Differences in the Development of Motor Skills in Portuguese Children Aged 12 Months after 3 Years of COVID-19 Confinement.

(1) Background: The objective of the study was to verify the effects of COVID-19 confinement on motor skills through a longitudinal study in Portuguese children who were one year old at the beginning of the pandemic. (2) Methods: The sample consisted of 88 children of both sexes, in the pre-COVID-19 assessment, they were 13.31 ± 2.4 months old and in the post-COVID-19 assessment, the same children were already 49.31 ± 2.5 months old. Motor skills were assessed using the PDMS-2 scales. For the statistical analysis, the Kolmogorov-Smirnov test was used to test normality, and the Wilcoxon test was used to compare the results of the two assessments in the same sample. (3) Results: There were statistically significant differences in all motor skills assessed, with children presenting, on average, worse results in all global motor skills in the post-COVID-19 assessment, as opposed to fine motor skills, showing better results in the post-COVID-19 assessment. (4) Conclusions: These results show the negative impact of the pandemic on children evaluated with a special emphasis on global motor skills, with the majority demonstrating values considered below average for their age, noting that the pandemic protocols may have had serious consequences on children's motor development, warning professionals who deal daily with children in these age groups about the importance of stimulating global motor skills.

The Impact of Birth Season and Sex on Motor Skills in 2-Year-Old Children: A Study in Jinhua, Eastern China.

BACKGROUND: This study investigates the effects of birth season and sex on the development of gross and fine motor skills in 2-year-old children in Jinhua, Eastern China. METHODS: Conducted in Jinhua, a city in central Zhejiang Province, Eastern China, this research involved 225 children, assessing their gross and fine motor skills using the Peabody Developmental Motor Scales, Second Edition. Scores were adjusted for age in months to avoid the relative age effect. Statistical analyses included MANOVA to evaluate the impacts of season and sex. RESULTS: Sex had no significant impact on overall motor development scores (p > 0.05). However, the season of birth significantly affected fine motor quotient (FMQ) and total motor quotient (TMQ) (p < 0.05). Boys' motor skills were generally unaffected by season, whereas girls born in winter exhibited superior fine motor skills compared to those born in summer. CONCLUSIONS: Seasonal environmental factors significantly influence early motor development, particularly fine motor skills in girls. These findings highlight the importance of considering seasonal variations in early childhood interventions aimed at enhancing exercise physiology and sports performance.

Assessment of the measurement properties of the Peabody Developmental Motor Scales-2 by applying the COSMIN methodology.

The Peabody Developmental Motor Scales-2 (PDMS-2) has been used to assess the gross and fine motor skills of children (0-6 years); however, the measurement properties of the PDMS-2 are inconclusive. Here, we aimed to systematically review the measurement properties of PDMS-2, and synthesize the quality of evidence using the Consensus-based Standards for the Selection of Health Measurements Instruments (COSMIN) methodology. Electronic databases, including PubMed, EMBASE, Web of Science, CINAHL and MEDLINE, were searched for relevant studies through January 2023; these studies used PDMS-2. The methodological quality of each study was assessed by the COSMIN risk-of-bias checklist, and the measurement properties of PDMS-2 were evaluated by the COSMIN quality criteria. Modified GRADE was used to evaluate the quality of the evidence. We included a total of 22 articles in the assessment. Among the assessed measurement properties, the content validity of PDMS-2 was found to be sufficient with moderate-quality evidence. The structural validity, internal consistency, test-retest reliability and interrater reliability of the PDMS-2 were sufficient for high-quality evidence, while the intrarater reliability was sufficient for moderate-quality evidence. Sufficient high-quality evidence was also found for the measurement error of PDMS-2. The overall construct validity of the PDMS-2 was sufficient but showed inconsistent quality of evidence. The responsiveness of PDMS-2 appears to be sufficient with low-quality evidence. Our findings demonstrate that the PDMS-2 has sufficient content validity, structural validity, internal consistency, reliability and measurement error with moderate to high-quality evidence. Therefore, PDMS-2 is graded as 'A' and can be used in motor development research and clinical settings.

Agreement between Hammersmith Neonatal Neurological Examination (HNNE) and Test of Infant Motor Performance (TIMP) in neurodevelopmental assessment of preterm infants <32 weeks' gestation at term corrected age.

