ABSTRACT
Theories of visual attention suggest a cascading development of subfunctions such as alertness, spatial orientation, attention to object features, and endogenous control. Here, we aimed to track infants' visual developmental steps from a primarily exogenously to more endogenously controlled processing style during their first months of life. In this repeated measures study, 51 infants participated in seven fortnightly assessments at postterm ages of 4-16 weeks. Infants were presented with the same set of static and dynamic paired comparison stimuli in each assessment. Visual behavior was evaluated by a newly introduced scoring scheme. Our results confirmed the suggested visual developmental hierarchy and clearly demonstrated the suitability of our scoring scheme for documenting developmental changes in visual attention during early infancy. Besides the general ontogenetic course of development, we also discuss intra- and interindividual differences which may affect single assessments, and highlight the importance of repeated measurements for reliable evaluation of developmental changes.
Subject(s)
Child Development , Problem Solving , Humans , Infant , Infant, NewbornABSTRACT
The Prechtl General Movement Assessment (GMA) has become a cornerstone assessment in early identification of cerebral palsy (CP), particularly during the fidgety movement period at 3-5 months of age. Additionally, assessment of motor repertoire, such as antigravity movements and postural patterns, which form the Motor Optimality Score (MOS), may provide insight into an infant's later motor function. This study aimed to identify early specific markers for ambulation, gross motor function (using the Gross Motor Function Classification System, GMFCS), topography (unilateral, bilateral), and type (spastic, dyskinetic, ataxic, and hypotonic) of CP in a large worldwide cohort of 468 infants. We found that 95% of children with CP did not have fidgety movements, with 100% having non-optimal MOS. GMFCS level was strongly correlated to MOS. An MOS > 14 was most likely associated with GMFCS outcomes I or II, whereas GMFCS outcomes IV or V were hardly ever associated with an MOS > 8. A number of different movement patterns were associated with more severe functional impairment (GMFCS III-V), including atypical arching and persistent cramped-synchronized movements. Asymmetrical segmental movements were strongly associated with unilateral CP. Circular arm movements were associated with dyskinetic CP. This study demonstrated that use of the MOS contributes to understanding later CP prognosis, including early markers for type and severity.
