Osnat Atun-Einy

Season of birth, crawling onset, and motor development in 7-month-old infants

Objective: To examine seasonal effect on motor development; in particular, the onset of crawling. Background: The acquisition of motor milestones demonstrates considerable age variation. Previous studies that examined the effect of season on motor development present inconsistent findings; geographical zone and climatic factors were among the identified factors. The present study was conducted in a Mediterranean climate. Method: Forty-seven full-term infants (25 boys and 22 girls), aged 7 months, were observed while playing in the home context, and the Alberta Infant Motor Scale (AIMS) was administered. Results: Infants who were born during the winter–spring (W) months started to crawl about 4 weeks earlier compared to infants born during the summer–autumn (S) months (t = 3.13, p = 0.003). Similarly, the AIMS total scores (t = 2.03, p = 0.05) and prone subscale (t = 2.19, p = 0.04) were significantly higher in W as compared to S born infants. Conclusion: The findings point to the involvement of season in the motor achievements of infants and suggest that aspects of the physical environment shape the experiences that contribute to developmental progress.

Sleep disruption and motor development: Does pulling-to-stand impacts sleep–wake regulation?

During the second half of the 1st year, periods of increased sleep disruption have been documented alongside overall improvement in sleep-wake regulation. The objective of the present research was to test if pulling-to-stand (PTS), a milestone typically achieved during the latter part of the 1st year, co-occurs with a period of disrupted sleep. In a longitudinal design, 20 healthy infants were followed-up, from 7 to 11-12 months, at 3-week intervals. Each measurement consisted of filmed motor observations and sleep recordings (actigraphy), both conducted at home. It was found that among early achievers of PTS (by 8 months), the milestone was time-linked to a period of disrupted sleep. The results point to the significance of timing in the interplay between domains of development, and highlight the importance of considering both chronological and developmental metrics in studying changes in sleep-wake regulation.

Parental beliefs and practices concerning motor development: Testing new tools

Abstract The parental beliefs on motor development (PB-MD) and the motor habits (MOHAB) questionnaires are new instruments measuring parental beliefs, practices, infant MOHAB, and environmental features regarding motor development. Psychometric properties of these questionnaires were tested using data of parents of 268 Dutch and Israeli infants aged 1-to-8-months. Face- and convergent validity of both questionnaires, as well as internal consistency and test–retest reliability of the PB-MD were satisfactory. Exploratory factor analysis revealed five factors in the PB-MD. Altogether, both questionnaires are valid, reliable and culturally sensitive instruments potentially useful for research and clinical practice.

Actigraphic motor activity during sleep from infancy to adulthood

ABSTRACT A secondary analysis of longitudinal and cohort studies was carried out to quantitatively investigate the motor activity pattern, recorded through actigraphy, during the first six hours of nocturnal sleep. The first study was of longitudinal nature. Ten healthy participants (four females) were monitored three times, at baseline (T1) when they were infants (mean age 7.10 ± 0.32 months), at the first follow-up examination (T2) around 4 months later (mean age 11.20 ± 0.63 months) and at the second follow-up (T3) around three years later, when they were preschoolers (mean age 4.68 ± 0.14 years). At T1, T2 and T3 each participant wore the actigraph Basic Mini-Motionlogger (Ambulatory Monitoring, Inc., Ardsley, NY, USA) over at least two consecutive nycthemeral cycles, with the aim to measure the mean hourly motor activity count. Seven- and 11-month-old infants had a higher level of motor activity over the night compared to preschoolers. Furthermore, motor activity increased as the night progressed, with a pronounced increment at both T1 and T2, while at T3 such an increase was less marked. The second study was cross-sectional and aimed to explore the motor activity pattern, using actigraphy, during the first six hours of nocturnal sleep in multiple-age healthy groups, from infancy to adulthood. We assigned participants to eight groups according to age: 20 (five females) aged around 10 months old (mean age 10.65 ± 0.67 months); 13 (nine females) aged around 4 years (mean age 4.38 ± 0.51 years); 21 (10 females) aged around 10 years (mean age 9.67 ± 0.91 years); 21 (nine females) aged around 20 years (mean age 19.33 ± 2.44 years); 20 (10 females) aged around 30 years (mean age 29.80 ± 1.99 years); 20 (15 females) aged around 40 years (mean age 40.70 ± 1.26 years); 20 (11 females) aged around 50 years (mean age 50.15 ± 2.80 years) and 20 (nine females) aged around 60 years (mean age 59.25 ± 3.23 years). The participants aged between 10 and 60 years wore the actigraph Basic Mini-Motionlogger over seven consecutive nycthemeral cycles (infants and preschoolers wore the actigraph over at least two consecutive nycthemeral cycles), with the aim to measure the mean hourly motor activity count. The results indicated a significantly higher motor activity count in 10-month-old infants compared to all the remaining age groups. Moreover, the pattern of motor activity of 10-month-old infants was different from that of all other groups, with the highest motor activity counts from the second to the sixth hour of sleep. Considered as a whole, the results of both studies converge regarding the high motor activity detected among infants, which could be explained by the presence of a maturational process that has not yet been fully completed at this stage of life. In both studies, only the motor activity of infants was above the cutoff level established for normal adults, highlighting the need to establish a specific cutoff value for infants.

