Premature infants are at risk for cerebral palsy (CP) that is typically diagnosed between 18–24 months. We present a case study of an infant who was discharged from the neonatal intensive care unit (NICU) without obvious neurological deficits but was later diagnosed with hemiplegic CP. The infant was enrolled in an infant motor study, which included neuroimaging and developmental motor assessments. At term, anatomical MRI showed bilateral periventricular leukomalacia, abnormal brain metabolites in frontal white matter via MR spectroscopy (MRS), and low fractional anisotropy (FA) values obtained from diffusional kurtosis imaging (DKI) in several cortical white matter tracts compared to a group of typically developing infants without neuroimaging abnormalities. In addition, the infant scored below average on a developmental assessment administered at term and three months as well as on the standard Bayley III assessment at 12 months. Abnormal neuroimaging and low scores on the early developmental assessment prompted referral for intervention services at two months. With intensive therapy, by 45 months, the infant was average in self-care, mobility, and communication skills, although below average in visual motor and gross motor coordination. This case highlights the clinical impact of early detection and referral using combined neuroimaging and developmental testing.

Young children’s mastery motivation and neurodevelopmental evaluation can contribute to overall early assessment for early intervention evaluation. At present, children born preterm (<37 weeks gestation) and with a low birth weight (LBW; <2500 g) are at increased risk of experiencing developmental delays and more nuanced cognitive and language challenges. The main objective of this exploratory study was to examine the connection between preterm children’s mastery motivation and their neurodevelopment, as well as to determine whether assessing mastery motivation can enhance assessment practices for early intervention (EI) programs. Parents of children born preterm completed the revised Dimensions of Mastery Motivation Questionnaire (DMQ18). Neurodevelopment was measured on the Bayley Scales of Infant and Toddler Development (BSID-III). Results revealed significant correlations between DMQ18 and BSID-III measures. Multivariate analysis showed that infants and toddlers born with a very low birth weight (VLBW; <1500 g) scored significantly lower on the infant DMQ18 and the BSID-III measures. Regression analyses revealed that birth weight and home environment were significant predictors of the children’s eligibility for EI programs. Infants’ social persistence with other children, gross motor persistence, and mastery pleasure, as well as toddlers’ objective cognitive persistence, social persistence with adults, gross motor persistence, mastery pleasure, and negative reaction to frustration, were important markers for evidenced-based practices in EI programs. This study demonstrates the utility of the DMQ18 as a contributory assessment measure and the importance of birth weight and home environment in predicting EI enrollment.

Date Presented 4/20/2018 This study explored the validity of the Specific Test of Early Infant Motor Performance (STEP) with gold standard infant motor assessments and brain neuroimaging. The STEP is a predictive developmental screening tool with the potential to improve early referral of at-risk infants to occupational therapy services. Primary Author and Speaker: Patty Coker-Bolt Additional Authors and Speakers: Lily Gullion, Jennifer Stansell Contributing Authors: Dorothea Jenkins, Laurel Gower, Truman Brown, Viswanathan Ramakrishnan, Hunter Moss

Date Presented 03/28/20 This presentation will provide an overview of mastery motivation, examine population metrics of the Dimensions of Mastery Questionnaire (DMQ 18) for children at high risk for developmental delays, and provide recommendations for early interventionists or parents to assist in improving overall ability by encouraging mastery motivation. This research is most applicable to those in early intervention or OTs assessing infants or toddlers in NICU follow-up clinics. Primary Author and Speaker: Lily Gullion Contributing Authors: Patricia Blasco, Sage Saxton