Motor impairment in very preterm‐born children: links with other developmental deficits at 5 years of age

Abstract

ABBREVIATIONS MNDMinor neurological dysfunction MABC-2 Movement Assessment Battery for Children -2nd edition AIM To elucidate the relation between motor impairment and other developmental deficits in very preterm-born children without disabling cerebral palsy and term-born comparison children at 5 years of (corrected) age.METHOD In a prospective cohort study, 165 children (81 very preterm-born and 84 term-born)were assessed with the Movement Assessment Battery for Children -2nd edition, Touwen's neurological examination, the Wechsler Preschool and Primary Scale of Intelligence, processing speed and visuomotor coordination tasks of the Amsterdam Neuropsychological Tasks, and the Strengths and Difficulties Questionnaire.RESULTS Motor impairment (≤15th centile) occurred in 32% of the very preterm-born children compared with 11% of their term-born peers (p=0.001). Of the very preterm-born children with motor impairment, 58% had complex minor neurological dysfunctions, 54% had low IQ, 69% had slow processing speed, 58% had visuomotor coordination problems, and 27%, 50%, and 46% had conduct, emotional, and hyperactivity problems respectively. Neurological outcome (odds ratio [OR]=41.7, 95% confidence intervals [CI] 7.5-232.5) and Full-scale IQ (OR=7.3, 95% CI 1.9-27.3) were significantly and independently associated with motor impairment. Processing speed (OR=4.6, 95% CI 1.8-11.6) and attention (OR=3.2, 95% CI 1.3-7.9) were additional variables associated with impaired manual dexterity. These four developmental deficits mediated the relation between preterm birth and motor impairment.INTERPRETATION Complex minor neurological dysfunctions, low IQ, slow processing speed, and hyperactivity/inattention should be taken into account when very preterm-born children are referred for motor impairment.

Motor impairment in very preterm infants: implications for clinical practice and research

“…3 Often co-occurring with these motor problems are other developmental disorders, such as attention-deficit-hyperactivity disorder, learning disabilities, and specific language impairment, which is suggestive of a shared etiology. 3 Van Hus et al 4 report that 32% of their very preterm cohort without CP (n = 81) had poor motor scores at age 5 years, less than the 42% prevalence of DCD reported in other preterm cohorts. 5,6 Van Hus et al examined what other developmental deficits were most associated with motor impairment, finding that four deficits -minor neurological dysfunction, low IQ, slow processing speed, and hyperactivity/inattention -mediated the relationship between preterm birth and motor impairment.…”

Physiotherapy intervention for 4-5 year old children born extremely preterm and/or extremely low birth weight

“…It has already been mentioned that preterm and LBW children do not just have isolated motor difficulties but other functional impairments as well (Burns & Bullock, 1985;FoulderHughes & Cooke, 2003;Marlow et al, 1989;Van Hus et al, 2014). This co-existence of impairments can be explained by the dynamic systems theory of development and the interacting nature of systems and environments (Sweeney et al, 2010).…”

“…This co-existence of impairments can be explained by the dynamic systems theory of development and the interacting nature of systems and environments (Sweeney et al, 2010). At five years of age very preterm children who have motor impairments are likely to have complex minor neurological dysfunctions, low intelligence, slow processing speed, visual-motor coordination difficulties and hyperactivity issues (Van Hus et al, 2014). These problems are likely to become quantitatively more significant when greater demands are placed on these children as they progress through school and beyond.…”

“…The range of neurodevelopmental impairments and their possible inter-relationship amongst children born very preterm or with ELBW has been briefly reviewed (Marlow et al, 1989;Van Hus et al, 2014). Diamond has also provided evidence of a link between cognitive and motor development and suggests that if either cognitive or motor function is affected, this often has an adverse impact on both areas of development (Diamond, 2000).…”

“…More recently, Van Hus et al explored the relationship between motor impairment and other developmental domains in a prospective cohort study comparing children born very preterm without disabling cerebral palsy to term born children at five years corrected age (Van Hus et al, 2014). The study found the incidence of motor impairment to be 32% amongst the very preterm children and 54% of these children had low IQ.…”