Gross motor development in children adopted from orphanage settings

Influence of different caregiving styles on fundamental movement skills among children

Purpose

This study investigated the influence of parenting and grandparenting caregiving styles on fundamental motor skills (FMS) of preschool children.

Method

A total of 1,326 preschool children (698 boys, 628 girls) aged 4-6 years were recruited from the kindergartens of Jinhua City, China. Locomotor skills (LM), ball skills (BS), and total fundamental movement skills (TS) of children were assessed by the Test of Gross Motor Development-3rd edition (TGMD-3).

Results

There were 978 children in parenting and 348 children in grandparenting caregiving styles. The LM, BS and TS scores of children were considerably (p < 0.001) increased with age (irrespective of sex or caregiving style). For the sex comparisons, BS scores of boys were significantly higher than girls (p < 0.001), while LM and TS scores were not different between boys and girls. For the caregiving style comparison, parenting is superior to grandparenting in developing of children's FMS. Parenting boys of 4-, 5-, and 6-years old showed better BS compared to age-matched parenting girls, whereas boys of 5-years old in grandparenting only showed better BS compared to same-age grandparenting girls (p < 0.05). Furthermore, parenting boys of 6-years reported higher LM (p < 0.01), BS (p < 0.001), and TS (p < 0.001) scores compared to grandparenting boys, but girls' FMS at all ages were not significantly different between the caregiving styles.

Conclusion

Parenting caregiving style is positively associated with proper development of FMS among children. Girl children with poor FMS in grandparenting may need a special care or intervention programs to promote their FMS.

Gahvora cradling in Tajikistan: Cultural practices and associations with motor development

In Tajikistan, infants are bound supine in a "gahvora" cradle that severely restricts movement. Does cradling affect motor development and body growth? In three studies (2013-2018), we investigated associations between time in the gahvora (within days and across age) and motor skills and flattened head dimensions in 8-24-month-old Tajik infants (N = 269, 133 girls, 136 boys)) and 4.3-5.1-year-old children (N = 91, 53 girls, 38 boys). Infants had later motor onset ages relative to World Health Organization standards and pronounced brachycephaly; cradling predicted walk onset age and the proficiency of sitting, crawling, and walking. By 4-5 years, children's motor skills were comparable with US norms. Cultural differences in early experiences offer a unique lens onto developmental processes and equifinality in development.

Handwriting kinematics during learning to write with the dominant left hand in converted left-handers

Converting left-handers to their non-dominant right hand was previously widespread, particularly for handwriting. The present study aimed to explore the extent to which adult, converted left-handers can learn writing with their dominant left hand during a 2-year training program. Eleven converted left-handers participated in the training. Handwriting kinematics were assessed at regular intervals (seven sessions) and compared to those of 11 innate left-handed controls matched for age, gender, and overall handedness score for basic (Finger, Wrist, Circle) and complex (Sentence, Copy) handwriting tasks. Regarding basic tasks in the training group, we found rapid increases in left and right-hand frequency and no significant differences between both hands at any time point, indicating successful hand transfer. After 24 months, training participants significantly surpassed controls for writing frequency in basic tasks with their left hand. For complex tasks, we identified significant increases in the training groups' left-hand writing frequency and duration between the first and last session. While training participants' left-hand writing remained significantly slower than their right-hand writing, statistics confirmed final differences between hands only for the duration of the Sentence task. Importantly, left-hand writing in the training group was characterized by lower frequency, lower automaticity, and prolonged duration after 24 months compared to innate left-handers. With training participants' left-hand writing skills significantly increasing for complex tasks and no final statistically significant differences between hands for frequency and automaticity, the program was considered effective. Nevertheless, within 2 years, training participants did not reach innate left-handers handwriting proficiency for complex tasks. Underlying reasons may be various, such as a non-optimal training program, a sensitive period for learning to write, irreversible neural changes during conversion in childhood, age-related decline of motor learning capacity, or retrograde interference between right- and left-hand writing.

