Intensive Training in Virtual Reality: A Feasibility Study. Pediatr Phys Ther 2023; 35:85-91. [PMID: 36459077 DOI: 10.1097/pep.0000000000000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the feasibility of virtual reality (VR) software built using the core concepts of hand-arm bimanual intensive training (HABIT) for improving upper extremity motor function in children with cerebral palsy (CP). METHODS Eight children with CP participated in a 10-day, 40-hour HABIT program. Half of the time custom VR software, HABIT-VR was used. The children's motor skills were assessed pre- and postintervention with the Assisting Hand Assessment, Box and Blocks Test, and Nine-Hole Peg Test. RESULTS The children had significant and clinically relevant changes in the Assisting Hand Assessment and Box and Blocks Test; however, Nine-Hole Peg Test scores did not change with intervention. CONCLUSION These data suggest that combining traditional HABIT strategies with HABIT-VR games improve upper extremity function and gross motor skills but not fine motor skills.
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Mitteregger E, Dirks T, Theiler M, Kretschmar O, Latal B. A family-tailored early motor intervention (EMI-Heart) for infants with complex congenital heart disease: study protocol for a feasibility RCT. Pilot Feasibility Stud 2022; 8:263. [PMID: 36564855 PMCID: PMC9784271 DOI: 10.1186/s40814-022-01220-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Children with congenital heart disease (CHD) undergoing open-heart surgery are at risk for developmental impairments with motor delay manifesting first and contributing to parental concerns. Only a few interventional studies aim to improve neuromotor development in infants with CHD with inconclusive results. We thus developed a family-tailored early motor intervention (EMI-Heart), which aims to promote motor development and family well-being in the first year of life after open-heart surgery. The primary aim described in this protocol is to evaluate feasibility of EMI-Heart. The secondary aim is to describe the difference between the intervention and control group in motor outcomes and family well-being at baseline, post-treatment, and follow-up. METHODS This prospective, parallel single-center feasibility randomized controlled trial (RCT) will compare EMI-Heart with standard of care in infants with complex CHD. Sixteen infants and their families, randomly allocated to EMI-Heart or the control group, will participate within the first 5 months of life. Infants assigned to EMI-Heart will receive early motor intervention for 3 months. The intervention's key is to promote infants' postural control to enhance motor development and partnering with parents to encourage family well-being. Feasibility outcomes will be (a) clinical recruitment rate and percentage of families completing EMI-Heart, (b) average duration and number of sessions, and (c) acceptability of EMI-Heart using a parental questionnaire post-treatment, and descriptive acceptability of EMI-Heart to the pediatric physiotherapist. Secondary outcomes of the intervention and control group will be infants' motor outcomes and questionnaires assessing family well-being at 3-5 months (baseline), at 6-8 months (post-treatment), and at 12 months of age (follow-up). We will evaluate feasibility using descriptive statistics. Non-parametric statistical analysis of secondary outcomes will assess differences between the groups at baseline, post-treatment, and follow-up. DISCUSSION This feasibility RCT will provide information about a newly developed family-tailored early motor intervention in infants with complex CHD. The RCT design will provide a foundation for a future large-scale interventional trial for infants with CHD after open-heart surgery. TRIAL REGISTRATION This study protocol (version 1.3, 01.02.2022) was approved by the Cantonal Ethics Commission Zurich (BASEC-Nr. 2019-01,787) and is registered by Clinicaltrials.gov (NCTT04666857).
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Affiliation(s)
- Elena Mitteregger
- grid.412341.10000 0001 0726 4330Child Development Center, University Children’s Hospital Zurich, Zurich, Switzerland ,grid.412341.10000 0001 0726 4330Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
| | - Tineke Dirks
- Paediatric Physiotherapy, Groningen, Netherlands
| | - Manuela Theiler
- Swiss Parents’ Association for the Child With Heart Disease (Elternvereinigung Für das Herzkranke Kind), Aarau, Switzerland
| | - Oliver Kretschmar
- grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland ,grid.412341.10000 0001 0726 4330Department of Pediatric Cardiology, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Beatrice Latal
- grid.412341.10000 0001 0726 4330Child Development Center, University Children’s Hospital Zurich, Zurich, Switzerland ,grid.412341.10000 0001 0726 4330Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland ,grid.7400.30000 0004 1937 0650University of Zurich, Zurich, Switzerland
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24
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Babik I, B Cunha A, Choi D, Koziol NA, T Harbourne R, C Dusing S, W McCoy S, A Bovaird J, L Willett S, Lobo MA. The Effect of START-Play Intervention on Reaching-Related Exploratory Behaviors in Children with Neuromotor Delays: A Secondary Analysis of a Randomized Controlled Trial. Phys Occup Ther Pediatr 2022; 43:321-337. [PMID: 36221306 DOI: 10.1080/01942638.2022.2131501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AIMS Children with neuromotor delays are at risk for reaching and object exploration impairments, which may negatively affect their cognitive development and daily activity performance. This study evaluated the effectiveness of the Sitting Together And Reaching To Play (START-Play) intervention on reaching-related exploratory behaviors in children with neuromotor delays. METHODS In this randomized controlled clinical trial, 112 children (Mean = 10.80, SD = 2.59 months old at baseline) with motor delays were randomly assigned to receive START-Play intervention or usual care-early intervention. Performance for ten reaching-related exploratory behaviors was assessed at baseline and 1.5, 3, 6, 12 months post-baseline. Piecewise linear mixed-effects modeling was used to evaluate short- and long-term effects of the intervention. RESULTS Benefits of START-Play were observed for children with significant motor delays, but not for those with mild delays. START-Play was especially beneficial for children with significant motor delays who demonstrated early mastery in the reaching assessment (i.e., object contact ≥65% of the time within 3 months after baseline); these children showed greater improvements in manual, visual, and multimodal exploration, as well as intensity of exploration across time. CONCLUSIONS START-Play advanced the performance of reaching-related exploratory behaviors in children with significant motor delays.
