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Lee EJ, Zwicker JG. Early identification of children with/at risk of developmental coordination disorder: a scoping review. Dev Med Child Neurol 2021; 63:649-658. [PMID: 33469912 DOI: 10.1111/dmcn.14803] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 12/12/2022]
Abstract
AIM To summarize current evidence for early identification and motor-based intervention for children aged 5 years and younger with/at risk of developmental coordination disorder (DCD). METHOD Using scoping review methodology and after duplicates were removed, 11 115 peer-reviewed articles and grey literature were independently screened by two authors. Data from 103 included records were extracted and synthesized by both assessors. One author entered the relevant data into tables, while the other author double-checked the entries. RESULTS Records included peer-reviewed studies, guidelines, conference presentations, and theses/dissertations. Most literature pertained to early identification (n=78), with fewer studies targeting intervention (n=22) or covering both topics (n=3). Literature was summarized in two main categories: (1) assessments for diagnostic criteria A and B; and (2) motor-based interventions for young children with/at risk of DCD. This article highlights the findings related to assessments, while a companion article summarizes the intervention literature. INTERPRETATION Emerging evidence shows that children, especially those at greatest risk of DCD, may be identified before formal school entry. Earlier identification will allow for earlier intervention, which may help to improve the developmental trajectories of children with/at risk of DCD and prevent secondary consequences of the disorder. It is recommended that health care providers explicitly use the term 'at risk of DCD'.
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Affiliation(s)
- Emily J Lee
- Rehabilitation Science Online Programs, University of British Columbia, Vancouver, British Columbia, Canada.,Nurture Society for Learning and Development, Vancouver, British Columbia, Canada
| | - Jill G Zwicker
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pediatrics, Division of Developmental Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.,Brain, Behaviour, and Development, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,Sunny Hill Health Centre at BC Children's Hospital, Vancouver, British Columbia, Canada.,CanChild Centre for Childhood Disability Research, Hamilton, Ontario, Canada
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2
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Baber S, Michalitsis J, Fahey M, Rawicki B, Haines T, Williams C. A Comparison of the Birth Characteristics of Idiopathic Toe Walking and Toe Walking Gait Due to Medical Reasons. J Pediatr 2016; 171:290-3. [PMID: 26787375 DOI: 10.1016/j.jpeds.2015.12.069] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 11/12/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine and compare the birth history or postnatal complications of idiopathic toe walking (ITW) and toe walking known to be associated with a medical condition. STUDY DESIGN This was a retrospective chart review of parent-reported birth histories of children who presented to a dedicated toe-walking clinic between 2010 and 2014. This cohort comprised children diagnosed with ITW and children with a medical reason for their toe-walking gait. Data were compared with Australian Perinatal statistical normative data. RESULTS Ninety-five children (60 males, 63%) were diagnosed with ITW, with a mean (SD) age of 5.8 (2.9) years. Children with an ITW gait were found to have greater rates of prematurity (OR 2.4; 95% CI 1.43-4.03), greater rates of admission to a special care nursery or neonatal intensive care unit (OR 1.98; 95% CI 1.23-3.18), and lower birth weights (OR 6.6; 95% CI 3.48-12.5) than the normative population. Children with a medical reason for toe walking (n = 28, 68% males) also had greater rates of prematurity (OR 2.4; 95% CI 0.94-6.09) than the normative population and more instrumented births than the ITW cohort (OR 1.56; 95% CI 0.64-3.77). No association was found between assisted-birth intervention and the ITW cohort compared with the normative population or group with a medical cause for toe walking. CONCLUSIONS ITW gait was associated with greater rates of complications during and after delivery. Such complications have been associated previously as risk factors for neurologic insult affecting motor development.
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Affiliation(s)
- Stephanie Baber
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - Joanne Michalitsis
- Victorian Paediatric Rehabilitation Service, Monash Medical Centre, Clayton, Victoria, Australia
| | - Michael Fahey
- Victorian Paediatric Rehabilitation Service, Monash Medical Centre, Clayton, Victoria, Australia
| | - Barry Rawicki
- Victorian Paediatric Rehabilitation Service, Monash Medical Centre, Clayton, Victoria, Australia
| | - Terry Haines
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia; Allied Health Research Unit, Monash Health, Cheltenham, Victoria, Australia
| | - Cylie Williams
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia; Allied Health Research Unit, Monash Health, Cheltenham, Victoria, Australia.
