Objective evaluation of muscle strength in infants with hypotonia and muscle weakness

The clinical evaluation of an infant with motor delay, muscle weakness, and/or hypotonia would improve considerably if muscle strength could be measured objectively and normal reference values were available. The authors developed a method to measure muscle strength in infants and tested 81 typically developing infants, 6–36 months of age, and 17 infants with Prader–Willi Syndrome (PWS) aged 24 months. The inter-rater reliability of the measurement method was good (ICC = .84) and the convergent validity was confirmed by high Pearson's correlations between muscle strength, age, height, and weight (r = .79–.85). A multiple linear regression model was developed to predict muscle strength based on age, height, and weight, explaining 73% of the variance in muscle strength. In infants with PWS, muscle strength was significantly decreased. Pearson's correlations showed that infants with PWS in which muscle strength was more severely affected also had a larger motor developmental delay (r = .75).     

The relationship of motor skills and adaptive behavior skills in young children with autism spectrum disorders

ObjectiveTo determine the relationship of motor skills and adaptive behavior skills in young children with autism.DesignA multiple regression analysis tested the relationship of motor skills on the adaptive behavior composite, daily living, adaptive social and adaptive communicative skills holding constant age, non-verbal problem solving, and calibrated autism severity.SettingMajority of the data collected took place in an autism clinic.ParticipantsA cohort of 233 young children with ASD (n = 172), PDD-NOS (n = 22) and non-ASD (developmental delay, n = 39) between the ages of 14–49 months were recruited from early intervention studies and clinical referrals. Children with non-ASD (developmental delay) were included in this study to provide a range of scores indicted through calibrated autism severity.InterventionsNot applicable.Main outcome measuresThe primary outcome measures in this study were adaptive behavior skills.ResultsFine motor skills significantly predicted all adaptive behavior skills (p < 0.01). Gross motor skills were predictive of daily living skills (p < 0.05). Children with weaker motor skills displayed greater deficits in adaptive behavior skills.ConclusionsThe fine and gross motor skills are significantly related to adaptive behavior skills in young children with autism spectrum disorder. There is more to focus on and new avenues to explore in the realm of discovering how to implement early intervention and rehabilitation for young children with autism and motor skills need to be a part of the discussion.     

The bone tissue of children and adolescents with Down syndrome is sensitive to mechanical stress in certain skeletal locations: A 1-year physical training program study

The systemic complications of Down syndrome (DS) attenuate the osteogenic response to physical activity in DS patients. Through an interventional study we showed the effects of physical training on development of bone mineral content (BMC) and density (BMD) as well as on quantitative bone ultrasound (QUS) parameters in individuals with DS. A total of 42 children with DS were randomly assigned to either an exercising (DS-E, n = 20, age 16 ± 1.8 years) or non-exercising group (DS-NE, n = 22, age 16.9 ± 1.5 years). DS-E group was assigned to a program of osteogenic activities with 60 min sessions twice a week, over 12 month period. Bone mass measures were performed by dual X-ray absorpsiometry (DXA) at the spine and hip, and ultrasound attenuation (BUA) and velocity (SOS) assessed from the calcaneus by QUS device. All bone parameters had evolved with age, except for neck BMD. One year of training increased BMC values at lumbar spine (7%, p < .005) and total hip (10%, p < .05), and BMD values only at lumbar spine (4%, p < .05). Changes in BUA and SOS values were not evident following training. Trained individuals increased their motor skills measured through Eurofit tests.It was concluded that a program of osteogenic physical training may induce bone improvement in children with DS, but with a lower magnitude than that reported in the specialized literature for individuals without DS.     

