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Published on: December 15, 2010
Hand Function at 18-22 Months Is Associated with School-Age Manual Dexterity and Motor Performance in Children Born
Andrea F Duncan1, Carla M Bann2, Nathalie L Maitre3
1Division of Neonatology and Department of Pediatrics, Children's Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Insights
Early hand function deficits in preterm infants predict later motor skill challenges, including manual dexterity issues, at school age. These findings highlight the need for early intervention to support long-term development and school success.
Area of Science:
- Developmental Pediatrics
- Neuroscience
- Rehabilitation Medicine
Background:
- Extremely preterm birth is associated with developmental challenges.
- Early identification of motor deficits is crucial for timely intervention.
- Hand function assessment in infancy can predict later motor outcomes.
Purpose of the Study:
- To investigate the association between early hand function (18-22 months) and school-age motor skills (6-7 years) in extremely preterm children.
- To determine if early hand function deficits predict specific deficits in the Movement Assessment Battery for Children, 2nd edition (MABC).
- To assess the predictive value of early hand function on MABC scores, controlling for confounding factors.
Main Methods:
- A prospective multicenter cohort study included 313 extremely preterm children.
- Early hand function was assessed at 18-22 months and MABC testing at 6-7 years.
- Mixed-effects regression models analyzed the association between early hand function deficits and MABC outcomes, adjusting for covariates.
Main Results:
- Children with early hand function deficits were more likely to have definite school-age deficits across all MABC subtests (Manual Dexterity, Aiming and Catching, Balance).
- Early deficits were significantly associated with lower scores in Manual Dexterity, Balance, and overall MABC performance.
- Even after controlling for confounders and excluding children with cerebral palsy or low IQ, early hand function deficits remained linked to manual dexterity impairments.
Conclusions:
- Hand function deficits identified in infancy among extremely preterm children are significant predictors of motor difficulties, particularly in manual dexterity, at school age.
- These associations persist independently of perinatal factors and therapeutic interventions.
- Early hand function assessment offers valuable insights for targeted interventions to improve school readiness and long-term outcomes.
Objectives:
To determine associations between hand function at age 18-22 months (early) and scores on the Movement Assessment Battery for Children, 2nd edition (MABC) at 6-7 years of age (school age) in extremely preterm children.
Study Design:
Prospective multicenter cohort of 313 extremely preterm children with early hand function assessment and school-age MABC testing. Early hand function was compared with "definite deficits" (MABC <5th percentile) and MABC standard scores. Early hand function was categorized as "no deficit" vs "any deficit." Mixed-effects regression models were used to evaluate the association of early hand function with MABC deficits, controlling for multiple demographic, neonatal, and childhood factors.
Results:
Children with early hand function deficits were more likely to have definite school-age deficits in all MABC subtests (Manual Dexterity, Aiming and Catching, and Balance) and to have received physical or occupational therapy (45% vs 26%; P < .001). Children with early hand function deficits had lower Manual Dexterity (P = .006), Balance (P = .035), and Total Test (P = .039) scores. Controlling for confounders, children with early hand function deficits had higher odds of definite school-age deficits in Manual Dexterity (aOR, 2.78; 95% CI, 1.36-5.68; P = .005) and lower Manual Dexterity (P = .031) and Balance (P = .027) scores. When excluding children with cerebral palsy and those with an IQ <70, hand function deficits remained significantly associated with manual dexterity.
Conclusion:
Hand function deficits at age 18-22 months are associated with manual dexterity deficits and motor difficulties at school age, independent of perinatal-neonatal factors and the use of occupational or physical therapy. This has significant implications for school success, intervention, and rehabilitative therapy development.
