Changes in early childhood science, theory, and best practices for improving outcomes of children with motor delay or dysfunction and their families have evolved rapidly since EI began. Changes in daily early intervention (EI) practice have been more elusive. Closing the gap between knowledge and practice requires EI providers to piece together information from a variety of knowledge streams including early childhood special education, pediatric rehabilitation, and cognitive psychology. The purpose of this article is to create a body of shared, evidence-based knowledge among providers responsible for addressing the needs of children with movement disorders and their families to effect changes in practice. This article discusses the evolution of EI practice models for children with motor concerns; examines related theories, interventions, and outcomes; and presents an alternative model based on contemporary evidence and grounded in dynamic systems theory. Researchers describe existing barriers to implementation of family-centered, support-based practices. Recommendations highlight the need for EI providers to collaborate with families to develop meaningful goals and to recognize and create opportunities for children to engage in high volumes of task-specific activity in a meaningful context. Continued research is required to verify effectiveness of this integrated model for improving child and family outcomes.
Department of Physical Therapy, University of Nevada, Las Vegas (Dr Hickman); Department of Rehabilitation Medicine, University of Washington, Seattle (Dr McCoy); Center for Child and Human Development, Georgetown University, Washington, DC (Dr Long); and Graduate Program in Orthopedic and Sports Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah (Dr Rauh).
Correspondence: Robbin Hickman, PT, DSc, PCS, Department of Physical Therapy, University of Nevada, 4505 Maryland Pkwy, Box 453029, Las Vegas, NV 89154 (firstname.lastname@example.org).
This work was completed as part of Dr Hickman's dissertation at Rocky Mountain University of Health Professions and was supported by the Nevada Center for Excellence in Disabilities at the University of Nevada, Reno. We thank Mary Lou Cahal for her assistance with graphics.