Trial Outcomes & Findings for SmarToyGym: Smart Detection of Atypical Toy-oriented Actions in At-risk Infants (NCT NCT02813889)

NCT ID: NCT02813889

Last Updated: 2024-08-06

Results Overview

Body movement (center of pressure) on a mat, in terms of average path length per second. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes without a toy. Path length was measured in distance with time normalized to 1 minute.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 36 participants
• Primary outcome timeframe: 1 session, about 1 hour in length
• Results posted on: 2024-08-06

Participant Flow

The same group of infants were analyzed throughout the study and for all outcome measures. The number differs for each outcome measure because data for some infants were excluded, the number varying for each study due to the specific outcome measure. These exclusions are specifically explained for each outcome measure in the outcome measures section. Infants #35 and #36 were consented, but no data was collected for them regarding any outcome measure.

Participant milestones

Measure	Full-Term Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Overall Study STARTED	26	10
Overall Study COMPLETED	19	10
Overall Study NOT COMPLETED	7	0

Reasons for withdrawal

Measure	Full-Term Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Overall Study Excluded 7 due to protocol adjustments. Specific exclusions listed under each outcome measure.	7	0

Baseline Characteristics

SmarToyGym: Smart Detection of Atypical Toy-oriented Actions in At-risk Infants

Baseline characteristics by cohort

Measure	Full-Term and Pre-Term Infants n=36 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development, and by low, moderate, and high risk. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Age, Categorical <=18 years	36 Participants n=5 Participants
Age, Categorical Between 18 and 65 years	0 Participants n=5 Participants
Age, Categorical >=65 years	0 Participants n=5 Participants
Age, Continuous	6 month STANDARD_DEVIATION 2 • n=5 Participants
Sex: Female, Male Female	24 Participants n=5 Participants
Sex: Female, Male Male	12 Participants n=5 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	3 Participants n=5 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	33 Participants n=5 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=5 Participants
Race (NIH/OMB) Asian	3 Participants n=5 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants
Race (NIH/OMB) Black or African American	11 Participants n=5 Participants
Race (NIH/OMB) White	21 Participants n=5 Participants
Race (NIH/OMB) More than one race	0 Participants n=5 Participants
Race (NIH/OMB) Unknown or Not Reported	1 Participants n=5 Participants

