Desenvolvimento motor de crianças prematuras e a termo: uso da Alberta Infant Motor Scale

Early childhood development monitoring during the first thousand days: Investigating the relationship between the developmental surveillance instrument and standardized scales

OBJECTIVE

This study aims to investigate the relationship between the Developmental Surveillance Instrument -Instrumento de Vigilância do Desenvolvimento (IVD), found in the Child's Booklet Caderneta da Crianca (CC), and standardized scales: Alberta Infant Motor Scale (AIMS) and Denver Developmental Screening Test (Denver-II).

METHODS

Employing an exploratory observational approach, we adopted a prospective longitudinal design with a quantitative approach. The convenience sample included 83 Brazilian children born between May and August 2019 in a public hospital. Of the total, 45 (54.22 %) were male, and 38 (45.78 %) were female. Developmental screening utilized the IVD, AIMS and Denver-II tests. Comparative analysis between groups employed Mann-Whitney or Kruskal-Wallis tests for numerical variables and chi-square/Fisher tests for categorical variables, with a significance level of 5 % (p < 0.05).

RESULTS

A significant correlation was observed between the IVD and the AIMS and Denver-II tests (p < 0.001) at months 1, 4, and 8.

CONCLUSION

The presence of a robust correlation between the IVD and the AIMS and Denver-II tests at months 1, 4, and 8 implies that the IVD in the Child's Booklet serves as a reliable and effective indicator for screening infant development during this critical period. Detecting issues early through these methods is crucial to ensure the well-being of children, allowing for appropriate interventions as needed.

Predicting Age of Independent Walking in Preterm Infants: A Longitudinal Study Using Neonatal Characteristics and Motor Development Variables

OBJECTIVE

To formulate an equation estimating months to independent walking in moderate to late preterm infants based on neonatal characteristics and gross motor development from 7 months to independent walking.

METHODS

Sixty infants born between 32 to 36 weeks were assessed using Alberta Infant Motor Scale (AIMS) for gross motor development. Neonatal characteristics were recorded at 7 months, and caregiver-reported independent walking onset. Pearson correlation analyzed age, AIMS scores, and neonatal factors. Multiple regression developed the prediction equation.

RESULTS

The equation for independent walking onset, which included gestational age (GA) at birth, total AIMS score at 10 months of age (10th AIMS), and birth head circumference (BHC), exhibited a strong correlation (r=0.707) and had a predictive power of 50.0%. The equation is as follows: age onset of independent walking (months)=33.157, -0.296 (GA), -0.132 (10th AIMS), -0.196 (BHC), with an estimation error of 0.631 months.

CONCLUSION

Neonatal characteristics, such as GA, 10th AIMS, and BHC, are key determinants in estimating the onset of independent walking in moderate to late preterm infants.

Early motor development: risk factors for delay in a population study in Southern Brazil

OBJECTIVE

To assess risk factors associated with motor development delay at three months of age.

METHODS

Cross-sectional study with mothers and their three-month-old babies in Southern Brazil. The Bayley-III Scale of Infant and Toddler Development (BSID-III) and the Alberta Infant Motor Scale (AIMS) were used to assess motor development.

RESULTS

We evaluated 756 mothers and their three-month-old babies. The overall mean motor development assessed by the BSID-III and the AIMS was 104.7 (SD 13.5) and 55.4 (SD 25.4), respectively. When assessed by the BSID-III, the lowest motor development scores were among babies born by cesarean delivery (p = 0.002), prematurely (p < 0.001), and with low birth weight (p < 0.001). When assessed by the AIMS, babies born prematurely (p = 0.002) and with low birth weight (p=0.004) had the lowest motor development means. After a cluster analysis, we found that babies born by cesarean delivery, with low birth weight, and prematurely had more impaired motor development compared with children born without any risk factors.

CONCLUSION

Identifying risk factors allows the implementation of early interventions to prevent motor development delay and, therefore, reduce the probability of other future problems.

