1
|
Abreu RWFD, Lima CRG, Verdério BN, Santos MMD, Dos Santos AN, Brugnaro BH, Rocha NACF. Association between environmental factors during the COVID-19 pandemic and functioning of infants with biological risk in the first year of life: Cross-sectional exploratory study. Early Hum Dev 2024; 191:105987. [PMID: 38520911 DOI: 10.1016/j.earlhumdev.2024.105987] [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: 01/31/2024] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Child development can be influenced by family and environmental factors, which changed during the COVID-19 pandemic. Thus, it is important to explore how these factors are associated with the functioning of infants with biological risk in the first year of life. OBJECTIVE This study aimed to investigate associations between family factors, home opportunities, caregiver perception of environmental support and barriers at home and environmental factors during the COVID-19 pandemic and gross motor skills and home participation in infants with biological risk in the first year of life. METHODS Fifty-six infants aged two to 12 months (M = 5.80 months; ±2.44) and their mothers performed remote assessments of gross motor skills using the Alberta Infant Motor Scale (AIMS); participation and environment (phone call) by the Young Children's Participation and Environment Measure (YC-PEM); family factors (income, age and maternal education), home opportunities - The Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS) and environmental factors during the COVID-19 pandemic (social distancing, emotional and financial factors and physiotherapy) (online forms). Regression models were constructed, considering gross motor skills and home participation as outcome variables, with a 5 % significance level. RESULTS We found that older maternal age (p = 0.001), more home opportunities (p = 0.043), and less rigorous social distancing (as opposed to total social distancing [p = 0.045]) were significantly associated with better gross motor skills; and higher maternal education (p = 0.050) was associated with more involvement in home activities. CONCLUSION Family factors, home opportunities and social distancing were differently associated with the gross motor skills and home participation of infants with biological risk in the first year of life.
Collapse
Affiliation(s)
- Raissa Wanderley Ferraz de Abreu
- Infant Development Analysis Laboratory (LADI), Departament of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Camila Resende Gâmbaro Lima
- Infant Development Analysis Laboratory (LADI), Departament of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Bruna Nayara Verdério
- Infant Development Analysis Laboratory (LADI), Departament of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Mariana Martins Dos Santos
- Infant Development Analysis Laboratory (LADI), Departament of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Adriana Neves Dos Santos
- Infant Development Analysis Laboratory (LADI), Departament of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil; Departament of Health Science, Federal University of Santa Catarina (UFSC), Araranguá, SC, Brazil.
| | - Beatriz Helena Brugnaro
- Infant Development Analysis Laboratory (LADI), Departament of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Nelci Adriana Cicuto Ferreira Rocha
- Infant Development Analysis Laboratory (LADI), Departament of Physiotherapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Mendez AI, Tokish H, McQueen E, Chawla S, Klin A, Maitre NL, Klaiman C. A Comparison of the Clinical Presentation of Preterm Birth and Autism Spectrum Disorder: Commonalities and Distinctions in Children Under 3. Clin Perinatol 2023; 50:81-101. [PMID: 36868715 PMCID: PMC10842306 DOI: 10.1016/j.clp.2022.11.001] [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] [Indexed: 03/05/2023]
Abstract
Premature infants and infants later diagnosed with autism spectrum disorder (ASD) share many commonalities in clinical presentations. However, prematurity and ASD also have differences in clinical presentation. These overlapping phenotypes can lead to misdiagnoses of ASD or missing a diagnosis of ASD in preterm infants. We document these commonalities and differences in various developmental domains with the hope of aiding in the accurate early detection of ASD and timely intervention implementation in children born premature. Given the degree of similarities in presentation, evidence-based interventions designed specifically for preterm toddlers or toddlers with ASD may ultimately aid both populations.
Collapse
Affiliation(s)
- Adriana I Mendez
- Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA 30322, USA; Marcus Autism Center, 1920 Briarcliff Road, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA
| | - Hannah Tokish
- Marcus Autism Center, 1920 Briarcliff Road, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA
| | - Emma McQueen
- Marcus Autism Center, 1920 Briarcliff Road, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA
| | - Shivaang Chawla
- Marcus Autism Center, 1920 Briarcliff Road, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA
| | - Ami Klin
- Marcus Autism Center, 1920 Briarcliff Road, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA
| | - Nathalie L Maitre
- Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA
| | - Cheryl Klaiman
- Marcus Autism Center, 1920 Briarcliff Road, Atlanta, GA 30329, USA; Department of Pediatrics, Emory University School of Medicine, 2015 Uppergate Drive, Atlanta, GA 30322, USA; Children's Healthcare of Atlanta, 1405 Clifton Road Northeast, Atlanta, GA 30322, USA.
| |
Collapse
|
4
|
Kim JA, Park S, Fetters L, Eckel SP, Kubo M, Sargent B. Infants born preterm demonstrate reduced task-specific exploration during the scaffolded kick-activated mobile task. JOURNAL OF MOTOR LEARNING AND DEVELOPMENT 2022; 10:429-448. [PMID: 37781091 PMCID: PMC10538249 DOI: 10.1123/jmld.2021-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
This study quantified the spatial exploration of 13 infants born very and extremely preterm (PT) at 4 months corrected age as they learned that moving their feet vertically to cross a virtual threshold activated an infant kick-activated mobile and compared results to 15 infants born full-term (FT) from a previously published study. Spatial exploration was quantified using two general spatial exploration variables (exploration volume, exploration path), two task-specific spatial variables (duration of time in the task-specific region of interest, vertical variance of kicks), and one non-task-specific spatial variable (horizontal variance of kicks). The infants born PT, similar to FT, increased their general spatial exploration and duration in the region of interest and did not change the vertical and horizontal variances of kicks. However, the infants born PT, compared to FT, spent less time in the task-specific region of interest and had a greater non-task-specific horizontal variance throughout the task. This may indicate that infants born PT and FT exhibit similar general spatial exploration, but infants born PT exhibit less task-specific spatial exploration. Future research is necessary to determine the contribution of learning and motor abilities to the differences in task-specific exploration between infants born PT and FT.
Collapse
Affiliation(s)
- Jeong Ah Kim
- Division of Biokinesiology & Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, 1540 E. Alcazar St., CHP 155, Los Angeles, CA 90033, USA
| | - Sungwoo Park
- Division of Biokinesiology & Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, 1540 E. Alcazar St., CHP 155, Los Angeles, CA 90033, USA
| | - Linda Fetters
- Division of Biokinesiology & Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, 1540 E. Alcazar St., CHP 155, Los Angeles, CA 90033, USA
| | - Sandrah P. Eckel
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Masayoshi Kubo
- Department of Physical Therapy, School of Rehabilitation Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Barbara Sargent
- Division of Biokinesiology & Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, 1540 E. Alcazar St., CHP 155, Los Angeles, CA 90033, USA
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Rohr LA, Cabral TI, Weber MD, Tudella E. Manual exploratory behaviors in six-month-old infants at environmental and biological risk. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 129:104317. [PMID: 35963139 DOI: 10.1016/j.ridd.2022.104317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 06/14/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Exploratory behaviors are essential and may improve different skill development. Different risk factors may negatively impact neuromotor development, such as biological risk and environmental risk. OBJECTIVE Assess and discriminate exploratory behaviors of infants at environmental or biological risk and infants at non-risk. METHODS Sixty-four six-month-old infants were divided into three independent groups: Group 1 (G1), 28 healthy full-term infants; Group 2 (G2), 21 full-term infants of low socioeconomic status (SES); Group 3 (G3), 15 very preterm infants. Nine exploratory behaviors were assessed: fingering, mouthing, waving, tapping, banging, transferring, rotating, alternating, and squeezing. RESULTS For the malleable object, fingering (p = 0.005) and transferring (p = 0.046) behaviors were different between G2 and G3 whereas waving behavior (p = 0.041) differed between G1 and G3 and transferring (p = 0.003) between G1 and G2. For the rigid object, waving was different between G1 and G3 (p = 0.018) whereas transferring behavior differed between G2 and G3 (p = 0.019). Total number of behaviors was significantly different between G1 and G2 for malleable (p = 0.019) and rigid objects (p = 0.009). Intragroup analysis revealed differences between malleable and rigid objects for transferring (p = 0.013), squeezing (p < 0.0001), fingering (p < 0.0001), and banging (p = 0.013) behaviors in infants from G1. Fingering and squeezing (p < 0.0001) were different between malleable and rigid objects in G2 (p = 0.009 and p < 0.0001) and G3 (p = 0.004 and p < 0.0001). CONCLUSION Risk factors and object properties influence exploratory behaviors, mainly in low SES infants. Fingering and banging behaviors are favored by rigid objects, while squeezing is favored by malleable objects.
