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Published on: November 21, 2013
Quality of general movements and psychiatric morbidity at 9 to 12 years
Mijna Hadders-Algra1, Hylco Bouwstra, Sabina E Groen
1Department of Paediatrics - Developmental Neurology, University Medical Center Groningen, Developmental Neurology, Groningen, The Netherlands. m.hadders-algra@med.umcg.nl
Insights
Abnormal general movements (GMs) in infancy may predict later behavioral problems. This study found a link between abnormal GMs and Attention Deficit Hyperactivity Disorder (ADHD) with co-occurring psychiatric conditions in school-aged children.
Area of Science:
- Developmental neuroscience
- Pediatric psychology
- Movement analysis
Background:
- General movements (GMs) are fundamental infant motility patterns.
- GM quality can indicate neurological development, but its link to behavioral issues is understudied.
- Early behavioral problems can lead to significant psychiatric morbidity.
Purpose of the Study:
- To investigate the association between abnormal general movements (GMs) and behavioral problems in school-aged children.
- Specifically, to explore the relationship between abnormal GMs and Attention Deficit Hyperactivity Disorder (ADHD), with or without psychiatric comorbidities.
Main Methods:
- Prospective study of 41 infants (25 low-risk, 16 high-risk for neurodevelopmental disorder).
- GM quality assessed at 'writhing' (0-2 months) and 'fidgety' (2-4 months) stages.
- Behavioral outcomes assessed at 9-12 years using parent/teacher reports (CBCL, TRF, ADHD questionnaire) and psychiatric diagnoses.
Main Results:
- Abnormal GMs during writhing and fidgety stages correlated with ADHD and psychiatric comorbidity (p<0.05).
- No significant association found between abnormal GMs and isolated ADHD.
- Abnormal fidgety GMs showed a weak link to school behavioral issues (TRF) and home hyperactivity (ADHD questionnaire).
Conclusions:
- Abnormal general movements in early infancy may signal an elevated risk for behavioral problems.
- The findings suggest a potential early indicator for ADHD with psychiatric comorbidity in later childhood.
Background:
General movements (GMs) form the basic motility of young infants. The quality of GMs may predict neurological outcome, but little is known about relationships between GM-quality and behavioral problems, including those resulting in overt psychiatric morbidity.
Aim:
To explore relationships between abnormal GMs and behavioral problems, in particular relationships between abnormal GMs and Attention Deficit Hyperactivity Disorder (ADHD) with or without psychiatric co-morbidity at school-age.
Methods:
Twenty-five low-risk full term infants and 16 infants at high risk for neurodevelopmental disorder but without cerebral palsy were studied prospectively. GM-quality was assessed during 'writhing' age (around term till 2 months post-term) and 'fidgety' age (2-4 months post-term). GMs were classified into normal and abnormal movements. When the children were 9-12 years, parents completed the Child Behavior Checklist (CBCL) and provided information on the presence of psychiatric diagnoses; teachers completed the Teachers Report Form (TRF). Both parents and teachers completed a questionnaire on ADHD-like behavior.
Results:
Abnormal GMs at 'writhing' and 'fidgety' age were related to the presence of ADHD with psychiatric co-morbidity (p<0.05), but not to isolated ADHD. Abnormal GMs at 'fidgety' age were weakly related to problematic behavior at school (TRF-scores) and hyperactive behavior at home (ADHD-questionnaire).
Conclusions:
This explorative study suggests that abnormal GMs in early infancy may be associated with an increased risk for behavioral problems, in particular for ADHD with psychiatric co-morbidity at school-age.