The relationship between motor abilities and early social development in a preschool cohort of children with cerebral palsy

AimTo investigate the relationship between motor ability and early social development in a cohort of preschool children with cerebral palsy (CP).DesignPopulation-based cohort study.MethodsParticipants were 122 children with CP assessed at 18, 24 and 30 months, corrected age (ca). Motor ability was measured by the Gross Motor Function Classification System (GMFCS) with classification assigned by physiotherapists. The sample was representative of a population-based cohort (I = 48, 38.4%, II = 19, 15.2%, III = 17, 13.6%, IV = 22, 17.6% and V = 19, 15.2%). Social development was measured by the Paediatric Evaluation of Disability Inventory (PEDI) and included capabilities in social interaction, social communication, interactive play and household/community tasks.ResultsCross-sectional analyses indicated a significant relationship between motor ability and social development at 18 months, F(4, 56) = 11.44, p < .0001, η² = .45, at 24 months, F(4, 79) = 15.66, p < .0001, η² = .44 and at 30 months, F(4, 76) = 16.06, p < .0001, η² = .49. A longitudinal analysis with a subset of children (N = 24) indicated a significant interaction between age at assessment and GMFCS, F(2, 21) = 7.02, p = .005, η² = .40. Comparison with community norms indicated that at 18 months corrected age, 44.3% of the cohort was greater than two standard deviations below the mean (>2SD) for social development and a further 27.9% of the cohort was greater than one standard deviation below the mean (>1SD).InterpretationThere is a relationship between motor ability and social development in preschool children with CP. Children with CP may require support for social development in additional to physical interventions, from as early as 18 months.     

Pulmonary function in patients with hereditary motor and sensory neuropathy: A comparison of patients with and without spinal deformity

We assessed pulmonary function in hereditary motor and sensory neuropathy. Fourteen neuropathy patients without spinal deformity (group 1), 14 with spinal deformity (group 2), and 16 individuals with idiopathic spinal deformity (group 3) matched to group 2 for age, height and Cobb angle, were included. Hereditary motor and sensory neuropathy severity was measured with Charcot–Marie–Tooth Neuropathy Score. All participants exhibited mild decrease in maximal inspiratory pressure at the mouth. One-way analysis of variance yielded significant main effects for lung volumes – slow vital capacity, forced expiratory volume in 1 s, and total lung capacity (p’s < .01), attributable to greater volumes in group 1 compared to groups with spinal deformity – and transfer factor for carbon monoxide (p = .013), reflecting differences between groups 1 vs. 2. Slow vital capacity and total lung capacity correlated with maximal inspiratory pressure at the mouth in group 2, whereas slow vital capacity correlated with muscle work in group 3 (p’s < .05). Decreased lung volume may be due to impaired respiratory muscle strength in hereditary motor and sensory neuropathy with spinal deformity and due to spinal deformity in idiopathic patients.     

Implicit and explicit motor learning: Application to children with Autism Spectrum Disorder (ASD)

Aims and objectivesThis study aims to determine whether children with Autism Spectrum Disorder (ASD) are capable of learning a motor skill both implicitly and explicitly.MethodsIn the present study, 30 boys with ASD, aged 7–11 with IQ average of 81.2, were compared with 32 typical IQ- and age-matched boys on their performance on a serial reaction time task (SRTT). Children were grouped by ASD and typical children and by implicit and explicit learning groups for the SRTT.ResultsImplicit motor learning occurred in both children with ASD (p = .02) and typical children (p = .01). There were no significant differences between groups (p = .39). However, explicit motor learning was only observed in typical children (p = .01) not children with ASD (p = .40). There was a significant difference between groups for explicit learning (p = .01).DiscussionThe results of our study showed that implicit motor learning is not affected in children with ASD. Implications for implicit and explicit learning are applied to the CO-OP approach of motor learning with children with ASD.     

Intra-rater reliability of motor unit number estimation and quantitative motor unit analysis in subjects with amyotrophic lateral sclerosis

