The predictive value of early oral motor assessments for neurodevelopmental outcomes of moderately and late preterm infants

Zhang, Xianhong; Zhou, Mingyang; Yin, Huaying; Dai, Ying; Li, Yuwei

doi:10.1097/md.0000000000009207

Cited by 10 publications

(9 citation statements)

References 23 publications

(26 reference statements)

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“…The NOMAS and GMA are already used to predict neurodevelopmental disorders separately [ 8 – 10 , 13 , 14 , 20 , 24 ]. Furthermore, both these assessment methods were shown to be related to later developmental functioning, using Bayley assessment tool [ 15 , 16 , 21 , 23 , 32 ]. Our study demonstrated that the NOMAS and detailed GMA were related to later developmental functioning outcomes in all infants, in addition to the relationship between each other.…”

Section: Discussionmentioning

confidence: 99%

“…The rates of disorganized sucking patterns according to the NOMAS were reported as 42.37% in moderately and late infants at 36 to 37 weeks postmenstrual age by Zhang et al [ 23 ] which excluded infants with neurological disorders. Our findings showed a higher incidence of normal sucking patterns in both all infants and preterm infants than a previous study [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

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Are sucking patterns and early spontaneous movements related to later developmental functioning outcomes? A cohort study

Yardımcı-Lokmanoğlu,

Demir,

Porsnok

et al. 2024

Eur J Pediatr

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Sucking patterns and early spontaneous movements have an important role in the determination of later developmental problems, but the relationship of the two together with long-term outcomes has not been investigated. The objectives of this study were to (i) examine the relationship between sucking patterns using the Neonatal Oral Motor Assessment Scale (NOMAS) and fidgety movements and other movement patterns using detailed General Movements Assessment (GMA), and (ii) investigate the relationship between these early assessment methods and developmental functioning outcomes at later ages. We analyzed the NOMAS from 34 weeks’ postmenstrual age up to 10 weeks post-term and GMA between 9 and 20 weeks post-term age, and the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) was applied for the developmental functioning outcomes to 62 infants (61%, 62/102) between 12 and 42 months of age. Among 102 infants at-risk, 70 (69%) showed a normal sucking pattern, and 85 (83%) had fidgety movements. The median Motor Optimality Score-Revised (MOS-R), as determined by GMA, of all infants was 24. The NOMAS was related to the MOS-R and its subcategories (p < 0.05) in all infants at-risk. The NOMAS, MOS-R and its subcategories were also related to cognitive, language, and motor development at later ages according to Bayley-III (p < 0.05). Conclusion: This longitudinal study showed that the quality of sucking patterns, fidgety movements, and MOS-R were related to later developmental functioning, indicating that abnormal sucking patterns, aberrant fidgety movements, and lower MOS-R might predict developmental disorders. What is Known:• Sucking patterns and early spontaneous movements in which central pattern generators play an important role are related.• Sucking patterns and early spontaneous movements might be used separately to predict developmental outcomes. What is New:• Sucking patterns and early spontaneous movements, when used together, were related to later developmental functioning, including cognitive, language, and motor development in at-risk infants.• Predictive value of sucking patterns was lower for each developmental functioning outcome than early spontaneous movements.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Are sucking patterns and early spontaneous movements related to later developmental functioning outcomes? A cohort study

Yardımcı-Lokmanoğlu,

Demir,

Porsnok

et al. 2024

Eur J Pediatr

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“…The Neonatal Oral-Motor Assessment Scale (NOMAS), developed in the mid-1980s, is a common observational tool used to assess jaw and tongue movement with qualitative results of normal sucking, disorganized sucking, or dysfunctional sucking pattern (71)(72)(73)(74). A dysfunctional pattern is believed to be a sign of neurological impairment (75,76), however it is controversial (71,74). One problem lies in the NOMAS relying purely on the training and experience of the rater performing the scale because it is only an observation of how the infant feeds.…”

