What is Dynamic Movement Intervention (DMI)?
Dynamic Movement Intervention (DMI) is a hands-on therapy technique that pediatric physical and occupational therapists use to help children with motor delays reach their milestones: rolling, sitting, four-point, crawling, standing, walking, and moving between positions. The therapist sets up a specific exercise, and your child's body responds by working to hold itself up against gravity. DMI's goal is to build automatic postural responses, the quick, unplanned adjustments that keep us upright, and to stimulate neuroplasticity so your child's brain makes new and stronger connections.
How DMI therapy works
DMI was introduced in February 2021 by two physical therapists, Jake Kreindler and Jo-Anne Weltman. It grew out of Cuevas Medek Exercises (CME), and DMI describes itself as an evolution of that approach that reflects current research on neurorehabilitation, technologies, and methodologies.
In a session, the therapist holds your child at a specific point on the body and presents an exercise that asks your child to respond. As your child gets stronger, the therapist moves their hands farther from the center of the body so your child controls more of the movement. DMI's parent guide gives an example: supporting a child at the ankles while they stand is less support than holding them at the hips.
Each exercise is repeated around five times, and a session includes many different exercises. The same exercises can carry over from session to session until the movements become automatic. Exercises happen on a DMI table, with DMI's box set, or on the floor, depending on what your child can do.
Who is DMI for?
DMI is used with children who have any type of motor delay, big or small, from babies who are not rolling yet to kids who walk but need help with stairs or uneven ground. DMI says children can benefit regardless of their level of cognition or the extent of their neurological injury, and its clinical commentary says DMI can be started as early as 1 month of age, including in a NICU step-down unit with gentle handling.
The conditions DMI lists include:
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 guideWho should not do DMI
DMI is not used with children who have severe brittle bone diseases such as osteogenesis imperfecta. DMI's clinical commentary also says that children with spina bifida, SMA, extreme low tone, or a risk of osteopenia or osteoporosis must be treated with extreme precaution, as should children who are new to DMI or returning after a long break. If any of these apply to your child, ask the therapist how they adapt the exercises.
What families and therapists report
DMI describes the benefits it aims for: gross motor skills that become automatic, a gradual reduction in how much support your child needs, and better alignment and postural control. DMI's clinical commentary says that, anecdotally, reports from practitioners and parents have shown meaningful and often faster improvements in gross motor function than expected. These are reports from families and therapists, not study results, and every child is different.
One child's progress has also been measured and published in a medical journal. In a 2026 case report in the journal Pathophysiology, a girl with Apert syndrome received DMI as an intensive program in monthly cycles over eight months, from about 16 to 24 months of age. Her score on the Gross Motor Function Measure (GMFM-88) rose from 29.00% to 68.68%, with the biggest gains in sitting, crawling, and kneeling. It is one child, with no comparison group, so it cannot tell you what DMI will do for yours. It is a real, measured result.
What the research shows so far
DMI is new, so research is still catching up. Here is where it stands:
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No controlled study of DMI has been published yet.
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The 2026 case report above is the only DMI outcome report in a peer-reviewed journal.
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Two randomized trials of DMI are registered. One, comparing DMI with the Bobath approach in children with spastic cerebral palsy, finished in June 2026, and its results have not been released yet. A second, at Cairo University, compares DMI with a selective physical therapy program in children with spastic diplegia and has not posted results.
The field is debating DMI openly. In January 2026, the journal Pediatric Physical Therapy published a paper by Paleg and colleagues titled "Where's the Evidence? Challenging Therapists to Stop Legitimizing Dynamic Movement Intervention and Cuevas Medek Exercises," arguing that DMI should not be presented to families as an established treatment without evidence. DMI's founders published a response saying that foundational research on DMI is emerging and in a planning phase, and that "it is inaccurate to equate limited publication volume with a lack of intervention efficacy." A group of researchers, including several of the original authors, replied in July 2026.
What this means for you: a lack of published research does not mean DMI does not work, and it does not prove that it does. If conventional therapy has not brought the progress you hoped for, DMI is a reasonable thing to ask about. Ask the therapist how they will measure your child's progress, and be wary of any clinic that promises results.
What a typical DMI session looks like
Assessment and planning
After a brief assessment, the therapist identifies the skills your child is missing and chooses exercises that challenge your child at the highest level they can manage, along with exercises that build core and foundational milestones.
