Do Infants at Risk of Developing Cerebral Palsy or Other Neurodevelopmental Disorders Learn What They Practice?

Kristina Löwing,Rita Almeida,Ann-Christin Eliasson,Linda Holmström

doi:10.3390/jcm9072041

Kristina Löwing, Rita Almeida + Show 2 more

Open Access

https://doi.org/10.3390/jcm9072041

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Abstract

Through secondary analyses of the Small Step. Randomized Control Trial, we tested the hypothesis that children at risk of developing cerebral palsy (CP) or other neurodevelopmental disorders would learn what they practice, i.e., that they would have a more rapid development within the specifically trained foci (hand use or mobility) of each time period compared to the development rate within the foci not trained at that time. Nineteen infants (6.3 (1.62) months corrected age) included in the Small Step program were assessed at six time points during the intervention. For statistical analysis, general and mixed linear models were used, and the independent variables were the Peabody Developmental Motor scale (stationary, locomotion, grasping and visuomotor sub scales), the Gross Motor Function Measure-66 and the Hand Assessment for Infants. Outcomes related to gross motor function improved significantly more after mobility training than after hand use training, while fine motor function was improved to the same extent following both training types. Significantly higher improvements after the first training period were seen in one out of three outcome measures in both gross and fine motor assessments. The improvements observed were all independent of diagnosis at two years. The concept “you learn what you practice” was most clearly confirmed in the case of gross motor development.

Highlights

Interventions designed for children at risk for cerebral palsy (CP) or other neurodevelopmental disorders exploit the activity-dependent plasticity and rapid development of the central nervous system during the first years of life
The current investigation extends the findings of a recent Randomized Controlled Trial (RCT) [11] that evaluated the effects of the Small Step Program on young children
Almost all children who were not diagnosed with CP at two years were classified at level I on the Gross Motor Function Classification System—Expanded and Revised (GMFCS—E&R) and Mini-Manual Ability Classification system (MACS) classifications

Summary

Introduction

Interventions designed for children at risk for cerebral palsy (CP) or other neurodevelopmental disorders exploit the activity-dependent plasticity and rapid development of the central nervous system during the first years of life. A recent systematic review concluded that early intervention programs exert only weak positive effects on the outcome of infants at risk of developing CP [5]. The current investigation extends the findings of a recent Randomized Controlled Trial (RCT) [11] that evaluated the effects of the Small Step Program on young children.

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