Collapse
Affiliation(s)
- Liz Araújo Rohr
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Thais Invenção Cabral
- Pediatric Rehabilitation Lab, The Ohio State University Wexner Medical Center, Colombus, Ohio, United States.
| | - Meyene Duque Weber
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Eloisa Tudella
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.
| |
Collapse
|
7
|
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.
Collapse
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
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
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.
Collapse
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.
| |
Collapse
|
9
|
Babik I, Galloway JC, Lobo MA. Early exploration of one's own body, exploration of objects, and motor, language, and cognitive development relate dynamically across the first two years of life. Dev Psychol 2022; 58:222-235. [PMID: 34990201 PMCID: PMC9589518 DOI: 10.1037/dev0001289] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Early exploratory behaviors have been proposed to facilitate children's learning, impacting motor, cognitive, language, and social development. This study related the performance of behaviors used to explore oneself to behaviors used to explore objects, and then related both types of exploratory behaviors to motor, language, and cognitive measures longitudinally from 3 through 24 months of age via secondary analysis of an existing dataset. Participants were 52 children (23 full-term, 29 preterm). Previously published results from this dataset documented delays for preterm relative to full-term infants in each assessment. The current results related performance among the assessments throughout the first 2 years of life. They showed that the developmental trajectories of behaviors children used for self-exploration closely related to the trajectories of behaviors they employed to explore objects. The trajectories of both self and object exploration behaviors significantly related to trajectories of children's motor, language, and cognitive development. Specifically, significant relations to global development were observed for self-exploratory head lifting, midline head and hand positioning, hand opening, and behavioral variability, as well as for object-oriented bimanual holding, mouthing, looking, banging, manipulating, transferring of objects, and behavioral intensity and variability. These results demonstrate continuity among the early exploratory behaviors infants perform with their bodies alone, exploratory behaviors with portable objects, and global development. The findings identify specific self- and object-exploration behaviors that may serve as early indicators of developmental delay and could be targeted by interventions to advance motor, language, and cognitive outcomes for infants at risk for delay. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
Affiliation(s)
- Iryna Babik
- Department of Psychological Science, Boise State University, Boise, ID, USA
| | - James Cole Galloway
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Michele A. Lobo
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, DE, USA
| |
Collapse
|
10
|
Infants exploring objects: A cascades perspective. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2022; 64:39-68. [PMID: 37080674 DOI: 10.1016/bs.acdb.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Infants spend much of their time exploring objects (Herzberg et al., 2021), and object exploration is linked to learning and development in various domains (e.g., social, cognitive, motor). But how does exploration develop in the first place, and how, exactly, does exploration promote learning? One way to approach these process-oriented questions is with a developmental cascades perspective, which holds that new skills emerge from earlier-developing ones and that various interactions with people and objects accumulate over time to influence multiple domains of development (Masten & Cicchetti, 2010). In this chapter, we describe object exploration from a developmental cascades perspective. In Section 2, we describe typical and atypical trajectories of exploration behaviors, noting how these behaviors emerge from earlier-developing cognitive and motor skills. In Section 3, we discuss how object exploration opens the door for new types of learning opportunities. In Section 4, we discuss early experiences that may shape the development of object exploration. Altogether, we aim to convey that new developments in exploration skills are extensions of earlier-developing skills, and that seemingly insignificant exploratory behaviors (e.g., shaking a rattle) may result in numerous and varied consequences for the developing infant.
Collapse
|
11
|
Zhou J, Smith BA. Infant Reaching in the First Year of Life: A Scoping Review of Typical Development and Examples of Atypical Development. Phys Occup Ther Pediatr 2022; 42:80-98. [PMID: 33975491 DOI: 10.1080/01942638.2021.1921092] [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: 10/21/2022]
Abstract
AIMS Our objective was to identify the most common variables used for infant reaching assessment, describe values of these variables across the first year of life, and identify methodological considerations and knowledge gaps for future research. METHODS Studies were included if they met the following criteria: (1) assessed infant reaching in any position, (2) included a sample of infants with typical development: healthy, full-term, with no known impairments, (3) infants were under one year old at the first data collection, and (4) counted successful reaches resulting in object contact. RESULTS We identified 6 commonly assessed kinematic reaching variables: frequency, duration, movement units, peak velocity, average velocity, and straightness index. Methodological inconsistencies limit our ability to interpret values of these variables across studies. CONCLUSIONS Eliminating inconsistencies in study design and data analysis methods is the next step to defining a normative reference standard for reaching development. Establishing a normative reference standard for reaching in the first year of life will be important for assessment of typical and atypical reaching development.
Collapse
Affiliation(s)
- Judy Zhou
- Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Beth A Smith
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Division of Research on Children, Youth, and Families, Children's Hospital Los Angeles, Los Angeles, California, USA
| |
Collapse
|
12
|
Burstein O, Zevin Z, Geva R. Preterm Birth and the Development of Visual Attention During the First 2 Years of Life: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e213687. [PMID: 33783515 PMCID: PMC8010593 DOI: 10.1001/jamanetworkopen.2021.3687] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/18/2021] [Indexed: 12/17/2022] Open
Abstract
Importance Preterm birth is associated with an increased risk for long-lasting attention deficits. Early-life markers of attention abnormalities have not been established to date but could provide insights into the pathogenesis of attention abnormalities and could help identify susceptible individuals. Objective To examine whether preterm birth is associated with visual attention impairments in early life, and if so, in which attention functions and at which developmental period during the first 2 years of life. Data Sources PubMed and PsycINFO were searched on November 17, 2019, to identify studies involving visual attention outcomes in infants born preterm vs full term. Study Selection Peer-reviewed studies from the past 50 years met the eligibility criteria if they directly assessed visual attention outcomes until the age of 2 years in generally healthy infants born preterm or full term. The selection process was conducted by 2 independent reviewers. Data Extraction and Synthesis The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline was followed. Random-effects models were used to determine standardized mean differences. The risk of bias was assessed both within and between studies. Main Outcomes and Measures Five nascent indices of visual attention were analyzed, including very basic functions-namely, the abilities to follow and fixate on visual targets-and more complex functions, such as visual processing (ie, habituation), recognition memory (ie, novelty preference), and the ability to effortfully focus attention for learning. Results A total of 53 studies were included, with 69 effect sizes and assessing a total of 3998 infants (2047 born preterm and 1951 born full term; of the 3376 for whom sex was reported, 1693 [50.1%] were girls). Preterm birth was associated with impairments in various attention indices, including visual-following in infancy (Cohen d, -0.77; 95% CI, -1.23 to -0.31), latency to fixate (Cohen d, -0.18; 95% CI, -0.33 to -0.02), novelty preference (Cohen d, -0.20; 95% CI, -0.32 to -0.08), and focused attention (Cohen d, -0.28; 95% CI, -0.45 to -0.11). In the neonatal period, preterm birth was associated with superior visual-following (Cohen d, 0.22; 95% CI, 0.03 to 0.40), possibly owing to the additional extrauterine exposure to sensory stimulation. However, this early association waned rapidly in infancy (Cohen d, -0.77; 95% CI, -1.23 to -0.31). Conclusions and Relevance The findings suggest that preterm birth is associated with impingements to visual attention development in early life, as manifested in basic and then complex forms of attention. Advancements in neonatal care may underlie improvements found in the current era and accentuate several early protective factors.
Collapse
Affiliation(s)
- Or Burstein
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Zipi Zevin
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Ronny Geva
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel
- Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| |
Collapse
|
13
|
Molinini RM, Koziol NA, Tripathi T, Harbourne RT, McCoy SW, Lobo MA, Bovaird J, Dusing SC. Measuring Early Problem-Solving in Young Children with Motor Delays: A Validation Study. Phys Occup Ther Pediatr 2021; 41:390-409. [PMID: 33517815 DOI: 10.1080/01942638.2020.1865501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 11/23/2020] [Accepted: 12/14/2020] [Indexed: 01/13/2023]
Abstract
AIM There is a lack of evidence-based tools for measuring problem-solving in young children with motor delays. The purpose of this study was to evaluate the construct validity and responsiveness of the Assessment of Problem-Solving in Play. METHODS 125 young children (10.72, SD 2.62 months) with mild, moderate, and severe motor delays were assessed with the Bayley Scales of Infant and Toddler Development, Third Edition Cognitive Scale and the Assessment of Problem-Solving in Play up to 4 times over 12 months. The baseline and change over time assessment scores were compared. RESULTS The Assessment of Problem-Solving in Play was strongly, positively correlated with the Bayley Scales of Infant and Toddler Development, Third Edition Cognitive Scale raw scores at baseline (r=.83, p<.001) and for changes in scores across time (r=.64, p<.001). On average, participants demonstrated positive change in problem-solving scores across time. Participants with severe motor delay scored lower at baseline and changed less as compared to other participants. CONCLUSIONS Results provide evidence for the construct validity and responsiveness of the Assessment of Problem-Solving in Play scores in quantifying problem-solving in young children with motor delays 7-27 months of age.
