The award recognizes the best paper published in the journal Pediatric Physical Therapy in 2023.

BY JOHN HOBBS MA ’14

ASSISTANT PROFESSOR OF RESEARCH KARI KRETCH DPT ’19 has earned a Toby Long Award for her paper, titled “’Learn the Signs. Act Early.”: Updates and Implications for Physical Therapists,” published in the journal Pediatric Physical Therapy.

The article follows a 2022 update to the Centers for Diseases Control’s “Learn the Signs, Act Early,” a developmental milestone checklist developed in 2004 that gives caregivers and primary care practitioners a tool to determine whether a child is reaching developmental milestones in a typical age range.

The milestones — which measure four developmental domains: social/emotional, language/communication, cognitive and movement/physical development — had initially been developed based on expert opinion. The 2022 update ensures each milestone is supported by evidence-based research and uses clear, unambiguous language.

“When the new milestone checklists were published, I observed lots of discussion from pediatric physical therapists on social media,” Kretch said. “Most of the reactions were negative, and many were based on incorrect information.”

Setting the Record Straight

Kretch and the paper’s co-authors aimed to set the record straight.

“In this article, we provide background on what changes were made and why, and what physical therapists’ role is in implementing the new guidelines,” she said. One area of particular contention was the removal of crawling as a developmental milestone.

“Although many physical therapists believe crawling is essential for development, current research does not really support this belief,” Kretch explained. “We argue that the removal of crawling was appropriate given the goal of ensuring that the milestones are evidence-based.

While the award is meaningful to Kretch as a young researcher, it is her hope it will help spread the word to her colleagues.

“I am excited to be recognized because it will hopefully improve the visibility and reach of the article,” she said. “The more clinicians who read the article, the better!”

Kretch shares authorship with two other USC faculty members, Associate Professor Stacey Dusing and Associate Professor of Clinical Physical Therapy Barbara Sargent PhD ’13.

“I am fortunate to work with wonderful collaborators at USC and beyond,” Kretch said. “Collaboration allows us to leverage our complementary skills and strengths to make the science better.” Kretch joined the faculty in 2021, after completing a postdoctoral fellowship at the Motor Development Lab.