Background and Purpose: This study had 2 purposes: (1) to compare the emergence of reaching in infants born full-term and infants born at less than 33 weeks of gestational age and (2) to evaluate the effectiveness of a movement training program on the emergence of reaching in this preterm population.Participants: Twenty-six infants born at less than 33 weeks of gestational age and with a birth weight less than 2,500 g were randomly assigned to receive 20 minutes of daily movement training (PT-M group) or daily social training (PT-S group) and were compared with 13 infants born full-term (FT-S group).Methods: Reaching and hand-object interactions were tested every other week for 8 weeks. At each visit, infants were allowed six 30-second opportunities to contact a midline toy.Results: The FT-S and PT-M groups reached earlier and more consistently than the PT-S group. Specifically, the subjects in the FT-S group contacted the toy for longer durations and with an open, ventral surface of their hand. The PT-M group demonstrated increases in the number of hand-object contacts, the number of consistent reaches, and the percentage of time interacting with the toy and the surface of hand-object contact.Discussion and Conclusion: This project demonstrates that there are early gross motor skill differences in infants born at less than 33 weeks of gestational age. A caregiver-based daily training program, however, is effective at lessening some, but not all, of these differences over the short term.

Children with brain injuries or cerebral palsy (CP) comprise a large percentage of pediatric clients served by physical therapists. There is no consensus on wha

Purpose: To examine motor characteristics of children referred for evaluation for autism spectrum disorder (ASD) using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Methods: BSID-III scores were collected through retrospective chart review for 30 children (mean age = 31.57 ± 6 months) admitted to an outpatient autism evaluation clinic. Results: Children referred to an ASD clinic demonstrated a mean delay of 6 months for gross motor skills and 8 months for fine motor skills. There were no differences in total score or item analysis in group comparisons of motor characteristics in young children who did or did not receive a diagnosis of ASD. Conclusions: These results suggest that a delay in fine and gross motor skills at an early age is a characteristic of infants referred to an ASD clinic. Furthermore, the BSID-III may not be sensitive enough to distinguish between referred children with and without ASD.

OBJECTIVE. To measure upper-extremity and gross motor skill development in infants with and without risk factors for autism spectrum disorder (ASD). METHOD. Data were coded retrospectively from 39 infants who participated in longitudinal structured early developmental assessments. Twenty-five infants were at high risk for ASD, and the remaining 14 infants were classified as low risk. Upper-extremity and motor skill development were coded at ages 2, 4, and 6 mo. Five infants went on to receive an ASD diagnosis at age 2–4 yr. RESULTS. Infants at high risk for ASD demonstrated fewer midline behaviors with the upper extremities and delayed motor skill development than the low-risk group. Differences in motor skills were most apparent at age 4 mo. CONCLUSION. Early monitoring for motor delay in infants at high risk for ASD is warranted. Midline control and play with the upper extremities and overall motor skill development are possible assessment and therapeutic targets.

Background: Previous work has shown that full-term infants who were healthy contacted a toy with their feet several weeks before they did so with their hands and that movement training advanced feet reaching. Certain populations of preterm infants are delayed in hand reaching; however, feet reaching has not been investigated in any preterm population.Objective: The primary purpose of this study was to determine whether preterm infants born at less than 33 weeks of gestational age contacted a toy with their feet at 2 months of corrected age, before doing so with their hands, and whether movement training advanced feet reaching.Design: This study was a randomized controlled trial.Methods: Twenty-six infants born preterm were randomly assigned to receive daily movement training or daily social training. During the 8-week training period, the infants were videotaped in a testing session every other week from 2 to 4 months of age.Results: Both groups contacted the toy with their feet at 2 months of age during the first testing session prior to training, at an age when no infants consistently contacted the toy with their hands. After 8 weeks of training, the movement training group displayed a greater number and longer duration of foot-toy contacts compared with the social training group.Conclusions: These results suggest that movement experiences advance feet reaching as they do for hand reaching. For clinicians, feet-oriented play may provide an early intervention strategy to encourage object interaction for movement impairments within the first months of postnatal life. Future studies can build on these results to test the long-term benefit of encouraging early purposeful leg movements.