Collapse
Affiliation(s)
- Rebecca M Molinini
- Motor Development Lab, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Natalie A Koziol
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Tanya Tripathi
- Pediatric and Rehabilitation Laboratory, The Ohio State University, Columbus, Ohio, USA
| | - Regina T Harbourne
- Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Sarah Westcott McCoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Michele A Lobo
- Move to Learn Innovation Lab, Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA
| | - James Bovaird
- Educational Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Stacey C Dusing
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
14
|
A Novel Means-End Problem-Solving Assessment Tool for Early Intervention: Evaluation of Validity, Reliability, and Sensitivity. Pediatr Phys Ther 2021; 33:2-9. [PMID: 33337765 DOI: 10.1097/pep.0000000000000761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate validity, reliability, and sensitivity of the novel Means-End Problem-Solving Assessment Tool (MEPSAT). METHODS Children with typical development and those with motor delay were assessed throughout the first 2 years of life using the MEPSAT. MEPSAT scores were validated against the cognitive and motor subscales of the Bayley Scales of Development. Intra- and interrater reliability, developmental trends, and differences among groups were evaluated. RESULTS Changes in MEPSAT scores positively related to changes in Bayley scores across time for both groups of children. Strong intra- and interrater reliability was observed for MEPSAT scoring across all children. The MEPSAT was sensitive to identify change across time and differences in problem-solving among children with varying levels of motor delay. CONCLUSIONS The MEPSAT is supported by validity and reliability evidence and is a simple tool for screening early problem-solving delays and evaluating change across time in children with a range of developmental abilities. What this adds to the evidence: The novel MEPSAT is supported by validity and reliability evidence. It is sensitive to detect problem-solving differences among young children with varying motor ability and to capture changes in problem-solving across time. It requires minimal equipment and time to administer and score and, thus, is a promising tool for clinicians to screen for early problem-solving delays or to track intervention progress in young children with or at risk for problem-solving delays.
Collapse
|
15
|
Babik I, Cunha AB, Lobo MA. Assistive and Rehabilitative Effects of the Playskin Lift TM Exoskeletal Garment on Reaching and Object Exploration in Children With Arthrogryposis. Am J Occup Ther 2021; 75:7501205110p1-7501205110p10. [PMID: 33399059 PMCID: PMC7784035 DOI: 10.5014/ajot.2020.040972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Children with arthrogryposis multiplex congenita are often delayed in their development of reaching and object exploration, which can place them at risk for associated delays in motor and cognitive development. OBJECTIVE To evaluate the longitudinal assistive and rehabilitative effects of the Playskin Lift™ (hereinafter Playskin), a novel exoskeletal garment, on reaching and object exploration abilities in children with arthrogryposis. DESIGN Single-case ABA design with a 1-mo baseline, 4-mo intervention, and 1-mo postintervention. SETTING Home environment. PARTICIPANTS Seventeen children with arthrogryposis (ages 6-35 mo at first visit; 5 boys). INTERVENTION Participants used the Playskin daily for 30 to 45 min while participating in structured intervention activities to encourage reaching for objects across play spaces larger than they were typically able to. OUTCOMES AND MEASURES Participants were tested biweekly throughout the study with and without the Playskin using a systematic reaching assessment. Coding of reaching and object exploration behavior was performed using OpenSHAPA software; statistical analyses were conducted using Hierarchical Linear and Nonlinear Modeling software. Feasibility of the Playskin for daily home intervention was evaluated with a parent perception questionnaire. RESULTS Positive assistive effects (improved performance when wearing the Playskin within sessions) and rehabilitative effects (improved independent performance after the Playskin intervention) were observed with increased active range of motion, expanded reaching space, improved grasping with the ventral side of the open hand, and greater complexity and multimodality and intensity of object exploration. CONCLUSIONS AND RELEVANCE The Playskin may be a feasible, effective assistive and rehabilitative device to advance object interaction and learning in young children with arthrogryposis. WHAT THIS ARTICLE ADDS The novel exoskeletal Playskin garment improves reaching and object exploration in young children with arthrogryposis.
Collapse
Affiliation(s)
- Iryna Babik
- Iryna Babik, PhD, is Assistant Professor, Department of Psychological Science, Boise State University, Boise, Idaho
| | - Andrea Baraldi Cunha
- Andrea Baraldi Cunha, PT, PhD, is Research Associate, Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware, Newark
| | - Michele A Lobo
- Michele A. Lobo, PT, PhD, is Associate Professor, Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware, Newark;
| |
Collapse
|
16
|
Zuccarini M, Guarini A, Savini S, Faldella G, Sansavini A. Do 6-Month Motor Skills Have Cascading Effects on 12-Month Motor and Cognitive Development in Extremely Preterm and Full-Term Infants? Front Psychol 2020; 11:1297. [PMID: 32670158 PMCID: PMC7332837 DOI: 10.3389/fpsyg.2020.01297] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/18/2020] [Indexed: 11/17/2022] Open
Abstract
In this study, we analyzed whether 6-month gross and fine motor skills were related to 12-month gross and fine motor skills and cognitive development, controlling for 6-month cognitive skills, and neonatal status (extremely low gestational age ELGA ≤ 28 weeks vs. full-term FT ≥ 37 weeks). We also investigated, at 6 months, predictive indexes for motor and cognitive delay at 12-months. We assessed 40 infants (20 ELGA and 20 FT) at 6 and 12 months (corrected age for the ELGA infants). Six-month gross motor skills were related to 12-month gross motor, fine motor, and cognitive skills and predicted 12-month gross motor delay. Six-month cognitive skills explained an additional amount of variance of 12-month gross motor skills, whereas neonatal status explained an additional amount of variance of 12-month cognitive skills. Considering the intradomain and cross-domain cascading effects of early gross motor skills on later motor and cognitive development, these skills should be repeatedly assessed in ELGA infants in the first year of life for early identification of infants with delayed gross motor skills and implementation of customized interventions.
Collapse
Affiliation(s)
| | | | - Silvia Savini
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giacomo Faldella
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | |
Collapse
|
17
|
Dusing SC, Burnsed JC, Brown SE, Harper AD, Hendricks-Munoz KD, Stevenson RD, Thacker LR, Molinini RM. Efficacy of Supporting Play Exploration and Early Development Intervention in the First Months of Life for Infants Born Very Preterm: 3-Arm Randomized Clinical Trial Protocol. Phys Ther 2020; 100:1343-1352. [PMID: 32329778 PMCID: PMC7439229 DOI: 10.1093/ptj/pzaa077] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/21/2019] [Accepted: 04/16/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this project is to study the effect of a physical therapist intervention provided in the first months of life on developmental outcomes of infants born very preterm. Secondary aims are to investigate the impact of intervention timing on the efficacy and impact of the intervention on infants with and without cerebral palsy. METHODS This study is a multisite longitudinal controlled trial comparing developmental outcomes from infants in the Supporting Play, Exploration, and Early Development Intervention (SPEEDI)_Late or SPEEDI_Early group to a usual care group. SETTINGS ARE URBAN Urban and rural areas surrounding 2 academic medical centers. There will be 90 preterm infants enrolled in this study born at <29 weeks of gestation. SPEEDI is a developmental intervention provided by collaboration between a physical therapist and parent to support a child's motor and cognitive development. The primary outcome measure is the Bayley Scale of Infant and Toddler Development Cognitive and Gross Motor Scaled Scores. Secondary measures include behavioral coding of early problem solving skills, the Gross Motor Function Measure, and Test of Infant Motor Performance. IMPACT More than 270,000 infants are born very preterm in the United States each year, 50% of whom will have neurological dysfunction that limits their ability to keep pace with peers who are typically developing. This study is a step toward understanding the impact that intensive developmental intervention could have in this population in the first months of life.
