A Physical Therapy Intervention to Advance Cognitive and Motor Skills: A Single Subject Study of a Young Child with Cerebral Palsy

Background: Physical therapy interventions for children with severe motor impairments do not address the relationship between motor and cognitive development. Purpose: Evaluate the potential of a physical therapy intervention focusing on enhancing cognitive and motor outcomes in a child with severe motor impairments. Design: AB phase design without reversal. Methods: One child participated in 8 assessments from 4 to 29 months of age. The START-Play intervention was provided for 3 months following 4 baseline assessments over 12 months. Total Gross Motor Function Measure (GMFM), Sitting, Reaching, and Problem Solving assessments were completed. Visual inspection, 2 standard deviation (SD) Band Method, and percent of nonoverlapping data methods evaluated change. Results: This child had improved GMFM total and sitting scores, increased frequency of toys contacts, and increased rate of problem-solving behaviors following intervention. Conclusion: START-Play shows promise for children with severe motor impairments. Additional research is needed to evaluate efficacy. Video Abstract: For more insights from the authors, access Supplemental Digital Content 1, available at: http://links.lww.com/PPT/A273. (Pediatr Phys Ther 2019;31:347-352).