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Petkovic M, Chokron S, Fagard J. Visuo-manual coordination in preterm infants without neurological impairments. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 51-52:76-88. [PMID: 26812594 DOI: 10.1016/j.ridd.2016.01.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 01/14/2016] [Accepted: 01/14/2016] [Indexed: 06/05/2023]
Abstract
The extent of and reasons for visuo-manual coordination deficits in moderate and late preterm born infants without neurological impairments are not well known. This paper presents a longitudinal study on the visuo-manual development of twelve preterm infants, born after 33-36 weeks of gestation without neurological complications, between the ages of 6 and 12 months. Visuo-manual integration and grasping were assessed using the Peabody Developmental Motor Scales, along with bimanual coordination and handedness tests. Visual function was examined once prior to the beginning of the study. Gross motor development was also evaluated every month. Preterm infants were compared to a control group of ten full-term infants according to corrected age. Compared to full-terms, the visual perception of preterm infants was close to normal, with only a measure of visual fixation lower than in full-terms. In contrast, preterm infants had delayed development of visuo-manual integration, grasping, bimanual coordination, and handedness even when compared using corrected age. Tonicity and gestational age at birth were the main variables associated to the delays. These results are discussed in terms of the possible factors underlying such delays. They need to be confirmed on a larger sample of preterm born children, and to be correlated with later development. This would allow developing markers of future neuropsychological impairments during childhood.
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Affiliation(s)
- Maja Petkovic
- Djecji vrtic Sopot, V.Kovacica 18c, Zagreb, 10000, Zagreb Croatia; Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Centre Biomédical des Saints-Pères, 75006, Paris France.
| | - Sylvie Chokron
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Centre Biomédical des Saints-Pères, 75006, Paris France; Unité Vision & Cognition, Fondation Ophtalmologique Rothschild, 25 rue Manin, 75019, Paris France
| | - Jacqueline Fagard
- Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS UMR 8158, Centre Biomédical des Saints-Pères, 75006, Paris France
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Mitchell AW, Moore EM, Roberts EJ, Hachtel KW, Brown MS. Sensory processing disorder in children ages birth-3 years born prematurely: a systematic review. Am J Occup Ther 2015; 69:6901220030. [PMID: 25553748 DOI: 10.5014/ajot.2015.013755] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This systematic review of multidisciplinary literature synthesizes evidence of the prevalence and patterns of sensory processing disorder (SPD) in children ages birth-3 yr born preterm. Forty-five articles including physiological, behavioral, temperament, and SPD research met the inclusion criteria and provided 295 findings related to SPD-130 (44%) positive (evidence of SPD) and 165 (56%) negative (no evidence of SPD). The majority of findings related to sensory modulation disorder (SMD; 43% positive). The most prevalent subcategory of SMD was sensory overresponsivity (82% of findings positive). Evidence of sensory underresponsivity and sensory-seeking SMD, sensory discrimination disorder, and sensory-based motor disorder was limited. This study supports the education of neonatologists, pediatricians, and caregivers about the symptoms and potential consequences of SPD and helps justify the need for follow-up screening for SPD in children ages birth-3 yr born preterm. Research using measures based on sensory processing theory is needed.