Section: Assessmentsmentioning

confidence: 99%

Abnormal Nutritive Sucking as an Indicator of Neonatal Brain Injury

et al. 2021

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A term neonate is born with the ability to suck; this neuronal network is already formed and functional by 28 weeks gestational age and continues to evolve into adulthood. Because of the necessity of acquiring nutrition, the complexity of the neuronal network needed to suck, and neuroplasticity in infancy, the skill of sucking has the unique ability to give insight into areas of the brain that may be damaged either during or before birth. Interpretation of the behaviors during sucking shows promise in guiding therapies and how to potentially repair the damage early in life, when neuroplasticity is high. Sucking requires coordinated suck-swallow-breathe actions and is classified into two basic types, nutritive and non-nutritive. Each type of suck has particular characteristics that can be measured and used to learn about the infant's neuronal circuitry. Basic sucking and swallowing are present in embryos and further develop to incorporate breathing ex utero. Due to the rhythmic nature of the suck-swallow-breathe process, these motor functions are controlled by central pattern generators. The coordination of swallowing, breathing, and sucking is an enormously complex sensorimotor process. Because of this complexity, brain injury before birth can have an effect on these sucking patterns. Clinical assessments allow evaluators to score the oral-motor pattern, however, they remain ultimately subjective. Thus, clinicians are in need of objective measures to identify the specific area of deficit in the sucking pattern of each infant to tailor therapies to their specific needs. Therapeutic approaches involve pacifiers, cheek/chin support, tactile, oral kinesthetic, auditory, vestibular, and/or visual sensorimotor inputs. These therapies are performed to train the infant to suck appropriately using these subjective assessments along with the experience of the therapist (usually a speech therapist), but newer, more objective measures are coming along. Recent studies have correlated pathological sucking patterns with neuroimaging data to get a map of the affected brain regions to better inform therapies. The purpose of this review is to provide a broad scope synopsis of the research field of infant nutritive and non-nutritive feeding, their underlying neurophysiology, and relationship of abnormal activity with brain injury in preterm and term infants.

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“…Multiple studies have demonstrated that early feeding difficulties may predict later neurodevelopment delays (Tsai et al, 2010;Northam et al, 2012;Jadcherla et al, 2017;Zhang et al, 2017). In this first report of longer-term impact of taVNS-paired feeding, we investigated whether there were neurodevelopmental and sensory effects at 18 months in children who received taVNS treatment as infants.…”

Section: Introductionmentioning

confidence: 99%

Use of non-invasive transcutaneous auricular vagus nerve stimulation: neurodevelopmental and sensory follow-up

Aljuhani,

Coker-Bolt,

Katikaneni

et al. 2023

Front. Hum. Neurosci.

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ObjectiveTo assess the impact of non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) paired with oral feeding on long-term neurodevelopmental and sensory outcomes.MethodWe tested 21 of 35 children who as infants were gastrostomy tube (G-tube) candidates and participated in the novel, open-label trial of taVNS paired with oral feeding. To evaluate possible effects on development at 18-months after infant taVNS, we performed the Bayley-III (n = 10) and Sensory Profile (SP-2, n = 12) assessments before the COVID pandemic, and Cognitive Adaptive Test (CAT), Clinical Linguistics and Auditory Milestone (CLAMS), Ages and Stages Questionnaire (ASQ), and Peabody Developmental Motor Scales-2 gross motor tests as possible during and after the pandemic. We compared outcomes for infants who attained full oral feeds during taVNS (‘responders’) or received G-tubes (‘non-responders’).ResultsAt a mean of 19-months, taVNS ‘responders’ showed significantly better general sensory processing on the SP-2 than ‘non-responders’. There were no differences in other test scores, which were similar to published outcomes for infants who required G-tubes.ConclusionThis is the first report of neurodevelopmental follow-up in infants who received taVNS-paired feeding. They had similar developmental outcomes as historical control infants failing oral feeds who received G-tubes. Our data suggests that infants who attained full oral feeds had better sensory processing.

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The predictive value of early oral motor assessments for neurodevelopmental outcomes of moderately and late preterm infants

Cited by 10 publications

References 23 publications

Are sucking patterns and early spontaneous movements related to later developmental functioning outcomes? A cohort study

Are sucking patterns and early spontaneous movements related to later developmental functioning outcomes? A cohort study

Abnormal Nutritive Sucking as an Indicator of Neonatal Brain Injury

Use of non-invasive transcutaneous auricular vagus nerve stimulation: neurodevelopmental and sensory follow-up

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