Investigators will visit families at home both in-person and virtually via Zoom. At all
sessions, infants and caregivers will be videorecorded at home while playing together
with the infant's own toys (15 min) and with a standard set of age-appropriate
commercially available toys provided by the research team (15 min). During the harness
trial period, sessions will be divided so that the infant is observed both in and out of
the harness. Parent reports of language development (MacArthur-Bates Communicative
Development Inventory; 10 min) and locomotor development (Locomotor Experience Interview;
10 min) will be collected at the initial visit, study midpoint (3 months), and study exit
(6 months). Parents will be surveyed once about the feasibility and acceptability of the
body weight supported harness system at the end of the harness trial period (10 min), and
they will complete a study participation satisfaction survey at study exit (10 min). In
addition, infants will be administered the Bayley Scales of Infant and Toddler
Development-4 (30 min) and the Early Social Communication Scales (10 min) at the
beginning, middle, and end of study participation.
Participants will be observed twice a month for 6 months (one visit per month on Zoom and
the other in person), for a total of 12 observations per child.
Part 2 study participation will involve a total of 12 sessions per parent/infant dyad,
lasting between 30 and 70 min, depending on the visit protocol (see above).
Each family will also have a 1-month Harness Trial Period with the PUMA system in their
home. These will be staggered over the course of the study period. At the beginning of
the trial period, investigators will deliver the harness system to the home and assist
with setup and troubleshooting. Families will be given a brief training in harness setup
and use and a safety checklist to review daily before using the system with their infant.
Families will be asked to use the harness with their infant for at least 30 minutes
daily. The harness will be collected by the research team at the end of the trial period.
Each day during the Harness Trial Period, parents will track how long they use the
harness system with their infant (in minutes), what activities they engaged in (e.g., toy
play, book sharing), and any challenges they encountered (e.g., infant fussiness) in a
log (5 min).
The PUMA system is an FDA registered device manufactured by Enliten LLC that provides
body weight support while moving around. It consists of a 9' x 9' metal canopy frame with
no cover that is adjustable in height. Infants will wear custom lightweight cloth vests
designed specifically for the PUMA. The vest will be connected to a beam at the top of
the structure. The PUMA supports up to 60 pounds and permits movement anywhere beneath
the structure. In case of an emergency, a quick release unit can be pulled to rapidly
separate the harness from the support unit. For the PUMA, this device is attached to the
spreader bar, out of reach of the child user.