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Affiliation(s)
- Anita Witt Mitchell
- Anita Witt Mitchell, PhD, OTR, is Associate Professor, Occupational Therapy Department, University of Tennessee Health Science Center, Memphis;
| | - Elizabeth M Moore
- Elizabeth M. Moore, MOT, OTR/L, is Occupational Therapist, Signature Healthcare at St. Francis, Memphis, TN; At the time of the study, Elizabeth Moore, Emily Roberts, Kristen Hachtel, and Melissa Brown were Students, Department of Occupational Therapy, University of Tennessee Health Science Center, Memphis, TN
| | - Emily J Roberts
- Emily J. Roberts, MOT, OTR/L, is Occupational Therapist, Regional One Health, Memphis, TN
| | - Kristen W Hachtel
- Kristen W. Hachtel, MOT, OTR/L, is Occupational Therapist, First Choice Speech and Occupational Therapy, Hernando, MS
| | - Melissa S Brown
- Melissa S. Brown, MOT, OTR/L, is Occupational Therapist, Methodist Healthcare South Hospital, Memphis, TN
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Risk factors for postpartum depressive symptoms in low-income women with very low-birth-weight infants. Adv Neonatal Care 2015; 15:E3-8. [PMID: 25626986 DOI: 10.1097/anc.0000000000000131] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study examined factors associated with postpartum depressive symptoms in mothers with premature infants in the neonatal intensive care unit (NICU). SUBJECTS A total of 113 new mothers with very low-birth-weight infants in their initial NICU admission were recruited from 2 urban hospitals servicing low-income minority communities. DESIGN This study employed a cross-sectional design. METHODS Data were collected during the infants' postpartum NICU admission and included maternal demographic information (eg, age, education, race, living with the baby's father), infant illness severity (Neurobiologic Risk Score from infant's medical record), and maternal psychological measures (the Center for Epidemiologic Studies Depression Scale, the Perinatal Posttraumatic Stress Questionnaire, and the State-Trait Anxiety Inventory). RESULTS The findings indicated that 47 (42%) women had elevated postpartum depressive symptoms and 33 (30%) women had elevated postpartum posttraumatic stress symptoms (PTSs). Factors associated with postpartum depressive symptoms included PTS, anxiety, maternal age, and whether the mother lived with the baby's father (F₄, ₁₀₄ = 52.27, P < .001). The severity of the infants' illness, parental stress, and maternal education were not associated with depressive symptoms among low-income mothers of NICU infants. CONCLUSIONS On the basis of our findings, we recommend that low-income women should be screened for symptoms of anxiety, posttraumatic stress, and postpartum depression on their infants' admission to the NICU. When this is not feasible, we advise NICU healthcare providers to assess women for familial support, maternal age, posttraumatic stress related to their infants birth, and anxiety to determine which mothers are at the greatest risk for postpartum depressive symptoms. Screening for postpartum depression in the NICU can aid in early identification and treatment, thereby decreasing negative consequences for mothers and their infants.
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Dempsey AG, Keller-Margulis M, Mire S, Abrahamson C, Dutt S, Llorens A, Payan A. School-aged children born preterm: review of functioning across multiple domains and guidelines for assessment. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/1754730x.2014.978117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rosenblum S, Frisch C, Deutsh-Castel T, Josman N. Daily functioning profile of children with attention deficit hyperactive disorder: A pilot study using an ecological assessment. Neuropsychol Rehabil 2014; 25:402-18. [PMID: 25054849 DOI: 10.1080/09602011.2014.940980] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Children with attention-deficit hyperactivity disorder (ADHD) often present with activities of daily living (ADL) performance deficits. This study aimed to compare the performance characteristics of children with ADHD to those of controls based on the Do-Eat assessment tool, and to establish the tool's validity. Participants were 23 children with ADHD and 24 matched controls, aged 6-9 years. In addition to the Do-Eat, the Children Activity Scale-Parent (ChAS-P) and the Behavioral Rating Inventory of Executive Function (BRIEF) were used to measure sensorimotor abilities and executive function (EF). Significant differences were found in the Do-Eat scores between children with ADHD and controls. Significant moderate correlations were found between the Do-Eat sensorimotor scores, the ChAS-P and the BRIEF scores in the ADHD group. Significant correlations were found between performance on the Do-Eat and the ChAS-P questionnaire scores, verifying the tool's ecological validity. A single discriminant function described primarily by four Do-Eat variables, correctly classified 95.5% of the study participants into their respective study groups, establishing the tool's predictive validity within this population. These preliminary findings indicate that the Do-Eat may serve as a reliable and valid tool that provides insight into the daily functioning characteristics of children with ADHD. However, further research on larger samples is indicated.