Collapse
Affiliation(s)
- Stacey C Dusing
- Biokinesiology and Physical Therapy, University of Southern California, 1540 E Alcazar St, CHP 155, Los Angeles, CA 90033 (USA),Address all correspondence to Dr. Dusing at: Dr. Dusing is a Board-Certified Clinical Specialist in Pediatric Physical Therapy.
| | - Jennifer C Burnsed
- Department of Pediatrics and Neurology, University of Virginia, Charlottesville, Virginia
| | - Shaaron E Brown
- Board Certified Pediatric Specialist, Department of Physical Therapy, Virginia Commonwealth University Health, Richmond, Virginia
| | - Amy D Harper
- Department of Neurology, Virginia Commonwealth University
| | | | | | - Leroy R Thacker
- Department of Biostatistics, Virginia Commonwealth University
| | - Rebecca M Molinini
- Rehabilitation Movement Sciences Program and Motor Development Lab, Virginia Commonwealth University
| |
Collapse
|
18
|
Babik I, Cunha AB, Lobo MA. Play with objects in children with arthrogryposis: Effects of intervention with the Playskin Lift™ exoskeletal garment. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2019; 181:393-403. [PMID: 31232529 PMCID: PMC10740315 DOI: 10.1002/ajmg.c.31719] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/08/2019] [Accepted: 06/11/2019] [Indexed: 11/07/2022]
Abstract
Children with arthrogryposis multiplex congenita (AMC) often exhibit arm movement impairments that can negatively impact activities of daily living, such as reaching, object exploration, object play, and self-care. This study evaluated the effects of intervention involving the Playskin Lift™ (Playskin) exoskeletal garment on arm function during object play for children with AMC. Seventeen children with AMC (5 males; 6-35 months at the beginning of the study) were tested in their homes biweekly with and without the Playskin throughout a 1-month Baseline, 4-month Intervention, and 1-month Post-Intervention. Within sessions (assistive effects), children contacted and manipulated objects more while wearing the Playskin; they also showed greater intensity, complexity, and variability of behaviors performed during free play, as well as increased play space and reduced number of compensatory arm and trunk flings to facilitate reaching. Across time (rehabilitative effects), children significantly improved their visual-manual coupling as well as their ability to lift objects from a surface and to manipulate objects using one hand; in addition, children exhibited greater multimodality, variability, and intensity of their play behaviors. Current results suggest the Playskin Lift™ may serve as an effective assistive and rehabilitative device to improve play for children with arm movement impairments.
Collapse
Affiliation(s)
- Iryna Babik
- Department of Psychological Science, Boise State University, Boise, Idaho
| | - Andrea B. Cunha
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Michele A. Lobo
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, Delaware
| |
Collapse
|
19
|
Sitting Matters! Differences Between Sitters and Nonsitters at 6 Months' Adjusted Age in Infants At-Risk and Born Preterm. Pediatr Phys Ther 2019; 31:257-262. [PMID: 31225830 DOI: 10.1097/pep.0000000000000622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Sitting delays in infants born preterm compound cognitive and language deficits. This retrospective study examines differences in prematurity-related risk and compares developmental outcomes between sitters and nonsitters at 6 months' adjusted age. METHODS A total of 105 graduates of the neonatal intensive care unit met inclusion criteria. Infant demographic and medical risk profiles and 6-month Bayley Scales of Infant Development-3rd edition (BSID-III) cognitive and language scores were retrieved. Infants who sat with hands free greater than 60 seconds were classified as "sitters." RESULTS Sixty-nine percent of the sample were nonsitters and were born earlier, had lower birth weights, were chronologically older at follow-up, and spent more days with respiratory support. BSID-III scores were significantly higher in sitters but did not differ by gender, multiple birth, head ultrasound results, payment type, or race/ethnicity. CONCLUSION Sitting abilities at 6 months' adjusted age are associated with prematurity risk factors. Cognitive and language scores differ significantly between sitters and nonsitters.
Collapse
|
20
|
Kaul YF, Rosander K, Grönqvist H, Strand Brodd K, Hellström-Westas L, von Hofsten C. Reaching skills of infants born very preterm predict neurodevelopment at 2.5 years. Infant Behav Dev 2019; 57:101333. [PMID: 31238256 DOI: 10.1016/j.infbeh.2019.101333] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 05/13/2019] [Accepted: 06/09/2019] [Indexed: 12/26/2022]
Abstract
The purpose was to investigate associations between quality of reaching for moving objects at 8 months corrected age and neurodevelopment at 2.5 years in children born very preterm (gestational age (GA), 24-31 weeks). Thirtysix infants were assessed while reaching for moving objects. The movements were recorded by a 3D motion capture system. Reaching parameters included aiming, relative length of the reach, number of movement units, proportion of bimanual coupled reaches and number of hits. Neurodevelopment was assessed at 2.5 years by the Bayley Scales of Infant Development III. There were strong associations between infant reaching kinematics and neurodevelopment of cognition and language but the patterns differed: in children born extremely preterm (GA < 28 weeks), planning and control of reaching was strongly related to outcome, while in children born very preterm (GA 28-31 weeks) number of hits and bimanual strategies were of greater relevance. In conclusion, for extremely preterm infants, basic problems on how motion information is incorporated with action planning prevail, while in very preterm infants the coordination of bimanual reaches is more at the focus. We conclude that the results reflect GA related differences in neural vulnerability and that early motor coordination deficits have a cascading effect on neurodevelopment.
Collapse
Affiliation(s)
| | | | - Helena Grönqvist
- Department of Women's and Children's Health, Uppsala University, Sweden.
| | - Katarina Strand Brodd
- Department of Women's and Children's Health, Uppsala University, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Sweden.
| | | | | |
Collapse
|
21
|
Babik I, Cunha AB, Moeyaert M, Hall ML, Paul DA, Mackley A, Lobo MA. Feasibility and Effectiveness of Intervention With the Playskin Lift Exoskeletal Garment for Infants at Risk. Phys Ther 2019; 99:666-676. [PMID: 31155661 PMCID: PMC6545275 DOI: 10.1093/ptj/pzz035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 01/01/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND Infants born preterm and/or with brain injury often exhibit delays in the development of reaching and object exploration, increasing their risk of associated delays in cognitive development. OBJECTIVE The objective of this study was to longitudinally evaluate feasibility of use of the novel Playskin Lift exoskeletal garment (Playskin; developed and trademarked by Dr. Lobo's Super Suits FUNctional Fashion and Wearable Technology Program at the University of Delaware, Newark, DE, USA), the assistive and rehabilitative effects of intervention with the garment on reaching and object exploration ability, and to relate changes in reaching and object exploration to changes in cognition during intervention for infants at risk for developmental delays. DESIGN A multiple baseline single-case design with 1- to 2-month Baseline, 4-month Intervention, and 1-month Postintervention phases was implemented. METHODS Ten infants born preterm and/or with brain injury, mean [SD] age 2.2 [1.3] months at the beginning of the study, were assessed biweekly throughout the study both with and without the Playskin Lift. Assessments included a Reaching Assessment and the cognitive subscale of the Bayley Scales of Infant and Toddler Development. Reaching and object exploration behaviors were coded from videos of the Reaching Assessment. Results were analyzed using multilevel modeling in SAS. RESULTS The Playskin Lift improved infants' reaching ability, hand orientation for grasp and object exploration, and multimodal object exploration when worn within sessions, especially during the Intervention phase. The garment also improved independent reaching and object exploration across time during the Intervention phase, with retention of gains in the Postintervention phase. Improvement in reaching ability was positively related to changes in cognitive outcomes during the Intervention phase. LIMITATIONS Limitations included modest sample size and the potential confounds of development and experience with time. CONCLUSIONS The Playskin Lift can serve as a feasible, effective, and accessible assistive and rehabilitative device to advance reaching, object exploration, and cognition for infants at risk for future delays.
Collapse
Affiliation(s)
- Iryna Babik
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Andrea B Cunha
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware
| | - Mariola Moeyaert
- Division of Educational Psychology & Methodology, State University of New York at Albany, Albany, New York
| | - Martha L Hall
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware
| | - David A Paul
- Departments of Pediatrics and Neonatology, Christiana Care Health System, Newark, Delaware
| | - Amy Mackley
- Departments of Pediatrics and Neonatology, Christiana Care Health System
| | - Michele A Lobo
- Biomechanics & Movement Science Program, 210K CHS Building, 540 S. College Avenue, University of Delaware, Newark, DE 19713 (USA),Address all correspondence to Dr Lobo at:
| |
Collapse
|
22
|
Exploratory behavior and developmental skill acquisition in infants with Down syndrome. Infant Behav Dev 2019; 54:140-150. [DOI: 10.1016/j.infbeh.2019.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 02/06/2019] [Accepted: 02/06/2019] [Indexed: 11/22/2022]
|
23
|
Berger SE, Harbourne RT, Guallpa Lliguichuzhca CL. Sit Still and Pay Attention! Trunk Movement and Attentional Resources in Infants with Typical and Delayed Development. Phys Occup Ther Pediatr 2019; 39:48-59. [PMID: 29465319 DOI: 10.1080/01942638.2018.1432005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS (1) examine infant movement during an early posture (sitting) utilizing a novel video assessment technique; and (2) document the differences between infants with typical development (TD), premature infants with motor delay, and infants with cerebral palsy (CP) during focused and nonfocused attention (NFA). METHODS Infants were tested when they began to sit independently. We utilized Eulerian Video Magnification (EVM) to accentuate small trunk and pelvic movements for visual coding from video taken during a natural play task with and without focused attention (FA). RESULTS Trunk/pelvic movement varied as a function of both motor skill and attention. Infants with TD and CP made fewer trunk movements during periods of FA than NFA. Preterm infants exhibited more trunk/pelvic movement than the other groups and their movement did not differ based on attention type. CONCLUSIONS The EVM technique allowed for replicable coding of real-time "hidden" motor adjustments from video. The capacity to minimize extraneous movements in infants, or "sitting still" may allow greater attention to the task at hand, similar to older children and adults. Premature infants' excessive trunk/pelvic movement that did not adapt to task requirements could, in the long term, impact tasks requiring attentional resources.
