Baylor Physical Therapy Researcher Receives NIH Subaward to Study Relation Between Language/Communication and Motor/Physical Activity in Young Children with Down Syndrome

Megan Flores, PhD, PT, Clinical Associate Professor in the Department of Physical Therapy in Baylor University’s Robbins College of Health and Human Sciences, has received a two-year, National Institutes of Health (NIH) subaward in partnership with Sandra Vanegas, PhD, Research Assistant Professor in the Texas Center for Disability Studies in the University of Texas at Austin’s Steve Hicks School of Social Work. Baylor received $74,063 from the $275,000 award, and Flores will serve as Baylor’s principal investigator (PI).

“Megan’s involvement as a lead investigator in this NIH grant will help inform the intersection of language and motor development in children with Down syndrome. This is the first NIH grant for the Department, and it exemplifies our departmental mission to advance societal health,” Brian Young, PT, DSc, Chair and Clinical Professor, said. “Further understanding the needs within racially and ethnically diverse infants and toddlers with Down syndrome directly supports the Department’s value of inclusion—eliminating barriers and creating opportunity. We are very excited for Megan and her team to be awarded this opportunity.”

The project, “Characterizing Language and Motor Development of Racially/Ethnically Diverse Infants and Toddlers with Down Syndrome,” addresses current gaps in the understanding of Down syndrome. A rigorous research plan will be implemented to measure communication, language, motor skills, and physical activity to better comprehend how these skill sets develop and interact with each other. 

“There is evidence that developmental milestones are connected, and gains made in one domain may lead to gains in another. Sandra and I decided to write this grant together, using multiple methods to characterize early language and motor skills in children with Down syndrome so that interventions can be targeted to help improve acquisition of developmental skills.” Flores said. “We also felt it is important to study a diverse sample, including infants and families from underrepresented backgrounds. Central Texas is a uniquely qualified region to recruit racially and ethnically diverse children. Texas has a highly diverse population, with more than 60% from minority backgrounds—this equates to more than 17.5 million people.”  

The study will accurately represent the diversity of Texas by enrolling at least 60% of participants from racial and ethnic minority backgrounds. Of the total 72 participants, there will be an even split of infants with Down syndrome and infants who are typically developing, and all will range in age from 6 to 18 months. 

Language and motor development will be measured in a variety of ways, such as direct assessments, free play observations, naturalistic measurements, and parent reports. Within a 12-month period for each participant, the project will collect longitudinal data three times—at the time of enrollment and two more times, six months apart.

As Baylor’s PI, Flores will support the project in training, supervision, and analysis. To ensure measures are implemented with high validity and reliability, she will first train the research assistants. Then, she will provide supervision in the execution of project tasks which includes the use of the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4) assessment tool, coding of motor skills by using reach-to-grasp for the Skilled Reaching Rating Scale within the play observation, and ActiGraph accelerometers to collect movement data. Flores will also assist with the study’s statistical analysis.

“As a board-certified pediatric physical therapy specialist, I have worked with many children with Down syndrome over the years, helping them improve their gross motor skills. I have also conducted multiple research projects studying physical therapy interventions and outcome measures in children with Down syndrome,” Flores said. “I am thrilled to be able to contribute my expertise to this current NIH project.”

Flores and Vanegas originally met through their work with the Autism Consortium of Texas (ACT) Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program, which is a partnership between Baylor, UT Austin, and Texas State University. The two researchers serve as advisers to ACT LEND trainees, including clinical providers, family members, graduate students, and self-advocates, in their respected fields.

“As affiliate faculty for ACT LEND, I help teach trainees about physical therapy for individuals with intellectual and developmental disabilities. Sandra and I started talking about our research interests and found we had a common interest,” Flores said. “Our interdisciplinary collaboration allows us to holistically evaluate early development, and we hope to eventually develop interventions to improve development across domains for children with Down syndrome.”