Impaired Motor Development Research Articles

A Novel Loss of Function Variant in HCN1 Gene Underlies Early Infantile Epileptic Encephalopathy 24 [EIEE24]

Background: Early infantile epileptic encephalopathy (EIEE) is a rare neurological condition characterized by frequent seizures in the early stages of life, resulting in severely impaired cognitive and motor development. Although the specific causes of EIEE remain unknown, one of the primary causes is gene pathogenicity (even in the absence of consanguinity). Hyperpolarization-activated cyclic nucleotide-gated channels (HCNs) are essential for proper brain function. They are regulated by multiple genes, and mutations in these genes induce channel malfunction, which can result in various severe conditions, including EIEE. Herein, we have reported a patient presenting hallmarks of EIEE. Methods: The patient underwent clinical, radiographic, and genetic analysis. A thorough clinical examination and molecular study were conducted utilizing whole exome sequencing and Sanger sequencing. Results: Whole exome sequencing of the proband revealed a novel de novo nonsynonymous/nonsense variant (c.1468A>T; (p.Lys490Ter) in exon 6 of the HCN1 gene. This variant may cause channel dysfunction via nonsynonymous/nonsense-mediated decay or aberrant protein, which may be associated with EIEE phenotypes. Conclusions: This evidence backs the idea that HCN1 has a vital role in brain development and lose of function can cause a range of debilitating conditions. Still, the functional characterization study of the HCN1 variants will be the fundamental tool for a better understanding of EIEE in the near future.

Dynamics of postural control indicators during postneonatal medical habilitation in infants with impaired motor development, born at different gestational ages

Abstract. Diseases of the nervous system, among which perinatal lesions of the central nervous system and their consequences, occupy a leading place in the structure of morbidity and disability in infants of the first year of life. An urgent clinical task is to search for new objective criteria for the effectiveness of ongoing treatment and rehabilitation measures in patients who suffered perinatal lesions of the nervous system. Purpose. To assess the dynamics of postural control indicators during the postneonatal medical habilitation in infants with impaired motor development, born at different gestational ages. Material and methods. We examined 64 infants of the first year of life with impaired motor development, born at different stages of gestation (main group) and 16 healthy full-term infants (control group). Patients of the main group were divided into 4 subgroups: 1st (n = 16) were extremely premature, 2nd (n = 16) — moderately premature, 3rd (n = 16) — late preterm and 4th (n = 16) — full-term infants. The examination was conducted at 3–4 months of calendar (for full-term) and corrected (for premature babies) age and included a clinical assessment of postural control and computer stabilography, which were conducted before and after completion of the course of medical habilitation. Results. The severity of the dynamics of postural control indicators in infants of different gestational ages with impaired motor development was different and was maximum in very premature patients. Conclusion. The identified features of the dynamics of clinical and functional indicators in infants of the studied subgroups indicate the prospect of further development of objective criteria for assessing the effectiveness of treatment and habilitation measures. Their use will help ensure a personalized approach to the management of patients with motor development disorders and increase the effectiveness of medical habilitation.

Impaired motor and social skill development in infancy predict high autistic traits in toddlerhood

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder. Early diagnosis in the critical period is important for ASD children. Recent studies of neurodevelopmental behavioral features and joint attention in high-risk infants showed there are some special cues which can distinguish ASD from typical development infant. But the findings of high-risk population may not be applicable to the general population. It is necessary to “analogically” study the potential warning traits of ASD in infancy in the general population. We did a nested case-control study from June 2019 to November 2022 in Tianjin, China, including 76 general infants whom completed the neurodevelopmental evaluation, the Checklist for Autism in Toddlers-23 (CHAT-23) screening, and eye tracking task. Social behavior quotient in infancy was negatively correlated to CHAT-23 total scores in toddlerhood. Social behavior quotient in infancy was positively correlated to initiating joint attention in toddlerhood. Regression model showed that high fine motor scale and social behaviour scale quotient in infancy were associated with an decreased risk of the total score of CHAT-23 ≥ 2 in toddlerhood. The Receiver operating characteristic curve showed the social behaviour in infancy alone and the combination of fine motor and social behaviour in infancy contributed to auxiliary diagnosis of higher level of autistic traits in toddlerhood. These findings suggest that Impaired development of fine motor and social behavior in infancy are potential warning features of high autistic traits in general population.

