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Flanagan JE, Demchick BB, Landa R, Delany JV, Reinoso G. Early Play Behaviors of Infants at Elevated Likelihood for Autism Spectrum Disorder. Am J Occup Ther 2024; 78:7804185050. [PMID: 38768096 PMCID: PMC11220781 DOI: 10.5014/ajot.2024.050438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
IMPORTANCE Although research has examined early identification of autism spectrum disorder (ASD), few studies have found behavioral markers during midinfancy associated with later ASD diagnosis. OBJECTIVE To examine infants' play behaviors and atypical positions at age 6 mo and later outcome classification among infants at elevated likelihood (EL) and typical likelihood (TL) for ASD. Atypical positions refer to movement patterns indicative of motor delays or deviations, including atypical extension and flexion, poor weight shift and rotation, hypertonicity or hypotonicity, and the presence of primitive reflex patterns. DESIGN Observational cohort longitudinal design using blinded video analysis. PARTICIPANTS Fifty-eight infants (41 EL infants and 17 TL infants) 6 mo of age. RESULTS Infants later diagnosed with ASD needed more support to engage in play at age 6 mo compared with infants who did not receive an ASD diagnosis (U = 130, z = -2.29, p < .05, r = .31). Atypical positions at 6 mo of age were not associated with a later diagnosis of ASD. CONCLUSIONS AND RELEVANCE Play behaviors may be early indicators of developmental differences for infants later diagnosed with ASD. The results of this pilot study suggest the need to observe the quality of interaction with a caregiver and objects during early play, which may serve as potential early indicators of ASD. Plain-Language Summary: Few studies have found behavioral markers during midinfancy that are associated with a later diagnosis of autism spectrum disorder (ASD). The results of this study showed that infants who were later diagnosed with ASD were found to have differences in play behaviors compared to infants who were not later diagnosed with ASD. Thus, early play behaviors may be an early indicator of developmental differences for infants who are later diagnosed with ASD.
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Affiliation(s)
- Joanne E Flanagan
- Joanne E. Flanagan, ScD, OTR/L, is Associate Professor, Department of Occupational Therapy, Dr. Pallavi Patel College of Health Care Sciences, Nova Southeastern University, Clearwater, FL;
| | - Barbara B Demchick
- Barbara B. Demchick, ScD, OTR/L, FAOTA, is Professor Emerita, Department of Occupational Therapy and Occupational Science, Towson University, Baltimore, MD
| | - Rebecca Landa
- Rebecca Landa, PhD, is Executive Director, Center for Autism Services, Science and Innovation, Kennedy Krieger Institute, and Professor, Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Janet V Delany
- Janet V. Delany, DEd, is Professor Emerita, Towson University, Baltimore, MD
| | - Gustavo Reinoso
- Gustavo Reinoso, PhD, OTR/L, is Associate Professor, College of Pharmacy and Health Sciences, Drake University, Des Moines, IA
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De Bartolo D, Borhanazad M, Goudriaan M, Bekius A, Zandvoort CS, Buizer AI, Morelli D, Assenza C, Vermeulen RJ, Martens BHM, Iosa M, Dominici N. Exploring harmonic walking development in children with unilateral cerebral palsy and typically developing toddlers: Insights from walking experience. Hum Mov Sci 2024; 95:103218. [PMID: 38643727 DOI: 10.1016/j.humov.2024.103218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/05/2024] [Accepted: 04/12/2024] [Indexed: 04/23/2024]
Abstract
This longitudinal study investigated the impact of the first independent steps on harmonic gait development in unilateral cerebral palsy (CP) and typically developing (TD) children. We analysed the gait ratio values (GR) by comparing the duration of stride/stance, stance/swing and swing/double support phases. Our investigation focused on identifying a potential trend towards the golden ratio value of 1.618, which has been observed in the locomotion of healthy adults as a characteristic of harmonic walking. Locomotor ability was assessed in both groups at different developmental stages: before and after the emergence of independent walking. Results revealed that an exponential fit was observed only after the first unsupported steps were taken. TD children achieved harmonic walking within a relatively short period (approximately one month) compared to children with CP, who took about seven months to develop harmonic walking. Converging values for stride/stance and stance/swing gait ratios, averaged on the two legs, closely approached the golden ratio in TD children (R2 = 0.9) with no difference in the analysis of the left vs right leg separately. In contrast, children with CP exhibited a trend for stride/stance and stance/swing (R2 = 0.7), with distinct trends observed for the most affected leg which did not reach the golden ratio value for the stride/stance ratio (GR = 1.5), while the least affected leg exceeded it (GR = 1.7). On the contrary, the opposite trend was observed for the stance/swing ratio. These findings indicate an overall harmonic walking in children with CP despite the presence of asymmetry between the two legs. These results underscore the crucial role of the first independent steps in the progressive development of harmonic gait over time.