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of average path length per second. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes without a toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=8 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=7 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Path Length Per Second - No Toy (Birth Status)	0.0282 centimeters per second (cm/sec) Standard Deviation 0.0116	0.0428 centimeters per second (cm/sec) Standard Deviation 0.0144	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of average path length per second. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with elephant toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=8 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=7 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Path Length Per Second - Elephant Toy (Birth Status)	0.0311 centimeters per second (cm/sec) Standard Deviation 0.0171	0.0508 centimeters per second (cm/sec) Standard Deviation 0.0206	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of average path length per second. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with orangutan toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=8 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=7 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Path Length Per Second - Orangutan Toy (Birth Status)	0.0251 centimeters per second (cm/sec) Standard Deviation 0.105	0.0417 centimeters per second (cm/sec) Standard Deviation 0.0115	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of average path length per second. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with lion toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=8 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=7 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Path Length Per Second - Lion Toy (Birth Status)	0.0342 centimeters per second (cm/sec) Standard Deviation 0.0123	0.0421 centimeters per second (cm/sec) Standard Deviation 0.0126	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of path length per minute. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes without a toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=11 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=4 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Path Length Per Second - No Toy (Motor Control Outcome)	0.0287 centimeters per second (cm/sec) Standard Deviation 0.0110	0.0416 centimeters per second (cm/sec) Standard Deviation 0.0035	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of path length per minute. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with elephant toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=11 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=4 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Path Length Per Second - Elephant Toy (Motor Control Outcome)	0.0312 centimeters per second (cm/sec) Standard Deviation 0.0153	0.0617 centimeters per second (cm/sec) Standard Deviation 0.0181	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of path length per minute. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with orangutan toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=11 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=4 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Path Length Per Second - Orangutan Toy (Motor Control Outcome)	0.0260 centimeters per second (cm/sec) Standard Deviation 0.0100	0.0445 centimeters per second (cm/sec) Standard Deviation 0.0070	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of path length per minute. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with lion toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=11 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=4 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Path Length Per Second - Lion Toy (Motor Control Outcome)	0.0335 centimeters per second (cm/sec) Standard Deviation 0.0113	0.0416 centimeters per second (cm/sec) Standard Deviation 0.0025	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of standard deviation Y. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes without a toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=8 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=7 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Standard Deviation (Y) - No Toy (Birth Status) *StdDevY (Full-Term)	1.863 centimeters per minute (cm/min) Standard Deviation 0.920	—	—
Center of Pressure, Standard Deviation (Y) - No Toy (Birth Status) *StdDevY (Pre-Term)	—	0.799 centimeters per minute (cm/min) Standard Deviation 0.502	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of standard deviation Y. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with elephant toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=8 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=7 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Standard Deviation (Y) - Elephant Toy (Birth Status)	1.520 centimeters per minute (cm/min) Standard Deviation 0.710	1.159 centimeters per minute (cm/min) Standard Deviation 1.001	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of standard deviation Y. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with orangutan toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=8 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=7 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Standard Deviation (Y) - Orangutan Toy (Birth Status)	1.857 centimeters per minute (cm/min) Standard Deviation 0.981	0.890 centimeters per minute (cm/min) Standard Deviation 0.540	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of standard deviation Y. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with lion toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=8 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=7 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Standard Deviation (Y) - Lion Toy (Birth Status)	2.046 centimeters per minute (cm/min) Standard Deviation 0.658	0.738 centimeters per minute (cm/min) Standard Deviation 0.285	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of standard deviation Y. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes without a toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=11 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=4 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Standard Deviation (Y) - No Toy (Motor Control Outcome)	1.6920 centimeters per second (cm/sec) Standard Deviation 0.9442	0.6177 centimeters per second (cm/sec) Standard Deviation 0.3032	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of standard deviation Y. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with elephant toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=11 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=4 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Standard Deviation (Y) - Elephant Toy (Motor Control Outcome)	1.3491 centimeters per second (cm/sec) Standard Deviation 0.7232	1.6428 centimeters per second (cm/sec) Standard Deviation 1.7433	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of standard deviation Y. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with orangutan toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=11 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=4 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Standard Deviation (Y) - Orangutan Toy (Motor Control Outcome)	1.5857 centimeters per second (cm/sec) Standard Deviation 1.0106	1.0820 centimeters per second (cm/sec) Standard Deviation 0.6662	—

PRIMARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 21 excluded from enrolled 36: 7 infants were excluded from Center of Pressure analysis due to procedural adjustments. 11 infants were excluded from Center of Pressure analysis due to unusable data (infants either rolled or crawled on the mat, or they were fussy and were not able to be calmed while laying supine without being touched). 3 infants were excluded from Center of Pressure analysis due to technical issues (with the mat on the day of testing).

Body movement (center of pressure) on a mat, in terms of standard deviation Y. Early postural control (measured by center of pressure) was investigated to distinguish infants with future impairment in motor control from their typically developing peers. Lower path length is representative of greater postural control. The data analyzed was the condition where infant supine movement on the mat for up to two minutes with lion toy. Path length was measured in distance with time normalized to 1 minute.

Outcome measures

Measure	Full-Term Infants n=11 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=4 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Center of Pressure, Standard Deviation (Y) - Lion Toy (Motor Control Outcome)	1.8048 centimeters per second (cm/sec) Standard Deviation 0.7578	0.6503 centimeters per second (cm/sec) Standard Deviation 0.2535	—

PRIMARY outcome

Timeframe: 1 session, approximately 120 seconds during session 1 for the Elephant toy

Population: 13 excluded from enrolled 36: 2 infants were excluded from Toy Interaction analysis due to procedural adjustments. 5 were excluded from Toy Interaction analysis due to procedural inconsistencies. 6 were excluded from Toy Interaction analysis from unusable data (infants were either crying or crawling/rolling off the gym).

