Development of a global motor rating scale for young children (0-4 years) including eye-hand grip coordination

Validation of the Motor Functional Development Scale for Young Children to predict motor outcome in preterm infants: A 2 years follow-up study

OBJECTIVE

To examine the validity of the Motor Functional Development Scale for Young Children (DF-mot) to predict motor developmental delays in preterm infants.

METHOD

This retrospective cohort study includes 67 preterm infants who were assessed at 3-5 months by the DF-mot and the Alberta Infant Motor Scale (AIMS); and at 22-25 months by the Bayley Scales of Infant-Toddler Development (Bayley-III). The properties of the DF-mot and the AIMS were examined based on their ability to predict motor delays on the Bayley-III.

RESULTS

The DF-mot gross motor subscale -2 SD and the AIMS 10th centile showed best balance between sensitivity and specificity (respectively Se = 57.1%, Sp = 71.7% and Se = 50%, Sp = 73.5%). Overall, the DF-mot fine motor subscale fails to predict motor delays.

CONCLUSION

The DF-mot shows a lack of sensitivity and of positive predictive value to accurately predict motor outcome at 2 years in preterm infants.

ABBREVIATIONS

CA, Corrected age; AIMS, Alberta Infant Motor Scale; DF-mot/PML, Motor Functional Development Scale for Young Children postural motor locomotor; DF-mot/EHGC, Motor Functional Development Scale for Young Children eye-hand grip coordination; Bayley-III/GM, Gross motor subscale of the Bayley Scales of Infant-Toddler Development Third Edition; Bayley-III/FM, Fine motor subscale of the Bayley Scales of Infant-Toddler Development Third Edition.

The exploration of size and toddler interaction with liquid laundry detergent capsules

Liquid laundry capsules have been involved in multiple poisoning incidents with young children in the home. There are a range of contributing factors for these incidents, including influences from industry, culture, home environments, and parenting/supervision. There also are influences from children’s behaviour and decisions in reaction to potential hazards. Previous research examined the influence of capsule product appearance and colour on children’s behaviour around hazardous household items, but little research examines the influence of product size. This research explored if differences in the size of liquid laundry capsules result in different levels of toddler interaction. We compared two commercially available capsule designs that are identical in physical appearance but differ in physical size. Our research was conducted using three studies: Study 1, forced-choice test in an out-of-context laboratory setting; Study 2, an ecologically-valid, simulated real-world setting replicating a home laundry cabinet with a container of capsules left open; and Study 3, a second ecologically-valid study replicating a home laundry cabinet, this time with a capsule left outside its container. Capsule interaction was measured by grasping choice among samples of 156 toddlers ages 9–36 months. The same sample was used for Studies 1 and 2, and a second identically sized sample recruited for Study 3. Results from Study 1 indicated toddlers selected the small (49.8% selection) and large (50.2%) capsule with nearly identical frequency. Study 2 largely replicated Study 1: Toddlers selected the small capsule or container of small capsules 26.8% of the time and the large capsule or container of large capsules 22.3% of the time. Study 3 also replicated previous findings: Toddlers selected the smaller capsule 18.0% of the time and the larger 19.2%. We discuss study results, which suggest no appreciable difference in toddler’s grasping choice to smaller versus larger laundry capsules.

Concurrent and predictive validity of the Motor Functional Development Scale for Young Children in preterm infants

BACKGROUND

The Motor Functional Development Scale for Young Children (DF-mot) is a developmental tool assessing both gross and fine motor skills in term infants.

AIMS

To examine the concurrent validity of the DF-mot with the Alberta Infants Motor Scale (AIMS) in preterm infants and compare their ability in predicting scores on the Bayley Scales of Infant-Toddler Development (Bayley-III) at 12 months.

STUDY DESIGN

Retrospective cohort study.

SUBJECTS AND OUTCOME MEASURES

Hundred and eleven infants born at less than 32 weeks' gestation or with a birthweight less than 1500 g were assessed simultaneously on the DF-mot and the AIMS at age 3-5 months. Correlation analysis was used to determine the strength of association between the DF-mot and the AIMS. Among these, 62 were reassessed on the Bayley-III at age 9-12 months. Clinimetric properties were calculated to evaluate their ability to predict motor delay on the Bayley-III.

