Fidgety movements – tiny in appearance, but huge in impact

Einspieler, Christa; Peharz, Robert; Marschik, Peter B.

doi:10.1016/j.jped.2015.12.003

Cited by 130 publications

(122 citation statements)

References 64 publications

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“…The optical flow in the non-fidgety movement sequence changes rather smoothly over the whole image, whereas in the fidgety movement sequence the optical flow changes its orientation rapidly within different areas of the image. This coincides with the description of fidgety movements as unpredictable and spontaneous movements in all directions [37, 109]. …”

Section: Multidimensional Assessment Of Cpg-related Neurofunctions: Psupporting

confidence: 87%

“…Compared to the non-fidgety movement sequence, the fidgety movement sequence shows (i) higher short-term variance in r, (ii) larger number of small-to-medium-sized pulses in r and (iii) higher short-term variance in theta and phi, causing many spontaneous changes in the movement direction. Also these characteristics reliably match with Gestalt-based fidgety movements descriptions [37, 109]. …”

Section: Multidimensional Assessment Of Cpg-related Neurofunctions: Pmentioning

confidence: 87%

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A Novel Way to Measure and Predict Development: A Heuristic Approach to Facilitate the Early Detection of Neurodevelopmental Disorders

Marschik

Pokorny

Peharz

et al. 2017

Curr Neurol Neurosci Rep

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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.

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Section: Multidimensional Assessment Of Cpg-related Neurofunctions: Psupporting

confidence: 87%

Section: Multidimensional Assessment Of Cpg-related Neurofunctions: Pmentioning

confidence: 87%

A Novel Way to Measure and Predict Development: A Heuristic Approach to Facilitate the Early Detection of Neurodevelopmental Disorders

Marschik

Pokorny

Peharz

et al. 2017

Curr Neurol Neurosci Rep

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“…This is an exceptionally high rate of occurrence, as abnormal fidgety movements are usually rare (see also Table 2). It has been a matter of debate whether or not infants with a low muscle tone are more likely to show abnormal fidgety movements (Einspieler, Peharz, & Marschik, 2016; Yuge et al, 2011). Although this may not be consentaneously defined, a low muscle tone is a general feature in infants with Down syndrome (Latash, 2007; Morris, Vaughan, & Vaccaro, 1982).…”

Section: Discussionmentioning

confidence: 99%

“…Although this may not be consentaneously defined, a low muscle tone is a general feature in infants with Down syndrome (Latash, 2007; Morris, Vaughan, & Vaccaro, 1982). A number of studies have documented an association between abnormal fidgety movements and coordination difficulties and/or disabilities in fine manipulative skills at school age (Einspieler et al, 2007, Einspieler et al, 2016); others describe an exceedingly high rate of abnormal fidgety movements in infants who were later diagnosed with autism spectrum disorders or Rett syndrome (Einspieler et al, 2005, Einspieler et al, 2014). However, most so-called abnormal fidgety movements in infants later diagnosed with autism spectrum disorders or Rett syndrome did not correspond with the category of abnormal fidgety movements described in infants with brain injuries, which were exaggerated in amplitude and speed (Einspieler & Prechtl, 2005; Einspieler et al, 2016, Prechtl et al, 1997).…”

Section: Discussionmentioning

confidence: 99%

The motor repertoire in 3- to 5-month old infants with Down syndrome

Herrero

Einspieler

Aizawa

et al. 2017

Research in Developmental Disabilities

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BackgroundEven though Down syndrome is the most common chromosomal cause of intellectual disability, studies on early development are scarce.AimTo describe movements and postures in 3- to 5-month-old infants with Down syndrome and assess the relation between pre- and perinatal risk factors and the eventual motor performance.Methods and proceduresExploratory study; 47 infants with Down syndrome (26 males, 27 infants born preterm, 22 infants with congenital heart disease) were videoed at 10–19 weeks post-term (median = 14 weeks). We assessed their Motor Optimality Score (MOS) based on postures and movements (including fidgety movements) and compared it to that of 47 infants later diagnosed with cerebral palsy and 47 infants with a normal neurological outcome, matched for gestational and recording ages.Outcomes and resultsThe MOS (median = 13, range 10–28) was significantly lower than in infants with a normal neurological outcome (median = 26), but higher than in infants later diagnosed with cerebral palsy (median = 6). Fourteen infants with Down syndrome showed normal fidgety movements, 13 no fidgety movements, and 20 exaggerated, too fast or too slow fidgety movements. A lack of movements to the midline and several atypical postures were observed. Neither preterm birth nor congenital heart disease was related to aberrant fidgety movements or reduced MOS.Conclusions and implicationsThe heterogeneity in fidgety movements and MOS add to an understanding of the large variability of the early phenotype of Down syndrome. Studies on the predictive values of the early spontaneous motor repertoire, especially for the cognitive outcome, are warranted.What this paper addsThe significance of this exploratory study lies in its minute description of the motor repertoire of infants with Down syndrome aged 3–5 months. Thirty percent of infants with Down syndrome showed age-specific normal fidgety movements. The rate of abnormal fidgety movements (large amplitude, high/slow speed) or a lack of fidgety movements was exceedingly high. The motor optimality score of infants with Down syndrome was lower than in infants with normal neurological outcome but higher than in infants who were later diagnosed with cerebral palsy. Neither preterm birth nor congenital heart disease were related to the motor performance at 3–5 months.

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“…Fidgety movements are small movements of the neck, trunk and limbs in all directions and of variable acceleration; they last until the end of the 5 th month when intentional movements become predominant [14, 22]. If fidgety movements are present and normal in their quality, infants will very likely develop normally [13, 23]. None of the 16 infants with a later diagnosis of RTT (reported in the literature) ever showed normal fidgety movements; their fidgety movements were either absent or abnormal, i. e. jerky and too slow, or jerky and abrupt [7, 18, 21].…”

Section: The Motor Domainmentioning

confidence: 99%

Behavioural biomarkers of typical Rett syndrome: moving towards early identification

Einspieler

Freilinger

Marschik

2016

Wien Med Wochenschr

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SummaryThe dynamic course of Rett syndrome (RTT) is still said to begin with a period of apparently normal development although there is mounting evidence that individuals with RTT show behavioural peculiarities and abnormalities during their infancy. Their spontaneous general movements are abnormal from birth onwards. Normal cooing vocalisation and canonical babbling (if at all required) are interspersed with abnormalities such as proto-vowel and proto-consonant alternations produced on ingressive airstream, breathy voice characteristics, and pressed or high-pitched vocalisations. The gestural repertoire is limited. Certain developmental motor and speech-language milestones are not at all acquired or show a significant delay. Besides abnormal blinking, repetitive and/or long lasting tongue protrusion, and bizarre smiling, there are already the first body and/or hand stereotypies during the first year of life. We are currently on a promising way to define a specific set of behavioural biomarkers pinpointing RTT.

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Fidgety movements – tiny in appearance, but huge in impact

Cited by 130 publications

References 64 publications

A Novel Way to Measure and Predict Development: A Heuristic Approach to Facilitate the Early Detection of Neurodevelopmental Disorders

A Novel Way to Measure and Predict Development: A Heuristic Approach to Facilitate the Early Detection of Neurodevelopmental Disorders

The motor repertoire in 3- to 5-month old infants with Down syndrome

Behavioural biomarkers of typical Rett syndrome: moving towards early identification

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