Motor Development Comparison between Preterm and Full-Term Infants Using Alberta Infant Motor Scale

The Alberta Infant Motor Scale (AIMS) was developed to evaluate the motor development of infants up to 18 months of age. We studied 252 infants in three groups (105 healthy preterm infants (HPI), 50 preterm infants with brain injury (PIBI), and 97 healthy full-term infants (HFI) under 18 months, corrected age (CoA)) using AIMS. No significant differences were found among HPI, PIBI, and HFI in infants less than 3 months old, yet significant differences were noted in positional scores (p < 0.05) and total scores for those four to six months of age and seven to nine months of age. A significant difference was also found in standing items for infants over 10 months (p < 0.05). After four months, there was a difference in motor development between preterm (with and without brain injury) and full-term infants. In particular, there was a significant difference in motor development between HPI and HFI and between PIBI and HFI at four to nine months, when motor skills developed explosively (p < 0.05). After four months, motor developmental delays (10th ≥) were observed in HPI and PIBI at rates of 26% and 45.8%, respectively. Midline supine development, a representative indicator of early motor development, was slower even in healthy preterm infants than in full-term infants. AIMS has a good resolution to discriminate preterm infants who are showing insufficient motor development from 4 months to 9 months.

Factors Associating with the Segmental Postural Control during Sitting in Moderate-to-Late Preterm Infants via Longitudinal Study

(1) Background: biological variables and particular child rearing practices could be linked to postural control and rates of sitting onset. The segmental Assessment of Trunk Control (SATCo) is currently used as an assessment of postural control with a specific segment on premature infants. However, the association between related factors and segmental trunk control during sitting development in preterm infants via longitudinal assessments is still limited. Objective: to investigate the associations between biological and child rearing factors and segmental trunk control during sitting in moderate to late premature birth from the age of 4 months to age of independent sitting attainment. (2) Methods: forty-two infants born between 32 and 36 weeks of gestation were recruited. Their segmental trunk control was assessed using the SATCo. Their related factors were recorded from the age of 4 months to early onset of independent sitting attainment. The generalised estimating equation (GEE) model was used to identify the association between related factors and the SATCo with a linear distribution. (3) Results: cause of prematurity, baby rocking recliner and baby walker usage were negative factors, while play in a sitting position, opportunity to move on a traditional mat and sleep mattress were positive factors contributing to the segmental control of the trunk. (4) Conclusions: the experience of sitting on different surfaces and an opportunity to sit without support during the child rearing period from age of 4 months corrected could be positive factors associating with the segmental trunk control in moderate-to-late premature infants.

Motor trajectories of preterm and full-term infants in the first year of life

BACKGROUND

Motor development occurs throughout periods of motor skill acquisition, adjustment and variability. The objectives of this study were to analyze and compare biological and health characteristics and motor skill acquisition trajectories in preterm and full-term infants during the first year of life.

METHODS

Two thousand, five hundred and seventy-nine infants (1,361 preterm) from 22 states were assessed using the Alberta Infant Motor Scale. Multivariate General Linear Model, t-tests, ANOVA, and Tukey tests were used.

RESULTS

An age × group significant interaction was found for motor scores. On follow-up tests full-term infants had higher scores in prone, supine, sitting and standing postures that require trunk control from 9 to 10 months of age; although this advantage was observed for sitting from the second month of life.

CONCLUSION

During the first trimester of life, preterm infants have higher scores in the supine and standing postures. Regarding motor trajectories, from newborn to 12 months, the period of higher motor acquisition was similar between full-term and preterm infants for prone (3-10 months), supine (1-6 months), and standing (6-12 months). For the sitting posture, however, full-term infants had a period of intensive motor learning of acquisition from the first to 7 months of life, whereas for preterm infants a shorter period was observed (3-7 months).

CONCLUSION

Although the periods of higher motor acquisition were similar, full-term infants had higher scores in more control-demanding postures. Intervention for preterm infants needs to extend beyond the first months of life, and include guidance to parents to promote motor development strategies to achieve control in the higher postures.

Relationships Among 3 Movement Analysis Tests in Preterm Infants

PURPOSE

To investigate the relationships among the Infant Motor Profile (IMP), the Neuro-Sensory Motor Developmental Assessment (NSMDA), and the Alberta Infant Motor Scale (AIMS) in prematurely born infants.

