Starting at Birth: An Integrative, State-of-the-Science Framework for Optimizing Infant Neuromotor Health

Colleen Peyton*, Theresa Sukal Moulton, Allison J. Carroll, Erica Anderson, Alexandra Brozek, Matthew M. Davis, Jessica Horowitz, Arun Jayaraman, Megan O'Brien, Cheryl Patrick, Nicole Pouppirt, Juan Villamar, Shuai Xu, Richard L. Lieber, Lauren S. Wakschlag, Sheila Krogh-Jespersen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Numerous conditions and circumstances place infants at risk for poor neuromotor health, yet many are unable to receive treatment until a definitive diagnosis is made, sometimes several years later. In this integrative perspective, we describe an extensive team science effort to develop a transdiagnostic approach to neuromotor health interventions designed to leverage the heightened neuroplasticity of the first year of life. We undertook the following processes: (1) conducted a review of the literature to extract common principles and strategies underlying effective neuromotor health interventions; (2) hosted a series of expert scientific exchange panels to discuss common principles, as well as practical considerations and/or lessons learned from application in the field; and (3) gathered feedback and input from diverse stakeholders including infant caregivers and healthcare providers. The resultant framework was a pragmatic, evidence-based, transdiagnostic approach to optimize neuromotor health for high-risk infants based on four principles: (a) active learning, (b) environmental enrichment, (c) caregiver engagement, and (d) strength-based approaches. In this perspective paper, we delineate these principles and their potential applications. Innovations include: engagement of multiple caregivers as critical drivers of the intervention; promoting neuromotor health in the vulnerability phase, rather than waiting to treat neuromotor disease; integrating best practices from adjacent fields; and employing a strengths-based approach. This framework holds promise for implementation as it is scalable, pragmatic, and holistically addresses both the needs of the infant and their family.

Original languageEnglish (US)
Article number787196
JournalFrontiers in Pediatrics
StatePublished - Jan 24 2022


  • early intervention
  • infants
  • neuromotor health
  • physical therapy
  • transdiagnostic

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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