What is Dynamic Movement Intervention (DMI)?
Dynamic Movement Intervention (DMI) is a therapeutic technique used in pediatric physical and occupational therapy to help children with motor delays improve their automatic postural responses to gravity and progress toward developmental milestones: rolling, sitting, four-point, crawling, standing, walking, and transitions. The goal of DMI is to provoke a specific active motor response from the child through defined dynamic exercises prescribed by the therapist. DMI stimulates neuroplasticity to help your child's brain make new and improved connections and develop their motor milestones.
How DMI therapy works
DMI was co-founded in 2021 by physical therapists Jake Kreindler and Jo-Anne Weltman as an evolution of Cuevas Medek Exercises (CME), incorporating modern neurorehabilitation research and updated methodologies. The approach is grounded in the principle of neuroplasticity the brain's ability to reorganize and create new motor pathways through targeted, consistent input.
In a DMI session, the therapist uses specific handling and positioning to place children in postures that demand active stabilization against gravity. Each exercise is repeated around five times per set to build automatic motor responses. The therapist progressively reduces support as the child improves, moving from proximal (core) to more distal (extremity) muscle engagement.
DMI is not play-based in the traditional sense. It is a structured, therapist-directed exercise protocol. However, sessions are designed to be engaging and motivating for children, with exercises presented as achievable challenges.
Who can benefit from DMI?
DMI can be used with children from as young as 1-2 months of age, regardless of cognitive level or neurological impairment. It is commonly used for children with:
Cerebral Palsy
Improving postural control, motor planning, and functional mobility
CP-specific guideGlobal Developmental Delay
Targeting rolling, sitting, crawling, standing, and walking milestones
GDD-specific guideHypotonia (Low Muscle Tone)
Strengthening core stability and postural responses against gravity
Hypotonia guideGenetic & Chromosomal Disorders
Supporting motor development in a wide range of genetic conditions
Acquired Brain Injury
Retraining motor pathways and improving functional outcomes
Spinal Cord Lesions
Maximizing remaining motor function and compensatory strategies
Prematurity & NICU Graduates
Risk factors for motor delay that can be addressed early with DMI
Premature baby guideNote: DMI is applicable regardless of the child's level of cognition or the extent of neurological impairment. The approach can be adapted to each child's unique needs and abilities.
Potential benefits of DMI therapy
Practitioners and families report a range of potential benefits from DMI therapy. These include improved automatic postural responses, better trunk control and core strength, enhanced balance and coordination, and meaningful progress toward developmental milestones such as rolling, sitting, crawling, standing, and walking.
By targeting the central nervous system's ability to reorganize motor pathways, DMI aims to stimulate neuroplasticity in the developing brain. Families often report seeing gains in their child's independence and confidence as motor skills improve.
Motor Milestones
Progress toward rolling, sitting, crawling, standing, and walking
Postural Control
Improved automatic responses to gravity and better core stability
Neuroplasticity
Stimulating the brain to create new motor pathways through targeted input
What the research says
DMI has no published outcome research in a peer-reviewed journal. That isn't a matter of interpretation — it's the state of the literature, and there is active disagreement in the field about what it means.
In January 2026, the journal Pediatric Physical Therapy published a special communication titled “Where's the Evidence? Challenging Therapists to Stop Legitimizing Dynamic Movement Intervention and Cuevas Medek Exercises.” It is an international collaborative paper arguing that DMI and the related Cuevas Medek Exercises approach should not be presented to families as established treatments while evidence is absent. DMI's authors published a response defending the approach's grounding in neuroplasticity research and stating that foundational studies are in planning.
Separately, a randomized controlled trial comparing DMI to the Bobath approach in children with spastic cerebral palsy completed in June 2026. Its results have not yet been published.
What this means for you: DMI may still be worth trying, particularly if conventional therapy hasn't produced the progress you hoped for. But no one can currently tell you it works better than what your child is already receiving, and you should be cautious with any clinic that claims otherwise. Discuss it with your child's pediatrician or current therapist.
What a typical DMI session looks like
Assessment & Planning
The therapist begins by assessing the child's current motor skills and identifying areas of deficit. Based on this evaluation, they select exercises tailored to the child's specific needs and target developmental milestones.
Hands-On Facilitation
The therapist provides specific hands-on guidance to help the child perform movements in more typical patterns. Exercises work against gravity, often using unstable surfaces and dynamic positioning to challenge the child's neurological system.
Repetition & Progression
Each exercise is repeated approximately five times per set. The therapist gradually reduces support as the child improves, moving from proximal to more distal muscle engagement. Exercises are repeated across sessions until movements become automatic.
Session Structure
Session length varies by provider, and DMI does not publish a standard. DMI can be delivered as regular weekly sessions or compressed into an intensive of daily or twice-daily sessions across one or two weeks. Ask any clinic directly how long their sessions run and how many they recommend. Positions used include prone (on the stomach), supine (on the back), sidelying, kneeling, and standing. See a full walkthrough of a DMI session
DMI therapy in Idaho
DMI therapy is available in Idaho through several providers. Here is what families in the Treasure Valley and beyond need to know.
Boise & Treasure Valley
This site serves as your guide to finding DMI therapy options in the Boise and Treasure Valley area.
Lullaby Waters is a therapist-owned outpatient occupational therapy practice in Boise, combining aquatic therapy with sensory and developmental occupational therapy. They have a DMI-certified occupational therapist on staff who pairs DMI principles with aquatic and sensory-based approaches. Contact Lullaby Waters directly to ask about DMI availability and where sessions take place. Their DMI sessions are held at a Boise location separate from their main clinic.
Northern Idaho
Emily Sater, OTR/L, at Ascend Pediatric Therapy in Coeur d'Alene offers DMI therapy including intensive programs for families in northern Idaho and the Pacific Northwest. Ascend Pediatric Therapy was founded specifically to fill a gap in DMI therapy services for families in the region.
Visit Ascend Pediatric TherapyDMI practitioner certification
DMI practitioners complete a multi-level certification program through the DMI Therapy organization. Levels include Introductory Levels A, B, C; Intermediate Levels A, B; and Masters/Teachers Levels. When researching a provider, you may ask about their certification level to understand their training background.
Common questions about DMI
Is DMI the same as physical therapy or occupational therapy?
DMI is a specific therapeutic technique that can be used within physical therapy or occupational therapy sessions. It is not a replacement for these disciplines but rather an approach that trained PTs and OTs can incorporate into their practice.
At what age can a child start DMI?
DMI can be used with children from as young as 1-2 months of age, regardless of their cognitive level or the extent of their neurological impairment.
How is DMI different from traditional therapy?
DMI is highly structured and therapist-directed, with specific handling techniques designed to provoke automatic postural responses. It focuses on challenging the child's neurological system to its highest skill level against gravity, with exercises repeated systematically to build automatic motor responses.
Does insurance cover DMI therapy?
Coverage depends on your insurance plan and how the therapy is billed (often as physical or occupational therapy). We recommend contacting your insurance provider and the clinic directly to understand coverage options.
Learn More About DMI
For comprehensive information about DMI therapy, research, and provider resources, visit the official DMI Therapy website.
dmitherapy.com is the official source for DMI certification, research, and provider training
Ready to ask a provider about DMI?
This site doesn't provide therapy or referrals. What it can do is help you walk into a clinic knowing what to ask. Idaho has DMI-certified therapists in both Coeur d'Alene and Boise, and contacting them directly is the next step.