Abstract: S. Schwab, N. Carver, M. Forman, D. Abney, T. Davis, M. Riley, A. Paxton, P. Silva (2022)

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.

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Child-Caregiver Interactions During a Collaborative Motor Task in Children with Cerebral Palsy: A Descriptive Exploratory Study