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Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Minor neurological dysfunction and associations with motor function, general cognitive abilities, and behaviour in
Lina Broström1, Brigitte Vollmer1,2, Jenny Bolk1,3
1Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Insights
Children born extremely preterm face a higher risk of minor neurological dysfunction (MND), impacting motor skills, cognition, and behavior. This study highlights the long-term neurological and developmental challenges in this vulnerable population.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Child Psychology
Background:
- Extremely preterm birth (before 27 weeks gestation) is associated with increased risks of adverse neurodevelopmental outcomes.
- Minor neurological dysfunction (MND) represents subtle neurological impairments that can affect motor, cognitive, and behavioral development.
- Cerebral palsy (CP) is a well-known outcome of preterm birth, but less is understood about MND in those without CP.
Purpose of the Study:
- To determine the prevalence of minor neurological dysfunction (MND) at age 6 in children born extremely preterm without CP.
- To examine the association between MND and motor function, cognitive abilities, and behavior in this cohort.
- To compare neurological outcomes between extremely preterm infants and term-born controls.
Main Methods:
- A cohort study comparing 80 extremely preterm children (born <27 weeks gestation) with 90 term-born controls at a mean age of 6.5 years.
- Neurological assessment using a simplified Touwen Infant Neurological Examination.
- Evaluations included motor function (Movement Assessment Battery for Children, MABC-2), cognitive abilities (Wechsler Intelligence Scale for Children, WISC-IV), and behavior (Strengths and Difficulties Questionnaire, SDQ; Five to Fifteen questionnaire).
Main Results:
- Significantly higher rates of MND (simple and complex) were observed in the extremely preterm group compared to term-born controls (p<0.001).
- MND in preterm children was associated with poorer motor function (MABC-2, p<0.001), cognitive abilities (WISC-IV, p=0.005), and behavioral problems (SDQ parent-report, p=0.021 for overall, p=0.003 for peer problems).
- Teacher-reported behavioral and hyperactivity problems also differed significantly between children with and without MND (p=0.036 and p=0.019, respectively).
Conclusions:
- Children born extremely preterm without CP are at significant risk for developing minor neurological dysfunction (MND).
- MND in this population is linked to impairments in motor function, cognitive abilities, and behavioral challenges.
- Early identification and intervention for MND are crucial for improving long-term outcomes in extremely preterm survivors.
Aim:
To study the prevalence of minor neurological dysfunction (MND) at 6 years of age in a cohort of children born extremely preterm without cerebral palsy (CP) and to investigate associations with motor function, cognitive abilities, and behaviour.
Method:
This study assessed 80 children born at less than 27 weeks of gestation and 90 children born at term age between 2004 and 2007 at a mean age of 6 years 6 months. The assessments included a simplified version of the Touwen Infant Neurological Examination, the Movement Assessment Battery for Children, Second Edition (MABC-2), Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV), the Strengths and Difficulties Questionnaire (SDQ), and the parent version of the Five to Fifteen questionnaire.
Results:
Fifty-one of the children born preterm had normal neurology, 23 had simple MND, and six had complex MND compared with 88 who had normal neurology and two simple MND in the term-born group (p<0.001). There were significant differences between the children with normal neurology and MND in the preterm group in MABC-2-assessed motor function (p<0.001), general cognitive abilities with WISC-IV (p=0.005), and SDQ overall behavioural problems and peer problems reported by the parents (p=0.021 and p=0.003 respectively). SDQ teacher-reported overall behavioural and hyperactivity problems were significantly different between children with normal and simple MND (p=0.036 and p=0.019).
Interpretation:
Children born extremely preterm, in the absence of CP, are at risk of MND and this is associated with motor function, cognitive ability, and behaviour.
What This Paper Adds:
Extremely preterm birth carries a risk of minor neurological dysfunction (MND). MND in children born extremely preterm is associated with impaired motor function and cognitive abilities, and behavioural problems. Male sex is associated with MND in children born extremely preterm.
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