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Affiliation(s)
- Daniela De Bartolo
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Laboratory of Neuromotor Physiology, Scientific Institute for Research, Hospitalization and Health Care (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Marzieh Borhanazad
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marije Goudriaan
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Annike Bekius
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Coen S Zandvoort
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Annemieke I Buizer
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands; Emma Children's Hospital, Amsterdam UMC, Amsterdam, the Netherlands
| | - Daniela Morelli
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research, Hospitalization and Health Care (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Carla Assenza
- Department of Pediatric Neurorehabilitation, Scientific Institute for Research, Hospitalization and Health Care (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - R Jeroen Vermeulen
- Department of Pediatric Neurology, Maastricht University Medical Center, School of Mental Health and Neuroscience, Maastricht, the Netherlands
| | - Brian H M Martens
- Department of Pediatric Neurology, Maastricht University Medical Center, School of Mental Health and Neuroscience, Maastricht, the Netherlands
| | - Marco Iosa
- Department of Psychology, Sapienza University of Rome, Italy
| | - Nadia Dominici
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute for Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
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Sermpon N, Gima H. Correlation between pose estimation features regarding movements towards the midline in early infancy. PLoS One 2024; 19:e0299758. [PMID: 38416738 PMCID: PMC10901309 DOI: 10.1371/journal.pone.0299758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/14/2024] [Indexed: 03/01/2024] Open
Abstract
In infants, spontaneous movement towards the midline (MTM) indicates the initiation of anti-gravity ability development. Markerless 2D pose estimation is a cost-effective, time-efficient, and quantifiable alternative to movement assessment. We aimed to establish correlations between pose estimation features and MTM in early-age infants. Ninety-four infant videos were analysed to calculate the percentage and rate of MTM occurrence. 2D Pose estimation processed the videos and determined the distances and areas using wrist and ankle landmark coordinates. We collected data using video recordings from 20 infants aged 8-16 weeks post-term age. Correlations between MTM observations and distance values were evaluated. Differences in areas between groups of videos showing MTM and no MTM in the total, lower-limb, and upper-limb categories were examined. MTM observations revealed common occurrences of hand-to-trunk and foot-to-foot movements. Weak correlations were noted between limb distances to the midbody imaginary line and MTM occurrence values. Lower MTM showed significant differences in the lower part (p = 0.003) and whole area (p = 0.001). Video recording by parents or guardians could extract features using 2D pose estimation, assisting in the early identification of MTM in infants. Further research is required to assess a larger sample size with the diversity of MTM motor behaviour, and later developmental skills, and collect data from at-risk infants.
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Affiliation(s)
- Nisasri Sermpon
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa, Tokyo, Japan
- Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, Thailand
| | - Hirotaka Gima
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Arakawa, Tokyo, Japan
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Surowińska J, Sobieska M, Gajewska E. Qualitative assessment in the third month of life allows for a better prognosis of the achievement of motor milestones versus assessment of pathological reflexes- prospective studies on Polish children. Front Public Health 2023; 11:1253137. [PMID: 37780436 PMCID: PMC10536227 DOI: 10.3389/fpubh.2023.1253137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction The characteristic feature of primitive reflexes is that they occur early in development and must expire at a well-defined age. The study was conducted prospectively on a group of 107 children (74 boys). The study population included 83 infants born on time (weight 3,465 ± 395 g) and 24 born prematurely (weight 2,225 ± 793 g). Methods An analysis of motor development at 3 months of age consisting of a qualitative assessment (motor performance) and a check of reflexes was performed; at 9 months, the child was checked for crawling and sitting down, and at 16 months for walking. Results The more abnormal reflexes, the less likely it was to achieve the assessed milestones in time. It is possible to notice that the qualitative assessment is, in each case, a better predictor of the milestones than any of the reflexes, except for walking, where the Babkin reflex was strongly predictive. However, the qualitative assessment sum still occupies the second and third positions in prone and supine positions. Discussion The occurrence of Babkin's reflex at 3 months of age impacts the achievement of sitting down and walking functions. An abnormal Galant reflex was strongly associated with the lack of occurrence of crawling on time. At the same time, a high-quality score at 3 months of age guarantees the development of crawling on time, sitting down, and walking.