RESULTS

The concurrent validity study found a good level of correlation between the two scales (r = 0.79). The predictive validity study showed good sensitivity and negative predictive value for the AIMS 25th centile and the DF-mot -1 standard deviation to predict motor delay at 12 months (respectively Se = 100% and 84%; NPV = 100% and 77.8%).

CONCLUSIONS

The DF-mot is a valid instrument with good predictive validity in preterm infants, suggesting it can be used as a clinical useful tool to assess motor development.

Disappearance of Biased Visual Attention in Infants: Remediated Tonic Neck Reflex or Maturating Visual Asymmetry?

Typically, infants younger than four months fail to attend to the left side of their spatial field, most likely due to an innate asymmetrical tonic neck reflex (ATNR). In a critical transition, by four months of age, infants begin to reach and develop depth perception; and, by five months, they tend to monitor the entire spatial field. However, this developmental transition can be delayed. Moreover, there is always a residual right-sided spatial bias under cognitive load, a phenomenon that may also occur among adult stroke patients. While causative factors of biased visual attention in both infants and brain-injured adults may vary, mechanisms of remediation may be similar. This literature review addresses whether the infant's emergence of attention toward a full visual spatial field and the associated shift from monocular to binocular vision occurs because of (a) increased left side reaching, loosening the rarely mentioned high muscle tension ATNR or (b) maturational resolution of visual asymmetry in motion perception. More research is needed to investigate the origins of the infants' visual control system and factors involved in its development, especially because Alzheimer and dementia patients may also show primitive two-dimensional vision and deficits in perceiving objects-in-motion that seem to mirror infant visual perception.

Assessment of Gross Motor Development in the who Multicentre Growth Reference Study

The World Health Organization (WHO) Multicentre Growth Reference (MGRS) data management protocol was designed to create and manage a large data bank of information collected from multiple sites over a period of several years. Data collection and processing instruments were prepared centrally and used in a standardized fashion across sites. The data management system contained internal validation features for timely detection of data errors, and its standard operating procedures stipulated a method of master file updating and correction that maintained a clear trail for data auditing purposes. Each site was responsible for collecting, entering, verifying, and validating data, and for creating site-level master files. Data from the sites were sent to the MGRS Coordinating Centre every month for master file consolidation and more extensive quality control checking. All errors identified at the Coordinating Centre were communicated to the site for correction at source. The protocol imposed transparency on the sites' data management activities but also ensured access to technical help with operation and maintenance of the system. Through the rigorous implementation of what has been a highly demanding protocol, the MGRS has accumulated a large body of very high-quality data.

Variations in early gross motor milestones and in the age of walking in Japanese children

BACKGROUND

Gross motor development is usually assessed in terms of age of achievement of motor milestones. Although there is generally an impression of faster development if the milestones are achieved at younger ages, no longitudinal studies have been done on the associations between the milestones, especially in Japan. As a part of the Japan Children's Study, the purpose of the present study was to determine whether the achievement of gross motor milestones in infancy is related with the age of walking.

METHODS

This was a prospective cohort study of 290 healthy and term infants born in a district of Osaka City, Japan. Three milestones (rolling over, sitting, and crawling) were observed in the laboratory for infants aged at 4 and 9 months by a pediatrician and a developmental psychologist, and the age of walking was confirmed in questionnaires filled in by the parents at 18 and 27 months.

RESULTS

Children who could roll over at 4 months, and sit and crawl at 9 months, walked earlier than children who could not roll over, sit and crawl, respectively. With regard to crawling, children who were creeping had a 1 month delay in walking, and those who could not move forward had a 2 month delay compared to typical crawlers. On multiple regression analysis these three milestones were positively associated with walking: rolling over (β= 0.567), sitting (β= 1.973) and crawling (β= 1.473).

