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

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

•Means-end problem-solving (MEPS) should be a focus of early intervention.•MEPS tools might support screening for impaired problem-solving in young children with motor delays.•More time may be required to solidify MEPS learning for children with significant motor delays.•START-Play plus usual care d...

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Bibliographic Details
Published in:Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Brazil)), 2024-01, Vol.28 (1), p.100590-100590, Article 100590
Main Authors: Cunha, Andrea B., Babik, Iryna, Choi, Dongho, Koziol, Natalie, Harbourne, Regina T., Dusing, Stacey C., McCoy, Sarah W., Willett, Sandra L., Bovaird, James A., Lobo, Michele A.
Format: Article
Language:eng
Subjects:
Child
Child, Preschool
Children
Cognition
Early Intervention, Educational
Humans
Intervention
Learning
Means-end problem solving
Motor delay
Motor Skills Disorders
Original Research
Problem Solving
Prospective Studies
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Summary:•Means-end problem-solving (MEPS) should be a focus of early intervention.•MEPS tools might support screening for impaired problem-solving in young children with motor delays.•More time may be required to solidify MEPS learning for children with significant motor delays.•START-Play plus usual care did not impact MEPS performance more than usual care alone. Children with motor delays are at increased risk for delayed means-end problem-solving (MEPS) performance. 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. 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. 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. Motor delay severity and timing of task mastery impacted MEPS trajectories, whereas START-Play intervention did not impact MEPS for children with motor delays. NCT02593825 (https://clinicaltrials.gov/ct2/show/NCT02593825)
ISSN:1413-3555
1809-9246