Shaaron Brown, DPT, a pediatric physical therapist, works with Miles Mrozinski at home with his parents, Whitney and Brent Mrozinski. Miles is part of the START-Play Study.

Physical therapy program offers help for infants with delayed skills

U.S. Department of Education-backed clinical trial provides treatment for children with motor impairments

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Soon after he was born, Miles Mrozinski’s parents knew he would be developmentally delayed. He was diagnosed with Hypoxic-Ischemic Encephalopathy, a brain injury caused by oxygen deprivation to the brain during birth. It is the leading cause of death or severe impairment in infants and can be permanent.

“The hardest part is not knowing what his life will be like and also thinking that, as his parents, are we doing everything we possibly can to positively impact his development?” said Whitney Mrozinski, Miles’ mother.

A toddler with HIE experiences severe cognitive delays and motor impairments such as difficulty sitting up and picking up small objects. Like Miles, now a 1-year-old, babies with HIE must undergo physical and occupational therapies. To provide as many opportunities as possible for Miles, Mrozinski and her husband enrolled him in the Virginia Commonwealth University START-Play Study in April.

A team of researchers, including a VCU Department of Physical Therapy faculty member, was awarded a four-year, $3.4 million grant to facilitate the program. It is one of the largest national clinical trials of its kind. START-Play Study goals include investigating and offering physical therapy interventions that improve the mobility of children struggling with common motor skills.

As part of the program the last two months, Whitney Mrozinski has seen improvement in her son’s abilities. She views VCU faculty as top-notch care providers.

“Miles has learned to sit on his own for short periods of time since starting the program, and he can also correct some of his movements as he leans from side to side,” she said.

Typical therapy services do not focus on the loss of opportunity and learning skills early in development, said Stacey Dusing, Ph.D., an associate professor in the Department of Physical Therapy. That is why this type of intensive therapy, and the funding to do it, is so important.

Dusing is the principal investigator for the project at VCU. Emily Marcinowski, Ph.D., is a VCU postdoctoral fellow in charge of recruitment and assessment. Also working for the program are students from the Department of Physical Therapy in the School of Allied Health Professions, the Department of Psychology in the College of Humanities and Sciences and the interdisciplinary Ph.D. program in Rehabilitation and Movement Science.

“We are excited to be part of this effort because the research we’re conducting will contribute to research going on around the world on this topic,” Dusing said. “One goal of the study is to advance the motor and cognitive skills of enrolled children in order to better prepare them to learn in preschool and beyond.”

During the 12-week intervention, children receive specialized therapy based on their ability to perform childlike skills such as crawling and reaching. Sessions take place in a family’s home and parents are encouraged to do exercises with their children between START-Play sessions. Additionally, five assessment visits are scheduled over the course of one year. The children range in age from 7 months to 16 months.

Dusing said Miles’ progress is rewarding for the research team.

“He has gone from barely sitting and never using his right arm to belly crawling with both arms, and pulling up to standing with some help in only 10 weeks of START-Play intervention,” she said. “The collaboration between his parents and the research therapist has provided Miles incredible new motor and cognitive learning opportunities.”

We know he will learn to do everything.

The Mrozinski’s have a 3-year-old daughter, Adeline, who has normal motor skills and functions as a typical preschooler. It was hard for them to witness her progress normally, and now see Miles struggle. However, with Miles’ improvements since being in START-Play, the Chesterfield couple is hopeful.

“We have learned to love differently, unconditionally, and have our eyes opened up to a new world of respect and inclusivity,” said Whitney Mrozinski. “We hope to see Miles continue to get better with fine motor skills, as well as improving use of his right hand in the near future. Our long-term hopes for Miles don’t stop. We know he will learn to do everything.”

Parents interested in enrolling their children in START-Play can visit or call START-Play staff in the Motor Development Lab at VCU at 804-628-5037.


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