Children should be seen and also heard: an explorative qualitative study into the influences on children's choice of footwear, their perception of comfort and the language they use to describe footwear experiences

BACKGROUND

Footwear has an essential role including protection of the feet, overall performance, foot health and potentially, supporting normal development of the foot. In addition to these physical aspects which may influence choice of footwear design, there are psychological influences on what a person chooses to wear. The concept of footwear 'comfort' spans physical and psychological perceptions of comfort in adults. However, there is little understanding of what influences children's footwear choices, how children perceive footwear comfort, or the language used to describe footwear experiences. Therefore, this study aimed to explore these three parameters as the first step to informing the development of a scale to measure footwear comfort in children.

METHODS

A pragmatic qualitative design with thematic analysis as an analytical approach was implemented. Passive observation and short interviews were carried out with 23 children (aged 1-12 years) at a footwear manufactures headquarters and store. Prompts included shoes being tried on and field-notes were taken relating to verbal and non-verbal communication. Field notes were coded then themes were identified, reviewed and named.

RESULTS

Overall, the children equated comfort to softness. However, influences on footwear choice were multidimensional including aesthetics, psychosocial influences, identified 'comfort' and 'discomfort' areas, practical issues and predictive concerns; all interacting with the age of the child.

CONCLUSIONS

For children, footwear comfort is a complex phenomenon having physical, cognitive, social and emotional developmental components. This can be seen in how the children perceive the 'feel' of the shoe and how the shoe is assessed in the context of how the shoe meets the child's physical and psychosocial developmental needs. In younger children footwear preference is related to idiosyncratic tastes in aesthetics, physical ability and comfort. As children age, societal influences begin to expand the social function of footwear denoting group membership, to include themes that transcend the functional and social function of footwear. The knowledge from this study can inform the development of age group specific tools to evaluate comfort.

Processes and pathways in development via digital media: Examples from word learning

Word learning unfolds over multiple, cascading pathways which support in-the-moment processing and learning. The process is refined with each exposure to a word, and exposures to new words occur across a variety of forms and contexts. However, as children are exposed to more and more digital media, the ways in which children encounter, learn, and build on their vocabulary is also shifting. These shifts represent changes in context, content, and at the level of the child that can lead to negative outcomes. Less work, however, has discussed what these differences mean for how things change in the underlying developmental cascade and learning processes. Here, we suggest that the increasing presence of digital media may shift the developmental pathways for learning (the chain of events that support future learning) but not necessarily the developmental processes (the mechanisms underlying learning). Moreover, the interaction of the two may lead to different behavior and outcomes for learning in a digital era. We argue it is imperative for researchers to not only study how digital media differs from everyday learning, but directly measure if the well-worn pathways, processes, and variables found with decades of research with real items translate to a digital media era.

Motor problems in children with severe emotional and behavioural difficulties

BACKGROUND

There is growing evidence that children with motor difficulties are at risk of psychosocial problems and vice versa. However, it is not clear how far different aspects of motor function are predictive of psychosocial well-being in the context of other powerful factors, such as family upset, that are known to affect psychosocial development.

AIMS

To investigate the role of basic motor skills and primary reflex persistence in young children with severe emotional and behavioural difficulties (EBD).

SAMPLE

From a total sample of 225 children, three groups were selected: children excluded from school (severe EBD) (n = 29), a male comparison group (n = 38), and a female comparison group (n = 45). The groups were matched (at group level) on age, IQ, and level of social disadvantage.

METHOD

All of the selected children completed a range of standardized motor, cognitive, social, and behavioural measures, as well as a clinical protocol for primary reflex persistence.

RESULTS

Children with severe EBD had significant levels of motor difficulties, primary reflex persistence, and family upset, as well as significant literacy problems, attention deficits, and raised levels of hyperactivity/impulsivity relative to the comparison groups. A hierarchical multiple regression analysis revealed that basic motor skills, primary reflex persistence, family upset, hyperactivity, and literacy were all significant predictors of psychosocial functioning.

CONCLUSIONS

The findings suggest that motor difficulties and primary reflex persistence may act as independent stressors of psychosocial functioning in children with EBD. We suggest that specific movement interventions should be adopted to complement existing provision for children at risk of psychosocial problems.

