Minor neurological signs and perceptual-motor difficulties in prematurely born children

Abstract

Aim-To examine the spectrum of neurological dysfunction and perceptualmotor diYculties at school age in a cohort of prematurely born children, and the relation of these measures to neonatal brain lesions, intelligence quotient, and behavioural adjustment. Method-One hundred and eighty three children were tested at the age of 6 years using Touwen's Examination of the Child with Minor Neurological Dysfunction, the Movement Assessment Battery for Children (Movement ABC), the Developmental Test of Visual-Motor Integration (VMI), British Ability Scales, and Rutter Scales. Results-Twenty six children had definite cerebral palsy and one was blind. Of the remaining 156, the proportions falling below the 15th centile point were 31% on Touwen's Examination, 44% on the Movement ABC, and 17% on the VMI. Forty two passed all three tests. No child with a normal ultrasound scan developed cerebral palsy, whereas nearly all those with major lesions did. Minor lesions, however, were not generally predictive of later outcome. Correlations between the tests were generally low. Conclusions-These findings stress the need to assess neurological and perceptual motor functioning separately at school age and to monitor relationships with other aspects of development. (Arch Dis Child 1997;76:F9-F14)

Prevalence of Developmental Coordination Disorder Using the DSM-IV at 7 Years of Age: A UK Population–Based Study

“…25,26 Our finding of an increased risk of DCD with lower gestation and birth weight supports this link and adds credence to our case allocation methods.…”

Assessment of Developmental Coordination Disorder in Children Born With Extremely Low Birth Weights

“…IVH = intraventricular hemorrhage; PVL = periventricular leukomalacia; BPD = bronchopulmonary dysplasia (i.e., oxygen dependent at gestational age 36 weeks); ROP = retinopathy of prematurity; NEC = necrotizing enterocolitis; R 2 = 0.34, Adjusted R 2 = 0.21. risk for DCD. In the present study, the proportion of children with DCD at 5 years of age (i.e., approximately 66%) was higher than that reported in many studies of preterm children (Botting et al, 1998;Davis et al, 2007;de Kleine et al, 2003;Erickson et al, 2003;Hack et al, 2005;Hall et al, 1995;Jongmans et al, 1997;Wocadlo & Rieger, 2008,), but similar to that reported by Torrioli et al (2000). One possible explanation for this higher rate is that we included a subset of preterm children, those born at ≤1,000 g, who may be at higher risk of motor impairment, whereas, many previous studies have included a broader sample of preterms, children born at <1,500 g, who as a group could be at lower risk overall.…”

“…Even though these children may perform satisfactorily on measures of neurocognitive abilities during infancy, many display a wide range of impairments in motor, cognitive, and behavioral functions as they mature (Anderson, Doyle, & Victoria Infant Collaborative Study Group, 2003;Voss, Neubauer, Wachtendorf, Verhey, & Kattner, 2007). Difficulties in motor abilities have been consistently reported in preterm children (Davis, Ford, Anderson, & Doyle, 2007;de Kleine et al, 2003;Dewey, Crawford, Creighton, & Sauve, 1999;Foulder-Hughes & Cooke, 2003;Hack et al, 2005;Jongmans, Mercuri, Dubowitz, & Henderson, 1998;Taylor, Minich, Klein, & Hack, 2004;Wocadlo & Rieger, 2008) with the prevalence of motor disturbances ranging from 10-72% (Botting, Powls, Cooke, & Marlow, 1998;Davis et al, 2007;de Kleine et al, 2003;Erickson, Allert, Carlberg, & Katz-Salamon, 2003;Hack et al, 2005;Hall, McLeod, Counsell, Thomson, & Mutch, 1995;Jongmans, Mercuri, de Vries, Dubowitz, & Henderson, 1997;Torrioli et al, 2000;Wocadlo & Rieger, 2008). However, few studies have attempted to identify neonatal risk factors that predict degree of motor impairment (Keller, Ayub, Saigal, & Bar-Or, 1998;Mutch, Leyland, & McGee, 1993;Taylor, Klein, Drotar, Schluchter, & Hack, 2006).…”

Neurological soft signs in mainstream pupils

“…Other authors believe they represent a developmental lag rather than a fixed abnormality 5. Studies have found a high incidence of soft signs in children following premature6 or low birthweight7 birth, meningitis,8 and malnutrition 910 …”