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Affiliation(s)
- Iryna Babik
- Department of Psychological Science, Boise State University, Boise, ID, USA
| | - Andrea B Cunha
- Munroe Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Dongho Choi
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Natalie A Koziol
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Regina T Harbourne
- Department of Physical Therapy, Duquesne University, Pittsburgh, PA, USA
| | - Stacey C Dusing
- Department of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Sarah W McCoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - James A Bovaird
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Sandra L Willett
- Munroe Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michele A Lobo
- Department of Physical Therapy, Biomechanics and Movement Science Program, University of Delaware, Newark, DE, USA
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25
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Baker A, Niles N, Kysh L, Sargent B. Effect of Motor Intervention for Infants and Toddlers With Cerebral Palsy: A Systematic Review and Meta-analysis. Pediatr Phys Ther 2022; 34:297-307. [PMID: 35671383 PMCID: PMC9574888 DOI: 10.1097/pep.0000000000000914] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
PURPOSE To conduct a systematic review and meta-analysis on the effect of motor intervention on motor function of infants and toddlers with cerebral palsy (CP). METHODS Four databases were searched for randomized controlled trials (RCTs) of motor interventions for children with or at high risk of CP younger than 36 months. Studies were excluded if less than 50% of children developed CP. RESULTS Eleven RCTs included 363 children; 85% diagnosed with CP. Very low-quality evidence supports that: (1) task-specific motor training was more effective than standard care for improving motor function (small effect), (2) constraint-induced movement therapy (CIMT) may be more effective than bimanual play or massage for improving function of the more affected hand (moderate effect), and high-intensity treadmill training is no more effective than low-intensity for improving walking. CONCLUSIONS Very low-quality evidence supports that task-specific motor training and CIMT may improve motor function of infants and toddlers with CP.The Supplemental Digital Content Video Abstract is available at: http://links.lww.com/PPT/A382 .
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Affiliation(s)
- Aubrey Baker
- Children’s Hospital of Los Angeles, Division of
Pediatric Rehabilitation Medicine, 4650 Sunset Blvd., Los Angeles, California
- University of Southern California, Division of
Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, Los Angeles,
California
| | - Natalie Niles
- Children’s Hospital of Los Angeles, Division of
Pediatric Rehabilitation Medicine, 4650 Sunset Blvd., Los Angeles, California
- University of Southern California, Division of
Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, Los Angeles,
California
| | - Lynn Kysh
- Children’s Hospital of Los Angeles, Institute for
Nursing and Interprofessional Research, 4650 Sunset Blvd., Los Angeles,
California
| | - Barbara Sargent
- University of Southern California, Division of
Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, Los Angeles,
California
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Sargent B, Harbourne R, Moreau NG, Sukal-Moulton T, Tovin M, Cameron JL, Stevenson RD, Novak I, Heathcock J. Research Summit V: Optimizing Transitions From Infancy to Early Adulthood in Children With Neuromotor Conditions. Pediatr Phys Ther 2022; 34:411-417. [PMID: 35653258 PMCID: PMC9250600 DOI: 10.1097/pep.0000000000000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE The purpose of this executive summary is to review the process and outcomes of the Academy of Pediatric Physical Therapy Research Summit V, "Optimizing transitions from infancy to young adulthood in children with neuromotor disabilities: biological and environmental factors to support functional independence." SUMMARY OF KEY POINTS An interdisciplinary group of researchers, representatives from funding agencies, and individuals with neuromotor disabilities and their parents participated in an intensive 2.5-day summit to determine research priorities to optimize life transitions for children with neuromotor disabilities. Recommended priorities for research included (1) promoting self-determination and self-efficacy of individuals with neuromotor disabilities and their families, (2) best care at the right time: evidence-based best practice care, led and navigated by families seamlessly across the lifespan, (3) strengthening connections between developmental domains to enhance function and participation, and (4) optimal dosing and timing to support adaptive bone, muscle, and brain plasticity across the lifespan.
