INFANT CONTAINERS: A COMPREHENSIVE ANALYSIS OF MOVEMENT AND PLAY AFFORDANCES, DEVELOPMENTAL IMPACT, AND BELIEFS OF CAREGIVERS AND CLINICIANS

Abstract

Infant containers (e.g., jumpers, seats, strollers, and car seats) serve practical roles that are important for caregivers. For example, strollers and car seats can be used for transportation, jumpers and exersaucers for infant entertainment, swings for soothing and sleep, and seats and highchairs for feeding. The time that an infant spends in these devices every day can quickly add up: an infant may eat in a highchair, play in an exersaucer, nap in a swing, and ride in a car seat. This may negatively affect infants’ development and health, as these devices can limit infants’ movement and exploration of the environment. The purpose of this dissertation was to examine the association between the use of infant containers and infants’ development and physical activity, and to compare parents’ use and beliefs with therapists’ beliefs and educational practices regarding container use. This work aimed to inform professional recommendations and parent education regarding container use. In Aim 1, we conducted a systematic evaluation of the potential movement and play affordances of several container types and reported on the developmental claims made by the manufacturers. We found that containers vary in the affordances they provide for movement and play, with play gyms and exersaucers offering greater affordances, while car seats and carriers offer considerably fewer. Additionally, many containers had developmental claims made by the manufacturers, especially related to motor development and learning. Aim 2 involved cross-sectional surveys for parents and pediatric therapists to evaluate 1) parents’ use of containers, 2) the beliefs of parents and therapists about the impact of containers on infant development, and 3) pediatric therapists’ educational practices regarding container use. This study revealed that prolonged container use was associated with lower fine motor scores on the Ages and Stages Questionnaire 3rd edition (ASQ-3). Additionally, parents and therapists had significantly different beliefs about containers, and therapists’ recommendations about durations for container use differed from parents’ reported use. Moreover, pediatric therapists indicated different approaches to parent education regarding containers, with most recommending parents limit container use to a specific amount of time per day. Aim 3 was a pilot experiment to evaluate the immediate effects of containers and the floor on infants’ physical activity and to explore infants’ interactions with built-in toys. The container types, identified as having different levels of movement affordances in Aim 1, were the exersaucer, floor seat, and car seat. We found that, overall, infants’ physical activity was the highest in the floor condition compared to the exersaucer, floor seat, and car seat. This dissertation builds on previous research by conducting a comprehensive analysis of the association between container use and infants’ activity and development. It employed a variety of research methods, including content analysis, surveys, and movement analysis with wearable sensors. The findings can enhance parent education regarding containers by identifying gaps between parents’ and pediatric therapists’ beliefs and providing insight into the effects of varying container types on infants’ development and physical activity.