OBJECTIVES: To determine the agreement between HNNE and TIMP at TCA for preterm infants born <32+0 weeks' gestation, and to evaluate their correlation to PDMS-2 at 12-month corrected age (CA). METHODS: Infants born between November 2013 to June 2022 who had both HNNE and TIMP performed at TCA of 37+0-41+6 weeks gestation, and motor outcome assessed using the PDMS-2 at 12-month old were enrolled. The HNNE and 12-month PDMS-2 findings were categorized as optimal vs sub-optimal. TIMP was categorized as typical vs atypical. Cohen's kappa was used to determine the agreement between HNNE and TIMP. Sensitivity analysis and Receiver Operating Characteristic (ROC) curves were used to evaluate the predictive values of HNNE and TIMP on motor outcome at CA of 12-months. RESULTS: HNNE and TIMP done on 125 infants at TCA do not show reliable agreement. HNNE demonstrated slight and fair agreement with the 12-month Total Motor Quotient (TMQ) and Fine Motor Quotient (FMQ) of the PDMS-2 respectively. TIMP at TCA demonstrated fair agreement with all sub-domains of motor function on PDMS-2 at 12-months. In comparison with TIMP, HNNE at TCA is more sensitive at predicting suboptimal total, gross and fine motor outcomes at 12-month CA with sensitivity of 68.4 %, 51.9 %, and 83.3 % vs 44.4 %, 31.8 % and 53.3 % respectively. Atypical TIMP at TCA is more specific for suboptimal total, gross and fine motor outcomes at 12-month CA with specificity of 90.3 %, 89 % and 90.5 % respectively. Neurobehavioral assessments at TCA using HNNE and TIMP were predictive of suboptimal fine motor quotient at CA of 12-months with AUC of 0.760 (p = 0.011) and 0.718 (p = 0.032) respectively. The difference in AUC between the 2 instruments of 0.042 was not statistically significant (p = 0.741). CONCLUSIONS: While the HNNE and TIMP done at TCA did not demonstrate significant agreement, suboptimal HNNE and atypical TIMP at TCA were predictive of suboptimal FMQ on PDMS-2 at 12-month CA.

Immediate effects of a novel hand rehabilitation board on fine motor skills in children with cerebral palsy: A pilot study.

BACKGROUND: In children with cerebral palsy (CP), fine motor skills limit forearm supination and active extension of the elbow, wrist, or fingers. Therapeutic interventions focusing on improving the ranges at these joints while facilitating active movements are the key to augmenting fine motor skills. OBJECTIVE: This pilot study examines if children with CP (with UE involvement) exposed to the Novel Hand Rehabilitation (NHR) Board will demonstrate 1) changes in spasticity and passive ROM of forearm and wrist/finger muscles, and 2) improvement in fine motor abilities. METHODS: The forearm and wrist/fingers of children with spastic CP (N = 15; M = 7, F = 8) aged 49-72 months (65.33±6.355 months) were positioned on the NHR board till their tolerance limit or a minimum duration of 30 minutes. The outcome measures, i.e., spasticity (Modified Ashworth Scale), passive range of motion (PROM) of wrist and fingers, and fine motor skills (PDMS-2 - Fine motor scale), were recorded. RESULTS: The spasticity of forearm pronators (0.001) and wrist flexors (0.008) reduced significantly, but not in wrist extensors. Post-intervention improvements in wrist extension (p = 0.005) and ulnar deviation ROM (p = 0.007) were significant. In thumb, changes were non-significant for the CMC flexion, but extension (0.003) and abduction (0.001) as well as MCP extension (0.004) were significant. The post-intervention MCP extension ROM for the 2nd (0.001), 3rd (0.007), and 4th fingers (0.014) were also substantial, but not for PIP and DIP joints. The post-intervention percentage change in the Grasping and Visual-motor integration subtests of PDMS-2 was 11.03% (p = 0.002) and 5.09% (p = 0.001) respectively. CONCLUSION: The immediate effects on fine motor skills in children with CP after the NHR board application were positive and encouraging. Hence, the NHR board can be recommended as an intervention to improve the fine motor abilities of children with CP.

The importance of oriented physical activity in the first 48 months: differences in motor skills.