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Affiliation(s)
- Sara Rosenblum
- a The Laboratory of Complex Human Activity and Participation (CHAP), Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences , University of Haifa , Haifa , Israel
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Perricone G, Morales MR, Anzalone G. Neurodevelopmental outcomes of moderately preterm birth: precursors of attention deficit hyperactivity disorder at preschool age. SPRINGERPLUS 2013; 2:221. [PMID: 23741652 PMCID: PMC3664736 DOI: 10.1186/2193-1801-2-221] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 05/06/2013] [Indexed: 11/10/2022]
Abstract
Moderately preterm birth seems to be an evolutional risk condition at cognitive, behavioural and socio-relational levels. The study is aimed to investigate the likely occurrence of precursors of Attention Deficit Hyperactivity Disorder (ADHD) in moderately preterm children at preschool age. The research involved an experimental group made up of 50 moderately preterm children (mean: 34.6 weeks' gestational age, standard deviation [SD]: 2) without any medical and neurologic neonatal complications and low birth weight (mean:2100g., SD: 350g.) and a check group of 50 full term born children. Parents and teachers of children were administered specific questionnaires to detect ADHD. The outcomes show a risk of ADHD highlighting statically significant differences related to gender [F(2, 99) = 2.99, p = .04], birth [F(2, 99) = 9.6, p = .03] and interaction [F(2, 99) = 2.2, p = .01]. The moderately preterm children showed deficit in self-regulation [F(2, 99) = 1.14, p = .04] and attention deficit in daily life both in family [F(2, 99) = 7.8, p = .04] and school contexts [F(1, 99) = 3.3, p = .04]. The outcomes hint assessment paths aimed to monitor the aspects of cognitive, motor, behavioural development of moderately preterm children recognised as signs of problematic functioning profiles. Therefore, specific training will have been designed since preschool age in order to control the ADHD risk factors.
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Affiliation(s)
- Giovanna Perricone
- />Department of Psychology, University of Palermo, Italy, Viale delle Scienze – Ed. 15, Palermo, 90128 Italy
| | - M Regina Morales
- />Department of Psychology, University of Palermo, Italy, Viale delle Scienze – Ed. 15, Palermo, 90128 Italy
| | - Germana Anzalone
- />Faculty of Educational Sciences, University of Palermo, Italy, Viale delle Scienze – Ed. 15, Palermo, 90128 Italy
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Morales MR, Polizzi C, Sulliotti G, Mascolino C, Perricone G. Early precursors of low attention and hyperactivity in moderately and very preterm children at preschool age. Pediatr Rep 2013; 5:e18. [PMID: 24416497 PMCID: PMC3883084 DOI: 10.4081/pr.2013.e18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 11/07/2013] [Indexed: 11/22/2022] Open
Abstract
The low attention and hyperactivity are major morbidities associated with very and moderately preterm birth. The study has been aimed at investigating the likely occurrence of early precursors of Attention Deficit and Hyperactivity Disorder (ADHD) in very and moderately preterm children at preschool age. The involved children were: 25 very preterm children (M=29.4 weeks of gestational age, SD=2), with low birth weight (M=1200 g, SD=250 g); 35 moderately preterm children (M=34.6 weeks of gestational age, SD=1) with low birth weight (M=2100 g, SD=250 g); 60 healthy full-term children as the control group. Parents of children have been administered specific questionnaires to detect low attention and hyperactivity of their children at home. The data have shown the risk of precursors of ADHD, highlighting statistically significant birth-related differences in both hyperactivity/impulsivity [F(2,119)=3.5, P=0.03, η(2)=0.06] and inattention [F(2,119)=2.4, P=0.04, η(2)=0.04], where very preterm children have got higher scores in these two dimensions compared with full-term and moderately preterm children. The very preterm children have got higher scores of impulsivity and inattention than the full-term children (Tukey'HSD - Honestly Significant Difference; P<0.001).
