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Hospitalized Infants With Medical Complexity Experience Slow Acquisition of Gross Motor Skills
Kelly A Pflock1,2, Maria Fragala-Pinkham1, Julie Shulman1
1Physical Therapy and Occupational Therapy Department, Boston Children's Hospital, Boston, Massachusetts.
Insights
Hospitalized infants with complex medical conditions often experience gross motor delays. While they gain some skills during hospitalization, their development rate is slower than typical, indicating a need for interventions.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Rehabilitation Medicine
Background:
- Infant gross motor development during hospitalization is not well understood.
- Understanding skill acquisition in hospitalized infants with complex medical conditions is crucial for developing interventions.
- Establishing baseline gross motor abilities is essential for future research.
Purpose of the Study:
- To describe gross motor skills in infants with complex medical conditions during hospitalization.
- To evaluate the rate of gross motor skill development in hospitalized infants with prolonged stays.
Main Methods:
- Observational study of 143 infants (birth to 18 months) with complex medical conditions.
- Monthly evaluation of gross motor skills using the Alberta Infant Motor Scale.
- Regression analysis to assess the rate of change in gross motor skills.
Main Results:
- 64% of infants showed significant motor delay at initial evaluation.
- Infants with prolonged hospitalization gained skills at a rate of 1.4 points/month (Alberta Infant Motor Scale).
- Despite gains, 76% of infants with prolonged stays continued to have gross motor delays.
Conclusions:
- Hospitalized infants with complex conditions often present with baseline motor delays.
- These infants acquire gross motor skills at a slower rate during hospitalization compared to typical development.
- Further research is needed to assess interventions for mitigating gross motor delays in hospitalized infants.
Objectives:
The progression of infant gross motor development during an acute hospitalization is unknown. Understanding gross motor skill acquisition in hospitalized infants with complex medical conditions is necessary to develop and evaluate interventions that may lessen delays. Establishing a baseline of gross motor abilities and skill development for these infants will guide future research. The primary purposes of this observational study were to: (1) describe gross motor skills of infants with complex medical conditions (n = 143) during an acute hospitalization and (2) evaluate the rate of change in gross motor skill development in a heterogenous group of hospitalized infants with prolonged length of stay (n = 45).
Methods:
Gross motor skills in hospitalized infants aged birth to 18 months receiving physical therapy were evaluated monthly using the Alberta Infant Motor Scale. Regression analysis was completed to assess rate of change in gross motor skills.
Results:
Of the 143 participants, 91 (64%) demonstrated significant motor delay at initial evaluation. Infants with prolonged hospitalization (mean 26.9 ± 17.5 weeks) gained new gross motor skills at a significant rate of 1.4 points per month in Alberta Infant Motor Scale raw scores; however, most (76%) continued with gross motor delays.
Conclusions:
Infants with complex medical conditions admitted for prolonged hospitalization frequently have delayed gross motor development at baseline and have slower than typical acquisition of gross motor skills during hospitalization, gaining 1.4 new skills per month compared with peers acquiring 5 to 8 new skills monthly. Further research is needed to determine effectiveness of interventions designed to mitigate gross motor delay in hospitalized infants.