BACKGROUND: The importance of physical activity in the first months of age is well known, however, with the evolution of the urban environment, the excessive workload of parents and the excessive time in growing up in kindergartens has limited this same free practice and little has been studied about this issue. In Portugal, there are institutions that provide oriented physical activity for their children, however, this is optional, which may create disadvantages in children's motor skills in these ages. OBJECTIVE: The objective of the study isto verify if there are differences in the development of motor skills (global and fine) comparing children between 12 and 48 months who practice oriented physical activity (OPA) and children who do not. METHODS: Participated in this study, 400 children of both genders (28.14 ± 7.23 months). Two groups were created (the group that had oriented physical activity (30 min long and 2 times a week) and the group that didn't have oriented physical activity). For a better understanding they were divided into 3 age groups (12-23, 24-35 and 36-48 months). Motor skills were assessed using the PDMS-2 scales, for 6 months, following the instrument's application standards. RESULTS: In a first analysis, we found that the majority of children only start to practice oriented physical activity in institutions from 36 months of age, however, it is in the first months (from 12 to 35) that the greatest differences between the two groups can occur. The OPA group presented better results according to the mean values, in all motor skills. Differences between groups were most noticeable in Postural, locomotion and fine manipulation Skills (showing effect size: moderate and low). CONCLUSIONS: We can conclude that a practice of oriented physical activity in the first 48 months is fundamental to the development of motor skills. It is in the first months (up to 36) that there are greater differences, but it is also where there are less children carrying out guided physical activity. This is an important factor, and is determinant to make institutions aware of this importance of this variable in child development.

Peabody Developmental Motor Scales-2: The Use of Rasch Analysis to Examine the Model Unidimensionality, Motor Function, and Item Difficulty.

The Peabody Developmental Motor Scales-Second Edition (PDMS-2) is a valid and reliable instrument used in several countries, including Brazil, to assess gross and fine motor skills and identify motor deficits and eligibility for intervention for children with and without disabilities. However, the analysis of PDMS-2 items regarding the unidimensionality of the model, order of item difficulty, and whether the items portray the children's developmental trajectories still lacks investigation. Therefore, this study aims to: (1) analyze the unidimensionality of PDMS-2, (2) verify the model's capacity to explain the variance in the motor function responses, and (3) identify the level of difficulty of the items for Brazilian children. Children (n = 637; 51% girls) newborn to 71 months (M age = 21.7, SD = 18.6) were assessed using the PDMS-2. The Rasch analysis was conducted; the indexes of infit and outfit, and the point-biserial correlations coefficient were analyzed. The model unidimensionality was investigated using percentages of variance in the Rasch model (40% of variance). Results indicated that (1) for reflexes subscale, 62.5% of the items had correlations with the factor above 0.60, and two items had unadjusted infit and outfit; (2) for stationary subscale, 83.3% of the correlations of the items with the factor were above 0.50, and one item had unadjusted infit and outfit; (3) for locomotion subscale, 80.0% of the correlation of the items with the factor were above 0.50; all items had adequate infit and outfit; (4) for object manipulation subscale, 79.9% of the correlation of the items with the factor were above 0.50, and one item had unadjusted infit and outfit; (5) for grasping subscale, 92.3% of the correlation of the items with the factor were above 0.50, and one item had unadjusted infit and outfit; and (6) for the visual-motor integration subscale, 73.6% of the correlation of the items with the factor were above 0.50, and six items had unadjusted infit and outfit. The items with unadjusted fit were removed for further analysis. No changes in reliability and separation of items and people scores were observed without the unadjusted items; therefore, all items were maintained. A unidimensional model was found, and the reliability and discriminant capability of the items were adequate, and all items should be used to assess children. The PDMS-2 is appropriate for assessing Brazilian children.

Evaluation of the Psychometric Properties of the Portuguese Peabody Developmental Motor Scales-2 Edition: A Study with Children Aged 12 to 48 Months.

The purpose of this study was to examine the psychometric properties of Peabody Developmental Motor Scales II (PDMS-2-Folio and Fewell, 2000) using a Portuguese sample. The validation of the Portuguese version of the PDMS-2 was applied according to the manual, for 392 children, from two institutions, from 12 to 48 months, with an analysis of the internal consistency (α Cronbach), of test-retest reliability (ICC) and construct validity (confirmatory factor analysis). The results of the confirmatory factorial analysis (χ2 = 55.614; df = 4; p = 0.06; χ2/df =13.904; SRMR (Standardized Root Mean Square Residual) = 0.065; CFI (Comparative Fit Index) = 0.99, TLI = 0.99, RMSEA (Root Mean Square Error of Approximation) = 0.068) of two factors (Gross Motor and Fine Motor) as the original version but correlated. Most of the subtests had good internal consistency (α = 0.85) and good test-retest stability (ICC = 0.98 to 0.99). The results indicated that the Portuguese version of the PDMS-2 is adequate and valid for assessing global and fine motor skills in children aged 12 to 48 months, and can be used as a reference tool by health and education professionals to assess motor skills and, thus, allowing to detect maladjustments, deficiencies or precocity, so that children can later receive appropriate intervention.