Collapse
Affiliation(s)
- Sarah E Berger
- a Department of Psychology , The College of Staten Island and the Graduate Center of the City University of New York , New York , USA
| | - Regina T Harbourne
- b John G. Rangos School of Health Sciences , Duquesne University , Pittsburgh , Pennsylvania , USA
| | | |
Collapse
|
24
|
Zuccarini M, Guarini A, Iverson JM, Benassi E, Savini S, Alessandroni R, Faldella G, Sansavini A. Does early object exploration support gesture and language development in extremely preterm infants and full-term infants? JOURNAL OF COMMUNICATION DISORDERS 2018; 76:91-100. [PMID: 30300842 DOI: 10.1016/j.jcomdis.2018.09.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 07/18/2018] [Accepted: 09/23/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND An increasing body of research on typically and atypically developing infants has shown that motor skills play an important role in language development. To date, however, the role of specific object exploration skills for early gesture and vocabulary development has not been investigated in extremely low gestational age infants (ELGA, GA < 28 weeks), who are at greater risk for motor and language delays than full-term (FT) infants. PURPOSE This longitudinal study examined relations between 6-month active exploratory behaviors and 12- month word comprehension, gestures and vocal production, controlling for cognitive performance and neonatal condition (ELGA vs FT). METHODS Forty infants, 20 ELGA and 20 FT, and their mothers participated in the study. Mother-infant play interaction was video-recorded at 6 and 12 months. Oral and manual object exploration at 6 months and spontaneous gestures and vocal production at 12 months were coded. Word comprehension was evaluated with the Italian version of the MacArthur-Bates CDI parent questionnaire at 12 months. Cognitive performance was examined with the Griffiths Mental Developmental Scales at 6 months and the Bayley-III Scales at 12 months. RESULTS Regression analyses showed that after accounting for cognitive performance and neonatal condition, oral exploration was related to word comprehension, and manual exploration to gestures and vocal production in the overall sample. CONCLUSIONS Cascading effects of specific object exploration skills on gestures and language comprehension and production in preterm infants and FT infants are discussed. Clinical implications for early assessment of and interventions involving object exploration skills, which may affect language development, are considered for the preterm population.
Collapse
Affiliation(s)
| | | | | | - Erika Benassi
- Department of Psychology, University of Bologna, Italy
| | - Silvia Savini
- Department of Psychology, University of Bologna, Italy
| | - Rosina Alessandroni
- Neonatology and Neonatal Intensive Care Unit-S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Giacomo Faldella
- Neonatology and Neonatal Intensive Care Unit-S. Orsola-Malpighi Hospital, Bologna, Italy; Department of Medical and Surgical Sciences, University of Bologna, Italy
| | | |
Collapse
|
25
|
Cunha AB, Babik I, Ross SM, Logan SW, Galloway JC, Clary E, Lobo MA. Prematurity may negatively impact means-end problem solving across the first two years of life. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 81:24-36. [PMID: 29609836 PMCID: PMC6131031 DOI: 10.1016/j.ridd.2018.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 03/16/2018] [Accepted: 03/19/2018] [Indexed: 06/08/2023]
Abstract
Preterm infants are at risk for delays in motor, perceptual, and cognitive development. While research has shown preterm infants may exhibit learning delays in the first months of life, these delays are commonly under-diagnosed. The purpose of this study was to longitudinally evaluate behavioral performance and learning in two means-end problem-solving tasks for 30 infants born preterm (PT) and 23 born full-term (FT). Infants were assessed at 6, 9, 12, 18, and 24 months-old in tasks that required towel pulling or turntable rotation to obtain a distant object. PT infants performed more non-goal-directed and less goal-directed behavior than FT infants throughout the study, resulting in a lower success rate among PT infants. PT infants showed delayed emergence of intentionality (prevalence of goal-directed behaviors) compared to FT infants in both tasks. Amount and variability of behavioral performance significantly correlated with task success differentially across age. The learning differences documented between PT and FT infants suggest means-end problem-solving tasks may be useful for the early detection of learning delays. The identification of behaviors associated with learning and success across age may be used to guide interventions aimed at advancing early learning for infants at risk.
Collapse
Affiliation(s)
- Andrea Baraldi Cunha
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Iryna Babik
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Samantha M Ross
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Samuel W Logan
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - James C Galloway
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, DE, USA; Department of Psychology, University of Delaware, Newark, DE, USA
| | - Erika Clary
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Michele A Lobo
- Biomechanics & Movement Science Program, Department of Physical Therapy, University of Delaware, Newark, DE, USA.
| |
Collapse
|
26
|
Harbourne RT, Dusing SC, Lobo MA, Westcott-McCoy S, Bovaird J, Sheridan S, Galloway JC, Chang HJ, Hsu LY, Koziol N, Marcinowski EC, Babik I. Sitting Together And Reaching To Play (START-Play): Protocol for a Multisite Randomized Controlled Efficacy Trial on Intervention for Infants With Neuromotor Disorders. Phys Ther 2018; 98:494-502. [PMID: 29767802 DOI: 10.1093/ptj/pzy033] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 02/15/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND There is limited research examining the efficacy of early physical therapy on infants with neuromotor dysfunction. In addition, most early motor interventions have not been directly linked to learning, despite the clear association between motor activity and cognition during infancy. OBJECTIVE The aim of this project is to evaluate the efficacy of Sitting Together And Reaching To Play (START-Play), an intervention designed to target sitting, reaching, and motor-based problem solving to advance global development in infants with motor delays or neuromotor dysfunction. DESIGN This study is a longitudinal multisite randomized controlled trial. Infants in the START-Play group are compared to infants receiving usual care in early intervention (EI). SETTING The research takes place in homes in Pennsylvania, Delaware, Washington, and Virginia. PARTICIPANTS There will be 140 infants with neuromotor dysfunction participating, beginning between 7 to 16 months of age. Infants will have motor delays and emerging sitting skill. INTERVENTION START-Play provides individualized twice-weekly home intervention for 12 weeks with families to enhance cognition through sitting, reaching, and problem-solving activities for infants. Ten interventionists provide the intervention, with each child assigned 1 therapist. MEASUREMENTS The primary outcome measure is the Bayley III Scales of Infant Development. Secondary measures include change in the Early Problem Solving Indicator, change in the Gross Motor Function Measure, and change in the type and duration of toy contacts during reaching. Additional measures include sitting posture control and parent-child interaction. LIMITATIONS Limitations include variability in usual EI care and the lack of blinding for interventionists and families. CONCLUSIONS This study describes usual care in EI across 4 US regions and compares outcomes of the START-Play intervention to usual care.
Collapse
Affiliation(s)
- Regina T Harbourne
- Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA 15282 (USA)
| | - Stacey C Dusing
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia. Dr Dusing is a board-certified pediatric clinical specialist
| | - Michele A Lobo
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - Sarah Westcott-McCoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - James Bovaird
- Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Susan Sheridan
- Nebraska Center for Research on Children, Youth, Families, and Schools, University of Nebraska-Lincoln
| | - James C Galloway
- Department of Physical Therapy and Psychology, University of Delaware
| | - Hui-Ju Chang
- Rangos School of Health Sciences, Physical Therapy, Duquesne University
| | - Lin-Ya Hsu
- Department of Rehabilitation Medicine, University of Washington
| | - Natalie Koziol
- Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln
| | | | - Iryna Babik
- Department of Physical Therapy, University of Delaware
| |
Collapse
|
27
|
Ouss L, Le Normand MT, Bailly K, Leitgel Gille M, Gosme C, Simas R, Wenke J, Jeudon X, Thepot S, Da Silva T, Clady X, Thoueille E, Afshar M, Golse B, Guergova-Kuras M. Developmental Trajectories of Hand Movements in Typical Infants and Those at Risk of Developmental Disorders: An Observational Study of Kinematics during the First Year of Life. Front Psychol 2018. [PMID: 29515472 PMCID: PMC5826068 DOI: 10.3389/fpsyg.2018.00083] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
HighlightsThe kinematics of hand movements (spatial use, curvature, acceleration, and velocity) of infants with their mothers in an interactive setting
are significantly associated with age in cohorts of typical and at-risk infants differ significantly at 5–6 months of age, depending on the context: relating either with an object or a person.