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Affiliation(s)
- M. Regina Morales
- Ospedali Riuniti – Villa Sofia Cervello Hospital, Palermo
- Pediatric Psychology Research Unit, Department of Psychology, University of Palermo, Italy
| | - Concetta Polizzi
- Pediatric Psychology Research Unit, Department of Psychology, University of Palermo, Italy
| | | | - Claudia Mascolino
- Pediatric Psychology Research Unit, Department of Psychology, University of Palermo, Italy
| | - Giovanna Perricone
- Pediatric Psychology Research Unit, Department of Psychology, University of Palermo, Italy
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Original article Psychomotor development of preterm babies in the context of biomedical predictors in a Polish sample. HEALTH PSYCHOLOGY REPORT 2013. [DOI: 10.5114/hpr.2013.40466] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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School readiness of moderately preterm children at preschool age. EUROPEAN JOURNAL OF PSYCHOLOGY OF EDUCATION 2012. [DOI: 10.1007/s10212-012-0168-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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12
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Cserjesi R, VAN Braeckel KN, Timmerman M, Butcher PR, Kerstjens JM, Reijneveld SA, Bouma A, Bos AF, Geuze RH. Patterns of functioning and predictive factors in children born moderately preterm or at term. Dev Med Child Neurol 2012; 54:710-5. [PMID: 22630341 DOI: 10.1111/j.1469-8749.2012.04328.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to identify subgroups of children born moderately preterm (MPT) and term with distinctive levels and patterns of functioning, and the perinatal and demographic factors that predict subgroup membership. METHOD A total of 378 children aged 7 years, 248 MPT (138 males, 110 females; gestational age 32-36 wks) and a comparison group of 130 children born at term (58 males, 72 females; gestational age 38-41 wks), were selected from a community-based cohort study. Latent class analyses were performed on measures of intelligence, verbal memory, attention, executive functioning, and visuomotor and motor skills. χ(2) automatic interaction detection analyses were performed to detect associations between the subgroups and predictors. RESULTS Four subgroups differing in levels of performance were identified, with parental education being the only statistically significant determinant of subgroup assignment (p < 0.01). The subgroup that performed the most poorly showed an irregular pattern of performance, with specific weakness in attentional skill and relative strength in intelligence and verbal memory. Parental education predicted classification probability in the preterm group (p = 0.04) but not in the term group (p = 0.15). INTERPRETATION Our results show that the poorer performance of children born MPT reflects a higher proportion of children with below average performance rather than a subgroup with extremely poor performance. They indicate that MPT birth affects neurodevelopmental functioning at early school age only slightly, with effects being largest in such children with low parental education.
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Affiliation(s)
- Renata Cserjesi
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, the Netherlands.
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Outcome of extremely low birth weight infants: what's new in the third millennium? Neuropsychological profiles at four years. Early Hum Dev 2012; 88:241-50. [PMID: 21962769 DOI: 10.1016/j.earlhumdev.2011.08.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 08/20/2011] [Accepted: 08/23/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND Extremely low birth weight (ELBW) infants, even those not presenting severe neuromotor sequelae, continue to be at risk of developing multiple, complex disorders involving the cognitive, emotional and behavioural domains. Follow-up protocols are able, in the short term, to identify subjects at risk of developing major sequelae, however they fail to identify all children at risk of developing disorders. AIMS To investigate the cognitive, neuropsychological and behavioural outcomes of a sample of ELBW children at the age of four years in order to identify characteristic profiles. STUDY DESIGN Longitudinal study. SUBJECTS 16 healthy ELBW children born in 2005 and followed up until the age of four. OUTCOME MEASURE Performances on standardised tests evaluating intelligence, memory, cognitive visual functions, attention, and executive functions. RESULTS General intelligence was within normal range. Cognitive profile showed mild or moderate deficits with different levels of involvement in many of the examined functions, in particular executive functions, attention and naming. CONCLUSION There emerged a wide-ranging spectrum of weaknesses and deficits involving all the functions examined, which together give rise to a dysexecutive syndrome. Analysis of cognitive profiles showed that the sample could be divided into two subgroups of subjects that differ in the quality of their global cognitive and behavioural functioning. Our results confirm the need to continue follow up of ELBW children until school age, as this will allow early detection of at-risk children and the planning of timely preventive interventions.