METHODS

Sixty-one preterm infants with a birth weight under 2500 g were assessed by the IMP, the NSMDA, and the AIMS.

RESULTS

There was a significant correlation between the IMP total score and the AIMS percentile and between the IMP total score and the NSMDA functional levels. There were significant correlations between the AIMS percentile age and the NSMDA functional levels and between the AIMS total scores and the IMP total scores. In the infants with atypical development, the relationship was significant between the AIMS and the IMP; however, there was no relationship between the IMP and the NSMDA.

CONCLUSIONS

The 3 movement analysis tests are related. The IMP was found to be consistent with other movement analysis tests.

Motor development’s curves of premature infants on the first year of life according to Alberta Infant Motor Scale

Abstract Introduction: The motor trajectory of pre-term children is an important indicator of health during infancy, since alterations may be a signal for the need of professional intervention. Objective: To describe percentiles and motor development curves for Brazilian preterm infants in the first year of life, determining the reference values for categorization of motor performance assessed by the AIMS. Methods: Participated in this cross-sectional study 976 children born pre-term, newly-born to 12 months of corrected age. The Alberta Infant Motor Scale (AIMS) was used to assess participants’ motor development. The scores of the Brazilian norms were used as comparison criteria. Results: Children born pre-term showed lower scores compared to children born full-term indicating the need for a specific percentile curve for that population. The scores differentiated at P1 to P99 percentiles allowing for the categorization of children with typical development, at risk and with atypical development. At 0, 4, 8, 9, 10, 11 and 12 months an overlapping of extreme percentiles (P1, P5 and P10; P90, P95 and P99) was observed, but not in the other percentiles. Conclusion: The percentiles described indicate that preterm children presented lower motor performance than full-term children and AIMS has discriminant power for the clinical evaluation of these children. The developmental curves showed lower capacity for behavioral differentiation in the extreme percentiles.

Investigation of the Relationship Between Sensory Processing and Motor Development in Preterm Infants

OBJECTIVE

The aim of this study was to analyze the correlation between sensory processing and motor development in preterm infants.

METHOD

We included 30 preterm and 30 term infants with corrected and chronological ages between 10 and 12 mo. We used the Test of Sensory Functions in Infants to evaluate sensory processing and the Alberta Infant Motor Scale to evaluate motor development.

RESULTS

The Spearman correlation test indicated a strong positive relationship between sensory processing and motor development in preterm infants (r = .63, p < .001).

CONCLUSION

Given the relationship between sensory processing and motor development in the preterm group, the evaluation of sensory processing and motor development in preterm infants was considered necessary for the effective implementation of physiotherapy assessment and interventions.

Motor development of preterm infants assessed by the Alberta Infant Motor Scale: systematic review article

OBJECTIVE

Premature newborns are considered at risk for motor development deficits, leading to the need for monitoring in early life. The aim of this study was to systematically review the literature about gross motor development of preterm infants, assessed by the Alberta Infant Motor Scale (AIMS) to identify the main outcomes in development.

DATA SOURCE

Systematic review of studies published from 2006 to 2015, indexed in Pubmed, Scielo, Lilacs, and Medline databases in English and Portuguese. The search strategy included the keywords: Alberta Infant Motor Scale, prematurity, preterm, motor development, postural control, and follow-up.

DATA SUMMARY

A total of 101 articles were identified and 23 were selected, according to the inclusion criteria. The ages of the children assessed in the studies varied, including the first 6 months up to 15 or 18 months of corrected age. The percentage variation in motor delay was identified in the motor outcome descriptions of ten studies, ranging from 4% to 53%, depending on the age when the infant was assessed. The studies show significant differences in the motor development of preterm and full-term infants, with a description of lower gross scores in the AIMS results of preterm infants.

CONCLUSIONS

It is essential that the follow-up services of at-risk infants have assessment strategies and monitoring of gross motor development of preterm infants; AIMS is an assessment tool indicated to identify atypical motor development in this population.