Effects of early social deprivation on epigenetic statuses and adaptive behavior of young children: A study based on a cohort of institutionalized infants and toddlers

Early social deprivation (i.e., an insufficiency or lack of parental care) has been identified as a significant adverse early experience that may affect multiple facets of child development and cause long-term outcomes in physical and mental health, cognition and behavior. Current research provides growing evidence that epigenetic reprogramming may be a mechanism modulating these effects of early adversities. This work aimed to investigate the impact of early institutionalization—the immersion in an extreme socially depriving environment in humans—on the epigenome and adaptive behavior of young children up to 4 years of age. We conducted a cross-sectional study involving two comparison groups: 29 children raised in orphanages and 29 children raised in biological families. Genome-wide DNA methylation profiles of blood cells were obtained using the Illumina MethylationEPIC array; the level of child adaptive functioning was assessed using the Vineland Adaptive Behavior Scales-II. In comparison to children raised in families, children residing in orphanages had both statistically significant deficits in multiple adaptive behavior domains and statistically significant differences in DNA methylation states. Moreover, some of these methylation states may directly modulate the behavioral deficits; according to preliminary estimates, about 7–14% of the deviation of adaptive behavior between groups of children may be determined by their difference in DNA methylation profiles. The duration of institutionalization had a significant impact on both the adaptive level and DNA methylation status of institutionalized children.

Cultural translation and adaptation of the Alberta Infant Motor Scale Thai version

BACKGROUND

The Alberta Infant Motor Scale (AIMS) is a widely used screening tool used to measure gross-motor maturation for clinical and research usage in various countries. A cross-cultural translation and adaptation process is essential to produce reliable and applicable translated assessment tools.

AIMS

The purposes of this cross-sectional study were to obtain the Alberta Infant Motor Scale Thai version and to determine its reliability, validity, and applicability.

METHODS

The process of translation and cultural adaptation of the AIMS Thai version was performed. The conceptual, semantic, and idiomatic equivalences of the language of the AIMS Thai version were strictly reviewed by committee. The intra-rater/inter-rater reliabilities and concurrent validity with the Bayley III were examined in 30 full-term typically developing infants. Then, 19 infants from an orphanage and 23 typically developing infants were assessed using the final translated version of the AIMS.

RESULTS

The AIMS Thai version was generated systematically. Two therapists showed high intra-rater reliability using the Thai AIMS with an ICC of 0.995 (95% CI 0.989-0.998) and 0.979 (95%CI 0.919-0.992), and the inter-rater reliability was 0.988 (95%CI 0.976-0.994). The concurrent validity of the AIMS Thai version and the Bayley III was 0.969 (p < 0.01). The AIMS percentile of gross-motor development of orphaned infants (94.7%) were equal or lower than the 5th percentile, while the AIMS percentile of home-raised infants ranged from the 5th to the 90th percentile.

CONCLUSION

The translated and adapted AIMS Thai version is reliable and valid to use in Thai infants.

Attachment, Development, and Mental Health in Abused and Neglected Preschool Children in Foster Care: A Meta-Analysis

A proper preparation for foster parents to care for abused and neglected children includes effective training and initial diagnostics in order to plan individual treatment. Hence, a basic knowledge about the main psychosocial and developmental problems associated with abuse and neglect and their prevalence in foster children is needed. For this purpose, a systematical literature review and a series of meta-analyses were conducted. A total of 25 studies reporting data on development ( n = 4,033), mental health ( n = 726), and attachment ( n = 255) of foster children in preschool age met the inclusion criteria. The meta-analyses indicated prevalence rates of approximately 40% for developmental, mental health problems, and insecure attachment. Rates of disorganized attachment were estimated to 22%. These findings outline the necessity of an initial trauma-oriented diagnostics and trainings for foster parents that address foster children's development, mental health, and disorganized attachment.