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McAnulty GB, Duffy FH, Butler SC, Bernstein JH, Zurakowski D, Als H. Effects of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) at age 8 years: preliminary data. Clin Pediatr (Phila) 2010; 49:258-70. [PMID: 19448128 PMCID: PMC4097037 DOI: 10.1177/0009922809335668] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The current study reports the effects of NIDCAP (Newborn Individualized Developmental Care and Assessment Program) at 8 years of age for a randomized controlled trial of 38 very early born (< or =29 weeks postmenstrual age), high-risk preterm infants. It was hypothesized that the experimental group at school age in comparison with the control group would perform significantly better neuropsychologically and neuroelectrophysiologically. Twenty-two (11 control, 11 experimental) children of the original 38 (18 control, 20 experimental) participants were studied at school age with a detailed neuropsychological battery and with EEG spectral coherence measures. Results indicated significantly better right hemisphere and frontal lobe function in the experimental group than the control group, both neuropsychologically and neurophysiologically. Neurobehavioral and physiological results in the newborn period successfully predicted the beneficial brain function effects at age 8 years. Results support the conclusion that the NIDCAP intervention has lasting effects into school age.
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Affiliation(s)
- Gloria B. McAnulty
- Departments of Psychiatry, Harvard Medical School and
Children's Hospital Boston, Boston, Massachusetts
| | - Frank H. Duffy
- Departments of Neurology, Harvard Medical School and
Children's Hospital Boston, Boston, Massachusetts
| | - Samantha C. Butler
- Departments of Psychiatry, Harvard Medical School and
Children's Hospital Boston, Boston, Massachusetts
| | - Jane H. Bernstein
- Departments of Psychiatry, Harvard Medical School and
Children's Hospital Boston, Boston, Massachusetts
| | - David Zurakowski
- Departments of Orthopedics, Harvard Medical School and
Children's Hospital Boston, Boston, Massachusetts
| | - Heidelise Als
- Departments of Psychiatry, Harvard Medical School and
Children's Hospital Boston, Boston, Massachusetts
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Gischler SJ, Mazer P, Duivenvoorden HJ, van Dijk M, Bax NMA, Hazebroek FWJ, Tibboel D. Interdisciplinary structural follow-up of surgical newborns: a prospective evaluation. J Pediatr Surg 2009; 44:1382-9. [PMID: 19573666 DOI: 10.1016/j.jpedsurg.2008.12.034] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Revised: 10/22/2008] [Accepted: 12/29/2008] [Indexed: 01/18/2023]
Abstract
BACKGROUND Information on physical and developmental outcomes of children with anatomical congenital anomalies (CAs) may indicate the need for early intervention and reduce impact on the child's life and parental burden. METHODS From 1999 to 2003, 101 children with CA (76.5% of initial survivors) were seen 6-monthly in a tertiary children's hospital. Growth, neurologic outcome, mental and psychomotor development as determined with the Bayley Scales of Infant Development, and categorization of predictive sociodemographic and medical variables of the children were evaluated prospectively and longitudinally. RESULTS Congenital diaphragmatic hernia (CDH) and esophageal atresia patients showed impaired growth, that is, both height for age (-1.5 standard deviation score [SDS]) and weight for height (-1.0 SDS). Overall neurologic outcome was normal, however, suspect or abnormal for 40% of CDH patients. Overall mental development was normal, but psychomotor scores were significantly lower than the norm (95% confidence interval, 83.8-92.2 at 6 months and 87.9-98.5 at 24 months). Sex, maternal age, socioeconomic status, CA, severity-of-disease covariables, and need of medical appliances at home could predict negative outcome significantly (P < .05). CONCLUSIONS The CA survivors show impaired growth and psychomotor developmental delay up to age 2 years. This warrants specific follow-up programs and infrastructure for these patients.
