Characterization and intervention for upper extremity exploration & reaching behaviors in infancy

Abstract

The purpose of this article is to: 1) highlight general exploration, reaching, and object exploration behaviors as key activities of daily living in infancy, 2) describe how knowledge of early warning signs for these behaviors may improve early assessment, and 3) discuss interventions that may advance performance of these behaviors. Early intervention for at-risk infants and their families should focus on improving performance of these behaviors for several reasons. First, these early, interrelated upper extremity behaviors serve an integral role in global learning and development in infancy. Second, among at-risk populations, differences have been observed in the quantity and quality of performance of these behaviors. In many cases, these differences are in turn associated with additional perceptual-motor and cognitive delays. This article fills a gap in the literature by summarizing how early assessment and intervention can target these key early behaviors in populations at risk for upper extremity disabilities, such as those born preterm, with Down syndrome, brachial plexus palsy, or arthrogryposis multiplex congentia.

Protocol and Feasibility-Randomized Trial of Telehealth Delivery for a Multicomponent Upper Extremity Intervention in Infants With Asymmetric Cerebral Palsy

“…If successful with reaching, the child is assessed for the ability to independently grasp the toy. Maturity of grasp pattern as compared to a sequence for age in typically developing children 29 – 31 is noted (Supplemental Table 2). If the child is unable to grasp or demonstrates an immature or ineffective grasp pattern, the intervention is initiated at the basic level with a variety of toys selected to encourage increased maturity and variety of grasps (appropriate to the child’s corrected age), while allowing for successful completion of the task.…”

How Manual Object Exploration is Associated with 7‐ to 8‐Month‐Old Infants’ Visual Prediction Abilities in Spatial Object Processing

“…The objective of the present study was to determine whether 7‐ to 8‐month‐old infants’ object exploratory skills are associated with their performance of visually predicting the appearance of objects when they are moving in space. Between 7 and 8 months of age, infants are old enough to principally be able to perform sophisticated object manipulations (Soska et al., ), but still are at an age in which high variance in the development of object exploratory skills can be expected (Lobo, Galloway, & Heathcock, ). Because of the fact that predictive performances have not yet been studied in the context of infants’ spatial objects processing skills, we developed a new paradigm adapted from the typical occluder task, our object prediction task.…”

From Hemispheric Asymmetry through Sensorimotor Experiences to Cognitive Outcomes in Children with Cerebral Palsy

“…Enriched environment interventions can be implemented even before a child's motor and sensorimotor deficits become apparent. Early interventions implementing positioning a child in different postures (e.g., supine, prone, side-lying, supported sitting and standing, with frequent transitions among postures) to allow exploration of body affordances and body-environment interactions, as well as toy-oriented activities to promote reaching, visuomotor coordination, and object exploration, have been shown to be effective in facilitating children's motivation to play, self-generated movements, postural control, reaching, bimanual object exploration, crawling, walking, and problem-solving skills [435,448,[539][540][541][542][543][544][545][546][547][548][549]. Similarly, early interventions such as the GAME intervention [492,494], the Supporting Play Exploration and Early Development Intervention (SPEEDI [550]), and the Sitting Together and Reaching to Play intervention (START-Play [551,552]) have been shown to improve children's sensorimotor and motor skills.…”

“…More often, parental education is offered in conjunction with an ongoing physical therapy [492,[585][586][587]. Importantly, in research with typically developing infants and those born preterm, parentprovided interventions encouraging infants' independent head control, frequent transitions among different postures, general arm movements, reaching to midline, and reaching with both hands led to significant improvements in children's postural control, reaching, and object exploration [435,442,448,[542][543][544][545][546]588]. Future research should further investigate the utility of parent education in the rehabilitation of motor and sensorimotor skills in children with CP.…”