Move & PLAY Study (Understanding Determinants of Motor Abilities, Self-Care, and Play of Young Children with Cerebral Palsy)

Move play logo

The purpose of this study was to follow a large number of children over a period of one year to gain an understanding of factors associated with motor function, self-care, participation and play of young children with cerebral palsy (CP). We recruited 430 children in selected sites in both Canada and the United States, and maintained 90% of the sample over the year. We believe that the results of our study provide very useful information to improve the effectiveness and efficiency of rehabilitation services for preschool children with CP. Significant factors that are amenable to change are targets of intervention. Factors that cannot change assist with goal setting within children's likely potentials.

Click here to see Recruitment site details

Executive Summary of key findings from the Move & PLAY study.

The On Track Study is the next step in our program of research, following the Move & PLAY study, as we continue to investigate the development of children with cerebral palsy or gross motor delay.

Research Team

Doreen Bartlett, PT, PhD, Professor, School of Physical Therapy, Western University, London, Ontario, Canada and Scientist, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada

Lisa Chiarello, PT, PhD, PCS, FAPTA, Professor, Department of Physical Therapy and Rehabilitation, Sciences, Drexel University, Philadelphia, Pennsylvania, United States

Bob Palisano, PT, ScD, FAPTA, Distinguished Professor, Department of Physical Therapy and Rehabilitation, Drexel University, Philadelphia, Pennsylvania, United States, and Scientist, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada

Peter Rosenbaum, MD,FRCP(C), McMaster University, CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada

Sarah (Sally) Westcott McCoy, PT, PhD, FAPTA, Professor, Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, United States

Lynn Jeffries, PT, DPT, PhD, PCS, Associate Professor, Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States

Alyssa LaForme-Fiss, PT, PhD, PCS, Associate Professor, Department of Physical Therapy, Mercer University, Atlanta, Georgia, United States

Barbara Stoskopf, RN, MHSc, Project Coordinator, McMaster University, CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada

Audrey Wood, PT, MS, Regional Coordinator, Greater Philadelphia region, Drexel University, Philadelphia, Pennsylvania, United States

Allison Yocum, PT, DSc, PCS, Regional Coordinator, Greater Seattle-Tacoma region, University of Washington, Seattle, Washington, United States

Barbara Sieck Taylor, USA, Parent Consultant

Tina Hjorngaard, Canada, Parent Consultant

The research team gratefully acknowledges the contributions of Beth Tieman, PT, PhD, as well as the therapists, parents and children who were involved in the study.

Girl on swing

Project Updates

The following two presentations summarize the main results of the Move & PLAY Study

Measures

In the first presentation, you will learn to administer, score and interpret a collection of brief, reliable and valid instruments developed in the context of the Move & PLAY study that together provide a holistic picture of young children with cerebral palsy. The physical measures that are completed by a therapist include the Basal and Ceiling approach of the Gross Motor Function Measure (GMFM-66-B&C), the Early Clinical Assessment of Balance (ECAB), the Functional Strength Assessment (FSA) and the Spinal Alignment and Range of Motion Measure (SAROMM). Parent-completed measures include Family Expectations of Child, the Early Activity Scale for Endurance (EASE), Child Health Conditions, and Child Engagement in Daily Life.

Research Summaries

In the second presentation, you will learn about the Move & PLAY study model, how it was tested, and what the results tell us about groups of children with cerebral palsy with respect to determinants of outcomes of motor function, self-care, participation, enjoyment and play. A case study is presented and guidelines are provided on how these results can be applied to clinical decision making for individual children.

Twelve research summaries have been prepared from the results of the Move & PLAY Study, conducted by Doreen Bartlett, Lisa Chiarello, Robert Palisano, Peter Rosenbaum, Sally Westcott McCoy, Lynn Jeffries, Alyssa LaForme Fiss, Barbara Stoskopf, Audrey Wood, Allison Yocum, Barbara Sieck Taylor and Tina Hjorngaard. These 12 summaries have been refined with assistance of this research study team, including the dissemination facilitator (Barbara Stoskopf), parent consultants (Barbara Sieck Taylor and Tina Hjorngaard), study assessors, an independent group of parents of young children with CP, as well as therapists who provide services to such children but were not a part of the study. Each summary is meant to stand alone; however, when applicable, we provide information on the relationship between summaries and recommend if a particular summary should be read first. As an example, the summary on the conceptual model for this study provides an overview of the purpose and framework for the entire study, so the team recommends that it should be read first.

Furthermore, each summary has different parts to it, each of which may appeal differently to each reader. For example, the "thought boxes" at the end of each summary add a "so what?" component for parents and therapists who wish to fast forward to find out the more practical components of the summary, and see a "take home" message. For those readers unsure of certain terms used in the summaries, there are links to a glossary which defines some uncommon words, so readers can progress through these summaries more easily. For those individuals who would like to learn a bit more about the specific measures or psychometric properties of the tools used in the various research summaries, there are links that will take them to such information. Each summary also has a list of the references used in creating the summary, a link to the full research article from which the summary came (when available), and links to places where you can get more information on the topic presented (including specific contact information for some members of the research team).