Validación de la PDMS-2 en población española. Evaluación de la intervención de fisioterapia y la participación de los padres en el tratamiento de niños con trastornos del neurodesarrollo / Validation of the PDMS-2 scale in the Spanish population. Evaluation of physiotherapy intervention and parental involvement in the treatment of children with neurodevelopmental disorders

Objetivo: Adaptar transculturalmente la escala del desarrollo motor de Peabody, segunda edición (PDMS-2), del español mexicano al español de España y evaluar su validez. Determinar la eficacia del tratamiento fisioterápico (número de sesiones de fisioterapia y actividades propuestas por el fisioterape uta y realizadas por los padres) en niños con trastornos del neurodesarrollo de 0 a 3 años.Sujetos y métodos: Un primer estudio descriptivo prospectivo de validación de la PDMS-2, que incluyó a 74 sujetos con trastorno del neurodesarrollo con edades comprendidas entre 0 y 3 años. Un segundo ensayo clínico aleatorio para evaluar la intervención de fisioterapia (concepto Bobath) en el grupo experimental (n = 37), que recibió sesiones únicas de 30 minutos semanales durante ocho semanas frente al grupo de control (n = 37), que no recibió fisioterapia y utilizó la PDMS-2 para su evaluación. Resultados: Se encontró una adecuada confiabilidad interagente (coeficiente de correlación intraclase = 0,76). La escala mostró también una muy buena consistencia interna (alfa = 0,99). Hubo diferencias significativas entre ambos grupos a las ocho semanas. El grupo experimental obtuvo mejores puntuaciones en el postest después de administrar el tratamiento de fisioterapia (p < 0,001). Se encontraron coeficientes de correlación moderados y significativos entre el número de sesiones de fisioterapia y el cociente motor total (r = 0,38; p < 0,05) y las actividades realizadas en casa con el cociente motor total (r = 0,46; p = 0,005). Conclusiones: La PDMS-2 es un instrumento válido y fiable para medir el desarrollo motor grueso y fino en niños con trastorno del neurodesarrollo de 0 a 3 años. La fisioterapia es útil en la mejoría en niños con retraso del neurodesarrollo...(AU)

Aim: Cross-culturally adapt the PDMS-2 scale from Spanish-Mexican to Spanish-Spanish and evaluate its validity. To determine the efficacy of physiotherapy treatment (number of physiotherapy sessions and activities proposed by the physiotherapist and performed by the parents) in children with neurodevelopmental disorders between the ages of 0 and 3 years. Subjects and methods: A first prospective descriptive study of validation of the PDMS-2 scale including 74 subjects with neurodevelopmental disorder with aged from 0 and 3 years old. A second randomized clinical trial to evaluate the physiotherapy (Bobath concept) intervention in the experimental group (EG) (n = 37) who received unique 30-minute weekly sessions for 8 weeks against the control group (CG) (n = 37) that did not receive physiotherapy using the PDMS-2 scale for evaluation. Results: An adequate inter-rater reliablity was found (ICC = 0.76). The scale showed also a very good internal consistency (alpha = 0,99). Significant differences between both groups at 8 weeks. EG obtained better scores in the postest after administrating the physiotherapy treatment (p < 0.001) Moderate and significant correlation coefficients were found between the number of physiotherapy sessions and Total Motor Quotient (TMQ) (r = 0.38; p < 0.05) and the home actitvities with TMQ (r = 0.46; p = 0.005). Conclusions: The Peabody PDMS-2 scale is a valid and reliable instrument to measure gross and fine motor development in children with neurodevelopmental disorder aged from 0 and 3 years old. Physiotherapy is useful for helping children with delayed neurodevelopment improve. The number of physiotherapy sessions and the activities proposed by the physiotherapist and performed at home by the parents show a direct and positive relationship with the results obtained in motor development.(AU)

Effect of Siblings and Type of Delivery on the Development of Motor Skills in the First 48 Months of Life.

