An investigation of trunk control in infants and toddlers with down syndrome
Infants and toddlers with Down syndrome (DS) display gross motor developmental delays and decreased trunk control. Trunk control is a precursor to upright gross motor skills, but this relationship has not been fully explored in infants and toddlers with DS. The Gross Motor Function Measure (GMFM) is a reliable and valid measure of motor skills for children with DS. The Segmental Assessment of Trunk Control (SATCo) shows promise as a simple measure that can be employed by a physical therapist to measure segmental changes in trunk control, but it has not been studied in this population. The purposes of this study were: 1) to examine the reliability of the SATCo 2) to explore the relationship of the SATCo with the GMFM, and 3) to explore the impact of a dynamic standing device (Upsee) on trunk control and motor skills in infants and toddlers with DS. Eighteen children with DS, ages six to 24 months, were tested once on the GMFM and twice on the SATCo by two different physical therapists. SATCo scores among live and video recorded sessions were compared between three raters. The SATCo and GMFM were compared using Spearman’s rho correlation and linear regression. A subset of six children with DS participated in a A1BA2 withdrawal/reversal single-case experimental design study to explore the impact of a dynamic standing device home program on trunk control and gross motor skills in infants and toddlers with DS. Interrater reliability of the SATCo was moderate to good and intrarater reliability was good to excellent. The SATCo showed a good to excellent significant correlation with the GMFM and was a significant predictor of total GMFM scores in infants and toddlers with DS. After six weeks of using the dynamic standing device as a home program, three children had significant increases in GMFM scores and three children did not show significant changes. SATCo scores did not change significantly in any of the children and no adverse effects were reported. For infants and toddlers with DS, the SATCo is a reliable and valid tool and a home program using a dynamic standing device may improve gross motor skills.