Independent walking and cognitive development in preschool children with Dravet syndrome

Abstract

Aim To investigate the relation between cognitive and motor development in preschool aged children with Dravet syndrome, in particular between the age of independent walking and cognitive development. Method Results of cognitive and motor developmental assessments and the age of independent walking were retrieved retrospectively from the medical records of 33 children (17 males, 16 females; mean age at last evaluation 33.2mo, SD 8.2mo, range 9–48mo) diagnosed with Dravet syndrome. Cognitive and motor developmental age, derived from the Bayley Scales of Infant Development or through standardized neurodevelopmental assessment, were converted into cognitive and motor developmental quotients. Multiple test scores per child were included. Results A strong positive relation was found between cognitive and motor developmental quotient (Pearson r=0.854; p<0.001) in 20 children (slope=0.75; 95% CI: 0.54–0.95). A later age of independent walking was associated with a lower cognitive developmental quotient (28 children; p<0.001; slope=−1.01; 95% CI: −1.53 to −0.49). A higher cognitive developmental quotient was seen in children with an age at testing younger than 24 months. The cognitive developmental quotient of children with a delay in independent walking (>17.6mo) was significantly lower than those without a delay (p=0.006). Interpretation A strong relation exists between cognitive and motor development. Furthermore, the age of independent walking might be an important indicator of the development of children with Dravet syndrome. What this paper adds Cognitive and motor development are strongly related in children with Dravet syndrome. Later age of independent walking is associated with worse cognitive development in children with Dravet syndrome.

Comorbidities in Dravet Syndrome and Lennox–Gastaut Syndrome

“…1) [26][27][28][29][30][31][32]. However, recent data indicate variability in cognitive development among DS children tested before 24 months of age, suggesting that cognitive delay may begin before 2 years of age in some patients [33]. A study by Nabbout et al [31] in 67 children with DS showed that, after 6 years of age, IQ decreased with age, but patients continued acquiring new skills during the first decade.…”

“…A study by Nabbout et al [31] in 67 children with DS showed that, after 6 years of age, IQ decreased with age, but patients continued acquiring new skills during the first decade. Therefore, the progression of developmental delay seen from 2 years of age [22,26,27,[31][32][33][34][35] could reflect an early arrest of cognitive development, followed by an increasing discrepancy between developmental age and chronological age [26], rather than consistent cognitive regression.…”

“…Behavioral difficulties in children with DS usually include attention disorders and hyperactivity, aggressive behavior, and social problems [16,33]. These problems, which do not appear to be related to the severity or frequency of epilepsy, seem to increase in childhood, peak in adolescence, and then plateau or decrease in adulthood, while autistic traits tend to persist [28,49,[52][53][54].…”

The effect of motor development on cognition: an ethological perspective

“…It is noteworthy that the ability to stand and walk also seems to be accompanied by remarkable advances in cognitive functioning. The study by Verheyen et al 1 confirms this relation between independent walking and cognitive development, and adds an interesting element. The age of independent walking might be an important indicator of the development of children with Dravet syndrome and could therefore provide useful information for the implementation of the therapeutic protocol.…”

“…It is generally observed that disabled children do not participate in physical activities as regularly as those without a disability. 1 Whilst conventional therapy is effective and its role cannot be underestimated, engaging disabled children in physical activities is usually limited by poor self-motivation and a lack of exercise variety. Virtual reality is a useful therapeutic tool that addresses these issues.…”