Asymmetrical motor behaviour as a window to early leg preference: a longitudinal study in infants 7-12 months of age.

ABSTRACT This longitudinal study explored leg preference in infancy during half-kneel pulling-to-stand (PTS) and asymmetrical four-point kneeling, which is part of the typical motor repertoire of infants. The special characteristics of the half-kneel PTS as a discrete task, performed in a bilateral context provide the opportunity to explore leg preference during an asymmetrical behaviour. Twenty-seven infants were observed in their homes, every 3 weeks between the ages of 7–12 months. Leg preference was determined by the “lead-out” limb used as the infants pulled to stand from the half-kneeling position (half-kneel PTS). As a complementary measure, the leading leg during asymmetrical four-point kneeling and crawling (“asymmetrical four-point patterns”) was used in the 10 infants who developed these patterns. The infants studied showed a general preference for using a leading leg during half-kneel PTS, which was mostly consistent over the study period. A strong correlation was found between leg preferences during half-kneel PTS and asymmetrical four-point patterns. The findings documented functional asymmetry in infant lower limbs during half-kneel PTS and asymmetrical four-point patterns, highlighting the importance of the tasks used to define leg preference.

Physical Therapy for Young Children Diagnosed with Autism Spectrum Disorders–Clinical Frameworks Model in an Israeli Setting

Recent research findings suggest that many children with Autism Spectrum Disorders (ASD) demonstrate delayed and atypical motor achievements. It has now become clear that a more holistic, integrative and multi-disciplinary intervention is required to effectively address the motor-related impairments of this population. It is also crucial to ensure that this group of clients has access to early physical therapy (PT) interventions. Despite accumulating research on physical interventions, little is known about intervention model for implementation at a national level. This report introduces a model that uniquely illustrates implementation of PT services for a large number of children with ASD. The model has been operating for the past 2 years in one country (Israel), and includes an optional implementation model of PT practice settings for young children diagnosed with ASD. The Israeli setting offers a unique opportunity for implementing PT services for a multitude of children with ASD on a regular basis as an accepted/needed service. The initial outcomes of the present implementation suggest that an intensive PT intervention program might enhance therapeutic outcomes for this population, and contribute to our knowledge on the potential of PT for individuals with ASD.

Training Physical Therapists in Early ASD Screening

Physical therapists (PTs) are often one of the first professionals to evaluate children at risk. To examine the effect of an early screening training on pediatric PTs’: (1) knowledge of autism spectrum disorder (ASD), (2) clinical self-efficacy, and (3) identification of markers. Twenty-six PTs participated in a 2-day “Early ASD Screening” workshop. The ASD Knowledge and Self-Efficacy Questionnaire, and video case study analysis were completed pre- and post-training. Changes following training were significant for ASD knowledge related to etiology and learning performance, early signs, risk factors, and clinical self-efficacy. Rating the videoed case study after the training, was significantly more accurate than it was before. Training PTs is important for enhancing early identification of ASD.