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Affiliation(s)
- Barbara Sargent
- University of Southern California, Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, Los Angeles, California, USA
| | - Regina Harbourne
- Duquesne University, Rangos School of Health Sciences, Department of Physical Therapy, Pittsburgh, Pennsylvania, USA
| | - Noelle G. Moreau
- Louisiana State University Health Sciences Center – New Orleans, Department of Physical Therapy, School of Allied Health, New Orleans, Louisiana USA
| | - Theresa Sukal-Moulton
- Northwestern University, Departments of Physical Therapy and Human Movement Sciences and Pediatrics, Feinberg School of Medicine, Chicago, IL, USA
| | - Melissa Tovin
- Nova Southeastern University, Department of Physical Therapy, Fort Lauderdale, FL, USA
| | - Judy L. Cameron
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, USA
| | - Richard D. Stevenson
- University of Virginia School of Medicine, Department of Pediatrics, Charlottesville, VA, USA
| | - Iona Novak
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jill Heathcock
- The Ohio State University, School of Health and Rehabilitation Sciences, Division of Physical Therapy, Columbus, OH, USA
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Jensen-Willett S, Cunha A, Lobo MA, Harbourne R, Dusing SC, McCoy SW, Koziol NA, Hsu LY, Marcinowski EC, Babik I, An M, Bovaird JA. The Effect of Early-Life Seizures on Cognitive and Motor Development: A Case Series. Pediatr Phys Ther 2022; 34:425-431. [PMID: 35703307 DOI: 10.1097/pep.0000000000000918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This case series documents developmental changes over time and in response to a novel intervention, Sitting Together and Reaching to Play (START-Play), in children with early-life seizures. METHODS Thirteen children with early-life seizures were included from a subset of participants in the START-Play multisite, randomized controlled trial. Seven received 3 months of twice weekly START-Play intervention; 6 continued with usual care early intervention. Bayley Scales of Infant Development-III (Cognitive Composite), Gross Motor Function Measure-66 Item Set, Assessment of Problem-Solving in Play, and reaching assessments were administered at baseline, 3, 6, and 12 months postbaseline. Change scores are reported at 3 and 12 months postbaseline. RESULTS Over time, plateau or decline was noted in standardized cognition measures; motor development improved or was stable. Children receiving START-Play showed positive trends in problem-solving (71.4%) and reaching behaviors (57.2%). CONCLUSIONS Interventions such as START-Play that combine motor and cognitive constructs may benefit children with early-life seizures.
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Affiliation(s)
- Sandra Jensen-Willett
- Department of Physical Therapy (Dr Willett), Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska; Department of Physical Therapy (Drs Cunha and Lobo), Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware; Department of Physical Therapy (Dr Harbourne), Duquesne University, Pittsburgh, Pennsylvania; Division of Biokinesiology and Physical Therapy (Dr Dusing), University of Southern California, Los Angeles CA; Department of Rehabilitation Medicine (Drs Westcott-McCoy and Hsu), University of Washington, Seattle, Washington; Nebraska Center for Research on Children, Youth, Families and Schools (Drs Koziol and Bovaird), University of Nebraska-Lincoln, Lincoln, Nebraska; College of Human Science and Education (Dr Marcinowski), Louisiana State University, Baton Rouge, Louisiana; Department of Psychological Science (Dr Babik), Boise State University, Boise, Idaho; Department of Physical Therapy (Dr An), Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea
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An M, Marcinowski EC, Hsu LY, Stankus J, Jancart KL, Lobo MA, Dusing SC, McCoy SW, Bovaird JA, Willett S, Harbourne RT. Object Permanence and the Relationship to Sitting Development in Infants With Motor Delays. Pediatr Phys Ther 2022; 34:309-316. [PMID: 35653237 PMCID: PMC9200226 DOI: 10.1097/pep.0000000000000909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study examines object permanence development in infants with motor delays (MD) compared with infants with typical development (TD) and in relation to sitting skill. METHODS Fifty-six infants with MD (mean age = 10 months) and 36 with TD (mean age = 5.7 months) were assessed at baseline and then at 1.5, 3, and 6 months postbaseline. A scale was developed to measure object permanence (Object Permanence Scale [OPS]), and the Gross Motor Function Measure sitting subsection (GMFM-SS), and the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) were administered. RESULTS Interrater reliability of the OPS was excellent and correlation between the OPS and Bayley-III cognitive scores was moderately positive. Compared with TD, infants with MD were delayed in development of object permanence but demonstrated increased understanding over time and as sitting skills improved. CONCLUSION In children with MD, object permanence, as quantified by the OPS, emerges in conjunction with sitting skill.