ObjectivesTo assess the intra-rater reliability of decomposition-enhanced spike-triggered averaging (DE-STA) motor unit number estimation (MUNE) and quantitative motor unit potential analysis in the upper trapezius (UT) and biceps brachii (BB) of subjects with amyotrophic lateral sclerosis (ALS) and to compare the results from the UT to control data.MethodsPatients diagnosed with clinically probable or definite ALS completed the experimental protocol twice with the same evaluator for the UT (n = 10) and BB (n = 9).ResultsIntra-rater reliability for the UT was good for the maximum compound muscle action potential (CMAP) (ICC = 0.88), mean surface-detected motor unit potential (S-MUP) (ICC = 0.87) and MUNE (ICC = 0.88), and for the BB was moderate for maximum CMAP (ICC = 0.61), and excellent for mean S-MUP (ICC = 0.94) and MUNE (ICC = 0.93). A significant difference between tests was found for UT MUNE. Comparing subjects with ALS to control subjects, UT maximum CMAP (p < 0.01) and MUNE (p < 0.001) values were significantly lower, and mean S-MUP values significantly greater (p < 0.05) in subjects with ALS.ConclusionsThis study has demonstrated the ability of the DE-STA MUNE technique to collect highly reliable data from two separate muscle groups and to detect the underlying pathophysiology of the disease.SignificanceThis was the first study to examine the reliability of this technique in subjects with ALS, and demonstrates its potential for future use as an outcome measure in ALS clinical trials and studies of ALS disease severity and natural history.     

An investigation of the factors affecting flatfoot in children with delayed motor development

This study investigated the prevalence of flatfoot in children with delayed motor development and the relevant factors affecting it. In total, 121 preschool-aged children aged 3–6 with delayed motor development (male: 81; female: 40) were enrolled in the motor-developmentally delayed children group, and 4 times that number, a total of 484 children (male: 324; female: 160), of gender- and age-matched normal developmental children were used as a control group for further analyses. The age was from 3.0 to 6.9 years old for the participants. The judgment criterion of flatfoot was the Chippaux-Smirak index >62.70%, in footprint measurement. The results showed that the prevalence of flatfoot in children with motor developmental delay was higher than that in normal developmental children, approximately 58.7%, and that it decreased with age from 62.8% of 3-year-olds to 50.0% of 6-year-olds. The results also showed that motor-developmentally delayed children with flatfoot are at about 1.5 times the risk of normal developmental children (odds ratio = 1.511, p = 0.005). In addition, the prevalence of flatfoot is relatively higher in overweight children with delayed motor development, and that in obese children is even as high as 95.8% (23/24). Children with both excessive joint laxity and delayed development are more likely to suffer from flatfoot. The findings of this study can serve as a reference for clinical workers to deal with foot issues in children with delayed motor development.     

Accelerometer-determined physical activity and walking capacity in persons with Down syndrome,Williams syndrome and Prader–Willi syndrome

In this study we describe by use of accelerometers the total physical activity (PA), intensity pattern and walking capacity in 87 persons age 16–45 years with Down syndrome (DS), Williams syndrome (WS) and Prader–Willi syndrome (PWS). Participants were recruited from all over Norway, and lived either with their parents or in community residences with support.On average the participants generated 294 counts per minute (cpm) or 6712 steps per day, with most of the day spent in sedentary activity, 522 min/day, followed by 212 min/day in light PA, 71 min/day in lifestyle activity and 27 min/day in moderate-to-vigorous physical activity (MVPA). Inactivity was prevalent, as only 12% meet the current Nordic recommendations for PA.When compared, no differences for total physical activity or time in MVPA were observed between the three groups. However, participant with DS spent a mean of 73 min/day less and 43 min/day less in sedentary activities compared to participants with PWS and WS, respectively, (p = 0.011, 95% CI: ?10.9; ?80.1). In addition the DS-group spent a mean of 66 min/day more in light PA than the PWS-group and 41 min/day more than the WS-group, (p < 0.001, 95% CI: 29.3; 79.7). Participants with PWS spent on average 30 min/day less in lifestyle activities compared to both participants with DS and WS, (p < 0.001, 95% CI: ?14.2; ?45.4). No association between total PA and BMI were observed. Males were more active than females across all diagnoses. Males accumulated on average 85 counts per minutes more than females, (p = 0.002, 95% CI: 33.3; 136.7), 2137 more steps per day, (p = 0.002, 95% CI: 778; 3496). The mean walking capacity during six-minutes was 507 m (SD 112 m) for males and 466 m (SD 88 m) for females. Distance walked during testing decreased with 33.6 m when comparing normal or underweight participants to overweight participants, and 78.1 m when comparing overweight to obese participants (p < 0.001 95% CI: ?40.4; ?85.8). When adjusted for BMI no differences in walking capacity between the three genetic conditions were observed.     