Prevalence of iodine deficiency and associated factors among school-age children in Ethiopia: a systematic review and meta-analysis

BackgroundCurrently, iodine deficiency has become a significant burden globally; where 2 billion people and 29.8% of school-age children are iodine deficient. It is a leading cause of preventable brain damage among children, resulting in impaired cognitive and motor development. Even though salt iodization was started to be implemented to alleviate this burden in Ethiopia, primary studies assessing iodine deficiency in the country show highly variable findings, and no systematic review was conducted to determine the pooled prevalence of the problem which makes it difficult to assess the effect of the intervention as well as to design appropriate and timely measures. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of iodine deficiency and the common factors affecting its occurrence among school-age children in Ethiopia.MethodTo obtain the eligible studies, databases (EMBASE, Scopus, Hinari, and PubMed), websites (Google and Google Scholar), and references of the eligible studies were searched systematically. Data were extracted using an Excel spreadsheet and analyzed using the STATA 17 version. The I2 test was used to assess heterogeneity between the studies. A DerSimonian and Laird random-effects model was used to estimate the pooled prevalence and pooled odds ratio. A funnel plot and Egger’s test were used to detect publication bias.ResultA total of 15 eligible studies, representing 15,611 school-age children, were included in the systematic review and meta-analysis. The pooled prevalence of iodine deficiency among school-age children in Ethiopia was found to be 58% (95%CI 44.00–77.00), while the highest prevalence was recorded in the Oromia Region, which was 64% (95% CI 49–79). Goitrogenic food consumption (adjusted odds ratio (AOR) 2.93, 95% CI 1.60–5.35) and being female (adjusted odds ratio (AOR) 1.87, 95% CI 1.43–2.44) showed a significant association with the prevalence of iodine deficiency.ConclusionIodine deficiency among school-age children in Ethiopia was noticeably high. Goitrogenic food consumption and the sex of the child were determinant factors for the occurrence of iodine deficiency among the children. Therefore, appropriate advice should be given to households to limit goitrogenic foods in the diet of their children by giving due attention to their female children.

Anemia Awareness Program in a Suburban Middle School: A Pilot Study Promoting Students as Public Health Advocates in Their Community.

Almost a quarter of the people on earth are anemic, and most of them reside in regions of sub-Saharan Africa and South Asia. Anemia in children is linked with impaired cognitive and motor development and affects the future earning capacity. The most common cause of anemia is iron deficiency. The Indian Government has initiated multiple programs for the eradication of anemia. The prevalence of anemia has not decreased despite the improvements in the country's economy. It increased from 58.7% in 2015-16 to 67.1% in 2019-21 in childrenand from 50.4% in 2015-16 to 52.2% in 2019-21 in pregnant women. Maternal education, socioeconomic status, and number of children in the family are some factors that influence the prevalence of anemia. As these factors cannot be improved in a short time, we aimed to increase awareness about this issue by targeting school students from rural/semi-urban backgrounds. This pilot study aimed at promoting school students as public health advocates in their community. Anemia Awareness Program was conducted ina local middle school in the suburban area, which was attended by 153 class eight students (72 female). Pre- and post-test questionnaires comprising 20 multiple-choice/true-false type questions were used. Pre- and post-test scores were obtained. The second part of the study was the identification of students with anemia. Blood hemoglobin levels of 127 students (58 female) were measured from venous blood samples. The students were also asked to inform their friends/relatives about anemia and to send people with symptoms of anemia to the free two-day Anemia Awareness Camp organized by the Medical College Hospital for check-ups. The mean post-test score (15.68/20) was much higher than the pretest score (2.99/20). Thirty-eight (25 female) out of 127 students had mild/moderate microcytic hypochromic anemia, suggesting iron deficiency. Thirty-two persons visited the free health camp to receive information from the students, of whom four had normal hemoglobin levels. This pilot study showed that physician-conducted anemia awareness programs are relatively low-cost methods to spread information amongthe general population in India.

