Parent-reported engagement in a home-based, parent-delivered early intervention for infants with unilateral cerebral palsy.

Abstract

Quantify parent self-reported engagement over time in a randomized comparison trial (<b>R</b>ehabilitation <b>EA</b>rly for <b>C</b>ongenital <b>H</b>emiplegia, REACH) for infants with UCP and discover factors impacting engagement. This secondary analysis from the REACH clinical trial included <i>N</i> = 90 infants with or at risk for UCP, randomized to infant-friendly constraint-induced movement therapy (Baby-CIMT) or bimanual therapy (Baby-BIM). Pediatric Rehabilitation Intervention Measure of Engagement-General (PRIME-G) was administered at the start, midpoint, and end of intervention. Parent-reported engagement was near the maximum possible PRIME-G score at intervention start, with no significant difference in score distribution over time. No between-group differences in parent engagement were found. PRIME-G items scored lower over time by some parents related to fitting intervention within family life. No infant-, parent-, or therapist-related variables significantly predicted changes in PRIME-G scores. REACH interventions were designed to empower parents to provide intervention activities with their infant. Parent engagement was high for Baby-CIMT and Baby-BIM. Some parents may need support to integrate intervention within family life and sustain engagement over time.