This study aimed to verify whether the presence of siblings and the type of delivery had an influence on the motor skills development of children in the first 48 months of life. We developed a quantitative study with a sample of 405 children of both genders, divided according to the studied variables: children with siblings, children without siblings, children born via eutocic delivery, and children born via dystocic delivery. The instrument used in the study was the Peabody Developmental Motor Scales-2. Overall, the results indicated that children who had siblings had, on average, better outcomes regarding all motor skills (global and fine). Furthermore, those born via eutocic delivery, on average, had better outcomes regarding all motor skills (global and fine) when compared to children born via dystocic delivery. Thus, the presence of siblings in the family context and the type of delivery positively influenced motor development, especially after 24 months of age, showing that the presence of siblings providing cooperative activities through play and challenges improved cognitive, social, emotional, and physical development. Furthermore, a eutocic delivery, in addition to providing a better recovery from labor and the immediate affective bond between mother and child, also led to better results in terms of global and fine motor skills.

Earlier and higher dosing of alglucosidase alfa improve outcomes in patients with infantile-onset Pompe disease: Evidence from real-world experiences.

OBJECTIVE: Enzyme replacement therapy (ERT), the only approved therapy for infantile-onset Pompe disease (IOPD), had heterogeneous clinical effects due to factors such as severity, age at first treatment, dosage, and dosing regimens. We report the clinical and biochemical outcomes of a cohort of IOPD patients identified through newborn screening, and evaluating the dosage effect. STUDY DESIGN: A retrospective observational study was designed to describe the long-term clinical and biochemical outcomes of a uniform cohort of IOPD patients who have been treated with high-dosage of ERT. RESULTS: Twenty-eight patients received alglucosidase alpha at either the labeled dosage followed by a high dosage (n = 23) or a high dosage exclusively (n = 5). At a median age of 8.3 years (0.8-17.3), 15 patients were walkers, 8 were weak walkers, and 5 were nonwalkers. The three groups exhibited a significant difference in the age of gross motor decline (p < .001). In patients with classical IOPD diagnosed through newborn screening, those late in ERT initiation (p = .006) or late in high-dosage ERT initiation (p = .044) had a higher risk of motor decline. At the latest assessment, both serum creatine kinase (CK) and urinary glucose tetrasaccharide (uGlc4) levels were lowest in the walkers. During follow up, the biomarker levels, once rose, never returned to normal. CONCLUSION: Low CK and uGlc4 levels were correlated with favorable response to ERT in IOPD patients, although CK may be more fluctuated than uGlc4. High-dose ERT instituted immediately at newborn screening seems to give the best outcome, and a dosage increase is necessary upon - or, even better, before - a rise in biomarker levels.

Concurrent Validity of the Bayley-III and the Peabody Developmental Motor Scales-2 at 18 Months.

Aim: To determine concurrent validity between the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) and the Peabody Developmental Motor Scales, 2nd edition (PDMS-2). Methods: Both assessments were administered to 184 preterm children at 18 months corrected age; standard scores for total score, gross motor, and fine motor were calculated for each child. Cross-tabulation and Pearson correlation coefficient (r) determined concurrent validity between the Bayley-III and the PDMS-2 motor domains. Results: High correlations were found between total motor (r = 0.88), gross motor (r = 0.88), and fine motor scores (r = 0.79). Both assessments had 93% agreement on classification for motor impairment; 23 children were identified by both assessments as having motor impairments, but 12 children were identified differently on each assessment (7 as impaired on PDMS-2 but average on Bayley-III; 5 as impaired on Bayley-III but average on PDMS-2). Most children with motor impairments were identified as 1SD below the mean on the PDMS-2 (27/30) and Bayley-III (18/28); however, the Bayley-III identified more children 2SD below the mean (10/28) compared to the PDMS-2 (3/30). Conclusions: Both the Bayley-III and PDMS-2 identify motor delays in children; however, clinicians should be aware of the concurrent validity as each assessment may lead to differing results.

Concurrent Validity of Two Standardized Measures of Gross Motor Function in Young Children with Autism Spectrum Disorder.