Heterozygous CAPZA2 mutations cause global developmental delay, hypotonia with epilepsy: a case report and the literature review.

CAPZA2 encodes the α2 subunit of CAPZA, which is vital for actin polymerization and depolymerization in humans. However, understanding of diseases associated with CAPZA2 remains limited. To date, only three cases have been documented with neurodevelopmental abnormalities such as delayed motor development, speech delay, intellectual disability, hypotonia, and a history of seizures. In this study, we document a patient who exhibited seizures, mild intellectual disability, and impaired motor development yet did not demonstrate speech delay or hypotonia. The patient also suffered from recurrent instances of respiratory infections, gastrointestinal and allergic diseases. A novel de novo splicing variant c.219+1 G > A was detected in the CAPZA2 gene through whole-exome sequencing. This variant led to exon 4 skipping in mRNA splicing, confirmed by RT-PCR and Sanger sequencing. To our knowledge, this is the third study on human CAPZA2 defects, documenting the fourth unambiguously diagnosed case. Furthermore, this splicing mutation type is reported here for the first time. Our research offers additional support for the existence of a CAPZA2-related non-syndromic neurodevelopmental disorder. Our findings augment our understanding of the phenotypic range associated with CAPZA2 deficiency and enrich the knowledge of the mutational spectrum of the CAPZA2 gene.

Динамика показателей психомоторного развития на фоне медицинской абилитации у детей первого года жизни с нарушением моторного развития, родившихся с разным гестационным возрастом

Aim. To assess the dynamics of psychomotor development indicators during medical habilitation in infants of the first year of life with impaired motor development, born with different gestational ages. Design. Comparative study. Materials and methods. Eighty children of the first year of life were examined. The main group consisted of 64 infants with impaired motor development, the control group — 16 healthy full-term infants. Depending on the gestational age at birth, the infants of the main group were divided into 4 subgroups: very premature (n = 16), moderately premature (n = 16), late premature (n = 16), and full-term (n = 16) infants. Before and after the completion of the medical habilitation course, all patients were assessed for psychomotor development using the L.T. Zhurba and E.M. Mastyukova scale. Results. Before the medical habilitation course, patients in all studied subgroups showed a delay in psychomotor development, which was more pronounced in very premature infaants. Against the background of medical habilitation measures, the most pronounced positive dynamics were noted in premature babies, especially in very premature patients. Conclusion. The results obtained can be used to develop a differentiated approach to managing patients of different gestational ages with impaired motor development, which will help to increase the effectiveness of medical habilitation and minimize the severity of motor disorders. Keywords: perinatal central nervous system damage, impaired motor development, infants, premature infants, psychomotor development.

Long-term outcomes of visual motor integration and motor development children with retinopathy of prematurity.

