Follow the Leader: Observing interactions between children with Cerebral palsy and caregivers

Abstract

By Maia Forman, Health Sciences

Advisor: Sarah Schwab

Abstract: Children with cerebral palsy (CP) have a range of impairments affecting functional motor independence and often require caregiver support. The level of support provided, combined with the environment of the activity, affects the child's performance. Few studies have investigated the optimal level of support needed to facilitate motor task performance. Therefore, limited interventions that target caregiver-child interactions have been developed. The purpose of this exploratory study was to observe leader-follower dynamics between children with CP and their caregivers during a collaborative motor task, compared to children of typical development (TD) and their caregivers. Six children with CP and six age-matched children of TD assembled a spaghetti-marshmallow tower with their caregivers. To promote interaction, the child was instructed to touch only spaghetti, and the caregiver was only to touch marshmallows. Motion sensors were placed on the hands of both participants, and the conversations were recorded. The caregiver more commonly operated as the leader when dyads were successful in the task (i.e. a constructed tower). These trends were observed primarily in dyads of TD. Near synchrony or child leading was observed in dyads with CP as was less successful task performance. Changes in conversation dynamics were also found to influence interactions. Our results suggest flexible lead/lag relationships may contribute to successful dyadic motor task performance, and this dynamic may be diminished in child-caregiver dyads with CP. Although caregivers of children with CP may provide opportunities for independent motor task performance, they may not provide the optimal level of task facilitation and support.