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START-Play Physical Therapy Intervention Indirectly Impacts Cognition Through Changes in Early Motor-Based
Natalie A Koziol1, Kari S Kretch, Regina T Harbourne
1Nebraska Center for Research on Children, Youth, Families and Schools (Dr Koziol), University of Nebraska-Lincoln, Lincoln, Nebraska; Division of Biokinesiology and Physical Therapy (Drs Kretch and Dusing), University of Southern California, Los Angeles, California; Physical Therapy Department (Dr Harbourne), Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania; Biomechanics and Movement Science Program and Physical Therapy Department (Dr Lobo), University of Delaware, Newark, Delaware; Department of Rehabilitation Medicine (Drs McCoy and Hsu), University of Washington, Seattle, Washington; Rehabilitation and Movement Science (Ms Molinini), Virginia Commonwealth University, Richmond, Virginia; Department of Psychological Science (Dr Babik), Boise State University, Boise, Idaho; University of Nebraska Medical Center (Dr Cunha), University of Nebraska, Omaha, Nebraska; Munroe Meyer Institute (Dr Willett), University of Nebraska Medical Center, Omaha, Nebraska; Department of Educational Psychology (Dr Bovaird), University of Nebraska-Lincoln, Lincoln, Nebraska.
Insights
The Sitting Together and Reaching to Play (START-Play) physical therapy intervention improved cognition in infants with motor delays by enhancing motor-based problem-solving skills. This early intervention supports optimal infant development trajectories.
Area of Science:
- Developmental Pediatrics
- Neurorehabilitation
- Early Intervention
Background:
- Infants with motor delays often experience concurrent cognitive challenges.
- Early intervention programs aim to improve developmental trajectories.
- The role of perceptual-motor skills in cognitive development for infants with motor delays requires further investigation.
Purpose of the Study:
- To determine if the START-Play physical therapy intervention indirectly influences cognitive development in infants with motor delays.
- To examine the mediating role of perceptual-motor skills in the relationship between START-Play and cognition.
Main Methods:
- A randomized controlled trial involving 50 infants with motor delays.
- Intervention group received START-Play plus Usual Care Early Intervention (UC-EI); control group received UC-EI only.
- Perceptual-motor and cognitive skills were assessed at multiple time points over 12 months.
Main Results:
- Short-term improvements in sitting, fine motor skills, and motor-based problem-solving predicted long-term cognitive gains.
- The START-Play intervention demonstrated an indirect effect on cognition mediated by motor-based problem-solving skills.
- No significant indirect effect was found through sitting, reaching, or fine motor skills.
Conclusions:
- Early physical therapy, like START-Play, can positively impact cognitive development in infants with motor delays.
- Interventions blending activities across developmental domains and enriched social contexts promote optimal developmental pathways.
- Motor-based problem-solving appears to be a key mediator in the cognitive benefits of early physical therapy.
Purpose:
This study tested whether the Sitting Together and Reaching to Play (START-Play) physical therapy intervention indirectly impacts cognition through changes in perceptual-motor skills in infants with motor delays.
Methods:
Participants were 50 infants with motor delays randomly assigned to START-Play plus Usual Care Early Intervention (UC-EI) or UC-EI only. Infants' perceptual-motor and cognitive skills were assessed at baseline and 1.5, 3, 6, and 12 months post-baseline.
Results:
Short-term changes in sitting, fine motor skills, and motor-based problem-solving, but not reaching, predicted long-term changes in cognition. START-Play indirectly impacted cognition through motor-based problem-solving but not sitting, reaching, or fine motor skills.
Conclusions:
This study provided preliminary evidence that early physical therapy interventions that blend activities across developmental domains and are supported by an enriched social context can place infants on more optimal developmental trajectories.
