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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
'Low-normal' motor skills in infants at high risk for poor developmental outcomes: A prevalence and prognostic study
Marcella Danks1, Emma J Flynn1, Peter H Gray2
1School of Allied Health, Australian Catholic University, Brisbane, Australia.
Insights
High-risk infants often have
Area of Science:
- Neonatal development and pediatric motor assessment.
Background:
- Infants born extremely low-birthweight and preterm are at high risk for developmental challenges.
- Early identification of subtle motor skill deficits is crucial for timely intervention.
Purpose of the Study:
- To determine the prevalence of 'low-normal' motor skills in high-risk infants.
- To evaluate the prognostic value of these motor skills for long-term developmental outcomes.
Main Methods:
- Longitudinal study of 191 high-risk infants assessed at 4, 8, and 12 months corrected age.
- Utilized Alberta Infant Motor Scale (AIMS), Neuro-Sensory Motor Developmental Assessment (NSMDA), and Griffiths Mental Development Scale.
- Analyzed motor skill classifications and their correlation with general development.
Main Results:
- Over 50% of infants exhibited 'low-normal' motor skills at 4 months, decreasing to 14.86% by 12 months (AIMS).
- A significant proportion of infants with 'low-normal' AIMS scores were identified with motor impairment by NSMDA (up to 88.46%).
- Minimal motor impairment at 4 or 8 months predicted poorer general development at 12 months.
Conclusions:
- A high prevalence of 'low-normal' motor skills is observed in high-risk infants.
- Clinical motor assessments effectively identify infants with motor impairment.
- Early intervention for high-risk infants with 'low-normal' motor skills is recommended due to associated developmental risks.
Aim:
To investigate the prevalence and prognostic value of 'low-normal' motor skills in infants at high-risk for poor developmental outcomes.
Method:
Infants born extremely low-birthweight and extremely preterm discharged from neonatal intensive care between 2015 and 2018 completed the Alberta Infant Motor Scale (AIMS), Neuro-Sensory Motor Developmental Assessment (NSMDA) at corrected age 4, 8, and 12 months, and Griffiths Mental Development Scale at corrected age 12 months.
Results:
Participating infants (n = 191) with a mean gestational age (95% confidence interval [CI]) of 26.80 weeks (26.60, 27.1) and mean birthweight (95% CI) of 869 grams (843, 895) included 45 (23.80%) infants small for gestational age. AIMS rated 50.32%, 35.37%, and 14.86% of infants within the 'low-normal' motor skills range (1-2 SD below the mean for age) at 4, 8, and 12 months respectively. Of the infants within the AIMS 'low-normal' skills range, 55.70%, 88.46%, and 59.10% were classified as having impairment by NSMDA at 4, 8, and 12 months respectively. Griffiths assessment at 12 months identified only 7.33% of infants with 'low-normal' skills and 3.33% with motor disability. Minimal motor impairment rating on the NSMDA at 4 or 8 months significantly predicted general development at 12 months.
Interpretation:
High-risk infants with 'low-normal' motor skills may warrant referral to early intervention as associated impairment represents increased risk for poorer general development outcomes.
What This Paper Adds:
High prevalence of 'low-normal' motor skill exists in high-risk infants. Clinical motor assessment validly identifies infants with motor impairment. Minimal motor impairment in high-risk infants is prognostic of general development. High-risk infants with 'low-normal' motor skills may warrant early intervention. Griffiths Scales of Child Development, Third Edition assessment at 12-months age may under-identify motor difficulties.