Correlates of Gross Motor Competence in Children and Adolescents: A Systematic Review and Meta-Analysis

Background

Gross motor competence confers health benefits, but levels in children and adolescents are low. While interventions can improve gross motor competence, it remains unclear which correlates should be targeted to ensure interventions are most effective, and for whom targeted and tailored interventions should be developed.

Objective

The aim of this systematic review was to identify the potential correlates of gross motor competence in typically developing children and adolescents (aged 3–18 years) using an ecological approach.

Methods

Motor competence was defined as gross motor skill competency, encompassing fundamental movement skills and motor coordination, but excluding motor fitness. Studies needed to assess a summary score of at least one aspect of motor competence (i.e., object control, locomotor, stability, or motor coordination). A structured electronic literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Six electronic databases (CINAHL Complete, ERIC, MEDLINE Complete, PsycINFO^®, Scopus and SPORTDiscus with Full Text) were searched from 1994 to 5 August 2014. Meta-analyses were conducted to determine the relationship between potential correlates and motor competency if at least three individual studies investigated the same correlate and also reported standardized regression coefficients.

Results

A total of 59 studies were identified from 22 different countries, published between 1995 and 2014. Studies reflected the full range of age groups. The most examined correlates were biological and demographic factors. Age (increasing) was a correlate of children’s motor competence. Weight status (healthy), sex (male) and socioeconomic background (higher) were consistent correlates for certain aspects of motor competence only. Physical activity and sport participation constituted the majority of investigations in the behavioral attributes and skills category. Whilst we found physical activity to be a positive correlate of skill composite and motor coordination, we also found indeterminate evidence for physical activity being a correlate of object control or locomotor skill competence. Few studies investigated cognitive, emotional and psychological factors, cultural and social factors or physical environment factors as correlates of motor competence.

Conclusion

This systematic review is the first that has investigated correlates of gross motor competence in children and adolescents. A strength is that we categorized correlates according to the specific ways motor competence has been defined and operationalized (object control, motor coordination, etc.), which enables us to have an understanding of what correlates assist what types of motor competence. Indeed our findings do suggest that evidence for some correlates differs according to how motor competence is operationalized.

Predictors of motor developmental milestones during the first year of life

Studies suggest that both pre- and postnatal factors are predictors of age of attaining milestones in infancy. However, no studies evaluate the comparative strength of these predictors and the amount of the variance in development they explain. This study aimed to conduct a systematic evaluation of a broad selection of possible predictors of age at milestone attainment and to identify factors that explain significant inter-individual variance. Mothers of 5765 children of the Copenhagen Perinatal Cohort (1959-61) recorded 12 developmental milestones prospectively during the child's first year of life. Information on possible predictors was collected during pregnancy and at follow-up and was categorized into the domains: Family background, Pregnancy and delivery, Postnatal influences, and Postnatal growth. The domain Pregnancy and delivery contributed most of the explained variance in Overall mean of milestones (14.4%), with especially gestational age (β = -0.15; p ≤ 0.001) and birth weight (β = -0.16; p ≤ 0.001) being important predictors.

CONCLUSION

Several individual factors, especially gestational age, birth weight, breastfeeding, having lived in a full-time institution, and weight and head increase in the first year, were significantly associated with milestone attainment in the first year of life. Variables within the domain of Pregnancy and delivery explained the largest proportion of variance in milestone attainment compared to the other domains. What is known: • Younger age at attainment of motor developmental milestones positively predicts cognitive outcomes in adulthood. • Both pre- and postnatal factors have been associated with age of attaining milestones in infancy. What is new: • First study to provide a systematic evaluation of a broad selection of predictors of infant milestone attainment. • Variables within the domain of Pregnancy and delivery, especially gestational age and birth weight, explained the largest proportion of variance in milestone attainment. • The variance explained by the predictors decreased time-dependently with later milestones.

Early developmental milestones and age of independent walking in orphans compared with typical home-raised infants

AIM

Early gross motor development is a major indicator of global milestones in the first year of life, affecting the walking ability of a child. There has been limited research reporting on early motor development and the age of independent walking of orphaned infants compared to typical home-raised infants. The purpose of this study was to compare the mean scores of early gross motor movement at 4, 6 and 8months of age and at the age of walking attainment of typically raised infants and orphaned infants. In addition, we looked to compare the walking age between these same infants.

