Autism & Developmental

Effects of Activation of Preferred Stimulus on Tummy Time Behavior of an Infant with Down Syndrome and Associated Hypotonia

Boutot et al. (2018) · Behavior Analysis in Practice 2018
★ The Verdict

Activate a favorite toy during tummy time and watch head lifting rise in floppy infants with Down syndrome.

✓ Read this if BCBAs working with infants who have Down syndrome or hypotonia in early-intervention homes or clinics.
✗ Skip if Practitioners who only serve verbal school-age clients with no motor delays.

01Research in Context

01

What this study did

One five-month-old with Down syndrome and floppy muscles spent short play sessions on his tummy. A toy that lit up and played music sat just out of reach. The toy only turned on when the baby lifted his head for a few seconds. The team counted how often the baby raised his head before, during, and after the toy was used.

02

What they found

Head lifts jumped as soon as the toy lit up for lifts. When the toy was later turned off, the baby still kept his head up more than at the start. The brief test showed a quick, cheap way to help neck strength grow.

03

How this fits with other research

Fine et al. (2005) saw the same idea work for older clients. Their walkers played favorite videos each time a step was taken. Both studies link one simple motor act to an automatic, loved stimulus.

Chang et al. (2016) strapped a motion sensor to a school-age student's leg. Each walk triggered fun music through headphones. Again, preferred stimulation boosted physical output, now across walking instead of head lifting.

Soloveichick et al. (2020) looks different at first glance. They gently moved preterm babies to copy normal wriggles. Both papers are tiny infant case series, yet each shows early, low-cost action can shift motor paths before bad patterns settle in.

04

Why it matters

If you serve babies with Down syndrome or low tone, place a switch-activated toy in front of them during tummy time. Let the toy sing or flash only when the chin comes off the floor. You may see more lifts in minutes, and the strength can last after the toy is removed. No extra staff, no fancy equipment—just a battery and a smile.

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→ Action — try this Monday

Put a switch-activated musical toy under the baby’s chest. Set it to run for three seconds each time the head lifts two inches. Count lifts for five minutes and compare to baseline.

02At a glance

Intervention
other
Design
case study
Sample size
1
Population
down syndrome
Finding
positive

03Original abstract

Infants with Down syndrome often have low muscle tone (hypotonia) and need activities designed to increase muscle tone (e.g., tummy time). However, no study has examined the effects of strategies designed to increase of tummy time for this population. The current study investigated activation of a preferred toy as a strategy to increase head lifting during tummy time for a 5-month-old with Down syndrome and associated hypotonia. The intervention was successful and is a promising early strategy for addressing hypotonia in infants with Down syndrome. • Infants with Down syndrome often have associated hypotonia, or poor muscle tone. • “Tummy time” is widely described as an important activity for motor development in early infancy. • Activating preferred stimuli during tummy time increased head lifting in an infant with Down syndrome and hypotonia. • Activation of a preferred stimulus is an easy intervention that parents can use to enhance tummy time.

Behavior Analysis in Practice, 2018 · doi:10.1007/s40617-018-0212-5