Dissertations, Theses, and Capstone Projects

Date of Degree

9-2026

Document Type

Doctoral Dissertation

Degree Name

Doctor of Philosophy

Program

Psychology

Advisor

SARAH BERGER

Committee Members

REGINA HARBOURNE

LANA KARASIK

JENNIFER WAGNER

SANDRA WILLETT

Subject Categories

Developmental Psychology | Physical Therapy

Keywords

early physical therapy, embodied cognition, motor delays, infancy, object exploration, focused attention

Abstract

Early physical therapy (EPT) for infants with motor delays has traditionally emphasized motor milestone acquisition, yet growing evidence indicates that motor and cognitive development are fundamentally interconnected. Grounded in embodied cognition and developmental cascade theories, this dissertation conceptualized object exploration as a primary mechanism through which infants learn during EPT and examined how intervention approaches and adult behaviors shape opportunities for object exploration. Using retrospective analyses of video-recorded EPT sessions, two studies investigated how intervention approaches and adult behaviors influence infants' opportunities to learn through object exploration. Study 1 compared object exploration in the START-Play (SP) intervention and Usual Care (UC) by examining infants' look, touch, and focused attention (FA) during therapy sessions. Infants receiving SP demonstrated greater proportion of time engaged in object exploration and longer touch than those receiving UC, suggesting that interventions taking in consideration the interaction between motor and cognitive domains may provide richer opportunities for active exploration. Study 2 examined how physical therapists (PTs) and caregivers assist and interfere with infants' object exploration during EPT. Adult involvement played a critical role in shaping opportunities for exploration, and although both PTs and caregivers assisted and interfered with infants’ object exploration, intervention approaches differed in patterns of adult involvement. These findings underscore the importance of coordinating adult assistance with children's play interests and motor abilities to maximize learning opportunities. Together, these findings demonstrate that learning during EPT emerges from the dynamic interaction of infants' motor and cognitive abilities, intervention approaches, and adult-child interactions. By positioning object exploration as a central mechanism underlying developmental cascades, this dissertation advances the application of embodied cognition to pediatric rehabilitation and highlights the importance of interventions that intentionally balance motor and cognitive demands with responsive adult assistance to promote learning across developmental domains.

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