Time duration (in seconds) of infant interaction with the Elephant toy. Time spent in voluntary motor (feet and hand) interactions with the toy, analyzing grasp/touch/kick/mouth time. The data analyzed was the condition where the elephant toy was suspended within arm reach above the supine infant for approximately 120 seconds. The median and IQR measure the number of seconds the infant spent interacting with the toy. For numbers that were reported (0,0), those infants had no reaction and spent no time interacting with the toy. Toy interaction time ranged from 0-120 seconds.

Outcome measures

Measure	Full-Term Infants n=14 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Toy Interaction (Elephant Toy) - Grasp/Touch/Kick/Mouth Time	90.7 second (s) Interval 0.0 to 190.7	0 second (s) Interval 0.0 to 0.0	—

PRIMARY outcome

Timeframe: 1 session, approximately 120 seconds during session 1 for the Orangutan toy

Population: 13 excluded from enrolled 36: 2 infants were excluded from Toy Interaction analysis due to procedural adjustments. 5 were excluded from Toy Interaction analysis due to procedural inconsistencies. 6 were excluded from Toy Interaction analysis from unusable data (infants were either crying or crawling/rolling off the gym).

Time duration (in seconds) of infant interaction with the Orangutan toy. Time spent in voluntary motor (feet and hand) interactions with the toy, analyzing grasp/touch/kick/mouth time. The data analyzed was the condition where the orangutan toy was suspended within arm reach above the supine infant for approximately 120 seconds. The median and IQR measure the number of seconds the infant spent interacting with the toy. For numbers that were reported (0,0), those infants had no reaction and spent no time interacting with the toy. Toy interaction time ranged from 0-120 seconds.

Outcome measures

Measure	Full-Term Infants n=14 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Toy Interaction (Orangutan Toy) - Grasp/Touch/Kick/Mouth Time	69.3 seconds (s) Interval 26.3 to 240.1	27.9 seconds (s) Interval 0.0 to 30.4	—

PRIMARY outcome

Timeframe: 1 session, approximately 120 seconds during session 1 for the Lion toy

Population: 13 excluded from enrolled 36: 2 infants were excluded from Toy Interaction analysis due to procedural adjustments. 5 were excluded from Toy Interaction analysis due to procedural inconsistencies. 6 were excluded from Toy Interaction analysis from unusable data (infants were either crying or crawling/rolling off the gym).

Time duration (in seconds) of infant interaction with the Lion toy. Time spent in voluntary motor (feet and hand) interactions with the toy, analyzing grasp/touch/kick/mouth time. The data analyzed was the condition where the lion toy was suspended within foot reach above the supine infant for approximately 120 seconds. The median and IQR measure the number of seconds the infant spent interacting with the toy. For numbers that were reported (0,0), those infants had no reaction and spent no time interacting with the toy. Toy interaction time ranged from 0-120 seconds.

Outcome measures

Measure	Full-Term Infants n=14 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Toy Interaction (Lion Toy) - Grasp/Touch/Kick/Mouth Time	2.2 seconds (s) Interval 0.0 to 25.7	0 seconds (s) Interval 0.0 to 0.0	—

PRIMARY outcome

Timeframe: 1 session, approximately 120 seconds during session 1 for the Elephant toy

Population: 13 excluded from enrolled 36: 2 infants were excluded from Toy Interaction analysis due to procedural adjustments. 5 were excluded from Toy Interaction analysis due to procedural inconsistencies. 6 were excluded from Toy Interaction analysis from unusable data (infants were either crying or crawling/rolling off the gym).

Time duration (in seconds) of infant interaction with the Elephant toy. Time spent gazing at the toy. The data analyzed was the condition where the elephant toy was suspended within arm reach above the supine infant for approximately 120 seconds. The median and IQR measure the number of seconds the infant spent gazing at the toy. For numbers that were reported (0,0), those infants had no reaction and spent no time gazing at the toy. Toy interaction time ranged from 0-120 seconds.

Outcome measures

Measure	Full-Term Infants n=14 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Toy Interaction (Elephant Toy) - Gaze Time	59.6 seconds (s) Interval 22.6 to 71.4	0 seconds (s) Interval 0.0 to 4.7	—

PRIMARY outcome

Timeframe: 1 session, approximately 120 seconds during session 1 for the Orangutan toy

Population: 13 excluded from enrolled 36: 2 infants were excluded from Toy Interaction analysis due to procedural adjustments. 5 were excluded from Toy Interaction analysis due to procedural inconsistencies. 6 were excluded from Toy Interaction analysis from unusable data (infants were either crying or crawling/rolling off the gym).