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Affiliation(s)
- Saskia J Gischler
- Surgical Intensive Care Unit, Department of Pediatric Surgery, Erasmus MC, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
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Zomignani AP, Zambelli HJL, Antonio MÂRGM. Desenvolvimento cerebral em recém-nascidos prematuros. REVISTA PAULISTA DE PEDIATRIA 2009. [DOI: 10.1590/s0103-05822009000200013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO:Rever a literatura atual que aborda o crescimento e o desenvolvimento cerebral de crianças prematuras e as alterações cognitivas e motoras que podem decorrer da prematuridade. FONTES DE DADOS: Foram utilizadas as bases de dados Medline e Lilacs, selecionados artigos publicados entre os anos de 2000 e 2007 e livros-texto com conteúdo relevante. SÍNTESE DOS DADOS: A evolução do recém-nascido pré-termo diferencia-se da evolução apresentada pela população a termo. Estudos têm demonstrado que ex-prematuros apresentam alterações anatômicas cerebrais que se associam a prejuízos cognitivos. Várias regiões do sistema nervoso central (substância cinzenta, substância branca, corpo caloso, núcleo caudado, hipocampo e cerebelo) têm seus volumes avaliados por neuroimagem e, apesar de resultados controversos, parecem ter desenvolvimento alterado nessa população. Diante disso, espera-se haver repercussão funcional e/ou cognitiva em crianças, adolescentes e adultos nascidos prematuramente. Ex-prematuros avaliados na infância tardia e na adolescência demonstram alterações de quociente de inteligência, memória, capacidade para cálculos e função cognitiva global. Déficits motores, na capacidade de planejamento e de associação, na coordenação motora e na atenção também foram relatados na literatura. CONCLUSÕES: A prematuridade pode levar a alterações anatômicas e estruturais do cérebro devido à interrupção das etapas de desenvolvimento pré-natal. Tais alterações podem causar déficits funcionais, tornando os ex-prematuros sujeitos a problemas cognitivos e motores, assim como suas repercussões nas atividades de vida diária, mesmo na adolescência e idade adulta.
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Hemgren E, Persson K. Deficits in motor co-ordination and attention at 3 years of age predict motor deviations in 6.5-year-old children who needed neonatal intensive care. Child Care Health Dev 2009; 35:120-9. [PMID: 18991971 DOI: 10.1111/j.1365-2214.2008.00896.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND A total of 189 children without major impairments who needed neonatal intensive care (NIC) were followed up at ages 3 and 6.5 years. AIM To determine the prevalence of different motor deviations at age 6.5 years and the co-occurrence of attention deficits; also, to analyse the predictive ability of motor co-ordination and attention assessments at age 3 years for motor deviations at 6.5 years. METHOD A combined assessment of motor performance and behaviour (CAMPB) was used at the 3-year examination. The Test of Motor Impairment (TOMI) and the Motor-Perceptual Development (MPU) were used together with the criteria of the diagnostic and statistical manual of mental disorders (DSM-IV-TR) to define motor deviations. RESULTS At 6.5 years 64% of the children showed a motor deviation either as a delay according to MPU, a problem according to TOMI or Developmental Coordination Disorder (DCD) according to DSM-IV-TR. Higher proportions of children with attention deficit (50%) were found in the DCD group. The predictive ability of CAMPB was analysed in two ways: when all children with either a co-ordination or attention deficit, or both, at 3 years were considered to be at risk for motor deviations at 6.5 years, the sensitivity reached 78% and the specificity was 42%. But when only the 3 year olds with a combined deficit were considered to be at risk, the sensitivity was 37% and the specificity 89%; however, a positive predictive value of 86% was reached. CONCLUSION At 6.5 years of age a majority of NIC children with no major impairments showed motor deviations. To fulfil the DCD criteria in DSM-IV-TR, a strict definition of motor deviations is recommended. Attention deficits are more prevalent among children with DCD. Deficits in motor co-ordination and/or attention in 3-year-old children are strong predictors of motor deviations and, especially, of DCD at 6.5 years of age.
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Affiliation(s)
- E Hemgren
- Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala 751 85, Sweden.
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Affiliation(s)
- Samantha Butler
- Neurobehavioral Infant and Child Studies, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.
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