Assistant Physical Therapy Professor Dr. Regina Harbourne is leading the first national randomized controlled study of an intervention targeting the development of infants’ early motor skills to advance problem solving.
Funded by a $3.4 million grant from the U.S. Department of Education, the START-Play Program is one of the largest national clinical trials of its kind, with sites based at Duquesne University, the University of Delaware, Virginia Commonwealth University and the University of Washington.
The project evaluates the effectiveness of a comprehensive physical therapy intervention for infants with motor delays or dysfunction that targets sitting, reaching and motor-based problem solving in an effort to improve the infant’s awareness and readiness to learn. In previous research, Harbourne discovered that very early interventions of this kind not only advance an infant’s motor skills, but also the associated cognitive abilities.
“This is the first large study to explore how early intervention for motor skills affects thinking abilities of young infants who are experiencing delays in moving,” said Harbourne. “We suspect that being able to move helps the brain grow by actively experiencing things like cause and effect, object properties and social interaction, but we don’t know what type of early experience is best for infants with motor delays. This large trial will guide early intervention in new and potentially groundbreaking ways.”
In Pittsburgh, Harbourne has recruited six infants ranging from seven to 16 months of age for the study. The infants are typically delayed in motor skills and may have a history of prematurity, significant health issues/brain injury at or near birth or are at risk for cerebral palsy. The goal is to recruit 36 infants at each site.
The study participants are randomly split into two groups. One group of infants receive their usual early intervention services. The second group receives the specific START-Play intervention plus their early intervention services. Both groups receive intervention for 12 weeks. All families receive a stipend for participation in the study, and the children receive toys appropriate for early infant play.
The START-Play group members receive twice weekly home visits from a physical therapist who works with the infant and family. The intervention takes place in the home, which is a familiar environment for the infant, to get more accurate results. The physical therapist provides individual interventions that target sitting, reaching and problem-solving skills.
“The therapists and families work together to provide intensive, individualized, daily activities that advance reaching and sitting, using small increments of challenge and support for the skills,” said Harbourne. “Our intervention is based on developmental science and early education principles, built on the features of successful smaller trials and tracked by a set of comprehensive, sensitive, reliable assessment tools.
“Based on empirical and theoretical work that suggests reaching and sitting are early building blocks of problem solving, we predict that advancing these skills will improve school readiness.”
Follow-up assessments are done after the baseline measures at six weeks, three months and nine months to examine longer-term effects. “Our primary objectives examine change over time in sitting and reaching variables, and subsequent change in global development,” said Harbourne. “Differences in outcomes between the two intervention groups will be examined as well as the influence of motor skill change in sitting and reaching on problem solving skills to cognitive development.”
Parents interested participating can call 412.396.5547 for more information on the study.