Premature infants have a risk of neurodevelopmental deficits. Little is known, however, about how retinopathy of prematurity (ROP) affects visual motor integration (VMI), which is necessary for both fine motor skills and further school abilities. Due to the systemic escape of bevacizumab in the treatment of ROP, concerns regarding the long-term neurodevelopmental effect of the drug have arisen. The aim is to evaluate VMI and motor development long-term outcomes after intravitreal bevacizumab (IVB) injection and laser treatment for ROP. Two groups of premature children were included: Bevacizumab group - 16 premature children who received IVB treatment and laser group - 23 premature children who underwent laser photocoagulation treatment in this single center cross-sectional study. At 2-6 years of age, VMI (Beery-Buktenica Developmental Test), motor development (Peabody Developmental Motor Scales-2), visual acuity, and refractive status were assessed. The incidence of abnormal visual function was significantly higher in bevacizumab group than in laser group (p = 0.022). The incidence of abnormal VMI skill was significantly higher in bevacizumab group than in laser group (p = 0.024). Incidences of abnormal gross, fine, and total motor skills were significantly higher in bevacizumab group compared to laser group (p < 0.05). Premature children who received bevacizumab for ROP demonstrated significantly lower VMI and motor development features than those with laser treatment at preschool age. Although our results suggest the relevance of bevacizumab injection in impaired VMI and motor development outcomes, general level of sickness rather than treatment might be the cause of delayed motor development.

Factors in Infancy That May Predict Autism Spectrum Disorder.

The global increase in the prevalence of ASD (Autism Spectrum Disorder) is of great medical importance, but the reasons for this increase are still unknown. This study sought to identify possible early contributing factors in children who were later diagnosed with ASD. In this retrospective cohort study, postnatal records of 1105 children diagnosed with ASD were analyzed to determine if any signs of ASD could be found in a large database of births and well-baby care programs. We compared the recordings of typically developing children and analyzed the differences statistically. Rapid increases in weight, height, and head circumference during early infancy predict the development of ASD. In addition, low birth weight, older maternal age, and increased weight and height percentiles at six months of age together predict the development of ASD. At two years of age, these four parameters, in addition to impaired motor development, can also predict the development of ASD. These results suggest that the recent increase in ASD prevalence is associated with the "obesity epidemic" and with recommendations of supine sleeping to prevent Sudden Infant Death Syndrome, associated with atypical neural network development in the brain.

Early motor development: risk factors for delay in a population study in Southern Brazil.

To assess risk factors associated with motor development delay at three months of age. Cross-sectional study with mothers and their three-month-old babies in Southern Brazil. The Bayley-III Scale of Infant and Toddler Development (BSID-III) and the Alberta Infant Motor Scale (AIMS) were used to assess motor development. We evaluated 756 mothers and their three-month-old babies. The overall mean motor development assessed by the BSID-III and the AIMS was 104.7 (SD 13.5) and 55.4 (SD 25.4), respectively. When assessed by the BSID-III, the lowest motor development scores were among babies born by cesarean delivery (p = 0.002), prematurely (p < 0.001), and with low birth weight (p < 0.001). When assessed by the AIMS, babies born prematurely (p = 0.002) and with low birth weight (p=0.004) had the lowest motor development means. After a cluster analysis, we found that babies born by cesarean delivery, with low birth weight, and prematurely had more impaired motor development compared with children born without any risk factors. Identifying risk factors allows the implementation of early interventions to prevent motor development delay and, therefore, reduce the probability of other future problems.

Formation of postural control in infants of the first year of life with impaired motor development, born at different gestation periods

The postural control development is a complex physiological process, which is the basis for the development of motor functions. Approaches to the assessment of postural control and the features of its formation in infants of the first year of life have not been studied enough. Purpose. To reveal the features of postural control development in infants of the first year of life with the consequences of perinatal lesions of the central nervous system in the form of impaired motor development, born at different gestational ages. Material and methods. We examined 120 infants of the first year of life with impaired motor development and 16 infants without neurological pathology. Infants with impaired motor development were divided into 4 subgroups: 1 (n = 30) — full-term, 2 (n = 30) — very preterm, 3 (n = 30) — moderately preterm, 4 (n = 30) — late premature children depending on their gestational age at birth. The examination was conducted at 3–4 months of calendar age in full-term and corrected in premature infants and included an assessment of the neurological status, a clinical assessment of postural control, and computer stabilometry. Results. Violation of postural control was found in infants of the first year of life with the consequences of perinatal lesions of the central nervous system in the form of impaired motor development, born at different gestational ages. These postural disorders may be associated with changes in muscle tone and impaired sensorimotor integration. Conclusion. Further research will enable the development of objective criteria for diagnosing postural disorders in infants of the first year of life, depending on the gestational age at birth. This will contribute to the timely start of treatment and rehabilitation measures, reducing the frequency and severity of disabling consequences of perinatal lesions of the central nervous system.