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Affiliation(s)
| | - Magdalena Sobieska
- Department of Rehabilitation and Physiotherapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Gajewska
- Chair and Clinic of the Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
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Malak R, Fechner B, Stankowska M, Wiecheć K, Szczapa T, Kasperkowicz J, Matthews-Kozanecka M, Brzozowska TM, Komisarek O, Daroszewski P, Samborski W, Mojs E. The Importance of Monitoring Neurodevelopmental Outcomes for Preterm Infants: A Comparison of the AIMS, GMA, Pull to Sit Maneuver and ASQ-3. J Clin Med 2022; 11:6295. [PMID: 36362524 PMCID: PMC9657223 DOI: 10.3390/jcm11216295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/04/2022] [Accepted: 10/24/2022] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Clinicians and parents should closely monitor the neurodevelopment of very preterm infants. The aim of our study was to compare whether neurodevelopmental assessments completed by parents and those done by specialists yielded similar outcomes. We wanted to check whether the assessments completed by specialists and parents were comparable in outcomes to emphasize the important roles of early assessment of a child and of the parents in their child's treatment and medical care. Another aim was to check whether or not the pull to sit maneuver from the Neonatal Behavioral Assessment Scale (NBAS) is still a parable item in well-known scales of neurodevelopment. METHODS We assessed 18 preterm neonates in the fourth month of corrected age with scales such as the General Movement Assessment (GMA), the Alberta Infant Motor Scale (AIMS), and the pull to sit maneuver from the NBAS. Finally, we asked parents to complete the Ages and Stages Questionnaire, Third Edition (ASQ-3). RESULTS We found that the respective assessments completed by specialists and parents are comparable in outcomes. We also found that the pull to sit item from the NBAS was still a valid test since it showed similar findings to those from the AIMS, the GMA, and the ASQ-3. CONCLUSIONS The pull to sit item from the NBAS is an important item for assessment of very preterm infants. Specialists should also take into consideration the input and concerns of parents when planning for treatment and intervention.
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Affiliation(s)
- Roksana Malak
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Brittany Fechner
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Marta Stankowska
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Katarzyna Wiecheć
- Department of Clinical Psychology, Poznań University of Medical Sciences, 60-812 Poznan, Poland
| | - Tomasz Szczapa
- Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, II Department of Neonatology, Poznan University of Medical Sciences, 60-535 Poznan, Poland
| | - Joanna Kasperkowicz
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Maja Matthews-Kozanecka
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Teresa Matthews Brzozowska
- Department of Orthodontics and Masticatory Dysfunction, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Oskar Komisarek
- The Chair and Clinic of Maxillofacial Orthopaedics and Orthodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
- Department of Plastic, Reconstructive and Aesthetic Surgery, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-821 Bydgoszcz, Poland
| | - Przemysław Daroszewski
- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, 61-545 Poznan, Poland
| | - Włodzimierz Samborski
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznań University of Medical Sciences, 61-545 Poznan, Poland
| | - Ewa Mojs
- Department of Clinical Psychology, Poznań University of Medical Sciences, 60-812 Poznan, Poland
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Melillo R, Leisman G, Machado C, Machado-Ferrer Y, Chinchilla-Acosta M, Kamgang S, Melillo T, Carmeli E. Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders. Front Neurol 2022; 13:922322. [PMID: 35873782 PMCID: PMC9301367 DOI: 10.3389/fneur.2022.922322] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
We provide evidence to support the contention that many aspects of Autistic Spectrum Disorder (ASD) are related to interregional brain functional disconnectivity associated with maturational delays in the development of brain networks. We think a delay in brain maturation in some networks may result in an increase in cortical maturation and development in other networks, leading to a developmental asynchrony and an unevenness of functional skills and symptoms. The paper supports the close relationship between retained primitive reflexes and cognitive and motor function in general and in ASD in particular provided to indicate that the inhibition of RPRs can effect positive change in ASD.