Sensorimotor function in preschool-aged children with expressive language disorder

AimThe aim of the study was to evaluate functional motor performance and haptic object recognition in 5-year-old children with mild expressive language disorder (ELD) in comparison with age- and gender-matched healthy children.MethodsThe subjects were classified by speech-language pathologist using The Reynell Developmental Language Scales III and Boehm Test of Basic Concepts: Preschool as children with mild ELD (n = 29, incl. 23 boys and 6 girls) and children with typical language development as controls (n = 29, incl. 23 boys and 6 girls). The children were examined for manual dexterity, ball skills, static and dynamic balance by Movement-ABC, haptic object recognition (HOR), hand-grip strength (HGS) and vertical jumping performance.ResultsChildren with mild ELD demonstrated significantly higher scores (i.e., inferior performance) in all subtests of M-ABC (all p values <0.05), in haptic object recognition (p < 0.01) and vertical jumping height (p < 0.05) compared to controls. However, no statistically significant differences (p > 0.05) emerged from HGS. Boys with mild ELD demonstrated higher results in impairment score (p < 0.001), ball skills (p < 0.01) and balance (p < 0.01) of M-ABC, as well as in HOR (p < 0.05). Girls with mild ELD showed higher impairment score (p < 0.05) with lower percentile (p < 0.05) in M-ABC, indicating inferior motor performance, and lower HGS for the non-dominant hand (p < 0.05). Seven out of 29 (24.1%) children with mild ELD had definite or borderline motor difficulties, while only one child in control group (3.4%) demonstrated borderline motor difficulties.ConclusionsChildren with mild expressive language disorder do not perform as well as controls in tests of functional motor skills, but their results in tests demanding maximal muscle force generation are in level with typically developing children. Boys and girls with mild ELD demonstrated higher impairment scores in M-ABC, indicating the need to follow their overall development more closely.     

Phase reversal technique decreases cortical stimulation time during motor mapping

Neurophysiologic mapping of the primary motor cortex (PMC) is commonly used in supratentorial surgery. Electrical cortical stimulation is guided by anatomic landmarks towards the precentral gyrus, with recording of the triggered primary motor responses (TPMR) in the contralateral hemibody. Thus, factors such as distortion of the pericentral anatomy, small surgical fields, brain shifts and miscalibrated neuronavigational systems may lengthen the process and result in unnecessary stimulations, increasing the probability of triggering seizures. We hypothesized that central sulcus localization via the median somatosensory evoked potentials phase reversal technique (MSSEP PRT) accurately guides the surgeon, resulting in prompt identification of the PMC with minimal electrical stimulation. Multivariate Cox regression was used to study the impact of MSSEP PRT on time spent performing electrical cortical stimulation to TPMR. The analysis was adjusted for presence of increased cortical excitability, high motor thresholds, lesions close to PMC and fMRI data, in 100 consecutive standardized motor mapping procedures for brain tumor resection and epilepsy surgery. Phase reversal and change morphology of the recorded somatosensory evoked potentials quadrupled (hazard ratio [HR] 4.13, p < 0.0001) and doubled (HR 2.14, p = 0.02) the rate of obtaining TPMR, respectively. A 1 mA increase in motor threshold decreased the rate by 9% (HR 0.91, p = 0.0002). Afterdischarges triggered before TPMR and lesions in close proximity to PMC decreased the rate of TPMR by 76% (HR 0.23, p < 0.0001) and 48% (HR 0.52, p = 0.04), respectively. Informative PRT decreases stimulation time. Afterdischarges triggered before TPMR, high motor thresholds and lesions close to the PMC increase it.     