AIMS: This study provides information on how two standardized measures based on different theoretical frameworks can be used in collecting information on motor development and performance in 4- and 5-year-olds with autism spectrum disorder (ASD). The purpose of the study was to determine the concurrent validity of the Miller Function and Participation Scales (M-FUN) with the Peabody Developmental Motor Scales, Second Edition (PDMS-2) in young children with ASD. METHODS: The gross motor sections of the PDMS-2 and the M-FUN were administered to 22 children with ASD between the ages of 48 and 71 months. Concurrent validity between overall motor scores and agreement in identification of motor delay were assessed. RESULTS: A very strong correlation (Pearson's r =.851) was found between the M-FUN scale scores and the PDMS-2 gross motor quotients (GMQs). Strong agreement in identification of children with average motor skills and delayed motor skills at 1.5 standard deviations below the mean was also found. CONCLUSIONS: This study supports the concurrent validity of the M-FUN with the PDMS-2 for young children with ASD. While both tests provide information regarding motor delay, the M-FUN may provide additional information regarding the neurological profile of the child.

Prenatal naled and chlorpyrifos exposure is associated with deficits in infant motor function in a cohort of Chinese infants.

BACKGROUND: Organophosphate insecticides (OPs) are used worldwide, yet despite nearly ubiquitous exposure in the general population, few have been studied outside the laboratory. Fetal brains undergo rapid growth and development, leaving them susceptible to long-term effects of neurotoxic OPs. The objective here was to investigate the extent to which prenatal exposure to OPs affects infant motor development. METHODS: 30 OPs were measured in umbilical cord blood using gas chromatography tandem mass spectrometry in a cohort of Chinese infants. Motor function was assessed at 6-weeks and 9-months using Peabody Developmental Motor Scales 2nd edition (PDMS-2) (n=199). Outcomes included subtest scores: reflexes, stationary, locomotion, grasping, visual-motor integration (V-M), composite scores: gross (GM), fine (FM), total motor (TM), and standardized motor quotients: gross (GMQ), fine (FMQ), total motor (TMQ). RESULTS: Naled, methamidophos, trichlorfon, chlorpyrifos, and phorate were detected in ≥10% of samples. Prenatal naled and chlorpyrifos were associated with decreased 9-month motor function. Scores were 0.55, 0.85, and 0.90 points lower per 1ng/mL increase in log-naled, for V-M (p=0.04), FM (p=0.04), and FMQ (p=0.08), respectively. For chlorpyrifos, scores were 0.50, 1.98, 0.80, 1.91, 3.49, 2.71, 6.29, 2.56, 2.04, and 2.59 points lower for exposed versus unexposed infants, for reflexes (p=0.04), locomotion (p=0.02), grasping (p=0.05), V-M (p<0.001), GM (p=0.007), FM (p=0.002), TM (p<0.001), GMQ (p=0.01), FMQ (p=0.07), and TMQ (p=0.008), respectively. Girls appeared to be more sensitive to the negative effects of OPs on 9-month motor function than boys. CONCLUSIONS: We found deficits in 9-month motor function in infants with prenatal exposure to naled and chlorpyrifos. Naled is being aerially sprayed to combat mosquitoes carrying Zika virus, yet this is the first non-occupational human study of its health effects. Delays in early-motor skill acquisition may be detrimental for downstream development and cognition.

How Do Maternal Subclinical Symptoms Influence Infant Motor Development during the First Year of Life?

