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Inability of infants to push up in the prone position and subsequent development

Ayako Senju^1,2, Masayuki Shimono², Mayumi Tsuji³

¹Regional Center for Japan Environment and Children's Study (JECS), University of Occupational and Environmental Health, Kitakyushu, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society

|June 16, 2018

Insights

Infants unable to maintain prone position with extended arms at 6 months show developmental delays. These delays persist, particularly in gross motor skills, suggesting early intervention may be beneficial.

Area of Science:

Pediatric Development
Infant Motor Skills
Developmental Pediatrics

Background:

Routine screening identifies infants struggling with prone positioning at 6 months.
Limited data exists on the developmental trajectory of these infants.
This study examines the long-term development of infants with this characteristic.

Purpose of the Study:

To investigate the developmental course of full-term infants unable to maintain prone position with extended arm support at 6 months.
To compare the development of infants with and without this motor skill.
To identify potential areas and duration of developmental lag.

Main Methods:

2,020 full-term infants from the Japan Environment and Children's Study were enrolled.
Development was assessed using the Ages and Stages Questionnaire (ASQ-3) at multiple time points (0.5 to 3 years).
Infants were grouped based on their ability to maintain prone position with extended arms at 6 months for comparative analysis.

Main Results:

A significant gross motor delay was observed in infants unable to maintain prone position at 6 months, persisting until 3 years.
Delays were also noted in communication, fine motor, problem-solving, and personal-social domains, with varying durations.
Effect sizes for most domains decreased over time, becoming relatively small after 1.5 years.

Conclusions:

Infants with difficulty in prone positioning exhibit developmental lags compared to their peers.
While delays diminish over time, they can be persistent, especially in gross motor skills.
Early intervention should be considered for infants experiencing problematic or persistent developmental delays.

Read full analysis

Abstract

Background:

During routine health screening, some infants cannot maintain the prone position with extended arm support at 6 months. Little is known, however, about the development of full-term infants with this developmental deviation. We investigated the developmental course of infants with this characteristic.

Methods:

We enrolled 2,020 full-term infants who had been recruited at a regional center for the Japan Environment and Children's Study. Their development was measured using the Ages and Stages Questionnaire, third edition, at 0.5, 1, 1.5, 2, 2.5, and 3 years. The children were grouped according to their ability to stay prone on extended arms at 6 months, and their development was compared.

Results:

A total of 1,625 infants could stay prone on extended arms and 179 could not. We excluded 212 infants who could stay prone on extended arms only sometimes, and four who did not have a questionnaire response. In the gross motor domain, significant difference in questionnaire scores was observed between the "could" and "could-not" groups at 6 months (Hedges' g, 1.83) and persisted until 3 years (Hedges' g, 0.33). Significant differences were also observed in the communication, fine motor, problem solving, and personal-social domains at 6 months (Hedges' g, 0.20-0.58) and persisted until 1, 2, 2, and 1.5 years, respectively (Hedges' g, 0.21-0.25).

Conclusions:

Infants who cannot maintain the prone position on extended arms lag behind those who can, although the effect sizes become relatively small after 1.5 years of age. Early intervention may be considered if delay is problematic or persistent.

Keywords:

child development child development deviation motor skills prone position

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