A randomized controlled trial of clinic-based and home-based interventions in comparison with usual care for preterm infants: Effects and mediators

This study examined the effects and mediators of a clinic-based intervention program (CBIP) and a home-based intervention program (HBIP) compared with usual care in very-low-birth-weight (VLBW) preterm infants on developmental and behavioral outcomes at 24 months of age (corrected for prematurity). In this randomized controlled trial, VLBW preterm infants received either CBIP (n = 57), HBIP (n = 63), or usual care (n = 58) from hospitalization to 12 months. At 12 months, infant emotional regulation was assessed using the toy-behind-barrier procedure and dyadic interaction was observed during free play. At 24 months, infant developmental and behavioral outcomes were assessed using the Bayley Scales of Infant and Toddler Development- 3rd edition and the Child Behavior Checklist for Ages 1.5–5, respectively. Compared with infants under usual care, the CBIP-group infants showed higher cognitive composite scores (difference, 95% confidence interval (CI) = 4.4, 0.8–7.9) and a lower rate of motor delay (odds ratio (OR), 95% CI = 0.29, 0.08–0.99); the HBIP-group infants had lower sleep problem scores (difference, 95% CI = −1.4, −2.5 to −0.3) and a lower rate of internalizing problems at 24 months (OR, 95% CI = 0.51, 0.28–0.93) (all p < .05). The CBIP's effect on cognitive outcome was attenuated when maternal or dyadic interactive behavior was considered; whereas the HBIP's effect on sleep and internalizing behavior was attenuated when duration of orientation to a toy or object was considered. In conclusions, interventions enhanced the cognitive, motor, and behavioral outcomes of VLBW preterm infants. The effects on cognitive and behavioral outcomes might be mediated by early-improved mother–infant interaction and infant emotional regulation, respectively.     

Evaluation of developmental profiles of children with hydrocephalus

ObjectiveThe objective of this study was to compare the developmental characteristics of children with hydrocephalus with those of healthy children.Material and methodsA total of 109 children aged between 2 and 46 months were included in the study, 54 patients diagnosed with hydrocephalus and 55 healthy children were evaluated with demographic data forms and Denver Developmental Screening Test II.ResultsThe mean personal–social (p < 0.001), fine motor-adaptive (p < 0.001), language (p < 0.001), and gross motor subscale scores were significantly lower in children with hydrocephalus than in the control group. Personal–social (p = 0.002) and gross motor (p = 0.029) subscale scores were significantly lower in children with obstructive hydrocephalus than communicating hydrocephalus. There was a significant negative correlation between language scores and ages of the children with hydrocephalus (r = ?0.350, p = 0.009). It was found that children with obstructive hydrocephalus carry a 6.7 folds higher risk of experiencing problems in terms of personal–social development compared to those with communicating hydrocephalus (p = 0.011).ConclusionWe found that patients with hydrocephalus were developmentally retarded compared to the healthy control subjects. Retardation was the most prominent in the obstructive group. Our results showed that neurodevelopmental follow-up should be carried-out regularly in pediatric patients with hydrocephalus, and early intervention should be started in necessary cases.     

Effects of a trampoline exercise intervention on motor performance and balance ability of children with intellectual disabilities

Balance and motor impairments are most evident among inactive individuals with ID that might be particularly susceptible to a loss of basic functioning and further limit the person's autonomy in activities of daily living. The aim of the study was to assess the effect of a 12-week trampoline exercise intervention program on motor and balance ability of school aged children with intellectual disability (ID). Eighteen healthy schools aged children (mean age = 10.3 ± 1.6 years) with moderate ID were assigned either to an experimental group (n = 9) or a control group (n = 9). The experiment group attended a 12 weeks trampoline training intervention program consisting of daily individualized 20-min sessions, while the control group followed the regular school schedule. Balance was assessed using three tasks of increased difficulty (double-leg stance with eyes opened or closed, and one-leg stance with eyes opened) performed while standing on an electronic pressure platform (EPS). Motor performance of all participants was tested using sit and reach test and long and vertical jump tests all derived from the Eurofit Test Battery of physical fitness. Trampoline intervention resulted in significant improvements of participants’ performance in all motor and balance tests. In conclusion, trampoline training can be an effective intervention for improving functional outcomes and can be recommended as an alternative mode of physical activity programming for improving balance and motor performance. Furthermore, it also supports the idea that individuals with ID require enjoyable and interesting intervention programs such as the trampoline program used in this study so as to remain active and consequently to facilitate their overall development and promote a more active and healthier way of life.     

