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The E-words for promoting development and neuroplasticity for infants with or at high risk for cerebral palsy
1Neurorehabilitation and Biomechanics Research Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Insights
Early intervention for infants with cerebral palsy (CP) is crucial. This review highlights seven E-words to promote motor and neural development, emphasizing active infant engagement for better outcomes.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Rehabilitation Science
Background:
- Children with cerebral palsy (CP) experience developmental challenges due to early brain insults.
- Animal models suggest earlier interventions can improve recovery, a potential not yet fully realized in human infants.
- Existing frameworks like the F-words guide childhood disability interventions.
Purpose of the Study:
- To identify key components for promoting motor and overall development in infants with CP.
- To propose seven "E-words" (earlier, engagement, exploration, enriched environments, experiences, everyday, exercise) as a framework for intervention.
- To enhance behavioral and neural outcomes in infants with CP through targeted strategies.
Main Methods:
- A narrative review approach was employed.
- Literature search using a preliminary list of E-words combined with terms like 'infant', 'cerebral palsy', and 'development'.
- Identification of two additional E-words during the literature search process.
Main Results:
- The developing brain shows high responsiveness to the quality, quantity, and timing of early sensorimotor experiences.
- Active participation by the infant is essential for driving developmental processes.
- Each infant and family experiences the intervention process uniquely.
Conclusions:
- The seven E-words provide a framework for designing novel intervention strategies for infants with CP.
- These concepts offer new insights for clinical practice in pediatric rehabilitation.
- The proposed framework has broad implications for lifelong learning, health, and well-being in individuals with and without CP.
Abstract:
For children with cerebral palsy (CP) who sustain brain insults during early development, animal research on earlier intervention offers the possibility of recovery not yet realized in humans. Inspired by and similar to the F-words in childhood disability, this narrative review aims to highlight essential components for promoting motor and overall development that may be used with or modified for infants with CP to enhance behavioral and neural outcomes, summarized here by seven E-words: earlier, engagement, exploration, enriched environments, experiences, everyday, and exercise. A preliminary list of E-words was used as search terms in combination with 'infant', 'cerebral palsy', or 'development'. Two more E-words emerged during the literature search. Key messages are (1) the developing brain is highly responsive to the quality, quantity, and timing of early sensorimotor experiences, and (2) the infant's active participation is essential to drive this process which is experienced uniquely by each infant and family. The concepts presented through these E-words may stimulate the design of novel intervention strategies or provide new insights for clinical practice. These also have important implications for learning, health, and well-being across the lifespan for those with or without cerebral palsy, as well as setting the stage for the F-words.