CONCLUSION

The age and the patterns of sitting, crawling and rolling over were all related to the age of independent walking among Japanese infants. Consideration of milestone definition and variations is essential in medical check-up.

Comparative effects of 2 positional supports on neurobehavioral and postural development in preterm neonates

Preventing abnormal neurobehavioral and postural development requires careful nursing in preterm neonates. The purpose of this prospective study is to assess the effects of 2 different lying-position body supports for physiologic and functional positioning. Thirty preterm neonates were eligible, born between 28 and 35 weeks' gestation. A first sample experimented with a "Home-Cocoon" support made by nurses with rolled sheets, and a second sample provided a "Coconou" support, made with a specifically designed rolled pad. Assessments of body posture and of neurobehavior were administered pretest (on admission without support) and posttest (at discharge). In addition, nurses were asked to answer a questionnaire concerning motor behavior. All preterm neonates showed gains in postural development, but the "Coconou" group performed significantly better than the "Home-Cocoon" group, with fewer cranial deformities, with head positioning, arm relaxation, and better orthopedic leg position. The overall quality of behavior increased for the 2 groups, but visual pursuit was very significantly better for the "Coconou" group. Nurses' assessment was also better for the "Coconou" support. These results point to the benefits of positioning with a specifically designed support like "Coconou," promoting optimal prophylactic neurobehavioral and postural developmental care for preterm neonates.

Effect of positioning on the incidence of abnormalities of muscle tone in low-risk, preterm infants

BACKGROUND. The preterm infant is subject to the force of gravity: when its body lies pressed against the mattress on which it is placed.

AIMS

The purpose of this study was to investigate short-term effects of varied post-natal lying positions in order to prevent neuromuscular and postural abnormalities.

METHODS

60 low risk preterm infants of 31-36 weeks gestational age were enrolled for this randomised clinical trial. Initially each child underwent neurological and psychomotor assessments which included tonus and reflex protocols as well as behavioral, sensory motor and postural examinations. The lying positions of the treated group were varied (back, prone, and side) using a specially designed moldable mattress that maintained the functional position of the infant's body. The control group was placed on their stomachs, (the standard lying position used in 1994) with a standard orthopaedic bolster support under their hips. All infants underwent a second round of examinations upon discharge to assess any changes in neurological and psychomotor outcomes.

RESULTS

The sensory-motor skills examinations showed significant abnormalities in the control group: (1) dominance of the extensor muscles due to muscle shortening, (2) hyper abduction and flexion of the arms, and (3) global neuromuscular rigidity. Psychomotor and neurological exams of the control and treatment groups showed delayed developmental muscular acquisitions for infants in the control group.

CONCLUSION

Regular changes in posture, while retaining correct functional positions, allowed maintenance of normal neuromuscular and osteo-articular function and permitted the development of spontaneous and functional motor activity in low-risk perterm infants.

Zur Frage der Wirksamkeit von Frühförderung

Zusammenfassung. Eine Literaturübersicht erörtert Beiträge zur Wirksamkeit von Frühförderung für die Publikationsjahre 1995 bis 2002. Methodische Schwierigkeiten wie Definition von Fallgruppen, outcome-Kriterien und Kontrollgruppen schränken die Aussagekraft vorliegender Studien ein und ziehen die Angemessenheit von Effektivitätsprüfungen in Zweifel, die den komplexen interpersonalen Handlungsraum Frühförderung auf wenige Entwicklungsparameter reduzieren. Frühzeitigkeit und Intensität der Förderung scheinen sich zumindest kurzfristig günstig auf kognitive Merkmale wie etwa auch Sprachentwicklung auszuwirken. Für den motorischen Bereich gibt es derzeit keine Anzeichen für die Überlegenheit einer bestimmten Methode. Wenn auch Befunde für günstige Auswirkungen von Förderung positiver und responsiver Eltern-Kind-Interaktionen vorliegen, bilden sich für die Praxis bedeutsame umfassende Variablen wie familiäre Lebensqualität, Kompetenzgefühl und Befindlichkeit bislang kaum in der Forschung ab.