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The motor repertoire in 3- to 5-month old infants with Down syndrome
Dafne Herrero1, Christa Einspieler2, Carolina Y Panvequio Aizawa3
1School of Public Health, University of São Paulo, São Paulo, Brazil.
Insights
Infants with Down syndrome show varied motor skills and postures in early development. Their motor optimality score is lower than typically developing infants but higher than those with cerebral palsy.
Area of Science:
- Developmental Pediatrics
- Genetics
- Neurology
Background:
- Down syndrome is the most common genetic cause of intellectual disability.
- Early developmental studies in Down syndrome are limited.
- Understanding early motor development is crucial for intervention.
Purpose of the Study:
- To describe motor repertoire in 3- to 5-month-old infants with Down syndrome.
- To assess the relationship between pre- and perinatal factors and motor performance.
- To characterize fidgety movements and postures in infants with Down syndrome.
Main Methods:
- Exploratory study of 47 infants with Down syndrome (3-5 months old).
- Video assessment of spontaneous movements and postures, including fidgety movements.
- Calculation of the Motor Optimality Score (MOS).
- Comparison with control groups: infants with cerebral palsy and typically developing infants.
Main Results:
- Infants with Down syndrome had a significantly lower MOS than typically developing infants but higher than infants with cerebral palsy.
- Abnormal fidgety movements (absent, exaggerated, or slow/fast) were observed in a majority of infants.
- Atypical postures and lack of midline movements were noted.
- Preterm birth and congenital heart disease did not correlate with motor performance in this cohort.
Conclusions:
- Significant heterogeneity exists in the early motor repertoire of infants with Down syndrome.
- The findings highlight the variability of the early Down syndrome phenotype.
- Further research is needed to explore the predictive value of early motor repertoire for cognitive outcomes.
Background:
Even though Down syndrome is the most common chromosomal cause of intellectual disability, studies on early development are scarce.
Aim:
To describe movements and postures in 3- to 5-month-old infants with Down syndrome and assess the relation between pre- and perinatal risk factors and the eventual motor performance.
Methods And Procedures:
Exploratory study; 47 infants with Down syndrome (26 males, 27 infants born preterm, 22 infants with congenital heart disease) were videoed at 10-19 weeks post-term (median=14 weeks). We assessed their Motor Optimality Score (MOS) based on postures and movements (including fidgety movements) and compared it to that of 47 infants later diagnosed with cerebral palsy and 47 infants with a normal neurological outcome, matched for gestational and recording ages.
Outcomes And Results:
The MOS (median=13, range 10-28) was significantly lower than in infants with a normal neurological outcome (median=26), but higher than in infants later diagnosed with cerebral palsy (median=6). Fourteen infants with Down syndrome showed normal fidgety movements, 13 no fidgety movements, and 20 exaggerated, too fast or too slow fidgety movements. A lack of movements to the midline and several atypical postures were observed. Neither preterm birth nor congenital heart disease was related to aberrant fidgety movements or reduced MOS.
Conclusions And Implications:
The heterogeneity in fidgety movements and MOS add to an understanding of the large variability of the early phenotype of Down syndrome. Studies on the predictive values of the early spontaneous motor repertoire, especially for the cognitive outcome, are warranted.
What This Paper Adds:
The significance of this exploratory study lies in its minute description of the motor repertoire of infants with Down syndrome aged 3-5 months. Thirty percent of infants with Down syndrome showed age-specific normal fidgety movements. The rate of abnormal fidgety movements (large amplitude, high/slow speed) or a lack of fidgety movements was exceedingly high. The motor optimality score of infants with Down syndrome was lower than in infants with normal neurological outcome but higher than in infants who were later diagnosed with cerebral palsy. Neither preterm birth nor congenital heart disease were related to the motor performance at 3-5 months.
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