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Affiliation(s)
- Mihee An
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - Emily C. Marcinowski
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - Lin-Ya Hsu
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - Jaclynn Stankus
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - Karl L. Jancart
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - Michele A. Lobo
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - Stacey C. Dusing
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - Sarah W. McCoy
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - James A. Bovaird
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - Sandra Willett
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
| | - Regina T. Harbourne
- Kaya University, Gimhae-si, Gyeongsangnam-do, Republic of Korea (Dr An); Louisiana State University, Baton Rouge, Louisiana (Dr Marcinowski); University of Washington, Seattle, Washington (Drs Hsu and McCoy); Duquesne University, Pittsburgh, Pennsylvania (Drs Stankus and Harbourne and Mr Jancart); University of Delaware, Newark, Delaware (Dr Lobo); University of Southern California, Los Angeles, California (Dr Dusing); University of Nebraska-Lincoln, Nebraska (Dr Bovaird); University of Nebraska Medical Center, Omaha, Nebraska (Dr Willett)
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Dusing SC, Harbourne RT, Hsu LY, Koziol NA, Kretch K, Sargent B, Jensen-Willett S, McCoy SW, Vanderbilt DL. The SIT-PT Trial Protocol: A Dose-Matched Randomized Clinical Trial Comparing 2 Physical Therapist Interventions for Infants and Toddlers With Cerebral Palsy. Phys Ther 2022; 102:6566428. [PMID: 35421222 PMCID: PMC9291380 DOI: 10.1093/ptj/pzac039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/09/2022] [Accepted: 03/07/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Although early intervention for infants at risk for cerebral palsy is routinely recommended, the content of intervention is poorly described, varies widely, and has mixed supporting evidence. The purpose of this study was to compare efficacy of 2 interventions grounded in differing domains of the International Classification of Functioning, Disability and Health on developmental outcomes of infants with or at high risk of cerebral palsy. METHODS Infants who meet inclusion criteria will be randomized into either Sitting Together and Reaching To Play or Movement, Orientation, Repetition, Exercise Physical Therapy groups. Both groups will receive intervention twice weekly for 3 months and follow-up at 3, 6, 9, and 12 months from baseline. The primary objectives compare changes over time and between groups in sitting, gross motor, and cognitive development. The setting is the infant's home unless the caregiver requests otherwise. One hundred and fifty infants between 8 and 24 months of age will be enrolled in 3 geographically, racially, and ethnically diverse sites: Los Angeles, California; Omaha, Nebraska; and Seattle, Washington. Enrolled infants will demonstrate motor delays, emerging sitting skills, and signs of neurologic impairment. Sitting Together and Reaching To Play targets activities including sitting, reaching, and motor-based problem solving to improve global development. In contrast, Movement, Orientation, Repetition, Exercise Physical Therapy focuses on strengthening and musculoskeletal alignment while encouraging repeated movement practice. Outcome measures include the Gross Motor Function Measure, Bayley Scales of Infant Development-IV, Assessment of Problem Solving in Play, and a Parent Child Interaction assessment. Enrolled children will maintain usual intervention services due to ethical concerns with intervention withdrawal. IMPACT This will be the first study, to our knowledge, comparing efficacy of early physical therapy with dose-matched interventions and well-defined key principles. The outcomes will inform selection of key principle of intervention in this population.
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Affiliation(s)
- Stacey C Dusing
- Address all correspondence to Dr Dusing at: ; Follow the author(s): @motordevlab
| | - Regina T Harbourne
- Rangos School of Health Sciences, Department of Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Lin-Ya Hsu
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Natalie A Koziol
- College of Education and Human Sciences, Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Kari Kretch
- Ostrow School of Dentistry, Division of Physical Therapy and Biokinesiology, University of Southern California, Los Angeles, California, USA
| | - Barbara Sargent
- Ostrow School of Dentistry, Division of Physical Therapy and Biokinesiology, University of Southern California, Los Angeles, California, USA
| | - Sandra Jensen-Willett
- Munroe-Meyer Institute, Department of Physical Therapy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Sarah Westcott McCoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Douglas L Vanderbilt
- Developmental-Behavioral Pediatrics Section, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, California, USA
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Adiguzel H, Sarikabadayi YU, Elbasan B. Investigation of the effectiveness of family collaborative physiotherapy programs applied to high-risk infants. Physiother Theory Pract 2022:1-17. [PMID: 35387569 DOI: 10.1080/09593985.2022.2062504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The inclusion of families in intervention programs for infants may be more effective in ensuring adherence and positive outcomes. Approaches that include natural and enriched environments that provide communication and family interaction are important in the rehabilitation of high-risk infants. OBJECTIVE To compare the effectiveness of Family Collaborative Approach (FCA) and Neurodevelopmental Therapy (NDT)-based family training. METHODS High-risk infants (n = 63) with a mean age of 32.60 ± 4.53 months received early intervention for 12 weeks. Prechtl's General movements (GMs) assessment, Hammersmith Neonatal Neurological Examination (HNNE), Hammersmith Infant Neurological Examination (HINE), BAYLEY-III Scales of Infant and Toddler Development, and Third Addition (BSID-III) were performed. RESULTS Significant differences between groups were found in HINE scores at the 3rd, 6th, and 12th months (p ≤ .028), and in BSID-III scores at the 6th month (cognitive, language, and motor) (p < .001) and the 12th month (language) (p = .031). There was significant difference between NDT and control group in 3rd month HINE scores and Reflex&Reactions scores (p ≤ .021). FCA group and NDT group was significantly different from control group in 6th month HINE (p = .032) and 12th month HINE scores (p = .007). FCA group significantly different from NDT group (p ≤ .002) and control group (p < .001) in 6th month BSID-III cognitive, language, and motor scores. There was significant difference between FCA and control group in 12 month BSID-III language scores (p = .024). CONCLUSIONS Early physiotherapy interventions were effective in high-risk infants and FCA program was superior to NDT.
