Predictors of developmental gains in children enrolled in an early intervention setting

The purpose of this research was to determine whether initial developmental delay, site of intervention, frequency of intervention, age of the child, socio-economic status (SES), gender and ethnicity significantly predict developmental gains in a group of children enrolled in an early intervention setting. The records of 134 children enrolled in an inner-city program in Miami, Florida were reviewed for inclusion in this study. ^ Demographic variables, site placement and treatment frequencies were collected during a retrospective chart review. Level of delay was expressed using the developmental quotient and developmental gain was calculated using the mean gain on age equivalent scores or developmental tests. A multiple regression analysis was performed to determine which of the above variables significantly predicted developmental gains. Multivariate analysis compared developmental gains for all the developmental domains based on intervention site (center versus home-based) while controlling for developmental delay. ^ Children made greater developmental gains if they had higher developmental quotients and if they were younger at the time services were initiated. Frequency of intervention significantly improved developmental outcomes in children attending center-based programs. Children attending center-based programs also made significantly greater gains in gross motor skills compared to children attending home-based programs. ^ These findings emphasize the importance of early screening and referral of children with developmental delay and adjusting intervention for the child's developmental quotient. Children should receive intense treatment to maximize results. Decisions regarding program placement should be individualized according to the child's unique developmental pattern. Policy and program decisions affecting the curriculum of a child in early intervention need to reflect these multivariate considerations. ^

Neuromuscular Changes in Older Adults during the Lateral Step Task

Older adults may have trouble when performing activities of daily living due to decrease in physical strength and degradation of neuromotor and musculoskeletal function. Motor activation patterns during Lateral Step Down and Step Up from 4-inch and 8-inch step heights was assessed in younger (n=8, 24.4 years) and older adults (n=8, 58.9 years) using joint angle kinematics and electromyography of lower extremity muscles. Ground reaction forces were used to ascertain the loading, stabilization and unloading phases of the tasks. Older adults had an altered muscle activation sequence and significantly longer muscle bursts during loading for the tibialis anterior, gastrocnemius, vastus medialis, bicep femoris, gluteus medius and gluteus maximus muscles of the stationary leg. They also demonstrated a significantly larger swing time (579.1 ms vs. 444.8 ms) during the step down task for the moving leg. The novel data suggests presence of age-related differences in motor coordination during lateral stepping.