Convergent validity and discriminant validity of the SOMP-I were supported in preterm and term infants and facilitates early identification of infants with atypical motor development.

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Rational and aims: Early intervention is considered best practice for children with Cerebral Palsy (CP). Given that access to such intervention is known to vary, we aimed to investigate whether children with CP in Uppsala County, Sweden, have equal access to timely physiotherapy. Furthermore, we describe their birth history and CP profile to learn more about typical features that might enable earlier identification. Method: We conducted a retrospective chart review study including children born in the county from 2010 to 2016, who received a CP diagnosis by December 2018. Entries by doctors and physiotherapists working at Uppsala University Children's Hospital were reviewed. Results: Thirty-eight children were included (21 girls). Twenty-two (58%) were term born. Age at first visit to physiotherapy varied greatly and depended on referral source (p<0.000) and number of risk factors for CP (p<0.000). Children considered at low risk for CP received therapy later. Severity of motor impairment (p=0.001) and number of risk factors (p=0.014) influenced age at referral to habilitation services. Twenty-eight (74%) children were ambulatory at 2 years of age. Unilateral (n=16) and bilateral (n=17) spastic CP was most common. Children referred from the child health services (CHS) had milder forms of CP. Conclusion: Children with CP have unequal access to timely physiotherapy, and children referred from the CHS have the most delayed access. All professionals performing developmental surveillance and health monitoring should receive proper training and use evidence-based assessment methods when available to provide safe and equal care. Physiotherapy should be available prior to formal medical diagnosis.

The aim of this study was to investigate the level of motor development and the quality of motor performance during the first 10 months in relation to the Bayley Scales of Infant Development-third edition (Bayley-III) motor index at 2.5 years. Methods: Children born very preterm from a population-based study (n = 113) were assessed with the Structured Observation of Motor Performance in Infants (SOMP-I) at 2, 4, 6 and 10 months corrected age and the Bayley-III motor index at 2.5 years corrected age (n = 98). Logistic regressions were performed to investigate the independent association of each SOMP-I domain to Bayley-III motor index. Results: There were significant associations between the SOMP-I-scores and Bayley-III motor index per every assessment age. At 4 months, both level and quality were independently associated with a later motor outcome, OR for level was 1.26 (95% CI = 1.08-1.50, P = .002) and for quality, 0.75 (95% CI = 0.63-0.90, P = .002). Quality was independently associated with the Bayley-III motor index at 6 and 10 months: OR 0.080 (95% CI = 0.67-0.95 P = .010) and 0.79 (95% CI = 0.64-0.97, P = .026). Conclusion: Both SOMP-I domains, level and quality, are markers to identify motor problems early. Quality became more important with age.

Aim We investigated the impact of varying definitions on the prevalence of neurodevelopmental impairment (NDI) in children born very preterm at 6.5 years of age. Methods Cognitive development and neurosensory impairments were assessed in 91 children (40/51 girls/boys) born <32 gestational weeks, in 2004‐2007 in Uppsala county, Sweden. The results were compared with data from a reference group of 67 children born full term. The prevalence of NDI in the present cohort was reported according to definitions used by seven contemporary studies of children born very or extremely preterm. Results The prevalence of severe NDI varied from 2% to 23% depending on the definition used. The prevalence of cognitive impairment varied from 2% (−3 SD according to test norms) to 16% (−2 SD according to control group), the prevalence of cerebral palsy from 0% (severe) to 9% (any) and the prevalence of severe visual impairment from 0% (blindness) to 1% (visual acuity < 0.3). There were no children with severe hearing impairment. Conclusion A high variability in definitions affects the reporting of the prevalence of NDI in long‐term follow‐up studies of very or extremely preterm born children. There is a need for a better consensus to enable comparisons across studies.