Exploring the Effect of Early Motor Delay and Physical Therapy Interventions on the Parent-Child Relationship

Abstract

Emotional availability (EA) or the ability of the parent-child dyad to engage emotionally and partake in congruent and mutually enjoyable interactions, is essential for familial health and well-being. EA is considered the “connective tissue” of healthy parent-child relationships and is associated with secure attachment, maternal mental health, and children’s adaptive development. Most evidence supporting the integral role of EA on healthy outcomes is supported by typically developing populations in which adults present with a social or biological risk factor such as experiencing past traumas of adversities with mental health. In line with the transactional model of development, children are equal members of the dyad and play and active and integral role in dyadic interactions. Caregivers’ actions are rarely spontaneous but rather they are in response to children’s actions. EA is hypothesized to be 80-90% non-verbal highlighting the importance of children’s motor abilities in establishing the dyadic reciprocity of the relationship. Children with delayed or atypical motor skills are surmised to have difficulties with EA. This dissertation aimed to understand the relationship between emotional availability, children’s development, and early physical therapy interventions in young children with motor delays. Specifically, we were addressing gaps in knowledge on the relationship between early motor delays and the developmental change in emotional availability (Chapter 2), the bidirectional relationship between adult EA and children’s gross motor and problem-solving development (Chapter 3), and the effect of early physical therapy interventions on EA in young children with motor delays and their caregivers (Chapter 4). Our findings in Chapter 2 suggests that dyads with motor delay have different developmental trajectories of emotional availability than dyads with children with typical motor development. Chapter 3 highlights that in our young sample, Adult EA and child development influenced future performance within each domain respectively, but there were no current or future associations between the two variables. Lastly, results from Chapter 4 propose that early physical therapy interventions may uniquely affect dyadic emotional availability depending on how the intervention was delivered. Taken together, these studies provide critical information for the urgency to measure and treat qualities of the parent-child relationship as part of routine early therapy services in children with motor delay. We will discuss clinical implications for our findings as well opportunities for future translational research opportunities

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