MATERIALS AND METHODS

This cross-sectional study recruited 59 typical home-raised infants and 62 orphans. Their gross motor development was assessed using the Alberta Infant Motor Scale (AIMS). The age of walking attainment was also prospectively monitored and ascertained. The Student's independent t-test was used to analyse the differences of the AIMS scores at 4, 6 and 8months of age and at the age of independent walking between the two groups.

RESULTS

The orphans showed significantly lower AIMS scores at 4, 6 and 8months of age and the age of independent walking (P-value<0.05). The orphan group had a 5-month older mean age of walking attainment (15.0±4.2months) compared with typical home-raised infants (9.9±1.4months).

CONCLUSION

Orphans have delays in early gross motor development and walk independently at an older age, compared with home-raised infants.

Influences of gender and socioeconomic status on the motor proficiency of children in the UK

As the development of movement skills are so crucial to a child's involvement in lifelong physical activity and sport, the purpose of this study was to assess the motor proficiency of children aged 4-7 years (range=4.3-7.2 years), whilst considering gender and socioeconomic status. 369 children (176 females, 193 males, aged=5.96 ± 0.57 years) were assessed for fine motor precision, fine motor integration, manual dexterity, bilateral co-ordination, balance, speed and agility, upper-limb co-ordination and strength. The average standard score for all participants was 44.4 ± 8.9, classifying the participants towards the lower end of the average score. Multivariate analysis of covariance identified significant effects for gender (p<0.001) and socioeconomic status (p<0.001). Females outperformed males for fine motor skills and boys outperformed girls for catch and dribble gross motor skills. High socioeconomic status significantly outperformed middle and/or low socioeconomic status for total, fine and gross motor proficiency. Current motor proficiency of primary children aged 4-7 years in the UK is just below average with differences evident between gender and socioeconomic status. Teachers and sport coaches working with primary aged children should concentrate on the development of movement skills, whilst considering differences between genders and socioeconomic status.

Influence of nutrition and lifestyle on bone mineral density in children from adoptive and biological families

Background

The precise contributions of hereditary and environmental factors to bone density are not known. We compared lifestyle predictors of bone density among adopted and biological children.

Methods

The study comprised 18 adopted children (mean [SD] age, 14.0 [4.1] years) with their non-biological parents and 17 children with their biological parents. Bone mineral density (BMD; g/cm²) was measured at the lumbar spine, total femur, and distal radius. Nutritional intake was assessed by food frequency questionnaire. Information on smoking and physical activity was obtained by questionnaire.

Results

Intakes of all nutrients, corrected for energy intake, and all lifestyle characteristics except sleep duration were similar in biological children and their parents. As compared with their parents, adopted children had significantly different energy, protein, and calcium intakes and physical activity levels. In a regression model, BMD z scores of adopted children and their parents were significantly inversely associated at the spine and total femur, whereas BMD z scores of biological children and their parents were significantly positively associated at all measurement sites. The greatest proportion of total variance in BMD was accounted for by calcium intake among adopted children and by parental BMD among biological children.

Conclusions

For some lifestyle characteristics and nutrient intakes, the differences between parents and children were more obvious among adoptive families than among biological families. The most important lifestyle predictor of bone density was calcium intake.

Motor outcomes in children exposed to early psychosocial deprivation

OBJECTIVES

To determine the effect of psychosocial deprivation early in life on motor development, assess the impact of a foster care intervention on improving motor development, and assess the association between motor and cognitive outcomes in children with a history of institutional care.

STUDY DESIGN

In a randomized controlled trial, children living in Romanian institutions were randomly assigned to care as usual in the institution or placed in family-centered foster care as part of the Bucharest Early Intervention Project. The average age at placement into foster care was 23 months. At age 8 years, the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form (BOT2-SF) was applied to assess the motor proficiency of children in both groups, as well as a never-institutionalized group from the Romanian community.

