Neurodevelopmental assessment in the first year with emphasis on evolution of tone.

ABSTRACT

Neurodevelopmental assessment in the first year of life is important for determining presence or absence of brain damage. Assessment of passive tone is essential for planning interventional therapy. One hundred infants with a normal antenatal, natal and perinatal course were prospectively followed up for one year. Social smile had appeared by 6 weeks in all infants, transfer of objects at 6 months, clapping by 9 months and scribbling on paper (imitative or spontaneous) by 12 months. Neonatal reflexes disappeared by 3 months, lateral propping appeared in all infants at 9 months, however parachute reflex appeared in 96.5% of 87 infants tested at 9 months. Measurement of passive tone by popliteal angle and adductor angle was done at 3, 6, 9, 12 months and scarf sign was also evaluated. The mean popliteal angle increased from 100.6 +/- 5.4 at 3 months to 136 +/- 4.0 at 12 months, whereas the adductor angle increased from 84.8 +/-6.5 to 126.6 +/- 5.3 degrees. The fast and the quick component of the dorsiflexion angle showed a difference of less than 10 at all testings. Assessment of active tone in the form of head support at 3 months was present in all the infants, 95% had pull to sit at 6 months and all 100% had pull to stand at 9 months.