Caregiver support is an important contextual factor in the daily functioning of children with cerebral palsy (CP), but few studies have examined child-caregiver interactions during collaborative motor tasks to identify characteristics of effective support that should be promoted in clinical interventions. The aims of this exploratory study were to (1) describe the interaction dynamics of children with CP and typically developing (TD) children with their respective caregivers during a collaborative motor task and (2) develop clinically relevant hypotheses regarding features of child-caregiver interactions that relate to effective caregiver support. Twelve child-caregiver dyads (6 including children with CP, 6 including TD children) participated. Each dyad attempted to construct the tallest tower structure in 10 min using marshmallows and raw spaghetti. Time-series of upper extremity positions were obtained through motion capture and used to examine child-caregiver movement coordination. Videos were coded for language structure and number of building materials used. Five TD dyads and one CP dyad successfully constructed a free-standing tower. During periods of increased tower breakage, TD dyads demonstrated increased movement coordination compared to CP dyads. Unsuccessful dyads (most of whom were CP dyads) demonstrated interaction dynamics characterized by the child leading in movement during periods of increased tower breakage. Overall, in TD dyads, caregivers used more interrogatives than imperatives, and children used more imperatives than interrogatives. This pattern was reversed for CP dyads. From these results we identified future hypotheses about aspects of interactions that may facilitate collaborative motor performance (and thus caregiver support) between children with CP and their caregivers.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price includes VAT (USA)
Tax calculation will be finalised during checkout.
Conversation coding manual, conversation code, and movement coordination code available on the Open Science Framework (OSF): https://osf.io/stc83/
Abney, D. H., Paxton, A., Dale, R., & Kello, C. T. (2015). Movement dynamics reflect a functional role for weak coupling and role structure in dyadic problem solving. Cognitive Processing, 16(4), 325–332. https://doi.org/10.1007/s10339-015-0648-2.
Anaby, D., Korner-Bitensky, N., Steven, E., Tremblay, S., Snider, L., Avery, L., & Law, M. (2017). Current rehabilitation practices for children with cerebral palsy: focus and gaps. Physical & Occupational Therapy in Pediatrics, 37(1), 1–15. https://doi.org/10.3109/01942638.2015.1126880.
Angeli, J. M., Harpster, K. L., Hanson, E., Sheehan, A., & Schwab, S. M. (2019). Patient-and caregiver-identified preferences: Dimensions of change in developmental therapy treatment goals. Developmental Neurorehabilitation, 22(1), 39–46. https://doi.org/10.1080/17518423.2018.1425754.
Atkins-Burnett, S., & Allen-Meares, P. (2000). Infants and toddlers with disabilities: Relationship based approaches. Social Work, 45(4), 371–379.
Barfoot, J., Meredith, P., Ziviani, J., & Whittingham, K. (2017). Parent-child interactions and children with cerebral palsy: An exploratory study investigating emotional availability, functional ability, and parent distress. Child: Care, Health and Development, 43(6), 812–822. https://doi.org/10.1111/cch.12493.
Baum, F., & Fisher, M. (2014). Why behavioural health promotion endures despite its failure to reduce health inequities. Sociology of Health & Illness, 36(2), 213–225.
Coco, M. I., & Dale, R. (2014). Cross-recurrence quantification analysis of categorical and continuous time series: An R package. Frontiers in Psychology, 5(510), 1–14. https://doi.org/10.3389/fpsyg.2014.00510.
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20(1), 37–46.
Cox, R. F., & van Dijk, M. (2013). Microdevelopment in parent-child conversations: From global changes to flexibility. Ecological Psychology, 25(3), 304–315.
D’Arrigo, R., Ziviani, J., Poulsen, A. A., Copley, J., & King, G. (2018). Measures of parent engagement for children receiving developmental or rehabilitation interventions: a systematic review. Physical & Occupational Therapy in Pediatrics, 38(1), 18–38. https://doi.org/10.1080/01942638.2017.1373723.
Dale, R., & Spivey, M. J. (2006). Unraveling the dyad: Using recurrence analysis to explore patterns of syntactic coordination between children and caregivers in conversation. Language Learning, 56(3), 391–430. https://doi.org/10.1111/j.1467-9922.2006.00372.x.
Davidson, A. (2015). Social determinants of health: A comparative approach. Oxford University Press.
Davis, T. J., Pinto, G. B., & Kiefer, A. W. (2017). The stance leads the dance: the emergence of role in a joint supra-postural task. Frontiers in Psychology, 8(718), 1–13. https://doi.org/10.3389/fpsyg.2017.00718.
Duran, N. D., Paxton, A., & Fusaroli, R. (2019). ALIGN: Analyzing linguistic interactions with generalizable techNiques—A Python library. Psychological Methods, 24(4), 419.
Dusing, S. C., Marcinowski, E. C., Rocha, N. A. C. F., Tripathi, T., & Brown, S. E. (2019). Assessment of parent-child interaction is important with infants in rehabilitation and can use high-tech or low-tech methods. Physical Therapy, 99(6), 658–665. https://doi.org/10.1093/ptj/pzz021.
