Early Mobility and Crawling: Beliefs and Practices of Pediatric Physical Therapists in the United States.

PURPOSE: To characterize beliefs of pediatric physical therapists (PTs) in the United States regarding the role of crawling in infant development and clinical practice. METHODS: Pediatric PTs reported their beliefs about early mobility and crawling, clinical approaches related to early mobility and crawling, and agreement with the removal of crawling from the Centers for Disease Control and Prevention (CDC)'s updated developmental milestone checklists in an online survey. Analyses examined associations between information sources and beliefs, between beliefs and clinical approaches, and between beliefs and CDC update opinions. RESULTS: Most participants believed that crawling was important (92%) and linked to a variety of positive developmental outcomes (71%-99%) and disagreed with its removal from the CDC checklists (79%). Beliefs were linked with clinical approaches focused on promoting crawling and discouraging other forms of mobility. CONCLUSIONS: Further research is needed to determine whether pediatric PTs' beliefs and clinical practices are supported by evidence.

"Learn the Signs. Act Early.": Updates and Implications for Physical Therapists.

PURPOSE: In early 2022, the Centers for Disease Control and Prevention (CDC) updated their developmental surveillance milestone checklists. The purpose of this article is to clarify and interpret the updates from a physical therapist perspective and to discuss implications of the new milestones for physical therapists. SUMMARY OF KEY POINTS: The CDC's updated checklists provide clear, consistent, easy to use, and evidence-based developmental milestones to prompt discussion with families. The new checklists do not represent a lowering of standards and will likely increase, not decrease, referrals for screening, evaluation, and services. Crawling has been removed from the milestone checklists, as the current evidence suggests that crawling is highly variable and not essential for development. CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE: The updated milestone checklists will facilitate bringing vital services to children who need them. Physical therapists should support our primary care colleagues in implementing this useful program.

Immunity to avian pneumovirus infection in turkeys following in ovo vaccination with an attenuated vaccine.

Fertile turkey eggs after 24 days of incubation were vaccinated in ovo with a commercial live attenuated subtype A avian pneumovirus (APV) vaccine. Hatchability was not adversely affected. When a high dose (10 times maximum commercial dose) of vaccine was tested in maternal antibody negative (MA-) eggs, mild clinical signs developed in a small proportion of the poults for 1-4 days only. Post-vaccination antibody titres at 3 weeks of age were significantly higher than those seen when the same dose was administered by eyedrop or spray at day-old. A low dose (end of shelf-life titre) of vaccine given to MA- eggs did not cause disease and vaccinated poults were 100% protected against virulent APV challenge at 3 or 5 weeks of age. Post-vaccination antibody titres reached significant levels at 3 weeks of age, whereas those from MA- poults vaccinated by spray at day-old with a similar low dose did not. In a 'worst-case' scenario, maternal antibody positive (MA+) poults vaccinated in ovo with the low dose were still 77% protected against clinical disease, despite lack of seroconversion. The recommended commercial dose of vaccine given to MA- eggs in ovo induced 100% protection against virulent APV challenge for up to 14 weeks of age, even though post-vaccination antibody titres had dropped to insignificant levels at this age. In ovo vaccination with a mixture of the recommended commercial doses of live APV and Newcastle disease (ND) vaccines had no detrimental affect on the efficacy of the APV vaccine. This is the first report of the successful use of an APV vaccine being given in ovo. The results indicate that for turkeys, in ovo vaccination with a live attenuated APV vaccine is safe and effective against virulent challenge and comparable with vaccination by conventional methods.