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Published on: July 1, 2015
Transient tone abnormalities in high risk infants and cognitive outcome at five years
Sudha Chaudhari1, Mangalmurti Bhalerao, Anjali Chitale
1Division of Neonatology, Department of Pediatrics, KEM Hospital, Pune 411 011, Maharashtra, India. kemhrc@vsnl.com
Insights
Transient tone abnormalities in high-risk infants often resolve by 12 months, indicating normal cognitive outcomes by age five, though language skills may be affected. Early diagnosis of cerebral palsy should be cautious.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Child psychology
Background:
- Infant tone abnormalities can indicate developmental issues.
- Early identification of transient tone abnormalities (TTA) is crucial for prognosis.
- High-risk infants require careful monitoring for developmental outcomes.
Purpose of the Study:
- To identify transient tone abnormalities (TTA) in high-risk infants.
- To determine the prevalence of TTA.
- To assess the cognitive outcomes of infants with TTA at five years of age.
Main Methods:
- A prospective cohort observational study followed high-risk infants discharged from a neonatal unit.
- Infant tone was assessed using the Amiel Tison method at 3, 6, 9, and 12 months.
- Cognitive outcomes were evaluated at five years using the Stanford Binet IQ test and the Ayres Preschool Inventory.
Main Results:
- Out of 190 high-risk infants, 67 (35.2%) were classified as having TTA.
- Infants with TTA and normal high-risk infants showed significantly lower IQ scores compared to controls.
- Children with TTA exhibited poorer language development in the preschool inventory.
Conclusions:
- Tone abnormalities detected at 6 months may resolve by 12 months, advising against premature cerebral palsy diagnosis.
- High-risk infants with TTA demonstrate normal cognitive development at five years, with the exception of language skills.
- Transient tone abnormalities warrant careful monitoring but do not necessarily predict long-term cognitive deficits beyond language.
Objective:
to identify transient tone abnormalities and determine its prevalence in high risk infants and their cognitive outcome at 5 years.
Design:
prospective cohort observational study.
Setting:
high risk infants discharged from a level II neonatal unit in a 12 month period, and followed upto 5 years.
Methods:
High risk infants and normal controls were assessed for abnormalities of tone using the method described by Amiel Tison at 3, 6, 9, 12 months. An IQ by Stanford Binet method and a preschool inventory by Ayres, Bobath was done at 5 years. Those infants who had normal tone at 6 and 12 months were called normal high risk (HR) group and those who had abnormalities at 6 months, which disappeared at 12 months, were called the transient tone abnormalities (TTA) group.
Results:
out of 190 high risk infants, 113 were normal HR and 67 (35.2%) were labeled as TTA. Ten infants with cerebral palsy had abnormal tone throughout the first year. Controls had normal tone throughout the follow-up period. Although there was no difference in the IQ of the TTA group (98.5 ± 12.4) and the normal HR (99.1 ± 13.1) group, it was significantly less (P=0.04) than that of controls (106.1 ± 9.1). Preschool inventory in TTA children showed poor language development (P=0.014).
Conclusion:
many of the tone abnormalities detected at 6 months resolve by 12 months, hence a hasty diagnosis of cerebral palsy should not be made. High risk infants with transient tone abnormalities have a normal cognitive outcome at 5 years, except for poor language skills.