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Affiliation(s)
- Robert Melillo
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa, Israel
| | - Gerry Leisman
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa, Israel
- Department of Neurology, University of the Medical Sciences of Havana, Havana, Cuba
| | - Calixto Machado
- Department of Clinical Neurophysiology, Institute for Neurology and Neurosurgery, Havana, Cuba
| | - Yanin Machado-Ferrer
- Department of Clinical Neurophysiology, Institute for Neurology and Neurosurgery, Havana, Cuba
| | | | - Shanine Kamgang
- Department of Neuroscience, Carleton University, Ottawa, ON, Canada
| | - Ty Melillo
- Northeast College of the Health Sciences, Seneca Falls, New York, NY, United States
| | - Eli Carmeli
- Movement and Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa, Israel
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Feldhacker DR, Cosgrove R, Feiten B, Schmidt K, Stewart M. The Correlation between Retained Primitive Reflexes and Scholastic Performance among Early Elementary Students. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2021. [DOI: 10.1080/19411243.2021.1959482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Diana R. Feldhacker
- Department of Occupational Therapy, Creighton University, Omaha, Nebraska, USA
| | - Reilly Cosgrove
- Department of Occupational Therapy, Creighton University, Omaha, Nebraska, USA
| | - Ben Feiten
- Department of Occupational Therapy, Creighton University, Omaha, Nebraska, USA
| | - Kayleigh Schmidt
- Department of Occupational Therapy, Creighton University, Omaha, Nebraska, USA
| | - Marissa Stewart
- Department of Occupational Therapy, Creighton University, Omaha, Nebraska, USA
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Al-Saleh I, Moncari L, Jomaa A, Elkhatib R, Al-Rouqi R, Eltabache C, Al-Rajudi T, Alnuwaysir H, Nester M, Aldhalaan H. Effects of early and recent mercury and lead exposure on the neurodevelopment of children with elevated mercury and/or developmental delays during lactation: A follow-up study. Int J Hyg Environ Health 2020; 230:113629. [PMID: 32956901 DOI: 10.1016/j.ijheh.2020.113629] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023]
Abstract
This follow-up study of 82 children investigated the potential impact of early and recent exposure to mercury and lead on their neurodevelopmental performance at 5-8 years of age (2017-2018). Early exposure of these children to mercury, methylmercury, and lead was assessed during lactation at 3-12 months old, as well as their mother's exposure using measurements from a cross-sectional study (2011-2013). Only infants who failed to pass the neurodevelopment screening tools and/or had elevated mercury were included in this study. Urine and hair were sampled during the follow-up study to assess the children's recent exposure to mercury, methylmercury, and lead. Their cognitive performance and visual-motor integration were also measured using the Test of Non-Verbal Intelligence (TONI) and the Beery-Visual-Motor Integration (Beery VMI), respectively. The association between alterations in urinary porphyrins excretion and exposure to metals was analyzed and their influence on the children's neurodevelopment was explored. Linear regression models revealed a significant negative association between the infants' mercury exposure during lactation and the TONI Quotient (β = -0.298, 95%CI = -4.677, -0.414) and Beery VMI Age Equivalent scores at age 5-8 (β = -0.437, 95%CI = -6.383, -1.844). The mothers' blood methylmercury was inversely and significantly associated with their children's TONI Quotient (β = -0.231, 95%CI = -8.184, -0.331). In contrast, the children's Beery VMI Age Equivalent scores were positively and significantly associated with the hair methylmercury of the mothers (β = 0.214, 95%CI = 0.088, 3.899) and their infants (β = 0.256, 95%CI = 0.396, 4.488). These relationships suggest the presence of negative confounding that we did not take into account. Unlike mercury, there was some evidence that lead in breast milk had an inverse relationship with the children's visual-motor coordination skills. Our study did not show a clear association between children's recent exposure to metals and neurodevelopment. However, a significant inverse association was observed between the TONI Quotient and the interaction of hair methylmercury × ∑porphyrins (ß = -0.224, 95%CI = -0.86, -0.049), implying that porphyrins are a sensitive measure of low body-mercury burden. Although lead induced higher ∑porphyrins excretion in urine (β = 0.347, 95%CI = 0.107, 0.525), their interaction did not influence children's neurodevelopmental scores. The interactions between metals and porphyrins might provide insights into their potential contributory role in the pathogenesis associated with neurological disorders or other diseases. Despite the small sample size of the present study, its findings about the association between toxic metal exposure and the high risk of poor neurodevelopmental performance are worrying, particularly at an early age, and additional research is needed using larger sample sizes.