Environmental and developmental factors shape the developmental trajectories of hand movements in different cohorts: environment for infants with VIMs; stage of development for premature infants and those with West syndrome; and both factors for infants with orality disorders. The curvature of hand movements specifically reflects atypical development in infants with West syndrome when developmental age is considered.
We aimed to discriminate between typical and atypical developmental trajectory patterns of at-risk infants in an interactive setting in this observational and longitudinal study, with the assumption that hand movements (HM) reflect preverbal communication and its disorders. We examined the developmental trajectories of HM in five cohorts of at-risk infants and one control cohort, followed from ages 2 to 10 months: 25 West syndrome (WS), 13 preterm birth (PB), 16 orality disorder (OD), 14 with visually impaired mothers (VIM), 7 early hospitalization (EH), and 19 typically developing infants (TD). Video-recorded data were collected in three different structured interactive contexts. Descriptors of the hand motion were used to examine the extent to which HM were associated with age and cohort. We obtained four principal results: (i) the kinematics of HM (spatial use, curvature, acceleration, and velocity) were significantly associated with age in all cohorts; (ii) HM significantly differed at 5–6 months of age in TD infants, depending on the context; (iii) environmental and developmental factors shaped the developmental trajectories of HM in different cohorts: environment for VIM, development for PB and WS, and both factors for OD and; (iv) the curvatures of HM showed atypical development in WS infants when developmental age was considered. These findings support the importance of using kinematics of HM to identify very early developmental disorders in an interactive context and would allow early prevention and intervention for at-risk infants.
Collapse
Affiliation(s)
- Lisa Ouss
- Department of Child and Adolescent Psychiatry, Necker-Enfants-Malades Hospital, APHP Assistance Publique-Hopitaux De Paris, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France.,UMR 1129 Infantile Epilepsies and Brain Plasticity, Institut National de la Santé et de la Recherche Médicale, CEA, Université Paris Descartes, Paris, France
| | - Marie-Thérèse Le Normand
- Institut National de la Santé et de la Recherche Médicale & Laboratoire de Psychopathologie et Processus de Santé, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Kevin Bailly
- Institut des Systèmes Intelligents et de Robotique, Centre National de la Recherche Scientifique UMR 7222, Université Pierre et Marie Curie Univ Paris 06, Sorbonne Universités, Paris, France
| | - Marluce Leitgel Gille
- Department of Child and Adolescent Psychiatry, Necker-Enfants-Malades Hospital, APHP Assistance Publique-Hopitaux De Paris, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Christelle Gosme
- Department of Child and Adolescent Psychiatry, Necker-Enfants-Malades Hospital, APHP Assistance Publique-Hopitaux De Paris, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Roberta Simas
- Department of Child and Adolescent Psychiatry, Necker-Enfants-Malades Hospital, APHP Assistance Publique-Hopitaux De Paris, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | - Julia Wenke
- EA 3522, CRPMS, ED 450 Recherches en Psychanalyse et Psychopathologie, Université Paris Diderot, Université Sorbonne Paris Cité, Paris, France
| | - Xavier Jeudon
- Cellule Vidéo de l'Hôpital Necker Enfants Malades, Association A l'Aube de la Vie, Paris, France
| | | | | | - Xavier Clady
- Department of Visual Information, Vision Institute, Centre National de la Recherche Scientifique UMR S968, Institut National de la Santé et de la Recherche Médicale UMRS 7210, Université Pierre et Marie Curie Univ Paris 06, Sorbonne Universités, Paris, France
| | | | | | - Bernard Golse
- Department of Child and Adolescent Psychiatry, Necker-Enfants-Malades Hospital, APHP Assistance Publique-Hopitaux De Paris, Université Paris Descartes, Université Sorbonne Paris Cité, Paris, France
| | | |
Collapse
|
28
|
Domellöf E, Johansson AM, Rönnqvist L. Developmental progression and side specialization in upper-limb movements from 4 to 8 years in children born preterm and fullterm. Dev Neuropsychol 2018; 43:219-234. [PMID: 29377727 DOI: 10.1080/87565641.2018.1426765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study investigated developmental changes and differences in upper-limb movement organization from 4 to 8 years of age in children born preterm (PT) and fullterm (FT). Kinematic recordings of precision-demanding unimanual movements and lateral assessments were carried out in 37 children (18 PT). All children, particularly children born PT, displayed considerable gain in movement kinematics. Contrary to controls, children born PT displayed persistently less-evident side preference. Gestational age (GA) contributed significantly to kinematic differences shown, with larger upper-limb deviances in the lowest GAs, in agreement with cross-sectional findings of altered hemispheric connections and delayed side-specialization among children born very PT.
Collapse
Affiliation(s)
- Erik Domellöf
- a Department of Psychology , Umeå University , Umeå , Sweden
| | - Anna-Maria Johansson
- a Department of Psychology , Umeå University , Umeå , Sweden.,b Department of Community Medicine and Rehabilitation, Physiotheraphy , Umeå University , Umeå , Sweden
| | | |
Collapse
|
29
|
Berger SE, Harbourne RT, Horger MN. Cognition-Action Trade-Offs Reflect Organization of Attention in Infancy. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2018; 54:45-86. [PMID: 29455866 DOI: 10.1016/bs.acdb.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This chapter discusses what cognition-action trade-offs in infancy reveal about the organization and developmental trajectory of attention. We focus on internal attention because this aspect is most relevant to the immediate concerns of infancy, such as fluctuating levels of expertise, balancing multiple taxing skills simultaneously, learning how to control attention under variable conditions, and coordinating distinct psychological domains. Cognition-action trade-offs observed across the life span include perseveration during skill emergence, errors and inefficient strategies during decision making, and the allocation of resources when attention is taxed. An embodied cognitive-load account interprets these behavioral patterns as a result of limited attentional resources allocated across simultaneous, taxing task demands. For populations where motor errors could be costly, like infants and the elderly, attention is typically devoted to motor demands with errors occurring in the cognitive domain. In contrast, healthy young adults tend to preserve their cognitive performance by modifying their actions.
Collapse
Affiliation(s)
- Sarah E Berger
- The College of Staten Island and the Graduate Center of the City University of New York, New York, NY, United States.
| | - Regina T Harbourne
- John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Melissa N Horger
- The Graduate Center of the City University of New York, New York, NY, United States
| |
Collapse
|
30
|
Hall ML, Lobo MA. Design and development of the first exoskeletal garment to enhance arm mobility for children with movement impairments. Assist Technol 2018; 30:251-258. [PMID: 28541832 PMCID: PMC9835012 DOI: 10.1080/10400435.2017.1320690] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Children with a variety of diagnoses have impairments that limit their arm function. Despite the fact that arm function is important for early learning and activities of daily living, there are few tools to assist movement for these children, and existing devices have challenges related to cost, accessibility, comfort, and aesthetics. In this article, we describe the design process and development of the first garment-based exoskeleton to assist arm movement in young children with movement impairments: the Playskin LiftTM. We outline our design process, which contrasts with the traditional medical model in that it is interdisciplinary, user-centered, and addresses the broad needs of users, rather than device function alone. Then we report the results of field-testing with the initial prototype with respect to our design metrics on a toddler with significant bilateral arm movement impairments. Finally, we summarize our ongoing development aimed at increasing comfort, aesthetics, and accessibility of the garment. The interdisciplinary, user-centered approach to assistive technology design presented here can result in innovative and impactful design solutions that translate to the real world.
Collapse
Affiliation(s)
- Martha L. Hall
- Department of Fashion & Apparel Studies, University of Delaware, Newark, Delaware, USA,Department of Physical Therapy, University of Delaware, Newark, Delaware, USA,Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA
| | - Michele A. Lobo
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA,Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA
| |
Collapse
|
31
|
Babik I, Galloway JC, Lobo MA. Infants Born Preterm Demonstrate Impaired Exploration of Their Bodies and Surfaces Throughout the First 2 Years of Life. Phys Ther 2017; 97:915-925. [PMID: 28605484 DOI: 10.1093/ptj/pzx064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 06/07/2017] [Indexed: 02/09/2023]
Abstract
BACKGROUND Non-object-oriented exploratory behaviors infants perform with their bodies and surfaces have been proposed to be key precursors of infants' object exploration, early learning, and future cognitive development. Little is known about the developmental trajectories of these behaviors, especially for infants born preterm. OBJECTIVE The purpose of the study was to longitudinally compare non-object-oriented exploratory behaviors performed by full-term and preterm infants. DESIGN The study followed 24 full-term and 30 preterm infants (6 with significant brain injury) performing non-object-oriented exploratory behaviors in prone, supine, and sitting from birth through 24 months. METHODS Infants were observed without objects or direct social interaction for 3 minutes in prone and supine (0 through 9 months) and in sitting (3 through 24 months). Behavioral coding produced data that were analyzed using hierarchical linear modeling. Developmental trajectories of behaviors were compared among full-term infants, preterm infants without significant brain injury, and preterm infants with significant brain injury. RESULTS Compared to full-term peers, preterm infants showed poorer postural control (less head lifting in prone), midline behavior (holding the head in midline, holding both hands in midline), hand-to-mouth and visual-motor behaviors against gravity, and more asymmetrical one-handed fisting. Preterm infants performed fewer bouts of non-object-oriented exploratory behaviors, and their behaviors were less variable with fewer combinations. LIMITATIONS There was a limited sample of infants born preterm with significant brain injury. CONCLUSIONS Non-object-oriented exploratory behaviors are important for early perceptual-motor development. Key differences were noted in these behaviors for infants born preterm. These differences may lead to impaired reaching, object exploration, and cognition. Early intervention programs should utilize assessments and interventions that target these very early non-object-oriented exploratory behaviors.
