Everyday positioning experience in typically developing infants and infants with or at risk for cerebral palsy
1Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 Alcazar Street, Los Angeles, CA 90089, United States.
Insights
Infants at risk for cerebral palsy (CP) spend more time in passive positions and less time sitting or standing compared to typically developing infants. These differences in infant positioning highlight unique daily experiences for infants with or at risk for CP.
Area of Science:
- Developmental Pediatrics
- Motor Development
- Infant Care Practices
Background:
- Infant positioning during daily routines is crucial for motor, cognitive, and social development.
- Limited understanding exists regarding the everyday positioning of infants with or at risk for developmental disabilities, such as cerebral palsy (CP).
Purpose of the Study:
- To compare the everyday positioning experiences of infants at risk for CP with those of typically developing infants.
- To investigate differences in time spent in various postures and support types between these groups.
Main Methods:
- Ecological Momentary Assessment (EMA) via text message prompts was used to collect real-time infant positioning data.
- Caregivers reported infant posture (supine, prone, sitting, standing, suspended) and support (self, adult, device) 10 times daily for 8 days.
- The study included 25 infants at risk for CP (13 with confirmed CP) and 52 typically developing infants at 6, 9, and 12 months of age.
Main Results:
- Infant time in supine, prone, suspended, and adult support decreased with age, while sitting, standing, and self-support increased.
- Infants at risk for or with CP spent significantly more time supine, prone, and with adult support.
- These infants also spent less time sitting and standing compared to typically developing peers, with notable differences in supine and standing durations, even after controlling for motor milestones.
Conclusions:
- Significant disparities exist in the daily positioning experiences of infants with or at risk for CP compared to typically developing infants.
- These findings underscore the need for targeted interventions to promote more active and varied positioning in infants with developmental risks.
- Understanding these differences is vital for optimizing developmental support and learning opportunities for at-risk infants.
Abstract:
Infant positioning throughout everyday routines impacts physical growth, motor skill advancement, and access to learning opportunities supporting cognitive, social, and communicative development. However, we know little about everyday positioning experiences in infants with or at risk for developmental disabilities like cerebral palsy (CP) and how they differ from those of their typically developing peers. This study used Ecological Momentary Assessment to estimate time spent in different categories of posture (supine, prone, sitting, standing, and suspended) and support (self-support, adult support, and device support) throughout daily life in infants with or at risk for CP and age-matched infants with typical development. Twenty-five infants at risk (13 with confirmed CP) and 52 typically developing infants were tested at 6, 9, and/or 12 months of age (N = 101 sessions total). At each session, caregivers responded to text message prompts 10 times per day for 8 days and reported their infant's current positioning. Time supine, prone, suspended, and with adult support decreased with age, and time sitting, standing, and with self-support increased with age. Infants with or at risk for CP were more likely to be supine, prone, and supported by an adult, and were less likely to be sitting and standing, than infants with typical development; group differences in supine and standing time were especially dramatic. Notably, group differences persisted when controlling for achievement of relevant motor milestones. These results suggest considerable differences in everyday experiences in infants with or at risk for CP compared to their peers with typical development.
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