Time duration (in seconds) of infant interaction with the Orangutan toy. Time spent gazing at the toy. The data analyzed was the condition where the orangutan toy was suspended within arm reach above the supine infant for approximately 120 seconds. The median and IQR measure the number of seconds the infant spent gazing at the toy. For numbers that were reported (0,0), those infants had no reaction and spent no time gazing at the toy. Toy interaction time ranged from 0-120 seconds.

Outcome measures

Measure	Full-Term Infants n=14 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Toy Interaction (Orangutan Toy) - Gaze Time	83.5 seconds (s) Interval 60.3 to 96.9	44.8 seconds (s) Interval 37.6 to 84.0	—

PRIMARY outcome

Timeframe: 1 session, approximately 120 seconds during session 1 for the Lion toy

Population: 13 excluded from enrolled 36: 2 infants were excluded from Toy Interaction analysis due to procedural adjustments. 5 were excluded from Toy Interaction analysis due to procedural inconsistencies. 6 were excluded from Toy Interaction analysis from unusable data (infants were either crying or crawling/rolling off the gym).

Time duration (in seconds) of infant interaction with the Lion toy. Time spent gazing at the toy. The data analyzed was the condition where the lion toy was suspended within foot reach above the supine infant for approximately 120 seconds. The median and IQR measure the number of seconds the infant spent gazing at the toy. For numbers that were reported (0,0), those infants had no reaction and spent no time gazing at the toy. Toy interaction time ranged from 0-120 seconds.

Outcome measures

Measure	Full-Term Infants n=14 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Toy Interaction (Lion Toy) - Gaze Time	21.7 seconds (s) Interval 7.3 to 57.5	0 seconds (s) Interval 0.0 to 0.0	—

PRIMARY outcome

Timeframe: 1 session, approximately 120 seconds during session 1 for the Elephant toy

Population: 13 excluded from enrolled 36: 2 infants were excluded from Toy Interaction analysis due to procedural adjustments. 5 were excluded from Toy Interaction analysis due to procedural inconsistencies. 6 were excluded from Toy Interaction analysis from unusable data (infants were either crying or crawling/rolling off the gym).

Frequency of infant interactions with the Elephant toy. Frequency of mouthing, grasping, hand touch, foot touch, and kicking with the toy. The data analyzed was the condition where the elephant toy was suspended within arm reach above the supine infant for approximately 120 seconds. The median and IQR measure the number of occurrences the infant had interacting with the toy. For numbers that were reported (0,0), those infants had no reaction and spent no time interacting with the toy.

Outcome measures

Measure	Full-Term Infants n=14 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Number of Occurrences of Elephant Toy Interactions	22.5 occurrences Interval 0.0 to 32.0	0 occurrences Interval 0.0 to 2.0	—

PRIMARY outcome

Timeframe: 1 session, approximately 120 seconds during session 1 for the Orangutan toy

Population: 13 excluded from enrolled 36: 2 infants were excluded from Toy Interaction analysis due to procedural adjustments. 5 were excluded from Toy Interaction analysis due to procedural inconsistencies. 6 were excluded from Toy Interaction analysis from unusable data (infants were either crying or crawling/rolling off the gym).

Frequency of infant interactions with the Orangutan toy. Frequency of mouthing, grasping, hand touch, foot touch, and kicking with the toy. The data analyzed was the condition where the orangutan toy was suspended within arm reach above the supine infant for approximately 120 seconds. The median and IQR measure the number of occurrences the infant had interacting with the toy. For numbers that were reported (0,0), those infants had no reaction and spent no time interacting with the toy.

Outcome measures

Measure	Full-Term Infants n=14 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Number of Occurrences of Orangutan Toy Interactions	7 occurrences Interval 5.0 to 16.0	7 occurrences Interval 0.0 to 13.0	—

PRIMARY outcome

Timeframe: 1 session, approximately 120 seconds during session 1 for the Lion toy

Population: 13 excluded from enrolled 36: 2 infants were excluded from Toy Interaction analysis due to procedural adjustments. 5 were excluded from Toy Interaction analysis due to procedural inconsistencies. 6 were excluded from Toy Interaction analysis from unusable data (infants were either crying or crawling/rolling off the gym).