Summaries will be posted as associated full research manuscripts are accepted.

These summaries were created by parents and therapists, for parents and therapists. If you have any further questions regarding these summaries, or have feedback for our team, please contact the principal investigators, Doreen Bartlett and / or Lisa Chiarello.

Visualiser le matériel de diffusion en français ici

Research summaries currently available:

  1. Conceptual Model of the Move and PLAY Study
  2. Health Conditions of Children with Cerebral Palsy (CP)
  3. Gross Motor Function Measure (GMFM), New Shortened Versions
  4. Recreation and Rehabilitation Services
  5. Family Life
  6. Motor and Self-Care Abilities
  7. Self-Care and Ease of Caregiving
  8. Primary Impairments (coming soon)
  9. Secondary Impairments (coming soon)
  10. Children’s participation in Family Activities and Play (not yet available)
  11. Participation and Playfulness (not yet available)
  12. Closer Look at Rehabilitation Services (not yet available)

Limitations of these materials include:

  • the focus is only on outcomes of motor function, self-care, participation, enjoyment and playfulness and determinants that we perceive to be amenable to change
  • a brief measure of adaptive behaviour is not yet available

Suggestions on how these presentations can be used:

  • Self-study
  • Group In-services: lead by a "local champion": possibly a half-day session for measures and a separate half-day for use of model testing results
  • Between these sessions, individual therapists could collect data using the measures on one or more child on his / her caseload for "case illustrations" at the model testing session
  • The conceptual model might "open up" ideas about what services might include

Further recommendations for Pediatric Physical Therapy Curriculum based on the findings of the Move & PLAY study can be found here.

We are interested in hearing from you about the potential utility of this package of information in your setting. Please contact us through the CanChild email.

Resources

Selected Articles

Bartlett, D., Chiarello, L., Westcott McCoy, S., Palisano, R., Rosenbaum, P., Jeffries, L., LaForme Fiss, A., & Stoskopf, B. (2010). The Move & PLAY Study: An example of comprehensive rehabilitation outcomes research. Physical Therapy, 90(11), first published on August 19, 2010.

Reprinted with permission of the American Physical Therapy Association (APTA). This material is copyrighted, and any further reproduction or distribution requires written permission from APTA.

Bartlett D, Chiarello L, McCoy S, Palisano R, Jeffries L, Fiss A, Rosenbaum P, Wilk P. (2014). Determinants of gross motor function of young children with cerebral palsy: A prospective cohort study. Developmental Medicine & Child Neurology, 56(3), 275-282.

Bartlett D, Chiarello L, McCoy S, Palisano R, Jeffries L, LaForme Fiss A, Wilk P. Determinants of self-care participation of young children with cerebral palsy. Developmental Neurorehabilitation. 2014;17:403-13.

Brunton, L.K., & Bartlett, D.J. (2011). Validity and reliability of two abbreviated versions of the Gross Motor Function Measure. Physical Therapy, 91, 577-588.

Chang HJ, Chiarello LA, Palisano RJ, Orlin MN, Bundy A, Gracely EJ. The determinants of self-determined behaviours of young children with cerebral palsy. Research in Developmental Disabilities, 2014; 35:99-109.

Chiarello, L. Palisano, R. Bartlett, D., Westcott McCoy, S. (2011). A multivariate model of determinants of change in gross motor abilities and engagement in self care and play of young children with cerebral palsy. Physical & Occupational Therapy in Pediatrics, 31(2), 150-168.

Chiarello L, Palisano R, McCoy SW, Bartlett DJ, Wood A, Chang hJ, Kang, LJ, Avery L. Child Engagement in Daily Life: A measure of participation for young children with cerebral palsy. Disability and Rehabilitation. 2014;35:1804-16.

Jeffries L, Fiss A, Westcott McCoy S, Bartlett DJ. Description of primary and secondary impairments in young children with cerebral palsy. Pediatric Physical Therapy. 2016;28:7-14.

Jewell, A., Stokes, A., & Bartlett, D. (2011). Correspondence of classification between parents of children with cerebral palsy aged 2 to 6 years and therapists using the Gross Motor Function Classification System. Developmental Medicine and Child Neurology, 53(4), 334-337.

LaForme Fiss, A., Chiarello, L., Bartlett, D., Palisano, R., Jeffries, L., & Almasri, N. (2013). Family ecology of young children with cerebral palsy. Child: Care, Health and Development. Advance online publication. DOI:10.1111/cch.12062.

LaForme Fiss, A., Westcott McCoy, S., Bartlett, D., Chiarello, L., Palisano, R., Stoskopf, B., Jeffries, L., Yocum, A., & Wood, A. (2010). Sharing of lessons learned from multi-site research. Pediatric Physical Therapy, 22(4), 408-416.

LaForme Fiss, A. C., McCoy, S. W., Chiarello, L. A. (2012). Comparison of family and therapist perceptions of physical and occupational therapy services provided to young children with cerebral palsy. Phys Occup Ther Pediatr, 32(2), 210-26.

