Évaluation du potentiel neuromoteur du nourrisson : étude multicentrique internationale comparative longitudinale de deux méthodes cliniques d’examen

Abstract

Information provided by the neurologic assessment is important for identifying infants with neurologic abnormalities to start treatment as soon as possible. The conventional imaging and clinical are regularly in default during the neonatal period to predict the occurrence of future neurodevelopmental disorders. The routine clinical screening of infant neuromotor or “standard screening examination” (EDS), practiced by the majority of clinicians and general pediatricians is the most widely used method based on the recommendations of the standard Amiel-Tison examination. Other methods exist but have not necessarily been published. This is the case of the early assessment of motor abilities in infancy (EPAM), described by M. Michel Le Metayer. We conducted a prospective multicenter international study to compare the latter technique EPAM with the current reference method EDS, in a population of 227 children from five Belgian, Italian or French department of neonatology over a period of 2years. A concordance has been established between the two methods of examination but remains moderate (κ=0.38) even if the predictive power is statistically equivalent. The assessment of early motor abilities of the infant (EPAM) seems quite usable in current practice on condition of an appropriate training. The EPAM method could find all its interest in the clinical examination when precision components are requisite to apprehend severe neuromotor damage of infants with a neurological established risk.