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Affiliation(s)
| | | | - Ahmed Jomaa
- Center for Autism Research, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
| | | | | | | | | | | | | | - Hesham Aldhalaan
- Center for Autism Research, King Faisal Specialist Hospital and Research Centre, P.O. Box: 3354, Riyadh, 11211, Saudi Arabia
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Garfinkle J, Li P, Boychuck Z, Bussières A, Majnemer A. Early Clinical Features of Cerebral Palsy in Children Without Perinatal Risk Factors: A Scoping Review. Pediatr Neurol 2020; 102:56-61. [PMID: 31416726 DOI: 10.1016/j.pediatrneurol.2019.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 07/11/2019] [Accepted: 07/13/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The early identification of cerebral palsy (CP) in the primary care context is often problematic and referral for diagnosis often delayed. This study aimed to identify clinical features associated with the early detection of CP that can be used by the primary care provider. METHODS We performed a scoping review by searching six electronic databases. We included English language articles that addressed the diagnosis of CP and/or its differential diagnosis in children and ways of detecting CP before the diagnosis is established (i.e., early clinical signs of CP) via (1) questions on the patient's clinical history, (2) developmental screening and/or health questionnaires, or (3) physical or neurological examination. RESULTS Included studies (n = 41; 27 overview studies and 14 original studies) were grouped into the three themes. Most of the overview articles relied on expert opinion, and all original studies included patients at high risk of developing CP. The most commonly identified features from each theme were early hand preference on clinical history, delayed or absent achievement of motor developmental milestones on developmental screening, and persistent primitive reflexes on neurological examination. CONCLUSIONS Overall, the literature on the early observable clinical signs that should prompt referral for investigation of possible CP in the specific context of well-baby care surveillance was sparse and inconsistent. Further research should focus on evaluating the contribution of readily identifiable clinical features.
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Affiliation(s)
- Jarred Garfinkle
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Patricia Li
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Zachary Boychuck
- School of Physical & Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - André Bussières
- School of Physical & Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Annette Majnemer
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada; School of Physical & Occupational Therapy, McGill University, Montreal, Quebec, Canada.
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Flanagan JE, Schoen S, Miller LJ. Early Identification of Sensory Processing Difficulties in High-Risk Infants. Am J Occup Ther 2019; 73:7302205130p1-7302205130p9. [DOI: 10.5014/ajot.2018.028449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. Our objective was to determine the extent to which young children at high risk for sensory processing difficulties differed from those who were at low risk.
METHOD. We compared high- versus low-risk young children using standardized measures. High-risk participants had older siblings identified as having sensory processing difficulties after a comprehensive occupational therapy evaluation (n = 13); low-risk participants (n = 16) had typically developing siblings and no family history of sensory or other neurological disorders.
RESULTS. High-risk infants scored significantly lower on the Language and Cognitive scales of the Bayley Scales of Infant and Toddler Development–Third Edition. The high-risk group presented with more atypical positions on the Toddler and Infant Motor Evaluation and fewer sensation-seeking behaviors on the Toddler Sensory Profile–2.
CONCLUSION. Results suggest that sensory, motor, cognitive, and language dimensions may be associated with sensory processing difficulties. Implications exist for the design of future studies and for early intervention.