Daily training with realistic visual feedback improves reproducibility of event-related desynchronisation following hand motor imagery

ObjectiveFew brain–computer interface (BCI) studies have addressed learning mechanisms by exposure to visual feedback that elicits scalp electroencephalogram. We examined the effect of realistic visual feedback of hand movement associated with sensorimotor rhythm.MethodsThirty-two healthy participants performed in five daily training in which they were shown motor imagery of their dominant hand. Participants were randomly assigned to 1 of 4 experimental groups receiving different types of visual feedback on event-related desynchronisation (ERD) derived over the contralateral sensorimotor cortex: no feedback as a control, bar feedback with changing bar length, anatomically incongruent feedback in which the hand open/grasp picture on screen was animated at eye level, and anatomically congruent feedback in which the same hand open/grasp picture was animated on the screen overlaying the participant’s hand.ResultsDaily training with all types of visual feedback induced more robust ERD than the no feedback condition (p < 0.05). The anatomically congruent feedback produced the highest reproducibility of ERD with the smallest inter-trial variance (p < 0.05).ConclusionRealistic feedback training is a suitable method to acquire the skill to control a BCI system.SignificanceThis finding highlights the possibility of improvement of reproducibility of ERD and can help to use BCI techniques.     

Influence of methylphenidate on motor performance and attention in children with developmental coordination disorder and attention deficit hyperactive disorder

Individuals with attention deficit hyperactive disorder (ADHD) often have coexisting developmental coordination disorder (DCD). The positive therapeutic effect of methylphenidate on ADHD symptoms is well documented, but its effects on motor coordination are less studied. We assessed the influence of methylphenidate on motor performance in children with comorbid DCD and ADHD. Participants were 30 children (24 boys) aged 5.10–12.7 years diagnosed with both DCD and ADHD. Conners’ Parent Rating Scale was used to reaffirm ADHD diagnosis and the Developmental Coordination Disorder Questionnaire was used to diagnose DCD. The Movement Assessment Battery for Children-2 and the online continuous performance test were administrated to all participants twice, with and without methylphenidate. The tests were administered on two separate days in a blind design. Motor performance and attention scores were significantly better with methylphenidate than without it (p < 0.001 for improvement in the Movement Assessment Battery for Children-2 and p < 0.006 for the online continuous performance test scores).The findings suggest that methylphenidate improves both attention and motor coordination in children with coexisting DCD and ADHD. More research is needed to disentangle the causality of the improvement effect and whether improvement in motor coordination is directly affected by methylphenidate or mediated by improvement in attention.     

Assessment of physical fitness and exercise tolerance in children with developmental coordination disorder

Children with developmental coordination disorder (DCD) have been shown to be less physically fit when compared to their typically developing peers. The purpose of the present study was to examine the relationships among body composition, physical fitness and exercise tolerance in children with and without DCD. Thirty-seven children between the ages of 7 and 9 years participated in this study. Participants were classified according to results obtained on the Movement Assessment Battery for Children (MABC) and were divided in 2 groups: 19 children with DCD and 18 children without DCD. All children performed the following physical fitness tests: The five-jump test (5JT), the triple-hop distance (THD) and the modified agility test (MAT). Walking distance was assessed using the 6-min walking test (6MWT). Children with DCD showed higher scores than children without DCD in all MABC subscale scores, as well as in the total score (p < 0.001). Participants with DCD were found to perform significantly worse on the MAT (p < 0.001), the THD (p < 0.001) and 5JT (p < 0.05). Moreover, children with DCD had poorer performance on the 6MWT than children without DCD (p < 0.01). Our results found significant correlations among body mass index (BMI), THD (r = 0.553, p < 0.05), 5JT (r = 0.480, p < 0.05) and 6MWT (r = 0.544, p < 0.05) only in DCD group. A significant correlation between MAT and 5JT (r = −0.493, p < 0.05) was found. Similarly, THD and 5JT (r = 0.611, p < 0.01) was found to be correlated in children with DCD. We also found relationships among 6MWT and MAT (r = −0.522, p < 0.05) and the 6MWT and 5JT (r = 0.472, p < 0.05) in DCD group. In addition, we found gender specific patterns in the relationship between exercise tolerance, explosive strength, power, DCD, and BMI. In conclusion, the present study revealed that BMI was indicative of poorer explosive strength, power and exercise tolerance in children with DCD compared to children without DCD probably due to a limited coordination on motor control.     

