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Predictive value of early motor evaluation in preterm very low birth weight and term small for gestational age
Kari Anne I Evensen1, Jon Skranes, Ann-Mari Brubakk
1Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. karianne.i.evensen@ntnu.no
Insights
Early motor assessments like the Psychomotor Development Index (PDI) and Peabody Developmental Motor Scales (PDMS) can predict later motor skills in preterm and small for gestational age children. A normal motor exam at 1 and 5 years reliably predicts normal development at age 14.
Area of Science:
- Developmental Pediatrics
- Neuroscience
- Child Psychology
Background:
- Motor problems are prevalent in children born preterm or small for gestational age (SGA).
- Early identification of motor deficits is crucial for timely intervention and improved outcomes.
- Understanding the predictive value of early assessments aids in targeted developmental support.
Purpose of the Study:
- To evaluate the predictive accuracy of early motor assessments for identifying later motor skill deficits.
- To compare the effectiveness of different motor assessments (PDI, PDMS, Movement ABC) in predicting adolescent motor skills.
- To determine the predictive value of early assessments across different risk groups: very low birth weight (VLBW), SGA, and term-born controls.
Main Methods:
- Longitudinal study involving 28 VLBW, 57 SGA, and 77 term-born control children.
- Motor skills assessed at age 1 (PDI), age 5 (PDMS), and age 14 (Movement ABC).
- Analysis of sensitivity and specificity of low/borderline low scores for predicting motor problems at age 14.
Main Results:
- The Psychomotor Development Index (PDI) and Peabody Developmental Motor Scales (PDMS) showed good sensitivity for identifying motor problems in VLBW children at age 14.
- PDMS demonstrated moderate sensitivity in SGA and control groups, with improved prediction when borderline scores were included.
- High specificity for both PDI and PDMS was observed across all groups, indicating accurate identification of children without motor problems.
Conclusions:
- PDI and PDMS are valuable for early detection of motor issues in VLBW infants.
- PDMS is a better predictor of later motor problems in SGA and control children.
- Normal motor assessments at 1 and 5 years strongly predict normal motor skills in adolescence across all groups.
Background:
Motor problems are common in children born preterm or small for gestational age.
Aim:
To study the predictive value of early motor assessments for later motor skills.
Subjects:
Twenty-eight children born preterm with very low birth weight (VLBW: birth weight
Methods:
The psychomotor development index (PDI) of the Bayley Scales of Infant Development was used as a measure of motor skills at age one, the Peabody Developmental Motor Scales (PDMS) at age five and the Movement Assessment Battery for Children (Movement ABC) at age 14. Low/borderline low scores were defined as <-2SD/-1SD (PDI) or <5th/15th centile (PDMS; Movement ABC).
Results:
In the VLBW group, motor problems in adolescence were identified both by low PDI (sensitivity: 0.80; 95%CI:0.38-0.96) and PDMS scores (sensitivity: 0.83; 95%CI:0.44-0.97). In the SGA and the control group sensitivity was poor for low PDI and moderate for low PDMS scores. However, in the SGA group, sensitivity increased when borderline low PDMS scores were used as cut-off (sensitivity: 0.75; 95%CI:0.41-0.93). Specificity of PDI and PDMS was high in all three groups.
Conclusions:
Both PDI and PDMS may be valuable tools for early identification of motor problems in VLBW children, whereas PDMS best predicted motor problems in the two other groups. In all three groups, a normal motor examination at 1 and 5 years was highly predictive of normal motor skills at age 14.
