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Published on: November 21, 2013
Specific characteristics of abnormal general movements are associated with functional outcome at school age
Elisa G Hamer1, Arend F Bos2, Mijna Hadders-Algra3
1Department of Pediatrics, Division of Developmental Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands.
Insights
Assessing general movements (GMs) in infancy can predict developmental disorders. Specific GM characteristics like fidgety and stiff movements are linked to cerebral palsy and special education needs in children.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Movement Science
Background:
- General Movements (GMs) assessment is a non-invasive method for early identification of infants at risk for developmental disorders.
- Abnormal GMs in infancy can indicate underlying neurological issues affecting development.
Purpose of the Study:
- To determine if specific characteristics of definitely abnormal GMs in infancy correlate with developmental outcomes at school age.
- Investigating the predictive value of infant GM quality for long-term neurological and behavioral development.
Main Methods:
- An observational cohort study with long-term follow-up.
- Included 40 children with definitely abnormal GMs in infancy (median corrected age 10 weeks).
- Outcome measures included parental interviews (cerebral palsy, special education), Vineland Adaptive Behavior Scale, Developmental Coordination Disorder Questionnaire (DCD-Q), and Child Behavior Checklist.
Main Results:
- Absence of fidgety movements and presence of stiff movements were significantly associated with cerebral palsy (CP).
- Stiff movements also correlated with the need for special education.
- Lack of movement complexity and variation was linked to behavioral problems.
- No GM characteristics were associated with DCD-Q scores.
Conclusions:
- Evaluation of fidgety movements and movement stiffness enhances the predictive power of abnormal GMs for motor outcomes, especially CP.
- The quality of infant GMs reflects brain integrity and aids in predicting long-term developmental outcomes.
- GM assessment provides valuable insights into early brain development and potential risks.
Background:
Assessing the quality of general movements (GMs) is a non-invasive tool to identify at early age infants at risk for developmental disorders.
Aim:
To investigate whether specific characteristics of definitely abnormal GMs are associated with developmental outcome at school age.
Study Design:
Observational cohort study (long-term follow-up).
Subjects:
Parents of 40 children (median age 8.3 years, 20 girls) participated in this follow-up study. In infancy (median corrected age 10 weeks), the children (median gestational age 30.3 weeks; birth weight 1243 g) had shown definitely abnormal GMs according to Hadders-Algra (2004). Information on specific GM characteristics such as the presence of fidgety movements, degree of complexity and variation, and stiff movements, was available (see Hamer et al. 2011).
Outcome Measures:
A standardised parental interview (presence of CP, attendance of school for special education, Vineland Adaptive Behavior Scale to determine functional performance) and questionnaires (Developmental Coordination Disorder Questionnaire [DCD-Q] to evaluate mobility and Child Behavior Checklist to assess behaviour) were used as outcome measures.
Results:
Six children had cerebral palsy (CP), ten children attended a school for special education, and eight children had behavioural problems. Both the absence of fidgety movements and the presence of stiff movements were associated with CP (p=0.001; p=0.003, respectively). Stiff movements were also related to the need of special education (p=0.009). A lack of movement complexity and variation was associated with behavioural problems (p=0.007). None of the GM characteristics were related to DCD-Q scores.
Conclusions:
The evaluation of fidgety movements and movement stiffness may increase the predictive power of definitely abnormal GMs for motor outcome--in particular CP. This study endorses the notion that the quality of GMs reflects the integrity of the infant's brain, assisting prediction of long-term outcome.
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