Grounding early intervention: physical therapy cannot just be about motor skills anymore

Abstract

This perspective article provides support for 4 interrelated tenets: grounded perceptual-motor experience within cultural and social contexts forms cognition; exploration through early behaviors, such as object interaction, sitting, and locomotion, broadly facilitates development; infants and children with limited exploration are at risk for global developmental impairments; and early interventions targeting exploratory behaviors may be feasible and effective at advancing a range of abilities across developmental domains and time. These tenets emphasize that through the promotion of early perceptual-motor behaviors, broader, more global developmental advancements can be facilitated and future delays can be minimized across domains for infants and children with special needs. Researchers, educators, and clinicians should build on these tenets to further demonstrate the effectiveness of targeted early interventions. The goals of these interventions should be not only to advance targeted perceptual-motor skills in the moment but also to more broadly advance future abilities and meet the early intervention goal of maximizing children's learning potential.

Figure 1.

(A) More traditional view of cognition as something that exists outside of one's everyday experiences. (B) Grounded view of cognition as something that is created, maintained, and altered by everyday perceptual-motor experiences within social and cultural contexts.

Figure 2.

Hypothetical trajectories from birth toward level of readiness to learn and participate in preschool at 3 years of age. The hypothetical onsets of object interaction, sitting, and locomotion behaviors are indicated by the circle, triangle, and square, respectively, on each trajectory. In the typical development trajectory, object interaction, sitting, and locomotion emerge in the first year of life and act as vehicles to provide children with the tools needed to be successful in school. In the trajectory for children who have developmental delays and are provided ineffective or no early intervention services, object interaction, sitting, and locomotion behaviors emerge later and are performed less frequently and less variably—resulting in poorer cognitive development and lack of readiness to learn and participate by preschool age. The trajectory for children with developmental delays shows how this situation can be transformed with effective early intervention targeting early perceptual-motor behaviors to advance cognition and readiness to learn in school.