RESULTS

Children in the never-institutionalized group did significantly better on the BOT2-SF than children who had ever been institutionalized (P < .001). There was no significant difference in performance between children in the care as usual group and the foster care group. This finding also held true for all individual items on the BOT2-SF except sit-ups. Regression analyses revealed that the between-group and within-group differences in BOT2-SF scores were largely mediated by IQ.

CONCLUSION

Early deprivation had a negative effect on motor development that was not resolved by placement in foster care. This effect was predominantly mediated by IQ. This study highlights the importance of monitoring for and addressing motor delays in children with a history of institutionalization, particularly those children with low IQ.

The consequences of early institutionalization: can institutions be improved? - should they?

BACKGROUND AND SCOPE

The focus of this review is on institutionalized children, one of the most inequitably and severely treated groups of children. Although institutions vary, many share some common characteristics, including large groups, high children: caregiver ratios, many and changing caregivers, and caregiver-child interactions that lack warm, sensitive, contingently-responsive, and child-directed behaviors. Resident children develop poorly physically, mentally, and social-emotionally, but those adopted from institutions display substantial catch-up growth in many domains of development. If they are adopted at an early age, there have been no long-term consequences of institutionalization yet measured; but if institutionalization is prolonged, they display higher rates of long-term deficiencies and problems in many domains.

METHODS

This review is based on a database search of the literature, focusing on the development of children while residents, and the development of post-institutionalized children who have been transitioned from institutions to family care. It also draws on the reports and findings of the St. Petersburg-USA Orphanage Intervention.

FINDINGS

A combination of theories pertaining to attachment (especially caregiver attachment to the infant/toddler), chronic stress, and genetics may explain these outcomes. It appears that caregiver-child interactions are a major contributor to children's outcomes, and interventions in institutions that improve such interactions produce substantial increases in children's physical, mental, and social-emotional development, including for children with disabilities.

CONCLUSIONS

Deinstitutionalization and the creation of comprehensive professional child welfare systems emphasizing family care alternatives is a preferred goal, but this is likely to take many low-resource countries decades to develop. If substantial numbers of children remain in institutions despite best efforts to find families for them, improving the institutions might help to provide all the children with the best care possible under the circumstances.

Early deprivation impairs the development of balance and bilateral coordination

This study examined balance and bilateral coordination skills in a sample of internationally adopted, post-institutionalized (PI) children. We compared the performance of these PI children to two age-matched groups. One was a group of children who were internationally adopted from foster care (FC). The second group consisted of non-adopted children being raised in their birth families, who served as controls (Control). Both PI and FC children scored lower than control children on balance, while PI children scored lower than both FC and control children on bilateral coordination. These results suggest that aspects of institutional rearing impact the development of bilateral coordination, while factors common to internationally adopted children other than institutionalization impact the development of balance. Region of birth (Asia, Latin/South America, Russia/Eastern Europe) did not moderate associations between institutional duration and bilateral coordination.

A translational neuroscience perspective on the importance of reducing placement instability among foster children

Placement instability is a common occurrence among foster children and others involved with child welfare system services, and is associated with negative psychiatric and mental health outcomes. The purpose of this paper is to review and synthesize research in this area and to consider this information in terms of child welfare practice and policy. Evidence from 59 sources is reviewed, including research on (a) the connection between placement instability and poor outcomes; (b) sources of information that can be employed to reliably predict risk for placement instability; and (c) interventions designed to mitigate the effects of placement instability. The available empirical evidence suggests that placement instability and other family chaos is associated with disrupted development of the brain’s prefrontal cortex, which is involved in executive functioning. Poor executive functioning is implicated in elevated risk for ADHD, disruptive behavior disorders, substance abuse, and other forms of disinhibitory psychopathology. This might help to explain the high rates of psychiatric medication prescriptions for foster children. Notably, however, recent research findings have shown that placement instability is both predictable and preventable and that interventions to address placement instability have the potential to mitigate neurobiological and psychiatric effects of prior adversity.