CHILD GROWTH: CONCEPT ANALYSIS

ABSTRACT The aim of this study was to analyze the concept of child growth by identifying the attributes and consequences that make up the phenomenon. The concept analysis was supported by 41 studies and based on the evolutionary analysis model and integrative literature review. Five databases, Scopus, CINAHL, LILACS, PubMed, and the Cochrane Library were searched to select articles. The search found that growth has presented different connotations, including social and physiological aspects, which are part of the physical domain of child development. Attributes, antecedents, and consequences identified provide an overview of the phenomenon analyzed, because these point out several aspects previously related to other studies on child growth. The theoretical understanding about child growth can offer nurses in-depth knowledge about factors involved in this process, facilitating intervention-based decision-making.

Integrated sensory motor system in prematurely born children

PURPOSE

To investigate about an integrated sensory motor system existence in premature newborns, submitted to gustatory stimulation.

METHODS

Analytical and experimental study of contents, double-blind. Being participants 90 premature newborns, divided into two groups (water or sucrose analysis 12%). Recorded by 15 minutes (first and last moments, without stimulation; and second time with gustatory stimulation). Three independent judges analyzed the behaviors in the right hand and left hand in the mouth and suction in the left and right and hand during the various behavioral states, those being inserted in the database of Statistical Package for Social Science, being then considered that the events observed by at least two of them. It was made use of Spearman' s rank correlation test on a significance level by p<0.05.

RESULTS

Considering the groups both separately and together, right and left had initially moderate correlation, being right hand in the mouth remained strong at the end and left hand in the mouth finished on moderate and strong correlation, according to each behavioral state. Right hand suction in its total and sucrose showed a strong correlation initially in drowsy state, becoming moderate at the end. In alertness state there was initially a weak correlation in both stimuli ending in moderate correlation in sucrose and strong in water. Left hand suction presented initially moderate correlation on the alert state, ending in weak correlation in sucrose stimuli, which did not occur in the water that started and finished strong.

CONCLUSION

The oral stimulation influenced the hand-mouth coordination, showing early motor sensory integration. However, there was no discrimination about the gustatory capacity on the newborns.

Cross-cultural analysis of the motor development of Brazilian, Greek and Canadian infants assessed with the Alberta Infant Motor Scale

OBJECTIVE

To compare the motor development of infants from three population samples (Brazil, Canada and Greece), to investigate differences in the percentile curves of motor development in these samples, and to investigate the prevalence of motor delays in Brazilian children.

METHODS

Observational, descriptive and cross-sectional study with 795 Brazilian infants from zero to 18 months of age, assessed by the Alberta Infant Motor Scale (AIMS) at day care centers, nurseries, basic health units and at home. The Brazilian infants' motor scores were compared to the results of two population samples from Greece (424 infants) and Canada (2,400 infants). Descriptive statistics was used, with one-sample t-test and binomial tests, being significant p ≤ 0.05.

RESULTS

65.4% of Brazilian children showed typical motor development, although with lower mean scores. In the beginning of the second year of life, the differences in the motor development among Brazilian, Canadian and Greek infants were milder; at 15 months of age, the motor development became similar in the three groups. A non-linear motor development trend was observed.

CONCLUSIONS

The lowest motor percentiles of the Brazilian sample emphasized the need for national norms in order to correctly categorize the infant motor development. The different ways of motor development may be a consequence of cultural differences in infant care.

[Clinical outcomes in the first year of life of premature infants]

The aim of this retrospective cohort study was to investigate clinical outcomes of the first year of life of premature infants discharged from the Neonatal Intensive Care Unit (NICU) based on mortality and readmission data, and the motor development of the children. The sample consisted of 170 children with gestational age under 37 weeks and who survived hospitalization in neonatal intensive care unit (NICU). Data were collected from medical records, the hospital IT system and telephone interview with the caregiver. The authors found 100% survival during the study period and that 39.4% of the infants were often readmitted (26.5%) due to respiratory conditions. Their development was considered as expected, when using the corrected age. In conclusion, the premature infants from this study showed good clinical evolution of the proposed observation.