GMAGeneral movement assessment GMOS General movement optimality score AIM To explore the appropriateness of applying a detailed assessment of general movements and characterize the relationship between global and detailed assessment. METHOD The analysis was based on 783 video recordings of 233 infants (154 males, 79females) who had been videoed from 27 to 45 weeks postmenstrual age. Apart from assessing the global general movement categories (normal, poor repertoire, crampedsynchronized, or chaotic general movements), we scored the amplitude, speed, spatial range, proximal and distal rotations, onset and offset, tremulous and cramped components of the upper and lower extremities. Applying the optimality concept, the maximum general movement optimality score of 42 indicates the optimal performance. RESULTS General movement optimality scores (GMOS) differentiated between normalgeneral movements (median 39 [25-75th centile 37-41]), poor repertoire general movements (median 25 [22][23][24][25][26][27][28][29]), and cramped-synchronized general movements (median 12 [10-14]; p<0.01). The optimality score for chaotic general movements (mainly occurring at late preterm age) was similar to those for cramped-synchronized general movements (median 14 [12-17]). Short-lasting tremulous movements occurred from very preterm age (<32wks) to post-term age across all general movement categories, including normal general movements.The detailed score at post-term age was slightly lower compared to the scores at preterm and term age for both normal (p=0.02) and poor repertoire general movements (p<0.01).INTERPRETATION Further research might demonstrate that the GMOS provides a solid base for the prediction of improvement versus deterioration within an individual general movement trajectory.Abnormal general movements are among the most reliable early markers for neurodevelopmental disorders. 1,2Recently, Bosanquet et al. 3 reviewed various structural and functional assessment techniques for which the accuracy of predicting cerebral palsy was reported. Compared to cranial ultrasound, magnetic resonance imaging and neurological examination, the general movement assessment (GMA) provided best evidence, with a sensitivity of 98% (95% confidence interval [CI] 74-100) and a specificity of 91% (95% CI 83-93).3 Apart from the first promising attempts to analyse general movements with the aid of computerbased tools, 4,5 GMA is based on visual Gestalt perception. General movements are considered to be normal if the sequence, amplitude, speed, and intensity are variable. Abnormal general movements are characterized by a lack of variability, especially in the movement sequence. 1,6 Gestalt perception is a powerful tool when it comes to the analysis of complex phenomena. Experienced observers consistently achieved high interscorer agreements, ranging from 89% to 93%. 6 In addition to the global assessment of general movement patterns, it can also be worthwhile to look at different aspects and components of general movements, particularly i...

Purpose of ReviewSubstantial research exists focusing on the various aspects and domains of early human development. However, there is a clear blind spot in early postnatal development when dealing with neurodevelopmental disorders, especially those that manifest themselves clinically only in late infancy or even in childhood.Recent FindingsThis early developmental period may represent an important timeframe to study these disorders but has historically received far less research attention. We believe that only a comprehensive interdisciplinary approach will enable us to detect and delineate specific parameters for specific neurodevelopmental disorders at a very early age to improve early detection/diagnosis, enable prospective studies and eventually facilitate randomised trials of early intervention.SummaryIn this article, we propose a dynamic framework for characterising neurofunctional biomarkers associated with specific disorders in the development of infants and children. We have named this automated detection ‘Fingerprint Model’, suggesting one possible approach to accurately and early identify neurodevelopmental disorders.

Background-Little is known about the first half year of life of individuals later diagnosed with autism spectrum disorders (ASD). There is even a complete lack of observations on the first 6 months of life of individuals with transient autistic behaviours who improved in their sociocommunicative functions in the pre-school age.Aim-To compare early development of individuals with transient autistic behaviours and those later diagnosed with ASD.Study design-Exploratory study; retrospective home video analysis.Subjects-18 males, videoed between birth and the age of 6 months (ten individuals later diagnosed with ASD; eight individuals who lost their autistic behaviours after the age of 3 and achieved age-adequate communicative abilities, albeit often accompanied by tics and attention deficit).Method-The detailed video analysis focused on general movements (GMs), the concurrent motor repertoire, eye contact, responsive smiling, and pre-speech vocalisations.Results-Abnormal GMs were observed more frequently in infants later diagnosed with ASD, whereas all but one infant with transient autistic behaviours had normal GMs (p < 0.05). Eye contact and responsive smiling were inconspicuous for all individuals. Cooing was not observable in six individuals across both groups. Conclusions-GMs might be one of the markers which could assist the earlier identification of ASD. We recommend to implement the GM assessment in prospective studies on ASD.

BackgroundStudies on motor performance and its early markers are rare in China, especially in very low birth weight (VLBW) infants.ObjectiveApart from the assessment of the inter-scorer agreement, we aimed to analyze to what extent the motor repertoire at 10 to 18 weeks postterm was related to neonatal complications, and gross and fine motor performance at 12 months after term.Study designExploratory prospective study.SubjectsSeventy-four VLBW infants (58 males; mean gestational age = 29 weeks; mean birth weight = 1252 g).MethodFive-minute video recordings were performed at 10 to 18 weeks after term; fidgety movements and the concurrent motor patterns (resulting in a motor optimality score) were assessed according to the Prechtl general movements assessment (GMA). The gross and fine motor performance was assessed by means of the Peabody Developmental Motor Scales, second edition, at 12 months.ResultsReliability was excellent. Pneumonia was associated with absent fidgety movements; the motor optimality score was lower in infants with pneumonia and/or bronchopulmonary dysplasia. Both absent fidgety movements and a lower motor optimality score were associated with a poor or very poor gross and fine motor performance at the 12-month-assessment.ConclusionBoth the assessment of fidgety movements and the evaluation of the concurrent motor repertoire contribute significantly to an identification of VLBW children with a poor gross and fine motor outcome at 12 months. The results of this study document the need for an early identification of infants at high risk for a poor motor performance.

The present study aimed to define differences between silent and oral reading with respect to spatial and temporal eye movement parameters. Eye movements of 22 German-speaking adolescents (14 females; mean age = 13;6 years;months) were recorded while reading an age-appropriate text silently and orally. Preschool cognitive abilities were assessed at the participants’ age of 5;7 (years;months) using the Kaufman Assessment Battery for Children. The participants’ reading speed and reading comprehension at the age of 13;6 (years;months) were determined using a standardized inventory to evaluate silent reading skills in German readers (Lesegeschwindigkeits- und -verständnistest für Klassen 6–12). The results show that (i) reading mode significantly influenced both spatial and temporal characteristics of eye movement patterns; (ii) articulation decreased the consistency of intraindividual reading performances with regard to a significant number of eye movement parameters; (iii) reading skills predicted the majority of eye movement parameters during silent reading, but influenced only a restricted number of eye movement parameters when reading orally; (iv) differences with respect to a subset of eye movement parameters increased with reading skills; (v) an overall preschool cognitive performance score predicted reading skills at the age of 13;6 (years;months), but not eye movement patterns during either silent or oral reading. However, we found a few significant correlations between preschool performances on subscales of sequential and simultaneous processing and eye movement parameters for both reading modes. Overall, the findings suggest that eye movement patterns depend on the reading mode. Preschool cognitive abilities were more closely related to eye movement patterns of oral than silent reading, while reading skills predicted eye movement patterns during silent reading, but less so during oral reading.