A longitudinal study on gross motor development in children with learning disorders

This longitudinal study examined the development of gross motor skills, and sex-differences therein, in 7- to 11-years-old children with learning disorders (LD) and compared the results with typically developing children to determine the performance level of children with LD.In children with LD (n = 56; 39 boys, 17 girls), gross motor skills were assessed with the Test of Gross Motor Development-2 and measured annually during a 3-year period. Motor scores of 253 typically developing children (125 boys, 112 girls) were collected for references values.The multilevel analyses showed that the ball skills of children with LD improved with age (p < .001), especially between 7 and 9 years, but the locomotor skills did not (p = .50). Boys had higher ball skill scores than girls (p = .002) and these differences were constant over time. Typically developing children outperformed the children with LD on the locomotor skills and ball skills at all ages, except the locomotor skills at age 7. Children with LD develop their ball skills later in the primary school-period compared to typically developing peers. However, 11 year-old children with LD had a lag in locomotor skills and ball skills of at least four and three years, respectively, compared to their peers.     

Predictors for changes in various developmental outcomes of children with cerebral palsy—A longitudinal study

We aimed to identify predictors for the changes of various developmental outcomes in preschool children with cerebral palsy (CP). Participants were 78 children (49 boys, 29 girls) with CP (mean age: 3 years, 8 months; SD: 1 year, 7 months; range: 1 year to 5 years, 6 months). We examined eight potential predictors: age, sex, CP subtype, Gross Motor Function Classification System (GMFCS) level, selective motor control, Modified Ashworth Scale, and the spinal alignment (SA) and range of motion subscales of the Spinal Alignment and Range of Motion Measure (SAROMM). Developmental outcomes for cognition, language, self-help, and social and motor functions were measured at baseline and a 6-month follow-up with the Comprehensive Developmental Inventory for Infants and Toddlers. Regression model showed GMFCS level was a negative predictor for change of language (adjusted r² = 0.30, p < .001), motor function (adjusted r² = 0.26, p < .001), social function (adjusted r² = 0.07, p = 0.014), and self-help (adjusted r² = 0.26, p < .001). Age was a negative predictor for change of cognition (adjusted r² = 0.21, p < .001) and language functions (adjusted r² = 0.26, p < .001). SAROMM-SA was a negative predictor for cognitive change (adjusted r² = 0.30, p < .001). The GMFCS levels and age are robust negative predictors for change of most developmental domains in these children.     

Emerging cognitive profiles in high-risk infants with and without autism spectrum disorder

This paper examined early developmental trajectories in a large, longitudinal sample at high-risk for ASD (‘HR’) and low-risk (‘LR’) controls, and the association of trajectories with 3-year diagnosis. Developmental assessments were conducted at 6, 12, 24 months, and 3 years, with blinded “clinical best-estimate” expert diagnosis at age 3. HR infants were enrolled based only on familial risk. LR infants, from community sources, had no first- or second-degree ASD relatives. All infants were born at 36–42 weeks, weighing ≥2500 g, with no identifiable neurological, genetic, or severe sensory/motor disorders. Analytic phase I: semi-parametric group-based modeling to identify distinct developmental trajectories (n = 680; 487 HR; 193 LR); phase II: Trajectory membership in relation to 3-year diagnosis (n = 424; 310 HR; 114 LR). Three distinct trajectories emerged (1) inclining; (2) stable-average; (3) declining; trajectory membership predicted diagnosis (χ² = 99.40; p < .001). Most ASD cases were in stable-average (50.6%) or declining trajectories (33.8%); most non-ASD-HR infants were in inclining (51.9%) or stable-average (40.3%) trajectories. The majority of LR controls were in the inclining trajectory (78.9%). Within the declining trajectory, over half had ASD (57.8%), but 40% were non-ASD-HR infants. Declining/plateauing raw scores were associated with, but not exclusive to, ASD. Findings underscore the importance of monitoring the emergence of ASD symptoms and overall development in high-risk children. Evidence of developmental slowing or decline may be associated not only with ASD, but with other suboptimal outcomes, warranting careful clinical follow-up.