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START-Play Physical Therapy Intervention Impacts Motor and Cognitive Outcomes in Infants with Neuromotor Disorders: A Multisite Randomized Clinical Trial

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Title: START-Play Physical Therapy Intervention Impacts Motor and Cognitive Outcomes in Infants with Neuromotor Disorders: A Multisite Randomized Clinical Trial
Language: English
Authors: Harbourne, Regina T. (ORCID 0000-0001-8099-4145), Dusing, Stacey C, Lobo, Michele A., McCoy, Sarah W., Koziol, Natalie A., Hsu, Lin-Ya, Willett, Sandra, Marcinowski, Emily C., Babik, Iryna (ORCID 0000-0003-0574-4482), Cunha, Andrea B., An, Mihee (ORCID 0000-0002-5111-3094), Chang, Hui-Ju, Bovaird, James A., Sheridan, Susan M.
Source: Grantee Submission. 2021 101.
Peer Reviewed: Y
Page Count: 11
Publication Date: 2020
Sponsoring Agency: National Center for Special Education Research (ED)
Contract Number: R324A150103
Document Type: Journal Articles
Reports - Research
Descriptors: Program Effectiveness, Early Intervention, Infants, Neurological Impairments, Developmental Delays, Psychomotor Skills, Home Visits, Physical Therapy, Child Development, Cognitive Processes, Cognitive Development, Play, Problem Solving, Skill Development, Individual Characteristics, At Risk Persons, Communication Skills, Receptive Language, Expressive Language
Geographic Terms: Washington (Seattle), Nebraska (Omaha), Pennsylvania (Pittsburgh), Delaware, Virginia (Richmond)
DOI: 10.1093/ptj/pzaa232
Abstract: Objective: Our objective was to evaluate the efficacy of the Sitting Together and Reaching to Play (START-Play) intervention in young infants with neuromotor disorders. Method: This randomized controlled trial compared usual care-early intervention (UC-EI) with START-Play plus UC-EI. Analyses included 112 infants with motor delay (55 UC-EI, 57 START-Play) recruited at 7 to 16 months of age across 5 sites. START-Play included twice-weekly home visits with the infant and caregiver for 12 weeks provided by physical therapists trained in the START-Play intervention; UC-EI was not disrupted. Outcome measures were the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley); the Gross Motor Function Measure; reaching frequency; and the Assessment of Problem Solving in Play (APSP). Comparisons for the full group as well as separate comparisons for infants with mild motor delay and infants with significant motor delay were done. Piecewise linear mixed modeling estimated short- and long-term effects. Results: For infants with significant motor delay, positive effects of START-Play were observed at 3 months for Bayley cognition Bayley fine motor, and APSP and at 12 months for Bayley fine motor and reaching frequency outcomes. For infants with mild motor delay, positive effects of START-Play for the Bayley receptive communication outcome were found. For the UC-EI group, the only difference between groups was a positive effect for the APSP outcome, observed at 3 months. Conclusions: START-Play may advance reaching, problem-solving, cognitive, and fine motor skills for young infants with significant motor delay over UC-EI in the short term. START-Play in addition to UC-EI may not improve motor/cognitive outcomes for infants with milder motor delays over and above usual care. Impact: Concepts of embodied cognition, applied to early intervention in the START-Play intervention, may serve to advance cognition and motor skills in young infants with significant motor delays over usual care early intervention. Lay Summary: If you have a young infant with significant delays in motor skills, your physical therapist can work with you to develop play opportunities to enhance your child's problem-solving, such as that used in the START-Play intervention, in addition to usual care in order to help your child advance cognitive and motor skills.
Abstractor: As Provided
What Works Clearinghouse (WWC) Reviewed: Meets Evidence Standards without Reservations
WWC Study Page: https://ies.ed.gov/ncee/wwc/Study/90301
IES Funded: Yes
Entry Date: 2021
Accession Number: ED611838
Database: ERIC
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  Data: START-Play Physical Therapy Intervention Impacts Motor and Cognitive Outcomes in Infants with Neuromotor Disorders: A Multisite Randomized Clinical Trial
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  Data: <searchLink fieldCode="AR" term="%22Harbourne%2C+Regina+T%2E%22">Harbourne, Regina T.</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0001-8099-4145">0000-0001-8099-4145</externalLink>)<br /><searchLink fieldCode="AR" term="%22Dusing%2C+Stacey+C%22">Dusing, Stacey C</searchLink><br /><searchLink fieldCode="AR" term="%22Lobo%2C+Michele+A%2E%22">Lobo, Michele A.</searchLink><br /><searchLink fieldCode="AR" term="%22McCoy%2C+Sarah+W%2E%22">McCoy, Sarah W.</searchLink><br /><searchLink fieldCode="AR" term="%22Koziol%2C+Natalie+A%2E%22">Koziol, Natalie A.</searchLink><br /><searchLink fieldCode="AR" term="%22Hsu%2C+Lin-Ya%22">Hsu, Lin-Ya</searchLink><br /><searchLink fieldCode="AR" term="%22Willett%2C+Sandra%22">Willett, Sandra</searchLink><br /><searchLink fieldCode="AR" term="%22Marcinowski%2C+Emily+C%2E%22">Marcinowski, Emily C.</searchLink><br /><searchLink fieldCode="AR" term="%22Babik%2C+Iryna%22">Babik, Iryna</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0003-0574-4482">0000-0003-0574-4482</externalLink>)<br /><searchLink fieldCode="AR" term="%22Cunha%2C+Andrea+B%2E%22">Cunha, Andrea B.</searchLink><br /><searchLink fieldCode="AR" term="%22An%2C+Mihee%22">An, Mihee</searchLink> (ORCID <externalLink term="http://orcid.org/0000-0002-5111-3094">0000-0002-5111-3094</externalLink>)<br /><searchLink fieldCode="AR" term="%22Chang%2C+Hui-Ju%22">Chang, Hui-Ju</searchLink><br /><searchLink fieldCode="AR" term="%22Bovaird%2C+James+A%2E%22">Bovaird, James A.</searchLink><br /><searchLink fieldCode="AR" term="%22Sheridan%2C+Susan+M%2E%22">Sheridan, Susan M.</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Grantee+Submission%22"><i>Grantee Submission</i></searchLink>. 2021 101.
