Background: The environmental enrichment (EE) framework has inspired several early intervention (EI) approaches. This study evaluated the feasibility, safety, caregiver acceptance, and satisfaction of implementing the HEP Approach intervention, a novel EI model based on the EE paradigm. Outcome measures for motor development, individual functional goals, sensory functions, caregiver-provided environmental affordances, and motivation for movement were examined. Methods: A pre-post-study design examined 18 premature infants (<33 weeks six days gestation) with a corrected age of 4–10 months. A 21-item Likert scale survey assessed the feasibility, safety, acceptability, and satisfaction of implementing the HEP Approach intervention. The Peabody Developmental Motor Scales-2, Test of Sensory Functions in Infants, Affordances in the Home Environment for Motor Development, and Infant Movement Motivation Questionnaire were used for outcomes. The goal attainment scale measured progress toward parent goals. The HEP Approach consisted of 12 one-hour sessions implemented over three months. Results: Most participating parents found the HEP Approach intervention feasible, safe, acceptable, and satisfactory. GAS scores demonstrated significant gains with a mean t-score of 67.75 (SD = 2.00). Results found significant improvement (p ≤ 0.05) in all outcome measures. Conclusions: Results suggest that the HEP Approach intervention is safe, feasible, and acceptable to implement. Outcome measures were meaningful and sensitive in identifying improved motor development, individualized parental goals, sensory functions, caregivers’ use of environmental opportunities, and movement motivation in premature at-risk infants. Results suggest further studies on the HEP Approach are feasible, and highlight the potential of this intervention to inspire and guide future research in this field.

Background: Early intervention (EI) for infants identified as being at high risk for cerebral palsy (CP), or who have been diagnosed with it, is critical for promotion of postnatal brain organization. The aim of this study was to explore the effectiveness of the Homeostasis-Enrichment-Plasticity (HEP) Approach, which is a contemporary EI model that applies the key principles of enriched environment paradigms and neuronal plasticity from experimental animal studies to ecological theories of human development on the motor development, sensory functions, and parental goals of an infant with twin anemia polycythemia sequence (TAPS) and CP. Methods: An AB phase with follow-up single case study design which consisted of multiple baseline assessments with the Peabody Developmental Motor Scales-2 (PDMS-2) and the Test of Sensory Functions in Infants (TSFI) was used. Non-overlapping confidence intervals analysis was used for pre–post PDMS-2 scores. The measurement of progress toward goals and objectives was conducted using the Goal Attainment Scale (GAS). The HEP Approach intervention consisted of 12 one-hour sessions implemented over a period of 3 months, where a physical therapist provided weekly clinic-based parental coaching. Results: Results found a stable baseline during Phase A and improvement in response to the HEP Approach intervention during Phase B in both the PDMS-2 and TSFI according to 2SD Band analysis. The confidence intervals for the PDMS-2 scores also indicated a significant improvement after HEP intervention. The scores for both the PDMS-2 and the TSFI were consistent or showed improvement throughout the Follow-Up phase. A GAS t-score of 77.14 indicated that the infant exceeded intervention goal expectations. Conclusions: Although our findings suggest that the HEP Approach intervention has promise in enhancing sensory functions, motor skill outcomes, and parental goals in an infant with TAPS and CP, further research is required to validate and apply these results more broadly.

The Evaluation in Ayres Sensory Integration (EASI) is a performance-based assessment tool designed to evaluate sensory reactivity, sensory perception, postural-ocular control, bilateral integration, and praxis abilities in children aged 3 to 12 years. There is no standardized performance assessment to evaluate sensory integration functions with Turkish children. The objective of this study is to develop a translated and culturally adapted Turkish version of the EASI for use in clinical practice and research. A seven-step process for translation and cross-cultural adaptation was implemented based on current recommendations identified in the litterature. The process includes forward and backward translations, expert syntesis, linguistic review, cognitive interviews, and pilot testing. The seven-step procedure for translating and culturally adapting the EASI resulted in a Turkish version of the 20 subtests of the EASI. Although revisions were required in the synthesis and linguistic analysis phase, there were no semantic or conceptual inconsistencies in the forward translations. Some discrepancies between the backward translation and the original form were identified and resolved; none of the discrpencies were directly linked to the administration or scoring of the tests. A Turkish version of the EASI has been developed through a research-guided seven-step method, incorporating translation and cultural adaptation. The Turkish translation and cultural adaptation of the EASI will support evidence based practice and research in the field of sensory integration within the Turkish population.