An unavoidable reciprocal influence characterizes the mother-child dyad. Within this relationship, the presence of depression, somatization, hostility, paranoid ideation, and interpersonal sensitivity symptoms at a subclinical level and their possible input on infant motor competences has not been yet considered. Bearing in mind that motor abilities represent not only an indicator of the infant's health-status, but also the principal field to infer his/her needs, feelings and intentions, in this study the quality of infants' movements were assessed and analyzed in relationship with the maternal attitudes. The aim of this research was to investigate if/how maternal symptomatology may pilot infant's motor development during his/her first year of life by observing the characteristics of motor development in infants aged 0-11 months. Participants included 123 mothers and their infants (0-11 months-old). Mothers' symptomatology was screened with the Symptom Checklist-90-Revised (SCL-90-R), while infants were tested with the Peabody Developmental Motor Scale-Second Edition. All dyads belonged to a non-clinical population, however, on the basis of SCL-90-R scores, the mothers' sample was divided into two groups: normative and subclinical. Descriptive, t-test, correlational analysis between PDMS-2 scores and SCL-90-R results are reported, as well as regression models results. Both positive and negative correlations were found between maternal perceived symptomatology, Somatization (SOM), Interpersonal Sensitivity (IS), Depression (DEP), Hostility (HOS), and Paranoid Ideation (PAR) and infants' motor abilities. These results were further verified by applying regression models to predict the infant's motor outcomes on the basis of babies' age and maternal status. The presence of positive symptoms in the SCL-90-R questionnaire (subclinical group) predicted good visual-motor integration and stationary competences in the babies. In particular, depressive and hostility feelings in mothers seemed to induce an infant motor behavior characterized by a major control of the environmental space. When mothers perceived a higher level of hostility and somatization, their babies showed difficulties in sharing action space, such as required in the development of stationary positions and grasping abilities. In a completely different way, when infants can rely on a mother with low-perceived symptoms (normative group) his/her motor performances develop with a higher degree of freedom/independence. These findings suggest, for the first time, that even in a non-clinical sample, mother's perceived-symptoms can produce important consequences not in infant motor development as a whole, but in some specific areas, contributing to shape the infant's motor ability and his/her capability to act in the world.

Comparison of motor development of low birth weight (LBW) infants with and without using mechanical ventilation and normal birth weight infants.

BACKGROUND: To determine whether using mechanical ventilation in neonatal intensive care unit (NICU) influences motor development of low birth weight (LBW) infants and to compare their motor development with normal birth weight (NBW) infants at the age of 8 to 12 months using Peabody Developmental Motor Scale 2 (PDMS-2). METHODS: This cross sectional study was conducted on 70 LBW infants in two groups, mechanical ventilation (MV) group, n=35 and without mechanical ventilation (WMV) group, n=35 and 40 healthy NBW infants matched with LBW group for age. Motor quotients were determined using PDMS-2 and compared in all groups using ANOVA statistical method and SPSS version 17. RESULTS: Comparison of the mean developmental motor quotient (DMQ) of both MV and WMV groups showed significant differences with NBW group (p< 0.05). Also, significant difference was found between the gross DMQ of MV group and WMV group (p< 0.05). Moreover, in MV group, both gross and fine motor quotients were considered as below average (16.12%). In WMV group, the gross motor quotient was considered as average (49.51%) and the fine motor quotient was considered as below average (16.12%). CONCLUSION: It seems that LBW infants have poor fine motor outcomes. The gross motor outcomes, on the other hand, will be significantly more influenced by using mechanical ventilation. In addition, more differences seem to be related to lower birth weight. Very Low Birth Weight (VLBW) infants are more prone to developmental difficulties than LBW infants with the history of using mechanical ventilation especially in fine motor development.

Reliability and validity of the Peabody Developmental Motor Scales-second edition for assessing motor development of low birth weight preterm infants.

BACKGROUND: Motor developmental impairment is a common symptom in low birth weight neonates. The Peabody Developmental Motor Scales-second edition is an instrument for measuring motor abilities in these infants. This study aimed to validate the Peabody Developmental Motor Scales-second edition in Iran. METHODS: This was a prospective clinical validation study. The reliability and validity of the original measure were performed in accordance with published guidelines. To collect data, a total of 88 infants including 58 LBW infants and 30 normal birth weight control patients were included in the study, and the measure was completed for them. The Bayley Scales of Infant Development, second edition, and the Motor Scale (Psychomotor Development Index) also were completed for the study samples. To test reliability, the internal consistency was assessed by Cronbach alpha coefficient. Test-retest reliability was performed using Intraclass Correlation Coefficient at 1-week interval. Validity was evaluated using known groups comparison and criterion validity (convergent validity). RESULTS: The Cronbach alpha coefficient for the Peabody Developmental Motor Scales-second edition was 0.92. Further analysis also indicated that test-retest reliability was excellent (Intraclass Correlation Coefficient = .98). Validity as performed by known groups comparison indicated satisfactory result. The instrument well discriminated among subgroups of the study samples that differed in birth weight. The Psychomotor Development Index score correlated strongly with the Peabody Developmental Motor Scales-second edition (r for Fine Motor Scale = .91, P < 0.001 and r for the Peabody Developmental Motor Scales-second edition Gross Motor Scale = .93, P < 0.001). CONCLUSIONS: The findings suggest that the Iranian version of Peabody Developmental Motor Scales-second edition is a reliable and valid measure. It can now be used in clinical settings for assessing motor development in low birth weight infants.

