Barriers and facilitators to implementing early intervention for children with non-progressive motor disorders: A systematic review

Abstract

AIM: To identify and analyse barriers and facilitators to implementing early motor interventions for children with non-progressive motor disorders, and to propose strategies to enhance scalability and effectiveness. METHOD: We searched databases including MEDLINE, Embase, CINAHL, PubMed, PsycInfo, and Scopus for studies examining motor interventions for children (≤3 years) with non-progressive motor disorders in any setting. A mixed-methods approach was adopted, and all empirical study designs reporting stakeholders' perspectives were eligible. Included studies were critically appraised using the Critical Appraisal Skills Programme. A narrative synthesis was undertaken, with extracted barriers and facilitators mapped into the Consolidated Framework for Implementation Research, normalization process theory, and Expert Recommendations for Implementing Change frameworks to inform implementation strategies. RESULTS: Twenty-two studies were identified, mainly randomized controlled trial designs. Barriers included intervention complexity, financial constraints, workforce shortages, and infrastructure challenges. Facilitators encompassed intervention adaptability, caregiver engagement, interdisciplinary collaboration, and telehealth accessibility. Framework-informed strategies focus on workforce development, locally supported digital approaches, and family-centred support. INTERPRETATION: Addressing systemic, organizational, and individual barriers is crucial for effective intervention. Solutions such as readiness assessments, workforce development, and family-centred approaches enhance implementation. Digital integration and professional collaboration improve service accessibility and sustainability.

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