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Published on: January 12, 2019
Milestone Attainment in Young Children With Arthrogryposis Multiplex Congenita: Developmental Profile and Associated
Ahlam Zidan1,2, Sophia C Pasia2,3, Emmanouil Rampakakis4,5
1School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Insights
Children with arthrogryposis multiplex congenita (AMC) show significant delays, especially in gross motor skills. Early, coordinated interventions are crucial for developmental milestone attainment in these children.
Area of Science:
- Pediatric Development
- Musculoskeletal Disorders
- Congenital Conditions
Background:
- Developmental milestone data for children with arthrogryposis multiplex congenita (AMC) under five is limited.
- AMC affects multiple joints, potentially impacting overall child development.
Purpose of the Study:
- To describe the developmental status of young children with AMC.
- To identify factors associated with developmental milestone attainment in this population.
Main Methods:
- Multisite, cross-sectional study of 143 children (0-66 months) from a pediatric AMC Registry.
- Development assessed using the Ages and Stages Questionnaire, Third Edition (ASQ-3) across five domains.
- Analysis of demographic, perinatal, clinical, and parental factors.
Main Results:
- Gross Motor function was the most affected domain (over 90% below cutoff).
- Personal-Social and Fine Motor domains also showed significant limitations (53.1% below cutoff).
- Communication and Problem-Solving were relative strengths; NICU stay and joint contractures correlated with poorer outcomes.
Conclusions:
- Developmental attainment in AMC is influenced by musculoskeletal, perinatal, and family factors.
- Early, coordinated orthopedic, developmental, and family-centered interventions are essential.
- Addressing specific joint contractures and supporting families are key for improving outcomes.
Abstract:
Evidence on developmental milestones in children with arthrogryposis multiplex congenita (AMC) under the age of five is scarce. This multisite cross-sectional study described developmental status and examined factors associated with milestone attainment in 143 children aged 0-66 months from a pediatric AMC Registry. Development was assessed using the Ages and Stages Questionnaire, Third Edition (ASQ-3), across Communication, Gross Motor, Fine Motor, Problem-Solving, and Personal-Social domains. Independent variables included demographic, perinatal, clinical, and parental factors. Gross Motor function was the most limited domain, with more than 90% scoring close to/below the ASQ-3 domain-specific cutoff (≥ 2 SD below normative mean). Personal-Social scores were unexpectedly low, and Fine Motor limitations were also frequent, with 53.1% scoring close to/below the cutoff. Communication and Problem-Solving were relative strengths. Longer neonatal intensive-care unit stays were linked to poorer Communication and Fine Motor scores, and higher birth weight was associated with better Problem-Solving performance. Specific joint contractures, particularly those affecting the neck, shoulder, elbow, and knee, were associated with lower performance across domains, while higher parental education was related to better Personal-Social outcomes. Developmental attainment in AMC is shaped by interactions among musculoskeletal, perinatal, and family factors, underscoring the importance of early, coordinated orthopedic, developmental and family-centered interventions.
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