Frequency of infant interactions with the Lion toy. Frequency of mouthing, grasping, hand touch, foot touch, and kicking with the toy. The data analyzed was the condition where the lion toy was suspended within foot reach above the supine infant for approximately 120 seconds. The median and IQR measure the number of occurrences the infant had interacting with the toy. For numbers that were reported (0,0), those infants had no reaction and spent no time interacting with the toy.

Outcome measures

Measure	Full-Term Infants n=14 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Number of Occurrences of Lion Toy Interactions	1 occurrences Interval 0.0 to 19.0	0 occurrences Interval 0.0 to 0.0	—

SECONDARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 13 full-term, 6 pre-term. 17 excluded from enrolled 36: 5 were excluded from wrist/ankle analysis due to procedural adjustments. 7 were excluded from wrist/ankle analysis due to missing BINS score data. 2 were excluded from wrist/ankle analysis due to unusable data (infants were sitting during the video, which prevented successful pose estimation). 3 were excluded from wrist/ankle analysis due to missing video data.

Kinematic planar (x, y) representation of wrist position (in l) based on pose captured from a single camera and through machine learning. Right and left arm wrist position were measured. Wrist position is reported in pixels from the camera data and normalization of data (units of measure is represented as pixels per length of trunk, normalized units with respect to trunk length). A positive value indicates the movement of arm upwards, and a negative value indicates the movement of arm downwards, with respect to the baseline.

The camera data analyzed was the condition where infant supine movement on the mat for up to two minutes (without a toy). The camera was in a fixed position above the infant.

Outcome measures

Measure	Full-Term Infants n=5 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants n=5 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Wrist Position Wrist Position, x	0.008 pixels per normalized trunk length Standard Deviation 0.031	0.088 pixels per normalized trunk length Standard Deviation 0.239	-0.044 pixels per normalized trunk length Standard Deviation 0.146
Wrist Position Wrist Position, y	0.370 pixels per normalized trunk length Standard Deviation 0.229	0.268 pixels per normalized trunk length Standard Deviation 0.217	0.224 pixels per normalized trunk length Standard Deviation 0.185

SECONDARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 13 full-term, 6 pre-term. 17 excluded from enrolled 36: 5 were excluded from wrist/ankle analysis due to procedural adjustments. 7 were excluded from wrist/ankle analysis due to missing BINS score data. 2 were excluded from wrist/ankle analysis due to unusable data (infants were sitting during the video, which prevented successful pose estimation). 3 were excluded from wrist/ankle analysis due to missing video data.

Kinematic planar (x, y) representation of ankle position (in l) based on pose captured from a single camera and through machine learning. Right and left arm ankle position were measured. Ankle position is reported in pixels from the camera data and normalization of data (units of measure is represented as pixels per length of trunk, normalized units with respect to trunk length). A positive value indicates the movement of leg upwards, and a negative value indicates the movement of leg downwards, with respect to the baseline.

The camera data analyzed was the condition where infant supine movement on the mat for up to two minutes (without a toy). The camera was in a fixed position above the infant.

Outcome measures

Measure	Full-Term Infants n=5 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants n=5 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Ankle Position Ankle Position, x	-0.018 pixels per normalized trunk length Standard Deviation 0.190	0.017 pixels per normalized trunk length Standard Deviation 0.176	-0.056 pixels per normalized trunk length Standard Deviation 0.097
Ankle Position Ankle Position, y	1.580 pixels per normalized trunk length Standard Deviation 0.076	1.472 pixels per normalized trunk length Standard Deviation 0.094	1.348 pixels per normalized trunk length Standard Deviation 0.389

SECONDARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 13 full-term, 6 pre-term. 17 excluded from enrolled 36: 5 were excluded from wrist/ankle analysis due to procedural adjustments. 7 were excluded from wrist/ankle analysis due to missing BINS score data. 2 were excluded from wrist/ankle analysis due to unusable data (infants were sitting during the video, which prevented successful pose estimation). 3 were excluded from wrist/ankle analysis due to missing video data.