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  Data: 11
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  Data: 2020
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  Data: National Center for Special Education Research (ED)
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  Data: R324A150103
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  Data: Journal Articles<br />Reports - Research
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  Data: <searchLink fieldCode="DE" term="%22Program+Effectiveness%22">Program Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Early+Intervention%22">Early Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Infants%22">Infants</searchLink><br /><searchLink fieldCode="DE" term="%22Neurological+Impairments%22">Neurological Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Developmental+Delays%22">Developmental Delays</searchLink><br /><searchLink fieldCode="DE" term="%22Psychomotor+Skills%22">Psychomotor Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Home+Visits%22">Home Visits</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Therapy%22">Physical Therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Child+Development%22">Child Development</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+Processes%22">Cognitive Processes</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+Development%22">Cognitive Development</searchLink><br /><searchLink fieldCode="DE" term="%22Play%22">Play</searchLink><br /><searchLink fieldCode="DE" term="%22Problem+Solving%22">Problem Solving</searchLink><br /><searchLink fieldCode="DE" term="%22Skill+Development%22">Skill Development</searchLink><br /><searchLink fieldCode="DE" term="%22Individual+Characteristics%22">Individual Characteristics</searchLink><br /><searchLink fieldCode="DE" term="%22At+Risk+Persons%22">At Risk Persons</searchLink><br /><searchLink fieldCode="DE" term="%22Communication+Skills%22">Communication Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Receptive+Language%22">Receptive Language</searchLink><br /><searchLink fieldCode="DE" term="%22Expressive+Language%22">Expressive Language</searchLink>
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  Label: Geographic Terms
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  Data: <searchLink fieldCode="DE" term="%22Washington+%28Seattle%29%22">Washington (Seattle)</searchLink><br /><searchLink fieldCode="DE" term="%22Nebraska+%28Omaha%29%22">Nebraska (Omaha)</searchLink><br /><searchLink fieldCode="DE" term="%22Pennsylvania+%28Pittsburgh%29%22">Pennsylvania (Pittsburgh)</searchLink><br /><searchLink fieldCode="DE" term="%22Delaware%22">Delaware</searchLink><br /><searchLink fieldCode="DE" term="%22Virginia+%28Richmond%29%22">Virginia (Richmond)</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1093/ptj/pzaa232
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Our objective was to evaluate the efficacy of the Sitting Together and Reaching to Play (START-Play) intervention in young infants with neuromotor disorders. Method: This randomized controlled trial compared usual care-early intervention (UC-EI) with START-Play plus UC-EI. Analyses included 112 infants with motor delay (55 UC-EI, 57 START-Play) recruited at 7 to 16 months of age across 5 sites. START-Play included twice-weekly home visits with the infant and caregiver for 12 weeks provided by physical therapists trained in the START-Play intervention; UC-EI was not disrupted. Outcome measures were the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley); the Gross Motor Function Measure; reaching frequency; and the Assessment of Problem Solving in Play (APSP). Comparisons for the full group as well as separate comparisons for infants with mild motor delay and infants with significant motor delay were done. Piecewise linear mixed modeling estimated short- and long-term effects. Results: For infants with significant motor delay, positive effects of START-Play were observed at 3 months for Bayley cognition Bayley fine motor, and APSP and at 12 months for Bayley fine motor and reaching frequency outcomes. For infants with mild motor delay, positive effects of START-Play for the Bayley receptive communication outcome were found. For the UC-EI group, the only difference between groups was a positive effect for the APSP outcome, observed at 3 months. Conclusions: START-Play may advance reaching, problem-solving, cognitive, and fine motor skills for young infants with significant motor delay over UC-EI in the short term. START-Play in addition to UC-EI may not improve motor/cognitive outcomes for infants with milder motor delays over and above usual care. Impact: Concepts of embodied cognition, applied to early intervention in the START-Play intervention, may serve to advance cognition and motor skills in young infants with significant motor delays over usual care early intervention. Lay Summary: If you have a young infant with significant delays in motor skills, your physical therapist can work with you to develop play opportunities to enhance your child's problem-solving, such as that used in the START-Play intervention, in addition to usual care in order to help your child advance cognitive and motor skills.
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        Value: 10.1093/ptj/pzaa232
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        PageCount: 11
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      – SubjectFull: Program Effectiveness
        Type: general
      – SubjectFull: Early Intervention
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      – SubjectFull: Infants
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      – TitleFull: START-Play Physical Therapy Intervention Impacts Motor and Cognitive Outcomes in Infants with Neuromotor Disorders: A Multisite Randomized Clinical Trial
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