{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T09:08:30Z","timestamp":1788944910249,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Global developmental delay (GDD) affects multiple domains of early childhood development, including gross motor, cognitive and communication skills. Early, intensive, family-centered rehabilitation is considered key to optimizing functional outcomes in affected children. Case Presentation: We report a female child with GDD who began rehabilitation at our institution at 15 months of age, presenting with generalized hypotonia with superimposed fluctuating episodes of hypertonia, poor postural control, absent independent sitting, markedly reduced spontaneous motor activity, and associated cognitive and communication delay. Brain MRI at 7 months showed no parenchymal abnormality, with mildly enlarged extracerebral cerebrospinal fluid spaces and ventricular system. The metabolic and genetic evaluation performed so far, including microarray\/MLPA-based screening for common microdeletion syndromes and SMN1\/SMN2 genotyping, has not identified a specific underlying etiology. Diagnostic work-up is ongoing. Rehabilitation was delivered as a comprehensive, multidomain program; this report focuses specifically on the child\u2019s motor progression. Intervention: The child underwent the Early Intensive Stoj\u010devi\u0107-Polovina Rehabilitation Method (EIR-SPM), a high-intensity, continuous approach for children with cerebral palsy, at-risk infants, and other developmental disabilities, built on parental education enabling home-based continuity of therapy. Rehabilitation focus is selected according to the child\u2019s optimal developmental stage\u2014the milestone showing the least abnormal movement patterns and muscle tone\u2014rather than chronological age, with positions progressively adjusted following the trajectory of typical motor development described by Vojta. Results: Gross motor function, monitored using the Gross Motor Function Measure\u201388 (GMFM-88) at four assessment points from 15 months to 6 years 6 months of age, improved progressively from 10.8% to 48.9%, 64.7%, and finally 73.9%. The child achieved independent kneeling, reciprocal crawling, independent sitting in all positions, independent standing and assisted stepping. Conclusions: In this child with GDD of undetermined etiology, more than five years of intensive, family-centered rehabilitation according to the EIR-SPM were accompanied by substantial and sustained gains in gross motor function and functional independence. This report suggests that meaningful progress remains achievable even when rehabilitation begins later than the period considered optimal within the EIR-SPM framework, and that a family-centered structure may be what makes therapy of this intensity and duration sustainable.<\/jats:p>","DOI":"10.3390\/children13091218","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:05:43Z","timestamp":1788941143000},"page":"1218","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intensive Family-Centered Rehabilitation and Motor Outcomes in a Child with Global Developmental Delay: A Case Report"],"prefix":"10.3390","volume":"13","author":[{"given":"Jelena","family":"Erceg","sequence":"first","affiliation":[{"name":"Polyclinic \u201cProf. dr. sc. Milena Stoj\u010devi\u0107 Polovina\u201d, Svetice 36, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetislav","family":"Polovina","sequence":"additional","affiliation":[{"name":"Polyclinic \u201cProf. dr. sc. Milena Stoj\u010devi\u0107 Polovina\u201d, Svetice 36, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Polovina","sequence":"additional","affiliation":[{"name":"Polyclinic \u201cProf. dr. sc. Milena Stoj\u010devi\u0107 Polovina\u201d, Svetice 36, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ema","family":"Dobrijevi\u0107","sequence":"additional","affiliation":[{"name":"Polyclinic \u201cProf. dr. sc. Milena Stoj\u010devi\u0107 Polovina\u201d, Svetice 36, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2908-9048","authenticated-orcid":false,"given":"Romana","family":"Gjergja Jura\u0161ki","sequence":"additional","affiliation":[{"name":"Polyclinic \u201cProf. dr. sc. Milena Stoj\u010devi\u0107 Polovina\u201d, Svetice 36, 10000 Zagreb, Croatia"},{"name":"Neuropaediatric Department, Srebrnjak Children\u2019s Hospital, Srebrnjak 100, 10000 Zagreb, Croatia"},{"name":"Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, 31000 Osijek, Croatia"},{"name":"Faculty of Health Studies, University of Rijeka, Ulica Viktora cara Emina 5, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1007\/s13312-022-2522-5","article-title":"Diagnosis and Management of Global Development Delay: Consensus Guidelines of Growth, Development and Behavioral Pediatrics Chapter, Neurology Chapter and Neurodevelopment Pediatrics Chapter of the Indian Academy of Pediatrics","volume":"59","author":"Juneja","year":"2022","journal-title":"Indian Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1212\/01.WNL.0000031431.81555.16","article-title":"Quality Standards Subcommittee of the American Academy of Neurology; Practice Committee of the Child Neurology Society. 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