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Affiliation(s)
- Joanne E. Flanagan
- Joanne E. Flanagan, ScD, OTR, is Assistant Professor, Department of Occupational Therapy, University of Texas Medical Branch, Galveston;
| | - Sarah Schoen
- Sarah Schoen, PhD, OTR/L, is Director of Research, Sensory Therapies and Research (STAR) Institute for Sensory Processing Disorder, Greenwood Village, CO, and Associate Professor, Rocky Mountain University of Health Professions, Provo, UT
| | - Lucy Jane Miller
- Lucy Jane Miller, PhD, OTR/L, is Founder, Sensory Therapies and Research (STAR) Institute for Sensory Processing Disorder, Greenwood Village, CO
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Yamamoto A, Kihara K, Yagi M, Matsumoto Y, Tsuneishi S, Otaka H, Yonezawa M, Takada S. Application of a wearable switch to perform a mouse left click for a child with mix type of cerebral palsy: a single case study. Disabil Rehabil Assist Technol 2019; 15:54-59. [DOI: 10.1080/17483107.2018.1520309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Akio Yamamoto
- Department of Community Health Science, Graduate School of Health Science, Kobe University, Kobe, Japan
| | - Kenji Kihara
- Nikoniko-house Medical Welfare Center, Kobe, Japan
| | - Mariko Yagi
- Nikoniko-house Medical Welfare Center, Kobe, Japan
| | | | | | | | | | - Satoshi Takada
- Department of Community Health Science, Graduate School of Health Science, Kobe University, Kobe, Japan
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12
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Evaluation of Moro reflex with an objective method in late preterm and term infants. Early Hum Dev 2019; 129:60-64. [PMID: 30660088 DOI: 10.1016/j.earlhumdev.2019.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 11/21/2022]
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13
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Boxum AG, Dijkstra LJ, la Bastide-van Gemert S, Hamer EG, Hielkema T, Reinders-Messelink HA, Hadders-Algra M. Development of postural control in infancy in cerebral palsy and cystic periventricular leukomalacia. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 78:66-77. [PMID: 29787891 DOI: 10.1016/j.ridd.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 04/17/2018] [Accepted: 05/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Development of postural problems in Cerebral Palsy (CP) is largely unknown. Postural muscle activity is organized into two levels: 1) direction-specificity; 2) fine-tuning of direction-specific activity. AIM To study development of postural control until 21 months corrected age in subgroups of infants at very high-risk (VHR) of CP: a) with and without CP at 21 months; b) with and without cystic periventricular leukomalacia (cPVL), the brain lesion with highest risk of CP. METHODS AND PROCEDURES Longitudinal electromyography recordings of postural muscles during reaching were made in 38 VHR-infants (severe brain lesion or clear neurological signs) between 4.7 and 22.6 months (18 CP, of which 8 with cPVL). Developmental trajectories were calculated using linear mixed effect models. OUTCOMES AND RESULTS VHR-infants with and without CP showed virtually similar postural development throughout infancy. The subgroup of VHR-infants with cPVL improved performance in direction-specificity with increasing age, while they performed throughout infancy worse in fine-tuning of postural adjustments than infants without cPVL. CONCLUSIONS AND IMPLICATIONS VHR-infants with and without CP have a similar postural development that differs from published trajectories of typically developing infants. Infants with cPVL present from early age onwards dysfunctions in fine-tuning of postural adjustments; they focus on direction-specificity.
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Affiliation(s)
- Anke G Boxum
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, The Netherlands
| | - Linze-Jaap Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, The Netherlands
| | - Sacha la Bastide-van Gemert
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Elisa G Hamer
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, The Netherlands; Radboud University Medical Center, Department of Neurology, Nijmegen, The Netherlands
| | - Tjitske Hielkema
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, The Netherlands
| | - Heleen A Reinders-Messelink
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, The Netherlands; Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, The Netherlands
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, The Netherlands.
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Boxum AG, La Bastide-Van Gemert S, Dijkstra LJ, Hamer EG, Hielkema T, Reinders-Messelink HA, Hadders-Algra M. Development of the quality of reaching in infants with cerebral palsy: a kinematic study. Dev Med Child Neurol 2017; 59:1164-1173. [PMID: 28877349 DOI: 10.1111/dmcn.13538] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2017] [Indexed: 12/12/2022]
Abstract
AIM To assess development of reaching and head stability in infants at very high risk (VHR-infants) of cerebral palsy (CP) who did and did not develop CP. METHOD This explorative longitudinal study assessed the kinematics of reaching and head sway in sitting in 37 VHR-infants (18 CP) one to four times between 4.7 months and 22.6 months corrected age. Developmental trajectories were calculated using linear mixed effect models. Motor function was evaluated with the Infant Motor Profile (IMP) around 13 months corrected age. RESULTS Throughout infancy, VHR-infants with CP had a worse reaching quality than infants without CP, reflected for example by more movement units (factor 1.52, 95% CI 1.16-1.99) and smaller transport movement units (factor 1.86, 95% CI 1.20-2.90). Total head sway of infants with and without CP was similar, but infants with CP used more head movement units to achieve stability. The rate of developmental change in infants with and without CP was similar. Around 13 months, head control and reaching quality were interrelated; both were associated with IMP-scores. INTERPRETATION Infants with CP showed a worse kinematic reaching quality and head stability throughout infancy from early age onwards than VHR-infants without CP, implying that kinematically they do not grow into a deficit, but exhibit deficits from early infancy on. WHAT THIS PAPER ADDS Reaching quality improves throughout infancy in all infants at high risk (VHR-infants). Infants with cerebral palsy (CP) show a worse reaching quality than VHR-infants without CP. Infants with CP achieve head stability differently from infants without CP. Infants with CP exhibit kinematic reaching problems from early age onwards.
