Project for Cognitive Advancement in Infants With Neuromotor Disorders (CAN-Do)
|ClinicalTrials.gov Identifier: NCT02673658|
Recruitment Status : Completed
First Posted : February 4, 2016
Last Update Posted : February 18, 2019
|Condition or disease||Intervention/treatment||Phase|
|Motor Coordination or Function; Developmental Disorder||Behavioral: Motor + problem solving Behavioral: body weight support training||Not Applicable|
This longitudinal study will examine the ongoing interaction between the domains of cognitive and motor development in infants with neuromotor disability, as well as compare differences between groups of infants receiving two types of intervention.
The specific aims for this study are:
- To measure the changes of the head, trunk and pelvis as the primary orienting segments of the body during the achievement of sitting and the transition to crawling in infants with neuromotor disability.
- Describe the changes in problem-solving and cognitive abilities of infants with neuromotor disability as they transition to stable sitting and then to crawling.
- Using eye-tracking technology, quantify the evolution of focused attention in infants with neuromotor disability as the motor skills of sitting and the transition to crawling emerge.
- Compare motor skill, visual attention and cognitive change as sitting and crawling emerge between groups of infants with neuromotor disabilities receiving two different interventions, and determine the effects of distinctly different paradigms: one that focuses simply on building motor skill, and the other that builds motor and cognition together.
This is a longitudinal study, with between group comparisons to determine the effectiveness of the intervention, and within group comparisons to determine change over time. Measures will occur in the home at baseline, at the end of month 1 of intervention, the end of month 2, the end of month 3, and at a 9 month follow-up visit, for a total of 5 measurement times. Each session will take approximately 1 hour each time. Because we want to look at the child's movement and posture, the child should be clothed in either an undergarment or a bathing suit that allows a view of their trunk, legs and arms during the 5 measurement sessions. We will video the child's movement and posture and play doing two standardized infant tests during these measurement sessions. The child will sit on the floor as independently as they can and reach for toys and move through as many developmental postures as they can (crawling, pulling to stand, moving in and out of sitting). The parent will always be next to their child during measurement sessions.
Children will participate in one of the parent-delivered interventions for 3-months after being randomized to one of two groups. Both intervention groups are parent-delivered interventions, with differing goals and differing training. Parents will be trained in one of the following approaches:
Motor-based problem solving approach or the body weight support (BWS) approach.
In both of the above approaches, parents will receive weekly, one-hour sessions at home for updates and training from a physical therapist to advance the program for individual infants. Thus, there will be a total of 12 sessions with a therapist. Each program is individualized because no two infants will have exactly the same skill set. This individualization of programs is standard practice for early intervention. Generally, the suggestions will follow standard developmental guidelines, with sequencing of skills presented in the order of normal development. Both of these approaches are currently used in early intervention for young children with developmental disabilities, but we do not know which is more effective, or if either approach is effective.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||20 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Single (Outcomes Assessor)|
|Official Title:||Project for Cognitive Advancement in Infants With Neuromotor DisOrders:The CAN-DO Project|
|Study Start Date :||October 2015|
|Actual Primary Completion Date :||December 15, 2018|
|Actual Study Completion Date :||February 14, 2019|
Active Comparator: Motor + problem solving
This method focuses on spontaneous movement (rather than facilitated movement). Self-initiated, functionally directed movement is emphasized. Intervention includes guidance and cues, which gently call the child's attention to the support surface, and a set-up of the environment for small increments of movement so that the child can solve a movement problem. Passive movements are not used. Each small increment of movement to advance sitting skill or other motor skills is paired with a specific object or toy that challenges a cognitive concept for spatial problem solving. In this approach, the parent will adjust toys and supports to encourage changes of position from sitting, to transitions in and out of sitting to crawling or standing, but will not assist the child physically.
Behavioral: Motor + problem solving
Developmental motor tasks incorporating cognitive concepts such as object permanence
Active Comparator: Body weight support training
In this approach, infants will be supported physically by their parents to take steps, sit, crawl, or reach, in practice sessions focused simply on the motor skill. Toys or problem solving will not be part of this intervention, but the child will be assisted (lifted by the parent) through movement to improve strength and learn specific movements and new positions. The child will be able to perform as much of the movement as possible, but the parents will initiate the activity if the child does not initiate, and the parent will lift the child passively through the task if the child is unable to move.
Behavioral: body weight support training
Mobility tasks to change positions or move the body with assistance to initiate movement
- Gross Motor Function Measure [ Time Frame: baseline, 1 month, 2 month, 3 months, up to 9 months post baseline ]Longitudinal Gross Motor Function Measure change measures from baseline to: 1 month, 2 months, 3 months and 9 months post baseline
- Visual attention - time to switch between 2 targets, and look time [ Time Frame: baseline, 1 month, 2 month, 3 months, up to 9 months post baseline ]Longitudinal eye tracking change measures from baseline to: 1 month, 2 months, 3 months and 9 months post baseline
- Early Problem Solving Indicator [ Time Frame: baseline, 1 month, 2 month, 3 months, up to 9 months post baseline ]
Longitudinal Early Problem Solving Indicator change measures from baseline to:,
1 month, 2 months, 3 months and 9 months post baseline
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02673658
|United States, Pennsylvania|
|Pittsburgh, Pennsylvania, United States, 15282|
|Principal Investigator:||Regina T Harbourne, PhD||Duquesne University|