Everyday positioning experience in typically developing infants and infants with or at risk for cerebral palsy.

Infant positioning throughout everyday routines impacts physical growth, motor skill advancement, and access to learning opportunities supporting cognitive, social, and communicative development. However, we know little about everyday positioning experiences in infants with or at risk for developmental disabilities like cerebral palsy (CP) and how they differ from those of their typically developing peers. This study used Ecological Momentary Assessment to estimate time spent in different categories of posture (supine, prone, sitting, standing, and suspended) and support (self-support, adult support, and device support) throughout daily life in infants with or at risk for CP and age-matched infants with typical development. Twenty-five infants at risk (13 with confirmed CP) and 52 typically developing infants were tested at 6, 9, and/or 12 months of age (N = 101 sessions total). At each session, caregivers responded to text message prompts 10 times per day for 8 days and reported their infant's current positioning. Time supine, prone, suspended, and with adult support decreased with age, and time sitting, standing, and with self-support increased with age. Infants with or at risk for CP were more likely to be supine, prone, and supported by an adult, and were less likely to be sitting and standing, than infants with typical development; group differences in supine and standing time were especially dramatic. Notably, group differences persisted when controlling for achievement of relevant motor milestones. These results suggest considerable differences in everyday experiences in infants with or at risk for CP compared to their peers with typical development.