A “handy” reminder

Abstract

Because of the long-term risk of neurodevelopmental impairments, many neonatal intensive care unit (NICU) graduates receive developmental surveillance in high risk infant follow up programs. There are no national recommendations for the duration of follow up but a survey published in 2014 (J Perinatol 2014;34:71-74) showed that programs rarely extend through 5 years of age. A longitudinal study of extremely preterm children published this month in The Journal of Pediatrics reminds us that longer follow up may be necessary for many children. Duncan et al showed that toddlers who had difficulties with bimanual hand function at 18-22 months of corrected age continued to have both fine and gross motor difficulties at 6-7 years of age, independent of whether they had participated in occupational or physical therapy at 18-22 months. Duncan et al did not study whether the children in their study were monitored between study timepoints or if therapy services were continued between 18-22 months and 6-7 years. However, 35% of the cohort had fine motor impairments at 6-7 years suggesting they may have benefited from ongoing developmental monitoring and timely therapy services. We need more studies that help us understand the path between early impairments and school function and studies that help us to prepare high risk infants for school and ameliorate the impact of preschool impairments. Although this study focused on motor difficulties, we know that NICU graduates also are at risk for cognitive, social, and behavioral difficulties. This study therefore serves as a “handy” reminder to maintain developmental vigilance during the toddler years. Article page 51 ▸ Hand Function at 18-22 Months Is Associated with School-Age Manual Dexterity and Motor Performance in Children Born Extremely PretermThe Journal of PediatricsVol. 225PreviewTo determine associations between hand function at age 18-22 months (early) and scores on the Movement Assessment Battery for Children, 2nd edition (MABC) at 6-7 years of age (school age) in extremely preterm children. Full-Text PDF