Related Experiment Video
Updated: Sep 2, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Minor neurological signs and developmental performance in high risk children at preschool age
Julie Gosselin1, Claudine Amiel-Tison, Claire Infante-Rivard
1School of Rehabilitation, Faculty of Medicine, University of Montreal, Québec, Canada. Julie.Gosselin@umontreal.ca
Insights
Minor neurological findings in at-risk preschoolers correlate with developmental delays in coordination, language, and reasoning. A brief neurological exam can identify early markers of brain damage, aiding timely intervention.
Area of Science:
- Developmental Pediatrics
- Pediatric Neurology
- Child Psychology
Background:
- Children at high risk for developmental issues often present with subtle neurological signs.
- Early identification of neurological deficits is crucial for timely intervention and improved outcomes.
- Placental insufficiency is a known risk factor for adverse neurodevelopmental outcomes.
Purpose of the Study:
- To investigate the relationship between minor neurological abnormalities and developmental performance in high-risk preschoolers.
- To determine if specific neurological findings predict deficits in areas like coordination, language, and reasoning.
- To assess the utility of a brief neurological examination for identifying early markers of brain damage.
Main Methods:
- A cohort of 72 high-risk preschoolers (mean age 3y 8m) was assessed.
- Children were categorized based on neurological status: minimal cerebral palsy, Amiel-Tison triad, intermediate signs, or no findings.
- Developmental performance was evaluated using the Griffiths Mental Developmental Scales, assessing six subscales.
Main Results:
- Significant differences in coordination, language, and practical reasoning were observed based on neurological status.
- Abnormal stretch reflexes, particularly isolated right or bilateral, were associated with poorer language and practical reasoning skills.
- An isolated left stretch reflex showed less association with impaired developmental performance.
Conclusions:
- A concise neurological examination can effectively identify subtle neurological signs indicative of early brain damage.
- These findings highlight the importance of routine neurological screening in high-risk infants and children.
- Early detection through neurological assessment allows for proactive management and support for developmental challenges.
Abstract:
The aim of this study was to establish correlations between minor neurological findings and developmental performance. A cohort of 72 preschool children was studied (38 females, 34 males; mean age 3 years 8 months, SD 1 year 2 months, range 2 to 5 years) who were considered to be at high risk due to placental insufficiency. The cohort was divided into four categories of neurological status: (1) minimal cerebral palsy (MCP) with independent walking before age 2 years; (2) Amiel-Tison triad (ATT) including imbalance of passive axial tone, phasic stretch reflex in triceps surae, and cranial signs, particularly on the squamous suture; (3) intermediate with one or two of the three ATT signs; and (4) absence of neurological findings. Six subscales of the Griffiths Mental Developmental Scales assessing locomotion, eye-hand coordination, interpersonal skills, language, performance, and practical reasoning were administered. Significant differences were found according to neurological status in three specific domains of development: coordination (F=2.84, p=0.04), language (F=3.65, p=0.02), and practical reasoning (F=3.62, p=0.02). In addition, significant differences were also found in language (L) and practical reasoning (R) performances according to the side of the abnormal stretch reflex: bilateral stretches (L=87.8; R=75.3) or an isolated right stretch (L=95.3; R=83.6) are more strongly associated with impaired developmental performances than an isolated left stretch (L=101.3; R=88.2) with F=2.94; p=0.04 for language and F=3.00, p=0.04 for practical reasoning. We concluded that a short neurological examination, easily performed by pediatricians and family practitioners, can identify permanent markers of minor brain damage occurring before, during, or soon after birth and so anticipate consequences.
