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Neurological condition assessed with the Hempel examination and cognition and behaviour at 4years
Pamela Schendelaar1, Jorien Seggers1, Maas Jan Heineman2
1University of Groningen, University Medical Center Groningen, Dept Paediatrics, Div Developmental Neurology, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Aim:
To investigate associations between neurological condition, assessed with the Hempel examination, in terms of minor neurological dysfunction (MND) and neurological optimality, and cognition and behaviour at 4years.
Study Design:
Cross-sectional analyses within a prospective, assessor-blinded follow-up study.
Subjects:
Four-year-old singletons born to subfertile parents (n=235; 120 boys).
Outcome Measures:
Outcome parameters were complex minor neurological dysfunction (complex MND) and the neurological optimality score (NOS). Cognitive outcome was evaluated with the Kaufman Assessment Battery for Children, resulting in a total intelligence quotient (IQ). Behavioural outcome was evaluated with the Child Behavior Checklist, resulting in a total problem T-score.
Results:
Fifty-seven (24.3%) children had complex MND. None of the children showed fine motor dysfunction, suggesting a ceiling effect of the Hempel assessment. Complex MND was not correlated with IQ or total problem T-score. Nevertheless, a higher NOS was correlated with a higher IQ and a lower total problem T-score (adjusted mean estimate [95% confidence interval]: cognition: 0.445 [0.026; 0.865], p=0.038; behaviour: -0.458 [-0.830; -0.087], p=0.016).
Interpretation:
At age 4, complex MND assessed with the Hempel assessment was not associated with cognition and behaviour, presumably due to a ceiling effect in the Hempel domain of fine motor function. A more optimal neurological condition was associated with higher IQ and better behaviour.