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Affiliation(s)
- Hatice Adiguzel
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kahramanmaras Sutcu Imam University, Dulkadiroglu, Turkey
| | | | - Bulent Elbasan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Cankaya, Turkey
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Inamdar K, Khurana S, Dusing SC. Effect of Contingency Paradigm-Based Interventions on Developmental Outcomes in Young Infants: A Systematic Review. Pediatr Phys Ther 2022; 34:146-161. [PMID: 35184076 DOI: 10.1097/pep.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this systematic review was to identify controlled trials evaluating the efficacy of contingency paradigm-based interventions to improve feeding, motor, or cognitive outcomes during the first year of life. SUMMARY OF KEY POINTS Seventeen studies, including 10 randomized controlled trials, incorporating contingency paradigm-based interventions were identified. Three of 3 trials reported improvements in nutritive sucking using pacifier-activated lullaby in preterm infants before term age. Seven of 12 trials reported improvements in reaching, manual exploration, and kicking behaviors in term and preterm infants; and 6 of 10 trials reported gains in early cognition using sticky mittens and contingent toys. CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE Contingency paradigm-based interventions can improve feeding outcomes in the neonatal intensive care unit in very preterm infants, and increase reaching, and perceptual-cognitive behaviors in term infants. Future research is needed to establish contingency paradigms as an effective early intervention strategy. WHAT THIS ADDS TO THE EVIDENCE This review synthesizes a body of literature on contingency paradigm-based interventions and highlights its potential paradigm-based interventions to improve developmental outcomes in infants.
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Affiliation(s)
- Ketaki Inamdar
- Department of Physical Therapy (Ms Inamdar), Rehabilitation and Movement Science Program, Motor Development Lab, Virginia Commonwealth University, Richmond, Virginia; Department of Physical Therapy (Dr Khurana), Motor Development Lab, Virginia Commonwealth University, Richmond, Virginia; Division of Biokinesiology and Physical Therapy (Dr Dusing), Motor Development Lab, University of Southern California, Los Angeles, California
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Koziol NA, Butera CD, Kretch KS, Harbourne RT, Lobo MA, McCoy SW, Hsu LY, Willett SL, Kane AE, Bovaird JA, Dusing SC. Effect of the START-Play Physical Therapy Intervention on Cognitive Skills Depends on Caregiver-Provided Learning Opportunities. Phys Occup Ther Pediatr 2022; 42:510-525. [PMID: 35350970 DOI: 10.1080/01942638.2022.2054301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
Abstract
AIMS This study evaluated whether caregiver-provided learning opportunities moderated the effect of START-Play physical therapy intervention on the cognitive skills of young children with neuromotor delays, and whether START-Play impacted caregiver-provided learning opportunities over time. METHODS One hundred and twelve children with neuromotor delays (7-16 months) participated in a multisite randomized clinical trial evaluating the efficacy of START-Play. Children were assessed at baseline and 3 (post intervention), 6, and 12 months post baseline. Cognition was scored from the Bayley Scales of Infant & Toddler Development, Third Edition, cognitive scale. The proportion of time caregivers spent providing learning opportunities was coded from a 5-minute caregiver-child free play interaction. RESULTS Baseline caregiver-provided learning opportunities moderated the 3- and 12-month effects of START-Play on cognition. Cognitive gains due to START-Play were more pronounced for children whose caregivers provided more learning opportunities. START-Play did not impact caregiver-provided learning opportunities over time. CONCLUSIONS START-Play may have a lasting effect on children's cognition, but this effect is contingent on caregivers providing their child with ample opportunities to practice cognitive skills. Strategies for improving caregivers' uptake and transfer of START-Play principles to their daily routines should be evaluated. TRIAL REGISTRATION ClinicalTrials.gov NCT02593825.
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Affiliation(s)
| | | | - Kari S Kretch
- University of Southern California, Los Angeles, California, USA
| | | | | | | | - Lin-Ya Hsu
- University of Washington, Seattle, Washington, USA
| | - Sandra L Willett
- Munroe Meyer Institute, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Audrey E Kane
- Virginia Commonwealth University, Richmond, Virginia, USA
| | | | - Stacey C Dusing
- University of Southern California, Los Angeles, California, USA
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Babik I, Cunha AB, Lobo MA. A model for using developmental science to create effective early intervention programs and technologies to improve children's developmental outcomes. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2022; 62:231-268. [PMID: 35249683 DOI: 10.1016/bs.acdb.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Children born with a variety of environmental or medical risk factors may exhibit delays in global development. Very often, such delays are identified at preschool or school age, when children are severely overdue for effective early interventions that can alleviate the delays. This chapter proposes a conceptual model of child development to inform the creation of interventions and rehabilitative technologies that can be provided very early in development, throughout the first year of life, to optimize children's future developmental outcomes. The model suggests that early sensorimotor skills are antecedent and foundational for future motor, cognitive, language, and social development. As an example, this chapter describes how children's early postural control and exploratory movements facilitate the development of future object exploration behaviors that provide enhanced opportunities for learning and advance children's motor, cognitive, language, and social development. An understanding of the developmental pathways in the model can enable the design of effective intervention programs and rehabilitative technologies that target sensorimotor skills in the first year of life with the goal of minimizing or ameliorating the delays that are typically identified at preschool or school age. Specific examples of early interventions and rehabilitative technologies that have effectively advanced children's motor and cognitive development by targeting early sensorimotor skills and behaviors are provided.
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Affiliation(s)
- Iryna Babik
- Department of Psychological Science, Boise State University, Boise, ID, United States
| | - Andrea B Cunha
- Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, DE, United States
| | - Michele A Lobo
- Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, DE, United States.
