Early Intensive Postural and Movement Training Advances Head Control in Very Young Infants

Abstract

BACKGROUND: Daily experiences are thought to play an important role in motor development during infancy. There are limited studies on the effect of postural and movement experiences on head control. OBJECTIVE: The purpose of this study was to quantify the effects of postural and movement experiences on head control through a comprehensive set of measurements beginning when infants were 1 month old. DESIGN: This was a prospective, longitudinal, 2-cohort study. METHODS: Twenty-two full-term infants who were healthy were randomly assigned to either a training group or a control group. Infants were observed every other week from 1 to 4 months of age. Head control was assessed using a standardized developmental assessment tool, the Test of Infant Motor Performance (TIMP), as well as behavioral coding and kinematics of infants' head postures and movements in a supported sitting position. Caregivers performed at least 20 minutes of daily postural and movement activities (training group), or social interaction (control group) for 4 weeks. RESULTS: The training group had higher TIMP scores on head control-related items during the training period and after training stopped compared with the control group. Starting from the during training phase, the training group infants had their heads in a vertical and midline position longer compared with the control group infants. After training stopped, the training group infants actively moved their heads forward more often and for larger distances. LIMITATIONS: The experiences outside daily training were not monitored, and the results may be specific to the experimental setup for infants with typical development. CONCLUSIONS: Young infants are able to take advantage of postural and movement experiences to rapidly advance their head control as early as 4 to 6 weeks of postnatal life. Infant positioning, caregiver handling, and caregiver-infant interactions were likely contributing factors. This database of comprehensive measures may be useful in future trials focused on head control in infants with special needs.