Collapse
Affiliation(s)
- Iryna Babik
- Department of Physical Therapy, University of Delaware, Newark, Delaware
| | - James Cole Galloway
- Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware
| | - Michele A Lobo
- Department of Physical Therapy, Biomechanics and Movement Science Program, University of Delaware, 210K CHS Building, 540 South College Ave, Newark, DE 19713 (USA)
| |
Collapse
|
32
|
Zuccarini M, Guarini A, Savini S, Iverson JM, Aureli T, Alessandroni R, Faldella G, Sansavini A. Object exploration in extremely preterm infants between 6 and 9 months and relation to cognitive and language development at 24 months. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 68:140-152. [PMID: 28779627 DOI: 10.1016/j.ridd.2017.06.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 05/03/2017] [Accepted: 06/03/2017] [Indexed: 06/07/2023]
Abstract
Although early object exploration is considered a key ability for subsequent achievements, very few studies have analyzed its development in extremely low gestational age infants (ELGA- GA <28 weeks), whose early motor skills are delayed. Moreover, no studies have examined its developmental relationship with cognitive and language skills. The present study examined developmental change in Motor Object Exploration (MOE) and different types of MOE (Holding, Oral, Manual and Manual Rhythmic Exploration) in 20 ELGA and 20 full term (FT) infants observed during mother-infant play interaction at 6 and 9 months. It also explored whether specific types of MOE were longitudinally related to 24-month language and cognitive abilities (GMDS-R scores). ELGA infants increased MOE duration from 6 to 9 months, eliminating the initial difference with FT infants. In addition, ELGA infants showed a different pattern of Oral Exploration, that did not increase at 6 months and decrease at 9 months. Oral and Manual Exploration durations at 6 months were longitudinally related to 24-month GMDS-R language and cognitive performance scores respectively. We discuss the relevance of assessing early exploratory abilities in ELGA infants in order to implement customized intervention programs for supporting the development of these skills.
Collapse
Affiliation(s)
- Mariagrazia Zuccarini
- Department of Psychology, University of Bologna, Via Berti Pichat, 5-40127 Bologna, Italy.
| | - Annalisa Guarini
- Department of Psychology, University of Bologna, Via Berti Pichat, 5-40127 Bologna, Italy.
| | - Silvia Savini
- Department of Psychology, University of Bologna, Via Berti Pichat, 5-40127 Bologna, Italy.
| | - Jana M Iverson
- Department of Psychology, University of Pittsburgh, USA.
| | - Tiziana Aureli
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Italy.
| | - Rosina Alessandroni
- Neonatology and Neonatal Intensive Care Unit - S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Italy.
| | - Giacomo Faldella
- Neonatology and Neonatal Intensive Care Unit - S. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Italy.
| | - Alessandra Sansavini
- Department of Psychology, University of Bologna, Via Berti Pichat, 5-40127 Bologna, Italy.
| |
Collapse
|
33
|
Oudgenoeg-Paz O, Mulder H, Jongmans MJ, van der Ham IJM, Van der Stigchel S. The link between motor and cognitive development in children born preterm and/or with low birth weight: A review of current evidence. Neurosci Biobehav Rev 2017. [PMID: 28642071 DOI: 10.1016/j.neubiorev.2017.06.009] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The current review focuses on evidence for a link between early motor development and later cognitive skills in children born preterm or with Low Birth Weight (LBW). Studies with term born children consistently show such a link. Motor and cognitive impairments or delays are often seen in children born preterm or with LBW throughout childhood and studies have established a cross-sectional association between the two. However, it is not yet clear if, and if so, how, motor and cognitive skills are longitudinally interrelated in these children. Longitudinal studies with this population including measures of motor development during the first year of life and cognitive measures at later measurement points were included. The 17 studies included usually show a link between level and/or quality of motor development during the first year of life and later cognitive skills in children born preterm and/or with LBW. However, given the small number of studies, and a possible effect of early interaction between motor and cognitive skills affecting this relation, more work is clearly needed.
Collapse
Affiliation(s)
- Ora Oudgenoeg-Paz
- Department of Pedagogical and Educational Sciences, Utrecht University, The Netherlands.
| | - Hanna Mulder
- Department of Pedagogical and Educational Sciences, Utrecht University, The Netherlands
| | - Marian J Jongmans
- Department of Pedagogical and Educational Sciences, Utrecht University, The Netherlands
| | - Ineke J M van der Ham
- Department of Health, Medical, and Neuropsychology, Leiden University, The Netherlands
| | | |
Collapse
|
34
|
Passetti G, Cecchi F, Baldoli I, Sgandurra G, Beani E, Cioni G, Laschi C, Dario P. Sensorized toys for measuring manipulation capabilities of infants at home. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:7390-3. [PMID: 26737999 DOI: 10.1109/embc.2015.7320099] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Preterm infants, i.e. babies born after a gestation period shorter than 37 weeks, spend less time exploring objects. The quantitative measurement of grasping actions and forces in infants can give insights on their typical or atypical motor development. The aim of this work was to test a new tool, a kit of sensorized toys, to longitudinally measure, monitor and promote preterm infants manipulation capabilities with a purposive training in an ecological environment. This study presents preliminary analysis of grasping activity. Three preterm infants performed 4 weeks of daily training at home. Sensorized toys with embedded pressure sensors were used as part of the training to allow quantitative analysis of grasping (pressure and acceleration applied to toys while playing). Each toy was placed on the midline, while the infant was in supine position. Preliminary data show differences in the grasping parameters in relation to infants age and the performed daily training. Ongoing clinical trial will allow a full validation of this new tool for promoting object exploration in preterm infants.
Collapse
|
35
|
Dusing SC, Thacker LR, Galloway JC. Infant born preterm have delayed development of adaptive postural control in the first 5 months of life. Infant Behav Dev 2016; 44:49-58. [PMID: 27285202 DOI: 10.1016/j.infbeh.2016.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 12/23/2015] [Accepted: 05/12/2016] [Indexed: 12/14/2022]
Abstract
UNLABELLED Infants born preterm are at increased risk of developmental disabilities, that may be attributed to their early experiences and ability to learn. The purpose of this paper was to evaluate the ability of infants born preterm to adapt their postural control to changing task demands. METHODS This study included 18 infants born at 32 weeks of gestation or less whose posture was compared in supine under 2 conditions, with and without a visual stimulus presented. The postural variability, measured with root mean squared displacement of the center of pressure, and postural complexity, measured with the approximate entropy of the center of pressure displacement were measured longitudinally from 2.5 to 5 months of age. RESULTS AND DISCUSSION The infants looked at the toys in midline for several months prior to adapting their postural variability in a manner similar to full term infants. Only after postural variability was reduced in both the caudal cephalic and medial lateral direction in the toy condition did the infants learn to reach for the toy. Postural complexity did not vary between conditions. These findings suggest that infants used a variety of strategies to control their posture. In contrast to research with infants born full term, the infants born preterm in this study did not identify the successful strategy of reducing movement of the center of pressure until months after showing interest in the toy. This delayed adaptation may impact the infants ability to learn over time.