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34
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From Hemispheric Asymmetry through Sensorimotor Experiences to Cognitive Outcomes in Children with Cerebral Palsy. Symmetry (Basel) 2022. [DOI: 10.3390/sym14020345] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Recent neuroimaging studies allowed us to explore abnormal brain structures and interhemispheric connectivity in children with cerebral palsy (CP). Behavioral researchers have long reported that children with CP exhibit suboptimal performance in different cognitive domains (e.g., receptive and expressive language skills, reading, mental imagery, spatial processing, subitizing, math, and executive functions). However, there has been very limited cross-domain research involving these two areas of scientific inquiry. To stimulate such research, this perspective paper proposes some possible neurological mechanisms involved in the cognitive delays and impairments in children with CP. Additionally, the paper examines the ways motor and sensorimotor experience during the development of these neural substrates could enable more optimal development for children with CP. Understanding these developmental mechanisms could guide more effective interventions to promote the development of both sensorimotor and cognitive skills in children with CP.
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Kretch KS, Koziol NA, Marcinowski EC, Kane AE, Inamdar K, Brown ED, Bovaird JA, Harbourne RT, Hsu L, Lobo MA, Dusing SC. Infant posture and caregiver‐provided cognitive opportunities in typically developing infants and infants with motor delay. Dev Psychobiol 2022; 64:e22233. [DOI: 10.1002/dev.22233] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/30/2022]
Affiliation(s)
- Kari S. Kretch
- Division of Biokinesiology and Physical Therapy University of Southern California Los Angeles California USA
| | - Natalie A. Koziol
- Nebraska Center for Research on Children, Youth, Families and Schools University of Nebraska‐Lincoln Lincoln Nebraska USA
| | | | - Audrey E. Kane
- Department of Occupational Therapy Virginia Commonwealth University Richmond Virginia USA
| | - Ketaki Inamdar
- Department of Physical Therapy Virginia Commonwealth University Richmond Virginia USA
| | - Elena Donoso Brown
- Department of Occupational Therapy Duquesne University Pittsburgh Pennsylvania USA
| | - James A. Bovaird
- Department of Educational Psychology University of Nebraska‐Lincoln Lincoln Nebraska USA
| | - Regina T. Harbourne
- Department of Physical Therapy Duquesne University Pittsburgh Pennsylvania USA
| | - Lin‐Ya Hsu
- Department of Rehabilitation Medicine University of Washington Seattle Washington USA
| | - Michele A. Lobo
- Department of Physical Therapy University of Delaware Newark Delaware USA
| | - Stacey C. Dusing
- Division of Biokinesiology and Physical Therapy University of Southern California Los Angeles California USA
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36
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Lane AE, Heathcock J. Sensorimotor Surveillance in the First Year of Life: Imperatives for Physical and Occupational Therapy Practice. A Commentary on "Posture Matters: Object Manipulation during the Transition to Arms-Free Sitting in Infants at Elevated vs. Typical Likelihood for Autism Spectrum Disorder". Phys Occup Ther Pediatr 2022; 42:366-368. [PMID: 35702055 DOI: 10.1080/01942638.2022.2085015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Alison E Lane
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| | - Jill Heathcock
- School of Health & Rehabilitation Sciences, Ohio State University, Columbus, Ohio, USA
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Goode-Roberts M, Noonan K, Stout D, Calvery M, Brothers K, Doonan NW, Behrman AL. Case Report: Capitalizing on Development and Activity-Dependent Plasticity, an Interaction With Pediatric-Onset Spinal Cord Injury. Front Pediatr 2022; 10:804622. [PMID: 35425730 PMCID: PMC9002091 DOI: 10.3389/fped.2022.804622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Spinal cord injury (SCI) in infancy halts typical development secondary to paralysis/paresis and the limited ability to engage with the environment. Traditional therapies further restrict a child via bracing, equipment, and medications. In contrast, activity-based restorative therapies (ABRT) promote activation of the neuromuscular system below the level of injury and affords a more typical sensorimotor experience. CASE DESCRIPTION A premature male infant exhibiting hypotonia, poor head control, and extremity weakness was diagnosed at age 5 months with a remote incomplete upper cervical SCI based on magnetic resonance imaging (MRI), presumed to have occurred perinatally. From 4 to 15 months of age, he received physical, occupational and speech therapies. Enrolled in an ABRT program at 15 months, he was unable to sit, pull-to-stand, stand, or walk and had upper extremity impairments. Results of the Bayley-III Scales of Infant and Toddler Development revealed gross and fine motor scores consistent with a 4-month-old. METHODS Activity-based restorative therapies was provided 5 day/week: 1.5 h of activity-based locomotor training and 1 h of activity-based occupational therapy. RESULTS Activity-based restorative therapies are reported for 177 sessions and are on-going. Improvements are noted in trunk control, standing, walking, grasp, in-hand manipulation, and associated kinematics. Bayley-III fine motor score improved to that of a 16-month-old and gross motor score to that of a 7-month-old. DISCUSSION While the two treatment periods (i.e., 4-15 months old and 15-24 months) were each ∼9 months, the child's accelerated progress toward typical development during the latter, ABRT period is noteworthy. In comparison to the period of traditional therapies in which paralysis was compounded by a restrictive environment and compensation, ABRT provided a potentially rich sensorimotor experience with an emphasis on active weight-bearing and proper kinematics to activate the neuromuscular system below the lesion in an age-appropriate, task-specific context of activities. Improved physical capacity enabled exploration more typically associated with development at this age expanding the positive impact to other developmental domains.
