Neuro-MoD: Neuroplasticity With Motor Development

This study is for infants and toddlers between 8 and 24 months old who use one arm and/or hand differently following a perinatal brain injury. This is a time when investigators think they can best help improve how the brain controls movement. Investigators are testing whether the combination of transcutaneous auricular vagus nerve stimulation (taVNS) with 40 hours of constraint-induced movement therapy (CIMT) can help infants move their weaker arm and hand better and make the brain pathways for movement stronger.

Inclusion Criteria: * Infants aged 8 to 24 months, diagnosed with hemiplegia or with an evident unilateral upper-limb weakness due to perinatal brain injury * Gross Motor Function Classification System (GMFCS) level I-IV * Infants who have not received previous CIMT in the preceding 3 months * Able to make consecutive appointments for assessments and intervention over 2 weeks, and complete the 3-month follow-up. Exclusion Criteria: * GMFCS level V * Prior CIMT within the past 3 months * Severe motor impairment/quadriplegic involvement. * Uncontrolled seizure disorders, cardiomyopathy, severe congenital malformations, * significant sensory impairments, or conditions preventing safe participation in therapy sessions