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Affiliation(s)
- Anke G Boxum
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, the Netherlands
| | - Sacha La Bastide-Van Gemert
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Linze-Jaap Dijkstra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, the Netherlands
| | - Elisa G Hamer
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, the Netherlands.,Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Tjitske Hielkema
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, the Netherlands.,Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Heleen A Reinders-Messelink
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Rehabilitation Center 'Revalidatie Friesland', Beetsterzwaag, the Netherlands
| | - Mijna Hadders-Algra
- University of Groningen, University Medical Center Groningen, Department of Paediatrics - Developmental Neurology, Groningen, the Netherlands
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Lacerda DC, Ferraz-Pereira KN, Visco DB, Pontes PB, Chaves WF, Guzman-Quevedo O, Manhães-de-Castro R, Toscano AE. Perinatal undernutrition associated to experimental model of cerebral palsy increases adverse effects on chewing in young rats. Physiol Behav 2017; 173:69-78. [DOI: 10.1016/j.physbeh.2017.01.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/23/2017] [Accepted: 01/27/2017] [Indexed: 11/30/2022]
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Fluss J, Dinomais M, Kossorotoff M, Vuillerot C, Darteyre S, Chabrier S. Perspectives in neonatal and childhood arterial ischemic stroke. Expert Rev Neurother 2016; 17:135-142. [PMID: 27687767 DOI: 10.1080/14737175.2017.1243471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Over the last decade considerable advances have been made in the identification, understanding and management of pediatric arterial ischemic stroke. Such increasing knowledge has also brought new perspectives and interrogations in the current acute and rehabilitative care of these patients. Areas covered: In developed countries, focal cerebral arteriopathy is one of the most common causes of arterial ischemic stroke in childhood and imaging features are well characterized. However, there are ongoing debates regarding its underlying mechanisms, natural evolution and proper management. The implementation of thrombolytic therapy in acute pediatric stroke has been shown to be efficient in anecdotal cases but is still limited by a number of caveats, even in large tertiary centers. Finally, neonatal stroke represents a unique circumstance of possible early intervention before the onset of any neurological disability but this appears meaningful only in a selective group of neonates. Expert commentary: While perinatal stroke, a leading cause of cerebral palsy, appears to be multifactorial, a large number of childhood ischemic stroke are probably essentially triggered by infectious factors leading to vessel wall damage. Current research is aiming at better identifying risk factors in both conditions, and to define optimal acute and preventive therapeutic strategies in order to reduce significant long-term morbidity.
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Affiliation(s)
- J Fluss
- a Pediatric Neurology Unit, Pediatric Subspecialties Service, Children's Hospital , Geneva University Hospitals , Geneva , Switzerland
| | - M Dinomais
- b LUNAM, Université d'Angers , Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS) , EA7315 F-49000 , Angers , France.,c Département de Médecine Physique et de Réadaptation , CHU Angers , Angers , France
| | - M Kossorotoff
- d French Center for Pediatric Stroke, Pediatric Neurology Department , APHP-Necker-Enfants Malades University Hospital , Paris , France
| | - C Vuillerot
- e Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, L'Escale , French Center for Pediatric Stroke/Service de Médecine Physique et de Réadaptation Pédiatrique , Bron , France.,f CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive , Equipe Biostatistique Santé , Pierre-Bénite , France
| | - S Darteyre
- g Department of Pediatrics , French Polynesia Hospital , Tahiti , French Polynesia.,h Inserm U1090 Sainbiose and Université Lyon/Saint-Étienne , Dysfonction vasculaire et hémostase Team , Saint-Étienne , France
| | - S Chabrier
- h Inserm U1090 Sainbiose and Université Lyon/Saint-Étienne , Dysfonction vasculaire et hémostase Team , Saint-Étienne , France.,i CHU Saint-Étienne , French Center for Pediatric Stroke/Pediatric Physical and Pediatric Rehabilitation Medicine Department & Inserm CIC1408 , Saint-Étienne , France
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