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Affiliation(s)
- MacKenzie Goode-Roberts
- UofL Health, Frazier Rehab Institute, Kosair Charities Center for Pediatric NeuroRecovery, Louisville, KY, United States
| | - Kathryn Noonan
- UofL Health, Frazier Rehab Institute, Kosair Charities Center for Pediatric NeuroRecovery, Louisville, KY, United States
| | - Danielle Stout
- UofL Health, Frazier Rehab Institute, Kosair Charities Center for Pediatric NeuroRecovery, Louisville, KY, United States
| | - Margaret Calvery
- Norton Children's Medical Group, Louisville, KY, United States.,Department of Pediatrics, University of Louisville, Louisville, KY, United States
| | - Kyle Brothers
- Norton Children's Research Institute, Affiliated With the University of Louisville School of Medicine, Louisville, KY, United States
| | - Nicole Williams Doonan
- Department of Neurology, Gillette Children's Specialty Healthcare, St. Paul, MN, United States
| | - Andrea L Behrman
- Department of Neurological Surgery, Kosair Charities Endowed Chair in Pediatric NeuroRecovery, University of Louisville, Louisville, KY, United States
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Raja Vora J, Helmi A, Zhan C, Olivares E, Vu T, Wilkey M, Noregaard S, Fitter NT, Logan SW. Influence of a Socially Assistive Robot on Physical Activity, Social Play Behavior, and Toy-Use Behaviors of Children in a Free Play Environment: A Within-Subjects Study. Front Robot AI 2021; 8:768642. [PMID: 34881295 PMCID: PMC8645936 DOI: 10.3389/frobt.2021.768642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Play is critical for children's physical, cognitive, and social development. Technology-based toys like robots are especially of interest to children. This pilot study explores the affordances of the play area provided by developmentally appropriate toys and a mobile socially assistive robot (SAR). The objective of this study is to assess the role of the SAR on physical activity, play behavior, and toy-use behavior of children during free play. Methods: Six children (5 females, Mage = 3.6 ± 1.9 years) participated in the majority of our pilot study's seven 30-minute-long weekly play sessions (4 baseline and 3 intervention). During baseline sessions, the SAR was powered off. During intervention sessions, the SAR was teleoperated to move in the play area and offered rewards of lights, sounds, and bubbles to children. Thirty-minute videos of the play sessions were annotated using a momentary time sampling observation system. Mean percentage of time spent in behaviors of interest in baseline and intervention sessions were calculated. Paired-Wilcoxon signed rank tests were conducted to assess differences between baseline and intervention sessions. Results: There was a significant increase in children's standing (∼15%; Z = -2.09; p = 0.037) and a tendency for less time sitting (∼19%; Z = -1.89; p = 0.059) in the intervention phase as compared to the baseline phase. There was also a significant decrease (∼4.5%, Z = -2.70; p = 0.007) in peer interaction play and a tendency for greater (∼4.5%, Z = -1.89; p = 0.059) interaction with adults in the intervention phase as compared to the baseline phase. There was a significant increase in children's interaction with the robot (∼11.5%, Z = -2.52; p = 0.012) in the intervention phase as compared to the baseline phase. Conclusion: These results may indicate that a mobile SAR provides affordances through rewards that elicit children's interaction with the SAR and more time standing in free play. This pilot study lays a foundation for exploring the role of SARs in inclusive play environments for children with and without mobility disabilities in real-world settings like day-care centers and preschools.
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Affiliation(s)
- Joseline Raja Vora
- Social Mobility Lab, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Ameer Helmi
- Collaborative Robotics and Intelligent Systems (CoRIS) Institute, Oregon State University, Corvallis, OR, United States
| | - Christine Zhan
- Collaborative Robotics and Intelligent Systems (CoRIS) Institute, Oregon State University, Corvallis, OR, United States
| | - Eliora Olivares
- Social Mobility Lab, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Tina Vu
- Social Mobility Lab, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Marie Wilkey
- Social Mobility Lab, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Samantha Noregaard
- Social Mobility Lab, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Naomi T. Fitter
- Collaborative Robotics and Intelligent Systems (CoRIS) Institute, Oregon State University, Corvallis, OR, United States
| | - Samuel W. Logan
- Social Mobility Lab, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
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39
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Stuyvenberg CL, Brown SE, Inamdar K, Evans M, Hsu LY, Rolin O, Harbourne RT, Westcott McCoy S, Lobo MA, Koziol NA, Dusing SC. Targeted Physical Therapy Combined with Spasticity Management Changes Motor Development Trajectory for a 2-Year-Old with Cerebral Palsy. J Pers Med 2021; 11:jpm11030163. [PMID: 33673573 PMCID: PMC7997196 DOI: 10.3390/jpm11030163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/13/2021] [Accepted: 02/19/2021] [Indexed: 01/09/2023] Open
Abstract
Therapies for children with cerebral palsy (CP) often fail to address essential components of early rehabilitation: intensity, child initiation, and an embodied approach. Sitting Together And Reaching To Play (START-Play) addresses these issues while incorporating intensive family involvement to maximize therapeutic dosage. While START-Play was developed and tested on children aged 7–16 months with motor delays, the theoretical construct can be applied to intervention in children of broader ages and skills levels. This study quantifies the impact of a broader START-Play intervention combined with Botulinum toxin-A (BoNT-A) and phenol on the developmental trajectory of a 24 month-old child with bilateral spastic CP. In this AB +1 study, A consisted of multiple baseline assessments with the Gross Motor Function Measure-66 and the Assessment of Problem Solving in Play. The research participant demonstrated a stable baseline during A and changes in response to the combination of BoNT-A/phenol and 12 START-Play sessions during B, surpassing the minimal clinically important difference on the Gross Motor Function Measure-66. The follow-up data point (+1) was completed after a second round of BoNT-A/phenol injections. While the findings suggest the participant improved his gross motor skills with BoNT-A/phenol and START-Play, further research is needed to generalize these findings.
