Abstract
For infants with mild motor impairments, parent-provided cognitive opportunities during play continue to increase after mobility is achieved, in contrast to those with severe motor impairment, where cognitive opportunities decrease, as gross motor abilities remain stable. This analysis of two infants demonstrates this difference and will be confirmed in the analysis of 90 children with mild, moderate, and severe impairment. These findings have implications for early-intervention service providers.
Primary Author and Speaker: Audrey Kane
Additional Authors and Speakers: Stacey Dusing
Contributing Authors: Emily Marcinowski, Lin-Ya Hsu
Infants with identified developmental delays are eligible to receive early intervention services through Part C of the Individuals with Disabilities Education Act (IDEA, 2004). Occupational and physical therapy services are included as part of the array of early intervention services. Providers may address motor skill development and cognition, as part of play, which is a primary occupation of early childhood. Parents who provide their child with play opportunities including social interaction and practice of motor skills may positively impact not only motor skill development, but also language, cognitive, and social development (Childress, 2010; Karasik, et al, 2010). As infants learn to move, they began to explore their environment as a means to build cognitive constructs., thus, constraining this exploration can slow the rate of cognitive development (Thurman & Corbetta, 2017). The purpose of this analysis was to determine if parent-provided cognitive opportunities during play differ for children with mild and severe motor impairments (Question1) and to describe the relationship between parent-provided cognitive opportunities and the onset of mobility (Question2). This descriptive prospective cohort analysis will include participants enrolled in the Sitting Together and Reaching To Play (START-Play) clinical trial which focuses on advancing sitting and reaching to scaffold problem-solving (Harbourne, et al, 2018). The full sample includes more than 90 infants, recruited in 5 US cities, who were age 7-16 months and were learning to sit. Consented families participated in 5 visits over the course of a year. At each visit interaction between the parent and child in 5 minutes of free play was videotaped. Parents were instructed to play with their child as they typically would. Four toys were provided for the parent to use if desired. Custom behavioral coding was used to identify parent-provided cognitive opportunities during the play session. The child’s gross motor development was assessed using the Gross Motor Function Measure (GMFM-88) with the raw score used to evaluate change over time. Data from an extended baseline on 2 infants during a non-intervention period is used in this abstract to represent the data that will be included in the full analysis. A Mixed linear model will be used in the full analysis to evaluate change over time between severity groups and to describe the relationship between cognitive opportunity and mobility. Question 1: For Infant 1, a child with severe motor impairment, the amount of parent-provided cognitive opportunities declined between 4 and 16 months of age (16%-0%), while her mobility remained stable (GMFM-88 12-8). For Infant 2, a child with mild motor impairment, the amount of parent-provided cognitive opportunities increased slightly between 2 and 8 months of age (16%-40%), while his mobility remained fairly stable (GMFM-88 24-30). Question 2: The correlation between infant 2’s parent-provided cognitive opportunities and motor abilities increased after becoming mobile (R2= 0.114 to R2=0.835). If these cases are representative of the full group analysis they suggest that as a child with significant motor involvement ages, but does not become mobile (Infant 1), cognitive opportunities provided by their parents during play decline. As opposed to infants with mild motor impairment, whose parents continue to provide cognitive opportunities and increase these opportunities as mobility is achieved. Data from this preliminary analysis suggest early intervention service providers should include parent education and training on the importance of providing cognitive opportunities through play to promote a child’s cognitive development, particularly for those children with severe motor impairments.
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