Collapse
Affiliation(s)
- Stacey C Dusing
- Motor Development Lab, Department of Physical Therapy, Department of Pediatrics, Virginia Commonwealth University, United States.
| | - Leroy R Thacker
- School of Nursing, Virginia Commonwealth University, United States.
| | - James C Galloway
- Department of Physical Therapy, Biomechanics and Movement Sciences Program, University of Delaware, United States.
| |
Collapse
|
36
|
Lobo MA, Koshy J, Hall ML, Erol O, Cao H, Buckley JM, Galloway JC, Higginson J. Playskin Lift: Development and Initial Testing of an Exoskeletal Garment to Assist Upper Extremity Mobility and Function. Phys Ther 2016; 96:390-9. [PMID: 26316534 PMCID: PMC4774388 DOI: 10.2522/ptj.20140540] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 08/18/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND A person's ability to move his or her arms against gravity is important for independent performance of critical activities of daily living and for exploration that facilitates early cognitive, language, social, and perceptual-motor development. Children with a variety of diagnoses have difficulty moving their arms against gravity. OBJECTIVE The purpose of this technical report is to detail the design process and initial testing of a novel exoskeletal garment, the Playskin Lift, that assists and encourages children to lift their arms against gravity. DESIGN This report details the design theory and process, the device, and the results of field testing with a toddler with impaired upper extremity function due to arthrogryposis multiplex congenita. RESULTS The Playskin Lift is an inexpensive (<$30 material costs), easy to use (5/5 rating), comfortable (5/5 rating), and attractive (4/5 rating) device. While wearing the device, the child was able to contact objects more often throughout an increased play space, to look at toys more while contacting them, and to perform more complex interactions with toys. LIMITATIONS This report details initial testing with one child. Future testing with more participants is recommended. CONCLUSIONS These results suggest that by considering the broad needs of users, including cost, accessibility, comfort, aesthetics, and function, we can design inexpensive devices that families and clinicians can potentially fabricate in their own communities to improve function, participation, exploration, and learning for children with disabilities.
Collapse
Affiliation(s)
- Michele A Lobo
- M.A. Lobo, PT, PhD, Department of Physical Therapy, University of Delaware, 210K CHS Bldg, 540 South College Ave, Newark, DE 19713 (USA).
| | - John Koshy
- J. Koshy, BS, Department of Physical Therapy, University of Delaware
| | - Martha L Hall
- M.L. Hall, MS, Departments of Physical Therapy and Fashion and Apparel Studies, University of Delaware
| | - Ozan Erol
- O. Erol, MS, Department of Mechanical Engineering, University of Delaware
| | - Huantian Cao
- H. Cao, PhD, Department of Fashion and Apparel Studies, University of Delaware
| | - Jenner M Buckley
- J.M. Buckley, PhD, Department of Mechanical Engineering, University of Delaware
| | - James C Galloway
- J.C. Galloway, PT, PhD, Departments of Physical Therapy and Psychology, University of Delaware
| | - Jill Higginson
- J. Higginson, PhD, Department of Mechanical Engineering, University of Delaware
| |
Collapse
|
37
|
Babik I, Kokkoni E, Cunha AB, Galloway JC, Rahman T, Lobo MA. Feasibility and Effectiveness of a Novel Exoskeleton for an Infant With Arm Movement Impairments. Pediatr Phys Ther 2016; 28:338-46. [PMID: 27341584 PMCID: PMC4922496 DOI: 10.1097/pep.0000000000000271] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine whether a novel exoskeletal device (Pediatric-Wilmington Robotic Exoskeleton [P-WREX]) is feasible and effective for intervention to improve reaching and object interaction for an infant with arm movement impairments. METHODS An 8-month old infant with arthrogryposis was followed up every 2 weeks during a 1-month baseline, 3-month intervention, and 1-month postintervention. At each visit, reaching and looking behaviors were assessed. RESULTS Within sessions, the infant spent more time contacting objects across a larger space, contacting objects with both hands, and looking at objects when wearing the P-WREX. Throughout intervention, the infant increased time contacting objects both with and without the device and increased bilateral active shoulder flexion. CONCLUSIONS (1) It may be feasible for families to use exoskeletons for daily intervention, (2) exoskeletons facilitate immediate improvements in function for infants with impaired upper extremity mobility, and (3) interventions using exoskeletons can improve independent upper extremity function across time.
Collapse
Affiliation(s)
- Iryna Babik
- Department of Physical Therapy (Dr Babik, Ms. Kokkoni, Drs Galloway, and Lobo) University of Delaware, Newark, DE, USA
| | - Elena Kokkoni
- Department of Physical Therapy (Dr Babik, Ms. Kokkoni, Drs Galloway, and Lobo) University of Delaware, Newark, DE, USA
| | - Andrea B. Cunha
- Department of Physical Therapy (Dr Cunha), Federal University of São Carlos, São Carlos, Brazil
| | - James Cole Galloway
- Department of Physical Therapy (Dr Babik, Ms. Kokkoni, Drs Galloway, and Lobo) University of Delaware, Newark, DE, USA
| | - Tariq Rahman
- Department of Biomedical Research (Dr Rahman), Nemours/A.I. DuPont Hospital for Children, Wilmington, DE, USA
| | - Michele A. Lobo
- Department of Physical Therapy (Dr Babik, Ms. Kokkoni, Drs Galloway, and Lobo) University of Delaware, Newark, DE, USA
| |
Collapse
|
38
|
Lobo M, Galloway J, Heathcock J. Characterization and intervention for upper extremity exploration & reaching behaviors in infancy. J Hand Ther 2015; 28:114-24; quiz 125. [PMID: 25835251 PMCID: PMC4424113 DOI: 10.1016/j.jht.2014.12.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 10/23/2014] [Accepted: 12/03/2014] [Indexed: 02/03/2023]
Abstract
This article aims to: 1) highlight general exploration, reaching, and object exploration behaviors as key activities of daily living in infancy, 2) describe how knowledge of early warning signs for these behaviors may improve early assessment, and 3) discuss interventions that may advance performance of these behaviors. Early intervention should focus on improving performance of these behaviors because: a) these early, interrelated upper extremity behaviors serve an integral role in global learning and development in infancy, b) among at-risk populations, differences have been observed in the quantity and quality of performance of these behaviors and, in many cases, these differences are associated with related perceptual-motor and cognitive delays. This article highlights how early assessment and intervention can target these key early behaviors in populations at risk for upper extremity disabilities, such as those born preterm, with Down syndrome, brachial plexus palsy, or arthrogryposis multiplex congentia.
Collapse
Affiliation(s)
- M.A. Lobo
- Physical Therapy Department, University of Delaware, 540 South College Ave., Newark, DE 19713, USA
| | - J.C. Galloway
- Physical Therapy & Psychology Departments, University of Delaware, 540 South College Ave., Newark, DE 19713, USA
| | - J.C Heathcock
- Physical Therapy Department, 516 Atwell Hall, The Ohio State University, 453 West tenth Avenue, Columbus, OH 43210, USA
| |
Collapse
|
39
|
Real-World Performance: Physical Activity, Play, and Object-Related Behaviors of Toddlers With and Without Disabilities. Pediatr Phys Ther 2015; 27:433-41. [PMID: 26397093 DOI: 10.1097/pep.0000000000000181] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe and compare the occurrence and co-occurrence of physical activity (PA), play, and object-related behaviors in toddlers with and without disabilities. METHODS Participants included 23 toddlers (21 with typical development (TD) and 2 with disabilities). Direct observation was used to describe the type and level of PA, play interactions, and object-related behaviors through video recordings. RESULTS Toddlers demonstrated high variability, occurrence, and co-occurrence of all behaviors. Toddlers with disabilities displayed less variability, occurrence, and co-occurrence of several behaviors. CONCLUSION Toddlers with TD engage simultaneously in PA, play, and object-related behaviors for about 3 hours in a typical day. This same level of co-occurrence of behaviors may not be observed for children with disabilities. Intervention providers are encouraged to consider the behaviors of toddlers with TD, beyond the findings of this pilot study, as the reference standard when implementing technology and intervention strategies for children with disabilities.
Collapse
|
40
|
Lobo MA, Kokkoni E, de Campos AC, Galloway JC. Not just playing around: infants' behaviors with objects reflect ability, constraints, and object properties. Infant Behav Dev 2014; 37:334-51. [PMID: 24879412 PMCID: PMC4083016 DOI: 10.1016/j.infbeh.2014.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 02/26/2014] [Accepted: 05/04/2014] [Indexed: 10/25/2022]
Abstract
This study describes infants' behaviors with objects in relation to age, body position, and object properties. Object behaviors were assessed longitudinally in 22 healthy infants supine, prone, and sitting from birth through 2 years. Results reveal: (1) infants learn to become intense and sophisticated explorers within the first 6 months of life; (2) young infants dynamically and rapidly shift among a variety of behavioral combinations to gather information; (3) behaviors on objects develop along different trajectories so that behavioral profiles vary across time; (4) object behaviors are generally similar in supine and sitting but diminished in prone; and (5) infants begin matching certain behaviors to object properties as newborns. These data demonstrate how infants learn to match their emerging behaviors with changing positional constraints and object affordances.
Collapse
Affiliation(s)
- Michele A Lobo
- Department of Physical Therapy, The University of Delaware, United States.
| | - Elena Kokkoni
- Department of Physical Therapy, The University of Delaware, United States
| | | | - James C Galloway
- Departments of Physical Therapy and Psychology, University of Delaware, United States
| |
Collapse
|