Early Intensive Postural and Movement Training Advances Head Control in Very Young Infants

Background Daily experiences are thought to play an important role in motor development during infancy. There are limited studies on the effect of postural and movement experiences on head control. Objective The purpose of this study was to quantify the effects of postural and movement experiences on head control through a comprehensive set of measurements beginning when infants were 1 month old. Design This was a prospective, longitudinal, 2-cohort study. Methods Twenty-two full-term infants who were healthy were randomly assigned to either a training group or a control group. Infants were observed every other week from 1 to 4 months of age. Head control was assessed using a standardized developmental assessment tool, the Test of Infant Motor Performance (TIMP), as well as behavioral coding and kinematics of infants' head postures and movements in a supported sitting position. Caregivers performed at least 20 minutes of daily postural and movement activities (training group), or social interaction (control group) for 4 weeks. Results The training group had higher TIMP scores on head control–related items during the training period and after training stopped compared with the control group. Starting from the during training phase, the training group infants had their heads in a vertical and midline position longer compared with the control group infants. After training stopped, the training group infants actively moved their heads forward more often and for larger distances. Limitations The experiences outside daily training were not monitored, and the results may be specific to the experimental setup for infants with typical development. Conclusions Young infants are able to take advantage of postural and movement experiences to rapidly advance their head control as early as 4 to 6 weeks of postnatal life. Infant positioning, caregiver handling, and caregiver-infant interactions were likely contributing factors. This database of comprehensive measures may be useful in future trials focused on head control in infants with special needs.

[1]  L. Doyle,et al.  Do early intervention programmes improve cognitive and motor outcomes for preterm infants after discharge? A systematic review , 2009, Developmental medicine and child neurology.

[2]  S. Jeng,et al.  Neurobehavioral development at term in very low-birthweight infants and normal term infants in Taiwan. , 1998, Early human development.

[3]  L. B. Ames,et al.  The Neuromuscular Maturation of the Human Infant , 1943, The Yale Journal of Biology and Medicine.

[4]  P. Helders,et al.  Functional motor abilities of children with cerebral palsy: a systematic literature review of assessment measures , 1998, Clinical rehabilitation.

[5]  N. Warren African infant precocity. , 1972, Psychological bulletin.

[6]  D. Clark,et al.  Vestibular stimulation influence on motor development in infants. , 1977, Science.

[7]  J. Kramer,et al.  Training of head control in the sitting and semi-prone positions. , 1992, Child: care, health and development.

[8]  C. Super Environmental Effects on Motor Development: the Case of ‘African Infant Precocity’ , 1976, Developmental medicine and child neurology.

[9]  Robert Rosenthal,et al.  Effect sizes: Pearson's correlation, its display via the BESD, and alternative indices. , 1991 .

[10]  J. Brown,et al.  Posture as a determinant of visual behavior in newborns. , 1975, Child development.

[11]  Esther Thelen,et al.  Three-Month-Old Infants Can Learn Task-Specific Patterns of Interlimb Coordination , 1994 .

[12]  D R Pederson,et al.  The effects of vertical rocking frequencies on the arousal level in two-month-old infants. , 1973, Child development.

[13]  M. McGraw,et al.  The Neuromuscular Maturation of the Human Infant , 1945 .

[14]  G. Savelsbergh,et al.  General and task-related experiences affect early object interaction. , 2004, Child development.

[15]  K. Bobath,et al.  A neurophysiological basis for the treatment of cerebral palsy , 1980 .

[16]  T. Kolobe,et al.  Predicting motor outcome at preschool age for infants tested at 7, 30, 60, and 90 days after term age using the Test of Infant Motor Performance. , 2004, Physical therapy.

[17]  D. Sheftel,et al.  Longitudinal Performance of Infants with Cerebral Palsy on the Test of Infant Motor Performance and on the Alberta Infant Motor Scale , 2003, Physical & occupational therapy in pediatrics.

[18]  B. Hopkins,et al.  Maternal handling and motor development: an intracultural study. , 1988, Genetic, social, and general psychology monographs.

[19]  Neal Mv The relationship between a regimen of vestibular stimulation and developmental behavior of the small premature infant. , 1968 .

[20]  J. Cole,et al.  Effect of a developmental program on motor performance in infants born preterm. , 2001, The Australian journal of physiotherapy.

[21]  K. Lagerspetz,et al.  The effects of training in crawling on the motor and menta development of infants. , 1971, Scandinavian journal of psychology.

[22]  Mijna Hadders-Algra,et al.  A systematic review of the effects of early intervention on motor development. , 2005, Developmental medicine and child neurology.

[23]  E. Mercuri,et al.  Neurologic examination of preterm infants at term age: comparison with term infants. , 2003, The Journal of pediatrics.

[24]  A. Gesell,et al.  Psychology of Early Growth , 1938 .

[25]  C. K. Rovee,et al.  Conjugate reinforcement of infant exploratory behavior. , 1969, Journal of experimental child psychology.

[26]  I Söderkvist,et al.  Determining the movements of the skeleton using well-configured markers. , 1993, Journal of biomechanics.

[27]  H Forssberg,et al.  Training affects the development of postural adjustments in sitting infants. , 1996, The Journal of physiology.

[28]  Specificity of Practice Effects on Elementary Neuromotor Patterns , 1993 .

[29]  B. Hopkins,et al.  Motor development, maternal expectations, and the role of handling , 1990 .

[30]  M. Pane,et al.  Neurological examination of preterm infants at term equivalent age. , 2008, Early human development.

