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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.
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.
