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Published on: August 25, 2014
Neuromotor outcomes at school age after extremely low birth weight: early detection of subtle signs
Jennifer C Gidley Larson1, Ida Sue Baron, Kristine Erickson
1Department of Pediatrics, Inova Fairfax Hospital for Children, 3300Gallows Road, Falls Church, VA 22042, USA.
Insights
Subtle motor deficits are common in extremely low birth weight (ELBW) children, even with average cognition. Early assessment of coordination and movement can help initiate timely therapies for school readiness.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Neuroscience
Background:
- Motor impairments are common in extremely low birth weight (ELBW) children.
- Subtle neuromotor deficits may impact cognitive, academic, and behavioral development.
- Early identification of these deficits is crucial for intervention.
Purpose of the Study:
- To examine quantifiable signs of subtle neuromotor dysfunction in school-aged ELBW children.
- To assess ELBW children with age-appropriate cognition and design copying skills.
- To identify specific motor deficits indicative of neural system dysfunction.
Main Methods:
- A cohort of 97 participants (74 ELBW, 23 term-born) aged ~6.6 years was studied.
- Neuromotor outcomes were assessed using the Physical and Neurological Examination of Subtle Signs-Revised.
- Measures included dexterity, coordination, and visual-motor integration.
Main Results:
- ELBW children showed poorer performance in design-copying and dexterity compared to term-born peers.
- Slower timed movements and increased subtle overflow movements were observed in ELBW participants.
- Infants born <26 weeks gestation exhibited the most significant motor impairments.
Conclusions:
- Subtle motor dysfunctions are detectable and quantifiable in school-aged ELBW children, irrespective of cognitive level.
- Early assessment of incoordination, motor speed, and overflow movements is recommended.
- Timely therapies can prepare at-risk ELBW children for school entry and optimize developmental outcomes.
Objective:
Motor impairments are prevalent in children born at extremely low birth weight (ELBW; <1,000 g). Rarely studied are subtle motor deficits that indicate dysfunction or delay in neural systems critical for optimal cognitive, academic, and behavioral function. We aimed to examine quantifiable signs of subtle neuromotor dysfunction in an early school-aged ELBW cohort that coincidentally had age-appropriate cognition and design copying.
Method:
We studied 97 participants born between 1998 and 2001; 74 ELBW (6.7 years ± 0.75) compared with 23 term-born (6.6 years ± 0.29). Neuromotor outcomes were assessed using the Physical and Neurological Examination of Subtle Signs-Revised, and measures of dexterity/coordination and visual-motor integration.
Results:
ELBW participants performed worse than term-born on design-copying and dexterity, were age-appropriate compared to normative data, and had slower timed movements and more subtle overflow movements. Those ELBW born <26 weeks performed most poorly compared with those born 26-34 weeks and term-born.
Conclusion:
Subtle motor dysfunctions are detectable and quantifiable in ELBW children by school age, even in the presence of average cognition. Early age assessment of incoordination, motor speed, and overflow movements should aid initiation of timely therapies to prepare at-risk ELBW children for subsequent school entry and facilitate design of optimal early treatment strategies.