[31]  M. Woollacott,et al.  Motor Control: Translating Research into Clinical Practice , 2006 .

[32]  S. Campbell,et al.  Construct validity of the test of infant motor performance. , 1995, Physical therapy.

[33]  Michele A Lobo,et al.  Postural and object-oriented experiences advance early reaching, object exploration, and means-end behavior. , 2008, Child development.

[34]  M. Onis WHO Motor Development Study: Windows of achievement for six gross motor development milestones , 2006, Acta paediatrica (Oslo, Norway : 1992). Supplement.

[35]  Claes von Hofsten,et al.  Eye, Head and Trunk Control: The Foundation for Manual Development 1 The responsibility was shared equally between the authors. 1 , 1998, Neuroscience & Biobehavioral Reviews.

[36]  V. Maehle,et al.  Comparison of Active Motor Items in Infants Born Preterm and Infants Born Full Term , 2006, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[37]  M. Galea,et al.  A review of the effects of sleep position, play position, and equipment use on motor development in infants , 2007, Developmental medicine and child neurology.

[38]  W. Wornham,et al.  Practices and representations of child care and motor development among West Africans in Paris , 1993 .

[39]  S. Campbell,et al.  Population-Based Age Standards for Interpreting Results on the Test of Motor Infant Performance , 2006, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[40]  A Gramsbergen,et al.  Handbook of Brain and Behaviour in Human Development. , 2001 .

[41]  Richard Rondalis Predictive Validity of the Test of Infant Motor Performance as Measured by the Bruininks-Oseretsky Test of Motor Proficiency at School Age, , 2003, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[42]  M. Forslund,et al.  Neurological assessment of preterm infants at term conceptional age in comparison with normal full-term infants. , 1983, Early human development.

[43]  Everett V. Smith,et al.  Comparison of test of infant motor performance (TIMP) item responses among children with cerebral palsy, developmental delay, and typical development. , 2005, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[44]  K. Beard,et al.  Play position is influenced by knowledge of SIDS sleep position recommendations , 1995, Journal of paediatrics and child health.

[45]  B. Wright,et al.  Validity of the Test of Infant Motor Performance for prediction of 6‐, 9‐ and 12‐month scores on the Alberta Infant Motor Scale , 2002, Developmental medicine and child neurology.

[46]  L. Dubowitz,et al.  Neurological and Neurobehavioural Differences Between Preterm Infants at Term and Full-Term Newborn Infants , 1982, Neuropediatrics.

[47]  M. Woollacott,et al.  Changes in posture control across the life span--a systems approach. , 1990, Physical therapy.

[48]  D. Hedeker,et al.  Validity of the Test of Infant Motor Performance for discriminating among infants with varying risk for poor motor outcome. , 2001, The Journal of pediatrics.

[49]  Joyce Salls,et al.  The relationship of infant sleep and play positioning to motor milestone achievement. , 2002, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[50]  D. Damiano Rehabilitative Therapies in Cerebral Palsy: The Good, the Not As Good, and the Possible , 2009, Journal of child neurology.

[51]  T. Kolobe,et al.  Predictive validity of the test of infant motor performance as measured by the Bruininks-Oseretsky test of motor proficiency at school age. , 2002, Physical therapy.

[52]  M. Woollacott,et al.  Practice modifies the developing automatic postural response , 1997, Experimental Brain Research.

[53]  M. V. Neal Vestibular stimulation and developmental behavior of the small premature infant. , 1968, Nursing research report.

[54]  R. Herman,et al.  Sensory feedback for head control in cerebral palsy. , 1981, Physical therapy.

[55]  A. Majnemer,et al.  Influence of supine sleep positioning on early motor milestone acquisition , 2005, Developmental medicine and child neurology.

[56]  C. Gregg,et al.  The relative efficacy of vestibular-proprioceptive stimulation and the upright position in enhancing visual pursuit in neonates. , 1976, Child development.

[57]  C. Bauer,et al.  Factors Affecting Neurobehavioral Responses of Preterm Infants at Term Conceptional Age , 1984, Child development.

[58]  A. Vansant,et al.  Message for the New Millennium , 2000 .

[59]  J. Galloway,et al.  Movement Training Advances the Emergence of Reaching in Infants Born at Less Than 33 Weeks of Gestational Age: A Randomized Clinical Trial , 2008, Physical Therapy.

[60]  R. Finkel,et al.  The Test of Infant Motor Performance: Reliability in Spinal Muscular Atrophy Type I , 2008, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[61]  A. Needham,et al.  A pick-me-up for infants’ exploratory skills: Early simulated experiences reaching for objects using ‘sticky mittens’ enhances young infants’ object exploration skills , 2002 .

[62]  E. Thelen,et al.  Three-month-old infants can select specific leg motor solutions. , 2002, Motor control.

[63]  M. Mital,et al.  An Approach to Head, Neck and Trunk Stabilization and Control in Cerebral Palsy by use of the Milwaukee Brace , 1976, Developmental medicine and child neurology.

[64]  S. Campbell,et al.  Concurrent Validity of the Test of Infant Motor Performance with the Alberta Infant Motor Scale , 2000 .

[65]  Carole Hurran,et al.  Motor Assessment of the Developing Infant , 1995 .

[66]  E Thelen,et al.  Development of reaching during the first year: role of movement speed. , 1996, Journal of experimental psychology. Human perception and performance.

[67]  C P Wooldridge,et al.  Head position training with the cerebral palsied child: an application of biofeedback techniques. , 1976, Archives of physical medicine and rehabilitation.