Browsing by Author "Koziol, Natalie A."
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Item The Effect of START-Play Intervention on Reaching-Related Exploratory Behaviors in Children with Neuromotor Delays: A Secondary Analysis of a Randomized Controlled Trial(Physical and Occupational Therapy in Pediatrics, 2022-10-11) Babik, Iryna; Cunha, Andrea; Choi, Dongho; Koziol, Natalie A.; Harbourne, Regina T.; Dusing, Stacey C.; McCoy, Sarah W.; Bovaird, James A.; Willet, Sandra L.; Lobo, Michele A.Aims: Children with neuromotor delays are at risk for reaching and object exploration impairments, which may negatively affect their cognitive development and daily activity performance. This study evaluated the effectiveness of the Sitting Together And Reaching To Play (START-Play) intervention on reaching-related exploratory behaviors in children with neuromotor delays. Methods: In this randomized controlled clinical trial, 112 children (Mean = 10.80, SD = 2.59 months old at baseline) with motor delays were randomly assigned to receive START-Play intervention or usual care-early intervention. Performance for ten reaching-related exploratory behaviors was assessed at baseline and 1.5, 3, 6, 12 months post-baseline. Piecewise linear mixed-effects modeling was used to evaluate short- and long-term effects of the intervention. Results: Benefits of START-Play were observed for children with significant motor delays, but not for those with mild delays. START-Play was especially beneficial for children with significant motor delays who demonstrated early mastery in the reaching assessment (i.e., object contact ≥65% of the time within 3 months after baseline); these children showed greater improvements in manual, visual, and multimodal exploration, as well as intensity of exploration across time. Conclusions: START-Play advanced the performance of reaching-related exploratory behaviors in children with significant motor delays.Item START-Play Physical Therapy Intervention Indirectly Impacts Cognition Through Changes in Early Motor-Based Problem-Solving Skills(Pediatric Physical Therapy, 2023-07) Koziol, Natalie A.; Kretch, Kari S.; Harbourne, Regina T.; Lobo, Michele A.; McCoy, Sarah W.; Molinini, Rebecca; Hsu, Lin-Ya; Babik, Iryna; Cunha, Andrea Baraldi; Willett, Sandra L.; Bovaird, James A.; Dusing, Stacey C.Purpose: This study tested whether the Sitting Together and Reaching to Play (START-Play) physical therapy intervention indirectly impacts cognition through changes in perceptual-motor skills in infants with motor delays. Methods: Participants were 50 infants with motor delays randomly assigned to START-Play plus Usual Care Early Intervention (UC-EI) or UC-EI only. Infants' perceptual-motor and cognitive skills were assessed at baseline and 1.5, 3, 6, and 12 months post-baseline. Results: Short-term changes in sitting, fine motor skills, and motor-based problem-solving, but not reaching, predicted long-term changes in cognition. START-Play indirectly impacted cognition through motor-based problem-solving but not sitting, reaching, or fine motor skills. Conclusions: This study provided preliminary evidence that early physical therapy interventions that blend activities across developmental domains and are supported by an enriched social context can place infants on more optimal developmental trajectories.