Introduction: The Test of Ideational Praxis is a performance-based assessment designed to identify ideational praxis difficulties in children aged 3–12. However, Turkish therapists are currently unable to use this tool due to the lack of a linguistically and culturally appropriate version. This study aimed to develop a culturally adapted Turkish version of the Test of Ideational Praxis to support future normative data collection, psychometric evaluations and clinical application. Method: A seven-step process for translation and cross-cultural adaptation was conducted, including forward and backwards translation, expert synthesis, linguistic review, structured therapist evaluations and pre-testing with children. Each step was guided by established literature and best practice guidelines. Findings: The translation and adaptation process was completed successfully with 29 participants, including translators, therapists and 10 typically developing children aged 6–8 years (four girls and six boys). While minor revisions were required during the synthesis and linguistic review phases, the forward translations showed strong semantic and conceptual consistency. Discrepancies observed in the back translation were limited to phrasing and did not affect standardised administration or scoring. Both therapists and children confirmed that the Turkish version was clear, comprehensible and culturally appropriate, with no expressions, instructions or symbolic representations perceived as problematic. Conclusion: The Turkish translation and adaptation of the Test of Ideational Praxis provides a culturally adapted instrument that supports future validation studies and clinical piloting, offering a foundation for both research and practice on ideational praxis development in Türkiye.

Background and objectives: This study investigated the effectiveness of the Homeostasis-Enrichment-Plasticity (HEP) Approach in preterm infants with increased developmental risk, compared to the Traditional Treatment (TT) intervention for physical and occupational therapy.Materials and methods: Twenty-nine preterm infants (adjusted age, 4–10 months) were randomly assigned to two groups: the HEP Approach group and the TT group. The Peabody Developmental Motor Scales-2 (PDMS-2), Test of Sensory Functions in Infants (TSFI), and Beck Anxiety Inventory (BAI) were administered pre- and post-intervention. The intervention was implemented weekly for 12 weeks.Results: The baseline characteristics of the infants were similar. At the end of the treatment, a significant time effect was observed in motor skills and sensory functions across both groups, with improvements in all PDMS-2 and TSFI subtests (p < 0.05). Significant time × group interactions showed greater improvements in the HEP Approach group compared to the TT group for Fine Motor Quotient: F = 10.818, p = 0.003; Gross Motor Quotient: F = 5.691, p = 0.024; and Total Motor Quotient: F = 21.109, p < 0.001. For TSFI, the HEP Approach group showed greater improvements in Adaptive Motor Functions (F = 13.794, p = 0.001), Visual-Tactile Integration (F = 7.410, p = 0.011), and Total score (F = 11.316, p = 0.002). No significant time*group interactions were found for Reactivity to Tactile Deep Pressure, Ocular Motor Control, and Reactivity to Vestibular Stimulation (p > 0.05). Parental anxiety, measured by BAI, decreased significantly in both groups (F = 8.72, p = 0.006), but no significant time × group interaction was found (p > 0.05), indicating similar reductions in both groups.Conclusion: The HEP Approach demonstrated superior outcomes compared to the TT intervention in improving motor skills and sensory functions in preterm infants, while both interventions reduced caregiver anxiety.

Background and Clinical Significance: This case report explicates the implementation and outcomes of the Homeostasis-Enrichment-Plasticity (HEP®) Approach in a 10-month-old male infant with an increased risk of Autism Spectrum Disorder (ASD) who exhibited challenges in sensory functioning and motor development. Case Presentation: The intervention was carried out utilizing the eleven-step HEP® Approach process. The Peabody Developmental Motor Scale-2 (PDMS-2), Test of Sensory Function in Infants (TSFI), Adaptive Behavior Assessment System-3 (ABAS-3), and Goal Attainment Scale (GAS) were used as outcome measures before and after the intervention. A pediatric physical therapist conducted an hour-long intervention weekly for 10 weeks using the HEP® Approach implementation guide. Post-intervention, the infant's fine and gross motor skill scores in the PDMS-2 and General Adaptive Composite in the ABAS-3 exhibited significant improvement, as determined by the 95% confidence interval overlap analysis. The TSFI total score also improved categorically. An overall GAS score of +1.6 corresponded to a t-score of 74.12, indicating significant progress towards the individualized intervention goals. Conclusions: The HEP® Approach enhanced motor development, sensory functioning, general adaptive skills, and parental goals in a 10-month-old infant at risk for ASD. The results support further examination of the HEP approach's effectiveness in infants at risk for ASD.