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Effect of the START-Play Physical Therapy Intervention on Cognitive Skills Depends on Caregiver-Provided Learning
Natalie A Koziol1, Christiana D Butera2, Kari S Kretch2
1University of Nebraska-Lincoln, Lincoln, Nebraska, USA.
Insights
Caregiver involvement enhances the START-Play physical therapy intervention
Area of Science:
- Pediatric Physical Therapy
- Child Development
- Early Intervention
Background:
- Neuromotor delays affect young children's cognitive development.
- Early intervention programs aim to improve developmental outcomes.
- Caregiver engagement is crucial for treatment efficacy.
Purpose of the Study:
- To assess if caregiver-provided learning opportunities moderate START-Play's impact on cognitive skills in children with neuromotor delays.
- To determine if START-Play influences caregiver-provided learning opportunities over time.
Main Methods:
- A multisite randomized clinical trial involving 112 children (7-16 months) with neuromotor delays.
- Cognitive skills assessed using the Bayley Scales of Infant & Toddler Development, Third Edition.
- Caregiver learning opportunities quantified from observed free play interactions.
Main Results:
- Baseline caregiver learning opportunities moderated START-Play's effects on cognition at 3 and 12 months.
- Cognitive gains were greater for children with more caregiver-provided learning opportunities.
- START-Play did not significantly alter caregiver-provided learning opportunities.
Conclusions:
- START-Play shows lasting cognitive benefits, but these are dependent on caregiver support.
- Future research should explore strategies to enhance caregiver participation in early intervention.
- Optimizing caregiver-child interactions is key for maximizing intervention outcomes.
Aims:
This study evaluated whether caregiver-provided learning opportunities moderated the effect of START-Play physical therapy intervention on the cognitive skills of young children with neuromotor delays, and whether START-Play impacted caregiver-provided learning opportunities over time.
Methods:
One hundred and twelve children with neuromotor delays (7-16 months) participated in a multisite randomized clinical trial evaluating the efficacy of START-Play. Children were assessed at baseline and 3 (post intervention), 6, and 12 months post baseline. Cognition was scored from the Bayley Scales of Infant & Toddler Development, Third Edition, cognitive scale. The proportion of time caregivers spent providing learning opportunities was coded from a 5-minute caregiver-child free play interaction.
Results:
Baseline caregiver-provided learning opportunities moderated the 3- and 12-month effects of START-Play on cognition. Cognitive gains due to START-Play were more pronounced for children whose caregivers provided more learning opportunities. START-Play did not impact caregiver-provided learning opportunities over time.
Conclusions:
START-Play may have a lasting effect on children's cognition, but this effect is contingent on caregivers providing their child with ample opportunities to practice cognitive skills. Strategies for improving caregivers' uptake and transfer of START-Play principles to their daily routines should be evaluated.
Trial Registration:
ClinicalTrials.gov NCT02593825.
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