Assessment & Research

Object engagement and manipulation in extremely preterm and full term infants at 6 months of age.

Zuccarini et al. (2016) · Research in developmental disabilities 2016
★ The Verdict

ELGA infants look longer but touch less at 6 months—use active hand play as an early warning and intervention target.

✓ Read this if BCBAs doing developmental assessments with infants born before 28 weeks gestation.
✗ Skip if Practitioners who work only with children over 3 years or without medical-risk histories.

01Research in Context

01

What this study did

Doctors watched how 6-month-old babies handled toys. Some babies were born extremely early (ELGA). Others were born on time.

The team timed how long each baby looked at, touched, or mouthed a bright cube. They also gave every infant a quick motor test.

02

What they found

Pre-term babies stared at the cube longer, but their hands did less. They grabbed, transferred, and mouthed it less than full-term peers.

Their motor scores were also lower. Less hand play went hand-in-hand with slower overall development.

03

How this fits with other research

Zuccarini et al. (2017) followed the same ELGA babies. By 9 months the gap in total exploration had almost closed, and the early hand play at 6 months predicted better language and thinking scores at 2 years. The bad news of 2016 became a roadmap for tracking progress.

de Campos et al. (2012) reviewed 18 papers and warned that each risk group shows its own pattern. The 2016 ELGA data now give a clear benchmark within that bigger picture.

Rohr et al. (2022) added low-SES babies and different toy textures. They again saw less fingering and transferring in very-preterm infants, confirming the 2016 profile while showing texture also matters.

04

Why it matters

If you assess an ELGA baby, note how much they actually move the toy, not just look at it. Short manual play at 6 months flags later language and cognitive delays. Build treatment plans that get those hands busy—offer varied textures, prompt transferring, and schedule brief, frequent grasp opportunities. Early, active hand exploration is an easy, low-cost target that can shift long-term outcomes.

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During baby sessions, start a 1-minute timer and count how many times the infant transfers or mouths the toy—if below 3, add grasp prompts and textured objects next visit.

02At a glance

Intervention
not applicable
Design
case control
Sample size
40
Population
neurotypical
Finding
negative
Magnitude
medium

03Original abstract

Delays in the motor domain have been frequently observed in preterm children, especially those born at an extremely low gestational age (ELGA;<28 weeks GA). However, early motor exploration has received relatively little attention despite its relevance for object knowledge and its impact on cognitive and language development. The present study aimed at comparing early object exploration in 20 ELGA and 20 full-term (FT) infants at 6 months of age during a 5-minute mother-infant play interaction. Object engagement (visual vs manual), visual object engagement (no act vs reach), manual object engagement (passive vs active), and active object manipulation (mouthing, transferring, banging, turn/rotating, shaking, fingering) were analyzed. Moreover, the Griffiths Mental Development Scales 0-2 years (1996) were administered to the infants. Relative to FT peers, ELGA infants spent more time in visual engagement, and less time in manual engagement, active manipulation, mouthing, and turning/rotating. Moreover, they had lower scores on general psychomotor development, eye & hand coordination, and performance abilities. Close relationships emerged between manual object engagement and psychomotor development. Clinical implications of these results in terms of early evaluation of action schemes in ELGA infants and the provision of intervention programs for supporting these abilities are discussed.

Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2016.04.001