McCoy, S.W., Bartlett, D.J., Yocum, A., Jeffries, L., LaForme Fiss, A., Chiarello, L., & Palisano, R.J. (2013). Development and validity of the Early Clinical Assessment of Balance for young children with cerebral palsy. Developmental Neurorehabilitation. Advance online publication.DOI: 10.3109/17518423.2013.827755.

McCoy, S. W., Yocum, A., Bartlett, D. J., Mendoza, J., Jeffries, L., Chiarello, L., Palisano, R. J. (2012). Development of the Early Activity Scale for Endurance (EASE) for Children with Cerebral Palsy. Pediatric Physical Therapy, 24, 232-240.

McCoy SW, Bartlett DJ, Yocum A, Jeffries L, LaForme Fiss A, Chiarello L, Palisano RJ. Development and Validity of the Early Clinical Assessment of Balance for Young Children with Cerebral Palsy. Developmental Neurorehabilitation. 2014;17:375-383.

McLellan, A., Cipparone, C., Giancola, D., Armstrong, D., Bartlett, D. (2012). Medical and surgical procedures experienced by young children with cerebral palsy. Pediatric Physical Therapy, 24, 268-277.

Palisano, R., Begnoche, D., Chiarello, L., Bartlett, D., McCoy, S., & Chang, H-J. (2012). Amount and focus of physical therapy and occupational therapy for young children with cerebral palsy. Physical and Occupational Therapy in Pediatrics, 32(4), 368-382.

Palisano R, Chiarello L, McCoy SW, Bartlett D, An M. Use of the Child Engagement in Daily Life and Ease of Caregiving for children to measure change in young children with cerebral palsy. Physical and Occupational Therapy in Pediatrics. Early OnLine:1-16; 2014, DOI: 10.3109/01942638.2014.907221.

Randall KE, Bartlett DJ, McCoy S. Head-to-head comparison of the Early Clinical Assessment of Balance and the Pediatric Reach Test in Young Children with Cerebral Palsy. Pediatric Physical Therapy, 2014; 26:332-337.

Stoskopf B, Fedrock D, Bartlett D. Reinventing the adjustable bench for community-based research and practice. Suggestions from the Field. Pediatric Physical Therapy. 2014;26:274-276.

Ward KD, Chiarello LA, Bartlett DJ, Palisano RJ, McCoy SW, Avery L. Ease of Caregiving for Children: A measure of parent perceptions of the physical demands of caregiving to young children with cerebral palsy. Research in Developmental Disabilities. 2014; 35: 3403-15.

Wong, C, Bartlett DJ, Chiarello LA, Chang HJ, & Stoskopf B. (2011). Comparison of the prevalence and impact of health problems of pre-school children with and without cerebral palsy. Child: Care, Health and Development, 2011; 38(1):128-138.

Presentations

Following are the presentations and workshops related to the Move & PLAY study.

Relationship of Rehabilitation and Community Services to Gross Motor, Self-care, and Participation in Young Children with Cerebral Palsy

McCoy,S.W., Bartlett, D., Palisano, R., Chiarello, L., LaForme Fiss, A., Jeffries,L.

  • Presented at the Annual Meeting of the American Academy of Cerebral Palsy and Developmental Medicine, October 2013

Determinants of Ease of Caregiving of Young Children with Cerebral Palsy.

Chiarello, L., Randall, K., Bartlett, D., Palisano, R.

  • Presented at the 4th International Cerebral Palsy Conference, Pisa, Italy, October 2012

Translating the Move and PLAY Study: Thoughts for Families and Practitioners

Chiarello, L., Jeffries, L.

  • Presented at Educational session, 27th Annual International Conference on Young Children with Special Needs and Their Families, National Harbor, MD, November, 2011.

Determinants of Participation and Play of Young Children with Cerebral Palsy (poster presentation)

Chiarello, L., Bartlett, D., McCoy, S., Palisano, R., Jeffries, L., Fiss, A., Rosenbaum, P., Stoskopf, B., Wilk, P.

  • Research poster presented at the American Physical Therapy Association Combined Sections Meeting, February 2012 in Chicago, IL

How are we intervening to improve children's activity and participation: Beginning to open the black box.

Sarah W. McCoy, Lynn Jeffries.

  • Educational session presented at the American Physical Therapy Association's Combined Sections Meeting, San Diego, California, February 2010.

Playfulness of Young Children with Cerebral Palsy.

Lisa Chiarello (presenter), Hui-Ju Chang.

  • Platform presentation presented at the American Physical Therapy Association's Combined Sections Meeting, San Diego, California, February 2010.

Current pediatric physical therapy interventions for young children with cerebral palsy and relationship to gross motor and self-care abilities: A pilot study.

McCoy, Sarah W.; Jeffries, L.M.

  • Poster presented at American Physical Therapy Association Combined Sections Meeting, New Orleans, LA, February 2011.

Relationship of sitting and reaching to playfulness, participation, and adaptive behavior in young children with cerebral palsy

Westcott,S., Fritz, A.,Chiarello, L.

  • Presented at the Combined Sections Meeting of the American Physical Therapy Association, February 2014

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