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Affiliation(s)
- Corri L. Stuyvenberg
- Rehabilitation Science Graduate Program, University of Minnesota Medical School, MMC 388, 420 Delaware St. SE, Minneapolis, MN 55455, USA;
| | - Shaaron E. Brown
- Department of Physical Therapy, Virginia Commonwealth University Health System, 1300 East Marshall Street, P.O. Box 980419, Richmond, VA 23298, USA;
| | - Ketaki Inamdar
- Rehabilitation and Movement Science Program, College of Health Professions, Virginia Commonwealth University, 900 E. Leigh Street, Richmond, VA 23298, USA;
| | - Megan Evans
- College of Health Professions, Virginia Commonwealth University, 900 E. Leigh Street, Richmond, VA 23298, USA;
| | - Lin-ya Hsu
- Department of Rehabilitation Medicine, Division of Physical Therapy, University of Washington, 1959 NE Pacific Street, P.O. Box 356490, Seattle, WA 98195, USA; (L.-y.H.); (S.W.M.)
| | - Olivier Rolin
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University Health Sciences, 1223 E. Marshall Street, P.O. Box 980677, Richmond, VA 23298, USA;
| | - Regina T. Harbourne
- Rangos School of Health Sciences, Physical Therapy, Duquesne University, 600 Forbes Ave., Pittsburgh, PA 15282, USA;
| | - Sarah Westcott McCoy
- Department of Rehabilitation Medicine, Division of Physical Therapy, University of Washington, 1959 NE Pacific Street, P.O. Box 356490, Seattle, WA 98195, USA; (L.-y.H.); (S.W.M.)
| | - Michele A. Lobo
- Department of Physical Therapy and Biomechanics & Movement Science Program, University of Delaware, 540 S. College Ave., Newark, DE 19711, USA;
| | - Natalie A. Koziol
- Nebraska Center for Research on Children, Youth, Families & Schools, University of Nebraska Lincoln, 160 Prem S. Paul Research Center at Whittier School, Lincoln, NE 68583, USA;
| | - Stacey C. Dusing
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E Alcazar Street, CHP 155, Los Angeles, CA 90033, USA
- Correspondence:
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Peyton C, Sukal Moulton T, Carroll AJ, Anderson E, Brozek A, Davis MM, Horowitz J, Jayaraman A, O'Brien M, Patrick C, Pouppirt N, Villamar J, Xu S, Lieber RL, Wakschlag LS, Krogh-Jespersen S. Starting at Birth: An Integrative, State-of-the-Science Framework for Optimizing Infant Neuromotor Health. Front Pediatr 2021; 9:787196. [PMID: 35141178 PMCID: PMC8820372 DOI: 10.3389/fped.2021.787196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/17/2021] [Indexed: 11/18/2022] Open
Abstract
Numerous conditions and circumstances place infants at risk for poor neuromotor health, yet many are unable to receive treatment until a definitive diagnosis is made, sometimes several years later. In this integrative perspective, we describe an extensive team science effort to develop a transdiagnostic approach to neuromotor health interventions designed to leverage the heightened neuroplasticity of the first year of life. We undertook the following processes: (1) conducted a review of the literature to extract common principles and strategies underlying effective neuromotor health interventions; (2) hosted a series of expert scientific exchange panels to discuss common principles, as well as practical considerations and/or lessons learned from application in the field; and (3) gathered feedback and input from diverse stakeholders including infant caregivers and healthcare providers. The resultant framework was a pragmatic, evidence-based, transdiagnostic approach to optimize neuromotor health for high-risk infants based on four principles: (a) active learning, (b) environmental enrichment, (c) caregiver engagement, and (d) strength-based approaches. In this perspective paper, we delineate these principles and their potential applications. Innovations include: engagement of multiple caregivers as critical drivers of the intervention; promoting neuromotor health in the vulnerability phase, rather than waiting to treat neuromotor disease; integrating best practices from adjacent fields; and employing a strengths-based approach. This framework holds promise for implementation as it is scalable, pragmatic, and holistically addresses both the needs of the infant and their family.
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Affiliation(s)
- Colleen Peyton
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Theresa Sukal Moulton
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Allison J Carroll
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Erica Anderson
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States
| | - Alexandra Brozek
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Matthew M Davis
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Ann and Robert H. Lurie Children's Hospital, Stanley Manne Children's Research Institute, Chicago, IL, United States
| | - Jessica Horowitz
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | | | | | - Cheryl Patrick
- Division of Rehabilitative Services, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Nicole Pouppirt
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Juan Villamar
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Shuai Xu
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Richard L Lieber
- Shirley Ryan AbilityLab, Chicago, IL, United States.,Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lauren S Wakschlag
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sheila Krogh-Jespersen
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, United States.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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