Motor developmental status of moderately low birth weight preterm infants.

OBJECTIVE: Motor development is frequently reported to be impaired in very low birth weight (VLBW) infants, but little is known about the moderately low birth weight (MLBW) infants. The aim of this study was to investigate whether MLBW preterm infants present developmental delay. METHODS: In a historical cohort study, 18±2 month-old infants with a history of low birth weight (LBW) were identified. All infants with complications of LBW with negative effects on development were excluded. Healthy infants with normal birth weight (2500-4000 g) were included as controls. All infants were evaluated by the Peabody Developmental Motor Scale II (PDMS-2) test and final scores compared between the two groups. FINDING: 88 infants including 58 MLBW and 30 NBW with a mean birth weight of 1900±382.4 g and 3150±473.5 g respectively, were studied. In the MLBW group, gross and fine motor skill scores were below average in 6 (6.8%) and 10 (17%) infants, respectively. There were no significant differences between the two groups according to gross motor quotient (102.5±5.5 in NBW vs 100.1±7.2 in MLBW; P=0.1), but MLBW infants achieved significantly lower scores in fine motor (93.3±5.4 vs 99.6±5.0; P=0.001) and total motor quotient (97.0±5.9 vs 101.53±5.0; P=0.001). CONCLUSION: The finding of this study show developmental defects in fine motor skills in MLBW infants. Accurate monitoring of the developmental status of this population should be emphasized for an earlier recognition and intervention.

Lysine-restricted diet and mild cerebral serotonin deficiency in a patient with pyridoxine-dependent epilepsy caused by ALDH7A1 genetic defect.

Pyridoxine dependent epilepsy (PDE) is caused by mutations in the ALDH7A1 gene (PDE-ALDH7A1) encoding α-aminoadipic-semialdehyde-dehydrogenase enzyme in the lysine catabolic pathway resulting in an accumulation of α-aminoadipic-acid-semialdehyde (α-AASA). We present the one-year treatment outcome of a patient on a lysine-restricted diet. Serial cerebral-spinal-fluid (CSF) α-AASA and CSF pipecolic-acid levels showed decreased levels but did not normalize. He had a normal neurodevelopmental outcome on a lysine-restricted diet. Despite normal CSF and plasma tryptophan levels and normal tryptophan intake, he developed mild CSF serotonin deficiency at one year of therapy. Stricter lysine restriction would be necessary to normalize CSF α-AASA levels, but might increase the risks associated with the diet. Patients are at risk of cerebral serotonin deficiency and should be monitored by CSF neurotransmitter measurements.

Effects of home-based locomotor treadmill training on gross motor function in young children with cerebral palsy: a quasi-randomized controlled trial.

OBJECTIVE: To examine the effects of an intensive home-based program of treadmill training on motor skills related to walking in preambulatory children with cerebral palsy (CP). DESIGN: Quasi-randomized controlled trial. SETTING: Homes of the participants. PARTICIPANTS: Children with CP (N=12) with Gross Motor Function Classification System levels I and II were assigned to the intervention group (n=6; mean age ± SD, 21.76±6.50mo) and control group (n=6; 21.25±6.07mo). All children were tested preintervention, postintervention, at a 1-month follow-up, and at a 4-month follow-up. INTERVENTIONS: All children received their weekly scheduled physical therapy sessions at their homes. In addition, children in the intervention group walked on a portable treadmill in their homes 6 times per week, twice daily for 10- to 20-minute sessions, for 6 weeks. The intervention was carried out by the children's parents with weekly supervision by a physical therapist. MAIN OUTCOME MEASURES: Gross Motor Function Measure-66 Dimensions D/E, Peabody Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Inventory (PEDI), timed 10-m walk test (10MWT), and Functional Mobility Scale (FMS). The Friedman test and Mann-Whitney U test were conducted for within-group and between-group differences, respectively. RESULTS: There was a significant between-group treatment effect for the PDMS-2 at posttest (P=.01) and 1-month postintervention follow-up (P=.09), as well as for the PEDI at posttest (P=.01), the 1-month postintervention follow-up (P=.009), and the 4-month postintervention follow-up (P=.04). The FMS was significant at the posttest (P=.04). CONCLUSIONS: Home-based treadmill training accelerates the attainment of walking skills and decreases the amount of support used for walking in young children with CP.