Cross-Cultural Differences in Parental Beliefs about Infant Motor Development: A Quantitative and Qualitative Report of Middle-Class Israeli and Dutch Parents.

The present study explored cultural differences in parental beliefs about motor development across 2 Western cultures: Israel and the Netherlands. Can 2 cultural models be distinguished regarding infant motor development in Israel and the Netherlands or are parental beliefs about motor development similar across these cultures? Using a questionnaire containing closed and open questions, beliefs of 206 Israeli and 198 Dutch parents of first-born children between 2 and 7 months old were analyzed. Based on both quantitative and qualitative analyses, distinct cultural models were found showing that the Dutch attributed a bigger role to maturation and children’s own pace than to stimulation. The Israeli parents found stimulation of motor development important and discussed active stimulation more elaborately. When discussing supportive activities, the Israeli parents mentioned specific activities, whereas the Dutch parents used more general, vague expressions about support. Moreover, the Israeli parents discussed the need for expert advice and advice from relatives and other parents more than the Dutch parents, who rely on their own observations, books, or websites more often. The cultural background was the strongest predictor of parental beliefs about motor development. Parental education, age, children’s birth weight, gender, and having seen a physical therapist showed weaker relations with parental beliefs. Altogether, 2 distinguishing cultural models can be found, raising the question whether infant motor development can be approached similarly across Western cultures. Besides this implication for science, practitioners should also be aware of differences between cultures and between parents.

Novel Treatment for Improvement of Sensory-Motor, Function and Emotional Behavior of a Child with Autism Spectrum Disorder: A History Case Report

Background: Tailored interventions. One potential novel intervention is orthotic under-garments (OUG Autism spectrum disorder (ASD) is a prevalent neuro-developmental disorder frequently presenting sensory-motor impairments. The complexity and diversity of ASD typically calls for individualized). Aim: To explore the feasibility and effect of OUG as a supplementary therapeutic modality on motor, sensory capabilities and behavior of a child with ASD. Participant: A five years and eight months old child with ASD that presents hypotonia, poor postural control and coordination, a significant motor delay, severe sensory modulation problems, and unusual behaviors. Procedure: Motor, sensory and behavioral evaluations were performed pre (Pre-I) and after (Post-I) a four months intervention: Peabody Developmental Motor Scales-2 (PDMS-2), The Short Sensory Profile (SSP), therapists’ reports and parental interviews served as a behavior and emotion evaluation. Results: Motor function has improved (PDMS-2 percentile <1 Pre-I vs. Post-I 3). Sensory function has improved (Total SSP score 136 Pre-I vs. Post-I 102). Therapeutic and parental reports indicated a decrease of atypical behaviors, improvement in self-confidence and better social participation. Conclusion: According to the current case report, the OUG was found to be useful in improving sensory-motor functions and emotional behaviors of a child with ASD. Our findings provide a possible support to the introduction of orthotic undergarment as a part of individually tailored physical therapy interventions for the child with ASD.

Infant motor activity during sleep: Simultaneous use of two actigraphs comparing right and left legs

Motor asymmetry during the first hours of sleep documented in adults found higher activity in the non-dominant limb. The stage of development at which such asymmetries first appear is unknown. Twenty healthy infants were followed from 7 to 12months of age, at 3-week intervals, comparing motor activity of the right and left legs during sleep using twin actigraphs (AMI). Hour-by-hour analysis of the first seven hours of nocturnal sleep found no consistent difference in activity levels between the right and left legs. Using the standard algorithm for infants, which provides an overall estimate of sleep quality, revealed discrepancies in night waking episodes (Right versus Left) in 33% of the nights. Results pertaining to leg movement suggest that motor asymmetry is not yet present during the first year of life. However, given the large discrepancies in the detection of night waking, further investigation of the developmental course of circadian motor asymmetry is warranted.