Flynn, V., & Masur, E. (2007). Characteristics of maternal verbal style: Responsiveness and directiveness in two natural contexts. Journal of Child Language, 34(3), 519–543. https://doi.org/10.1017/S030500090700801X.
Fusaroli, R., Bahrami, B., Olsen, K., Roepstorff, A., Rees, G., Frith, C., & Tylén, K. (2012). Coming to terms: Quantifying the benefits of linguistic coordination. Psychological Science, 23(8), 931–939.
Karaaslan, O., Diken, I. H., & Mahoney, G. (2013). A randomized control study of responsive teaching with young Turkish children and their mothers. Topics in Early Childhood Special Education, 33(1), 18–27. https://doi.org/10.1177/0271121411429749.
Lira-Palma, D., González-Rosales, K., Castillo, R. D., Spencer, R., & Fresno, A. (2018). Categorical cross-recurrence quantification analysis applied to communicative interaction during Ainsworth’s Strange Situation. Complexity, 2018, 4547029. https://doi.org/10.1155/2018/4547029.
Marwan, N., & Kurths, J. (2004). Cross recurrence plots and their applications. In C. V. Benton (Ed.), Mathematical physics research at the cutting edge. (pp. 101–139). Nova Science Publishers Inc.
Marwan, N., Romano, M. C., Thiel, M., & Kurths, J. (2007). Recurrence plots for the analysis of complex systems. Physics Reports, 438(5–6), 237–329. https://doi.org/10.1016/j.physrep.2006.11.001.
Nicholls, D. A. (2018). The end of physiotherapy. Routledge.
Novak, I., McIntyre, S., Morgan, C., Campbell, L., Dark, L., Morton, N., … & Goldsmith, S. (2013). A systematic review of interventions for children with cerebral palsy: state of the evidence. Developmental Medicine & Child Neurology, 55(10), 885–910.https://doi.org/10.1111/dmcn.12246.
Novak, I., Morgan, C., Fahey, M., Finch-Edmondson, M., Galea, C., Hines, A., … & Shore, B. (2020). State of the evidence traffic lights 2019: Systematic review of interventions for preventing and treating children with cerebral palsy. Current Neurology and Neuroscience Reports, 20(2), 1–21.https://doi.org/10.1007/s11910-020-1022-z.
Østensjø, S., Carlberg, E. B., & Vøllestad, N. K. (2004). Motor impairments in young children with cerebral palsy: Relationship to gross motor function and everyday activities. Developmental Medicine & Child Neurology, 46(9), 580–589. https://doi.org/10.1111/j.1469-8749.2004.tb01021.x.
Pennington, L., Goldbart, J., & Marshall, J. (2004). Interaction training for conversational partners of children with cerebral palsy: A systematic review. International Journal of Language & Communication Disorders, 39(2), 151–170. https://doi.org/10.1080/13682820310001625598.
Rosenbaum, P., & Stewart, D. (2004). The World Health Organization International Classification of functioning, disability, and health: a model to guide clinical thinking, practice and research in the field of cerebral palsy. Seminars in Pediatric Neurology, 11(1), 5–10. From http://henriquetateixeira.com.br/up_artigo/thewor~1_se4zo4.pdf. Accessed 5 Oct 2019.
Sebanz, N., Bekkering, H., & Knoblich, G. (2006). Joint action: bodies and minds moving together. Trends in Cognitive Sciences, 10(2), 70–76.
Toro, J., & Martiny, K. (2020). New perspectives on person-centered care: An affordance-based account. Medicine, Health Care and Philosophy, 23(4), 631–644. https://doi.org/10.1007/s11019-020-09977-w.
World Health Organization. (2001). International classification of functioning, disability and health: ICF. World Health Organization.
We wish to thank Isabella Cipollone (UConn) and Sean Roach (UConn) for their contributions to video transcription. We would also like to thank the participants of this study.
This work was funded in part by an Ohio Physical Therapy Association Research Grant and Foundation for Physical Therapy Research Promotion of Doctoral Studies (PODS) Level I and Level II Awards supported by the American Physical Therapy Association Scholarship Fund and the Rhomberger Fund (SMS). This material was also based upon work supported by the National Science Foundation Graduate Research Fellowship under Grant No. (2035701) (NSC). Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation. The funding sources had no role in study design, data collection and analysis, or manuscript preparation.
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
All participants > 18 years provided informed consent. Participants < 18 years provided informed assent, and their parents provided informed consent.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Schwab, S.M., Carver, N.S., Forman, M.H. et al. Child-Caregiver Interactions During a Collaborative Motor Task in Children with Cerebral Palsy: A Descriptive Exploratory Study. J Dev Phys Disabil (2021). https://doi.org/10.1007/s10882-021-09798-6
- Cerebral palsy
- Physical therapy
- Occupational therapy
- Contextual factors