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

Uncovering distinct motor development trajectories in infants during the first half year of life

Infants undergo significant developmental changes in the first few months of life. While some risk factors increase the risk of developmental disability, such as preterm birth, the developmental trajectories of infants born pre-term (PT) and full-term (FT) present with individual variability. This study aims to investigate whether the utilization of data-driven unsupervised machine learning can identify patterns within groups of infants and categorize infants into specific developmental trajectories. Thirty-four infants, 19 FT and 15 PT, were assessed with the gross and fine motor subscales of the Bayley Scales of Infant and Toddler Development, version III (BSID-III) monthly for 2-5 visits between the ages of 1 and 6 months. Latent class growth analysis (LCGA) models were adopted to identify clusters of motor developmental trajectories during this critical time. Based on statistical significance, the linear, 2-class trend was selected as the best-fitting model for both gross and fine motor trajectories. Within this, LCGA reveals 2 developmental trends with varying beginning scores and developmental rates, including the low-baseline slow-growth (LBSG) subgroup, and the high-baseline fast-growth (HBFG) subgroup, with age (adjusted for prematurity) being equally distributed across both subgroups. Both subgroups, HBFG and LBSG, had a combination of infants born FT and PT (55% FT in HBFG, 56% FT in LBSG), supporting that preterm birth alone may not sufficiently categorize an infant's developmental trajectory. The later BSID-III gross motor score showed marginal difference between groups (p = 0.062). Similarly, the fine motor model displayed a mixture of both infants born FT and PT (68% FT in HBFG, 40% FT in LBSG). In this case, the late motor composite BSID score was different between groups (p = 0.04). Our study uses a novel approach of LCGA to elucidate heterogeneous trajectories of motor development for gross and fine motor skills during the first half of life and offers potential for early identification of subgroup membership. Furthermore, these findings underscore the necessity for individualized risk assessments and intervention strategies tailored to individual needs. Ultimately, further validation of these models may provide usefulness in uncovering distinct motor development trajectories in infants.

Sitting Acquisition and Early Communication Development: Are There Associations in Very Preterm Infants at Six Months of Corrected Age?

Background: Research in typically and some atypically developing populations showed associations between early motor and communication development, documenting how postural development can support communicative advancements. However, these relations have scarcely been investigated in the preterm population. Aims: The present study aimed to describe motor (gross and fine motor) and communication (receptive and expressive) skills of very preterm infants at six months of corrected age and their associations, focusing on sitting posture achievement and early vocal production. Methods: Seventy very preterm infants (≤32 weeks) with no major brain injuries were assessed with the BSID-III for gross and fine motor skills, receptive and expressive language skills, and cognitive skills and were categorized as mastering (sitters), partially mastering (emerging sitters), or not mastering (non sitters) unsupported sitting. The proportional duration of sitting postures (caregiver supported, arms supported, and unsupported) in an observative section was coded with the Interact software (version 20.8.3.0). Frequency per minute of vocal utterances (vocalizations, babbling, and total) during a parent-infant play interaction was coded with the CHILDES software v11. Results: Correlational analyses showed significant positive associations between motor composite score and language scores (composite and expressive scaled) and between gross motor and expressive language scaled scores but a negative association between arms supported sitting duration and vocal utterances. In addition, ANCOVAs showed that sitters had significantly higher BSID-III expressive language scaled scores and vocal utterances than non sitters and emerging sitters. Conclusions: These findings brought new evidence linking early motor and vocal development in very preterm infants, emphasizing the importance of using observational tools alongside standardized ones to identify developmental delays and plan tailored intervention programmes.

Physiotherapy Intervention on Premature Infants-A Pilot Study

Background and Objectives: Considering the fact that prematurity echoes in terms of motor development even up to the age of adolescence, through the presence of deficiencies, the importance of starting kinetotherapeutic treatment as soon as possible is highlighted, even in the absence of brain damage or obvious motor delays. Therefore, the objectives of this study are to analyze the factors that influence the level of motor development of premature babies up to 9 months and identify the motor development curve of premature babies according to the three stages of motor development: the position of symmetrical support on the elbows at 3 months, sitting with support at 6 months, and verticalization at 9 months. Materials and Methods: This prospective pilot study was conducted within a rehabilitation facility located in Targu Mureș, Romania, spanning a duration of 2 years from June 2021 to 2023. Results: The study involved a population of 78 children, all premature infants, selected from the patient pool of the rehabilitation facility, specifically chosen based on adherence to the predetermined inclusion and exclusion criteria outlined in the study protocol. Two physiotherapists specialized in child recovery were involved in the study, and one performed the assessments and the other applied the Bobath therapy. Conclusions: Early physiotherapy interventions can have a positive influence in terms of reducing differences in motor development between preterm and full-term infants. This study identified several factors that influence the motor development of premature infants. Among these, the most prominent biological factors were gestational age and birth weight.