Intensive Family-Centered Rehabilitation and Motor Outcomes in a Child with Global Developmental Delay: A Case Report

Background: Global developmental delay (GDD) affects multiple domains of early childhood development, including gross motor, cognitive and communication skills. Early, intensive, family-centered rehabilitation is considered key to optimizing functional outcomes in affected children. Case Presentation: We report a female child with GDD who began rehabilitation at our institution at 15 months of age, presenting with generalized hypotonia with superimposed fluctuating episodes of hypertonia, poor postural control, absent independent sitting, markedly reduced spontaneous motor activity, and associated cognitive and communication delay. Brain MRI at 7 months showed no parenchymal abnormality, with mildly enlarged extracerebral cerebrospinal fluid spaces and ventricular system. The metabolic and genetic evaluation performed so far, including microarray/MLPA-based screening for common microdeletion syndromes and SMN1/SMN2 genotyping, has not identified a specific underlying etiology. Diagnostic work-up is ongoing. Rehabilitation was delivered as a comprehensive, multidomain program; this report focuses specifically on the child's motor progression. Intervention: The child underwent the Early Intensive Stojčević-Polovina Rehabilitation Method (EIR-SPM), a high-intensity, continuous approach for children with cerebral palsy, at-risk infants, and other developmental disabilities, built on parental education enabling home-based continuity of therapy. Rehabilitation focus is selected according to the child's optimal developmental stage-the milestone showing the least abnormal movement patterns and muscle tone-rather than chronological age, with positions progressively adjusted following the trajectory of typical motor development described by Vojta. Results: Gross motor function, monitored using the Gross Motor Function Measure-88 (GMFM-88) at four assessment points from 15 months to 6 years 6 months of age, improved progressively from 10.8% to 48.9%, 64.7%, and finally 73.9%. The child achieved independent kneeling, reciprocal crawling, independent sitting in all positions, independent standing and assisted stepping. Conclusions: In this child with GDD of undetermined etiology, more than five years of intensive, family-centered rehabilitation according to the EIR-SPM were accompanied by substantial and sustained gains in gross motor function and functional independence. This report suggests that meaningful progress remains achievable even when rehabilitation begins later than the period considered optimal within the EIR-SPM framework, and that a family-centered structure may be what makes therapy of this intensity and duration sustainable.