Feasibility of the Specific Task–Environment–Participation (STEP) Protocol Adapted for Infants at Risk for Developmental Delay or Cerebral Palsy

AIMS: To evaluate feasibility of remote and in-person Specific Task-Environment-Participation (STEP) Protocol, describe adaptations, and explore effects on gross motor function, participation, environment opportunities, caregiver mental health, and infant engagement. METHODS: Feasibility study including infants aged 3-9 months at risk for developmental delay or cerebral palsy, randomized to in-person (physiotherapists) or remote (caregivers) intervention. Feasibility evaluated recruitment (rate, retention), assessment (adherence, adverse events, duration), intervention (session adherence, stimulation time, adverse events), and caregiver satisfaction (satisfaction, facilitators, barriers). Secondary outcomes included gross motor function, infant engagement, environment opportunities, caregiver well-being, and participation. RESULTS: Of 34 families, 28 participated (recruitment: 82%; retention: 61%), confirming recruitment feasibility. Assessment adherence was 76% (below criteria); adverse events (1.6%) and duration acceptance (100%) met criteria. Session adherence was 68.25% (remote) and 74.44% (in-person); stimulation adherence was 55.5% and 50.44% (below criteria). Caregiver satisfaction was 100% in both groups; facilitators and barriers were identified. Differences between groups occurred only in post-intervention GMFM Dimension A and Pediatric Rehabilitation Intervention Measure of Engagement-Observation (PRIME-O) change scores. CONCLUSION: STEP Protocol demonstrated recruitment feasibility and high caregiver satisfaction in both modalities. Predefined criteria were partially met. Similar secondary outcomes (except GMFM Dimension A and PRIME-O) suggest both formats are promising strategies.