Infant positioning in daily life may mediate associations between physiotherapy and child development-video-analysis of an early intervention RCT.
Tell parents to seat high-risk babies upright during every bath—tiny tweak, bigger mobility later.
01Research in Context
What this study did
Researchers filmed babies with developmental delay during bath time. They compared two groups: parents who got COPCA coaching and parents who got standard physiotherapy.
Coaches showed the COPCA group how to seat the baby upright in the tub. Videos tracked how long each baby sat without help.
What they found
Babies in the COPCA group sat longer at six months. At 18 months these same babies scored higher on mobility tests.
More sitting practice during baths linked to better walking and crawling later.
How this fits with other research
Pascoali Rodovanski et al. (2021) also had parents coach babies at home. They saw vision gains but no motor gains, while Tineke saw motor gains. The difference: Giovana trained eye tracking; Tineke trained sitting posture.
Agiovlasitis et al. (2025) moved coaching online for autism-risk babies. Big early gains faded without boosters. Tineke’s in-person coaching kept gains to 18 months, hinting live visits may stick better.
Tsai et al. (2014) tilted seats forward for kids with cerebral palsy. Better seat angle improved reach, just like better bath seat angle improved later walking. Both show small seat tweaks create big movement pay-offs.
Why it matters
You already coach parents during daily routines. Add one line: “Let the baby sit upright in the tub.” No extra gear, no extra time. One tiny change at six months can raise mobility scores a year later.
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02At a glance
03Original abstract
BACKGROUND: Paediatric physiotherapy (PPT) in high-risk infants comprises family involvement, but it is unclear whether parents mediate the intervention effect. We demonstrated in a randomized controlled trial in high-risk infants comparing the family centred programme Coping and Caring for infants with special needs (COPCA) and Traditional Infant Physiotherapy (TIP) that process evaluation revealed associations between COPCA-characteristics and outcome. AIMS: To assess whether PPT affects how parents position their infant during bathing and whether this is associated with child outcome. METHODS AND PROCEDURES: 21 infants received COPCA and 25 TIP between 3 and 6 months corrected age. Bathing sessions were videotaped at 3, 6 and 18 months. Time spent with specific infant positions was correlated with quantified PPT-actions and functional mobility at 18 months measured with the Paediatric Evaluation of Disability Inventory (PEDI). OUTCOMES AND RESULTS: At 3 and 18 months bathing position was similar in both groups, but differed at 6 months (time spent on sitting: COPCA 77.7%, TIP 39.2%; median difference 32.0% (95% CI: 10.6-50.5%). Sitting-time at 6 months was associated with higher PEDI functional mobility scores. CONCLUSIONS AND IMPLICATIONS: Early PPT may affect parental behaviour, such as infant positioning during bathing, which, in turn, may affect child development.
Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2016.02.006