Development Through the Lens of a Perception-Action-Cognition Connection: Recognizing the Need for a Paradigm Shift...

Area of Science:

• Pediatric physical therapy
• Developmental neuroscience
• Motor control

Background:

• Clinical reasoning in pediatric movement disorders relies on understanding development.
• Current evidence supports task-specific, salient, and exploratory interventions.
• Neuromaturational approaches remain prevalent despite conflicting evidence.

Purpose of the Study:

• To advocate for a paradigm shift in clinical reasoning for pediatric movement disorders.
• To move from neuromaturational views towards grounded cognition, variability, complexity, and adaptability.
• To introduce the Perception-Action Approach as a clinical assessment and intervention method.

Main Methods:

• Review of evidence supporting a shift in developmental theories.
• Examination of established theories: perception-action, dynamic systems, and neuronal group selection.
• Introduction of the Perception-Action Approach.

Main Results:

• Evidence supports interventions that are task-specific, repetitive, salient, and promote exploration.
• Optimal interventions enhance perception of affordances and target movement variability and adaptability.
• A shift from neuromaturational to dynamic, adaptive approaches is supported by research.

Conclusions:

• A paradigm shift is needed, moving clinical reasoning towards grounded cognition, variability, complexity, and adaptability.
• The Perception-Action Approach offers a framework for assessment and intervention aligned with current evidence.
• This approach can enhance knowledge translation for clinicians working with atypical development.