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Identifying and Evaluating Young Children with Developmental Central Hypotonia: An Overview of Systematic Reviews and
Álvaro Hidalgo Robles1, Ginny S Paleg2, Roslyn W Livingstone3
1Facultad de Educación, Universidad Internacional de La Rioja, 26006 Logroño, Spain.
Insights
This study reviewed tools for identifying and evaluating developmental central hypotonia in children aged 2 months to 6 years. The Hammersmith Infant Neurological Examination is recommended for younger children, while clinical algorithms and tools aid older ones.
Area of Science:
- Pediatrics
- Neurology
- Developmental Pediatrics
Background:
- Developmental central hypotonia involves reduced muscle tone from non-progressive brain damage.
- This condition can cause developmental delays and functional impairments.
- Evaluating interventions is challenging due to a lack of diagnostic clarity.
Purpose of the Study:
- To systematically review evidence on tools for identifying and evaluating developmental central hypotonia.
- To focus on children aged 2 months to 6 years.
- To assess the quality and applicability of existing evaluative tools.
Main Methods:
- A systematic review of systematic reviews and syntheses was performed.
- Searches included major databases (PubMed, Scopus, Cochrane, etc.) and hand-searching.
- Methodological quality and risk-of-bias were evaluated for included studies and tools.
Main Results:
- Three systematic reviews, one clinical algorithm, three measurement protocols, and two additional tools were identified.
- The Hammersmith Infant Neurological Examination shows strong properties for children aged 2 months to 2 years.
- A clinical algorithm and specific tools offer guidance for children aged 2-6 years.
Conclusions:
- The Hammersmith Infant Neurological Examination is a key tool for infants with hypotonia.
- Clinical algorithms and tools provide necessary guidance for evaluating older children.
- Further research is needed to develop and validate evaluative tools for this population.
Abstract:
Children with developmental central hypotonia have reduced muscle tone secondary to non-progressive damage to the brain or brainstem. Children may have transient delays, mild or global functional impairments, and the lack of a clear understanding of this diagnosis makes evaluating appropriate interventions challenging. This overview aimed to systematically describe the best available evidence for tools to identify and evaluate children with developmental central hypotonia aged 2 months to 6 years. A systematic review of systematic reviews or syntheses was conducted with electronic searches in PubMed, Medline, CINAHL, Scopus, Cochrane Database of Systematic Reviews, Google Scholar, and PEDro and supplemented with hand-searching. Methodological quality and risk-of-bias were evaluated, and included reviews and tools were compared and contrasted. Three systematic reviews, an evidence-based clinical assessment algorithm, three measurement protocols, and two additional measurement tools were identified. For children aged 2 months to 2 years, the Hammersmith Infant Neurological Examination has the strongest measurement properties and contains a subset of items that may be useful for quantifying the severity of hypotonia. For children aged 2-6 years, a clinical algorithm and individual tools provide guidance. Further research is required to develop and validate all evaluative tools for children with developmental central hypotonia.
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01:12Alterations in Muscle Tone ll
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