Kinematic (x, y) representation of wrist movement (in l/s) based on pose captured from a single camera and through machine learning. Right and left arm wrist movement were measured. Wrist movement is reported in pixels from the camera data and normalization of data (units of measure is represented as pixels per length of trunk, normalized units with respect to trunk length). A positive value indicates the movement of arm upwards, and a negative value indicates the movement of arm downwards, with respect to the baseline.

The camera data analyzed was the condition where infant supine movement on the mat for up to two minutes (without a toy). The camera was in a fixed position above the infant.

Outcome measures

Measure	Full-Term Infants n=5 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants n=5 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Wrist Velocity Wrist Velocity, x	0.034 pixels (per trunk length) per second Standard Deviation 0.014	0.048 pixels (per trunk length) per second Standard Deviation 0.017	0.048 pixels (per trunk length) per second Standard Deviation 0.023
Wrist Velocity Wrist Velocity, y	0.035 pixels (per trunk length) per second Standard Deviation 0.016	0.045 pixels (per trunk length) per second Standard Deviation 0.019	0.054 pixels (per trunk length) per second Standard Deviation 0.023

SECONDARY outcome

Timeframe: 1 session, about 1 hour in length

Population: 13 full-term, 6 pre-term. 17 excluded from enrolled 36: 5 were excluded from wrist/ankle analysis due to procedural adjustments. 7 were excluded from wrist/ankle analysis due to missing BINS score data. 2 were excluded from wrist/ankle analysis due to unusable data (infants were sitting during the video, which prevented successful pose estimation). 3 were excluded from wrist/ankle analysis due to missing video data.

Kinematic (x, y) representation of ankle movement (in l/s) based on pose captured from a single camera and through machine learning. Right and left ankle movement were measured. Ankle movement is reported in pixels from the camera data and normalization of data (units of measure is represented as pixels per length of trunk, normalized units with respect to trunk length). A positive value indicates the movement of leg upwards, and a negative value indicates the movement of leg downwards, with respect to the baseline.

The camera data analyzed was the condition where infant supine movement on the mat for up to two minutes (without a toy). The camera was in a fixed position above the infant.

Outcome measures

Measure	Full-Term Infants n=5 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	Pre-Term Infants n=9 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. Infants were also categorized by typical and atypical (at-risk for neuromotor delay or physical disability) development. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.	High-Risk Infants n=5 Participants Two populations will be involved in testing in the SmarToyGym: 1. Full-term infants (born at a gestational age of \> 37 weeks) between 3 months and 11 months of age. 2. Pre-term infants (born at a gestational age \< 36 weeks) between 3 months and 11 months of age. The risk of neuromotor dysfunction was classified by the BINS test (low, moderate, high) computed at corrected aged for preterm infants and chronological age for full-term infants. SmarToyGym: We aim to develop a SmarToyGym where sensitized, wireless toys are strategically hung and placed within reach of infants to elicit toy-oriented body and arm/hand movements. Each toy will be equipped with sensors capable of measuring the infant's grasping actions such as squeezing, pinching, tilting, etc. A low-cost 3D motion capture system will be used to collect video data and the infants' reaching and body kinematics in response to the toys. A pressure mat will be used to measure postural changes to detect weight shifts, rolling, crawling and other movements away from the initial posture.
Ankle Velocity Ankle Velocity, x	0.052 pixels (per trunk length) per second Standard Deviation 0.020	0.072 pixels (per trunk length) per second Standard Deviation 0.029	0.067 pixels (per trunk length) per second Standard Deviation 0.042
Ankle Velocity Ankle Velocity, y	0.041 pixels (per trunk length) per second Standard Deviation 0.018	0.067 pixels (per trunk length) per second Standard Deviation 0.039	0.062 pixels (per trunk length) per second Standard Deviation 0.046

Adverse Events

Full-Term Infants

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Pre-Term Infants

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Michelle J. Johnson

Penn Medicine Center for Physical Medicine and Rehabilitation

Phone: 4148130128

Email: johnmic@pennmedicine.upenn.edu

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place