Hands-on facilitation
The therapist places their hands at specific points and gives clear movement cues, and each exercise works against gravity to bring out the next skill. Some children cry at first. DMI's parent guide explains that this is usually a child communicating that the work is hard or that a new movement feels unfamiliar, and that children settle as their confidence grows. Bringing a favorite toy, book, music, or tablet can help.
Repetition and progression
Each exercise is repeated around five times. As your child improves, the therapist gives less support, moving their hands farther from the center of the body, and exercises are repeated across sessions until the movements become automatic.
How often
DMI can be done once or twice a week, or every day for a set period as part of a therapy intensive. DMI also recommends a daily home exercise program when parents are comfortable with it. Session length varies by provider, so ask each clinic how long their sessions run and how many they recommend.
DMI therapy in Idaho
This site recommends one Idaho DMI provider, Ascend Pediatric Therapy in Coeur d'Alene.
Read the parent's guide to DMI therapy in IdahoNorthern 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 therapists train through a multi-level program run by DMI Therapy: Introductory Levels A, B, and C; Intermediate Levels A and B; and Master/Teacher levels. Only therapists who have completed Level C may offer an official DMI Therapy Intensive. Asking a therapist about their level is normal, and a good clinic will answer plainly.
Common questions about DMI
What is DMI therapy?
DMI, or Dynamic Movement Intervention, is a hands-on technique used by pediatric physical and occupational therapists to help children with motor delays build automatic postural responses and reach milestones like sitting, crawling, and walking.
Is DMI the same as physical therapy or occupational therapy?
DMI is a technique that trained physical therapists and occupational therapists use within their sessions. DMI says it is considered physical therapy or occupational therapy depending on the practitioner's background.
At what age can a child start DMI?
DMI's clinical commentary says DMI can be started as early as 1 month of age, with gentle handling, regardless of a child's level of cognition or the extent of their neurological injury.
How is DMI different from traditional therapy?
DMI is structured and therapist-directed. The therapist uses specific hand placements to bring out automatic postural responses, challenges your child at the highest level they can manage against gravity, and repeats each exercise around five times so the movement becomes automatic.
Is there research on DMI?
Research is early. No controlled study has been published yet, one peer-reviewed case report documents a child's progress with DMI, and two randomized trials are registered without published results.
Who should not do DMI?
DMI is not used with children who have severe brittle bone diseases such as osteogenesis imperfecta, and children with conditions like spina bifida, SMA, or extreme low tone need extra precautions.
Does insurance cover DMI therapy?
Sometimes. It depends on whether the clinic or therapist accepts insurance, and DMI is billed as physical or occupational therapy depending on the therapist's background. Ask your insurer and the clinic, and see our guide to what DMI costs.
Ready to ask a provider about DMI?
This site does not provide therapy or referrals. It is here to help you walk into a clinic knowing what to ask. Ascend Pediatric Therapy, the Idaho provider on this site, offers DMI therapy, and contacting them directly is the next step.
Sources
- DMI Therapy. Parent Resources and FAQ.
- Kreindler J, Weltman J. DMI Clinical Commentary. DMI Therapy.
- Oreščanin L, Biloglav Z, Škrlec I. Early Motor Development and Rehabilitation Outcomes in Apert Syndrome: Gross Motor Function Measures-Case Report. Pathophysiology. 2026;33(1):23.
- Paleg G, Pool D, Hidalgo-Robles Á, Frumberg D, Livingstone R, Damiano D. Where's the Evidence? Challenging Therapists to Stop Legitimizing Dynamic Movement Intervention and Cuevas Medek Exercises. Pediatric Physical Therapy. 2026;38(1):138-143.
- Kreindler J, Weltman J. Letter to the Editor: Clarifying the Scientific Basis and Clinical Relevance of DMI Therapy. Pediatric Physical Therapy. 2026;38(2):335-337.
- Pool D, Novak I, Dusing S, et al. Letter of Response to Clarifying the Scientific Basis and Clinical Relevance of Dynamic Movement Intervention Therapy. Pediatric Physical Therapy. 2026;38(3):403-404.
- ClinicalTrials.gov NCT07238634 and NCT06270550.