The impact of severity of motor delay, timing of task mastery, and START-play intervention on the development of means-end problem solving in young children

Andrea B Cunha; Iryna Babik; Dongho Choi; Natalie Koziol; Regina T Harbourne; Stacey C Dusing; Sarah W McCoy; Sandra L Willett; James A Bovaird; Michele A Lobo

doi:10.1016/j.bjpt.2024.100590

The impact of severity of motor delay, timing of task mastery, and START-play intervention on the development of means-end problem solving in young children

Braz J Phys Ther. 2024 Jan-Feb;28(1):100590. doi: 10.1016/j.bjpt.2024.100590. Epub 2024 Feb 9.

Authors

Affiliations

¹ Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA.
² Department of Psychological Science, Boise State University, Boise, ID, USA.
³ Nebraska Center for Research on Children, Youth, Families and Schools, University of Nebraska-Lincoln, Lincoln, NE, USA.
⁴ Department of Physical Therapy, Duquesne University, Pittsburgh, PA, USA.
⁵ Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, USA.
⁶ Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
⁷ Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE, USA.
⁸ Department of Physical Therapy, Biomechanics & Movement Science Program, University of Delaware, Newark, DE, USA. Electronic address: malobo@udel.edu.

Abstract

Background: Children with motor delays are at increased risk for delayed means-end problem-solving (MEPS) performance.

Objectives: To evaluate children with motor delays: 1) the impact of motor delay severity and MEPS mastery timing on developmental trajectories of MEPS; and 2) the effectiveness of Sitting Together And Reaching To Play (START-Play) intervention for improving MEPS.

Methods: This represents a secondary analysis from a multi-site randomized controlled trial, with blinded assessors and prospective registration. Children with mild or significant motor delays (n = 112, mean age=10.80, SD=2.59 months at baseline) were randomly assigned to START-Play or usual care early intervention (UC-EI) and assessed at five visits across one year using the Means-End Problem-Solving Assessment Tool that included three 30-second MEPS trials per visit. Task mastery occurred at the first visit the child achieved the highest level of performance in at least two of the three trials. Multilevel analyses evaluated trajectories of MEPS outcomes dependent upon the timing of MEPS mastery, motor delay severity, and intervention group.

Results: At baseline, children with mild motor delays demonstrated better MEPS than children with significant delays, but this difference was only observed for children who achieved mastery late. Children with significant delays demonstrated greater improvements in MEPS in the post-intervention phase compared to children with mild delays. No MEPS differences were found between START-Play and UC-EI.

Conclusion: Motor delay severity and timing of task mastery impacted MEPS trajectories, whereas START-Play intervention did not impact MEPS for children with motor delays.

Clinical trials registry identifier: NCT02593825 (https://clinicaltrials.gov/ct2/show/NCT02593825).

Keywords: Children; Cognition; Intervention; Learning; Means-end problem solving; Motor delay.

MeSH terms

Child
Early Intervention, Educational
Humans
Motor Skills Disorders*
Multicenter Studies as Topic
Problem Solving
Prospective Studies
Randomized Controlled Trials as Topic

Associated data

ClinicalTrials.gov/NCT02593825