Effect Of Spiritual Assistance On The Level Of Anxiety In Parents With Children With Attention Deficit Hyperactvity Disorder (ADHD)

Children with ADHD are a condition of children with various developmental problems such as impaired motor, sensory, language and psychomotor development, this condition can affect a variety of lives. The purpose of this study was to find out how the anxiety level of parents with children with ADHD before and after being given spiritual assistance. This research is a study with a pre-experimental design because there are no control variables and the sample is not chosen randomly. The design used is the one-group pretest-posttest design, so that it can be compared before and after treatment. This research was conducted in the working area of ​​the Colomadu Health Center on March 20-31, 2023. The total population in this study were 24 respondents, and the number of samples was also 24 respondents. Analysis it is found that the p value = 0.000 and the mean is 4.761. this means that the mean value is positive and indicates that there is a decrease in anxiety before and after the treatment of providing spiritual assistance to parents with children with ADHD. This study shows that there is an influence between giving spiritual assistance interventions in the form of prayer guidance and tawakkal on the anxiety level of parents with children with ADHD. This shows that the anxiety of parents with children with ADHD can be overcome by surrendering and drawing closer to God Almighty to pray for the healing of their children. and this means that the readiness of parents can also affect the child's recovery.

The Relationship Between Hemoglobin Level and Mother-Child Medical History of Children with Anemia who are Under Five Years Old

Background: The prevalence of anemia is a global public health concern, affecting both developed and developing countries. The effects of childhood anemia are devastating, ranging from stunted growth and impaired cognitive and motor development to an increased risk of mortality. Objective: The study aims to determine the mother and child medical history associated with hemoglobin levels among under-five children in Kut City. Methods: A cross-sectional study with a convenience sample (non-probability) was conducted among 264 children admitted to hospitals in Kut City. From September 1st, 2022, to March 1st, 2023. Data were collected via questionnaires, and descriptive and inferential statistics were used to evaluate the data. Results: The total number of children participating in the study was 264, with 39.0% having mild anemia and 60.0% having moderate anemia, according to the WHO classification of anemia. The results showed that the children most at risk of developing anemia were born to mothers with prenatal medical problems. As well as the period of admission of the child to the hospital. Children who were partially immunized showed the lowest mean of hemoglobin. In contrast, children with a History of acute blood loss showed the lowest mean of hemoglobin. The degree of anemia was significantly associated with a long duration admission in pediatric word or neonatal care unit. Conclusions: According to the study, the most critical factors facing anemia were high significant with partially immunized and a history of blood loss.

Diagnosis and referrals to physical therapy among caregivers of children with genetic disorders: a qualitative inquiry

Purpose Genetic disorders are common in Saudi Arabia. Impaired motor development is one of the major characteristics associated with genetic disorders. Early identifications and referrals are key to receiving physical therapy. This study aims to explore caregivers of children with genetic disorders’ experience with early identification and referrals to physical therapy. Materials and methods An inductive qualitative design of 16 caregivers of children with genetic disorders was done to investigate the identification and referral process to physical therapy. A thematic analysis was used to analyze the data and multiple coders coded the data to increase the trustworthiness of the analysis. Results The analysis led to emergence of four main themes. Caregivers revealed their struggle with the detection process. They struggled with the vague information related to their children’s condition. They also expressed a desperate need for guidance to clarify the process for genetic testing, counseling, and rehabilitation. Although their overall experience with physical therapy was satisfactory, they encountered a number of issues related to scheduling appointments, delayed referrals, and unconfirmed diagnoses. Conclusion The results of this study could indicate that more efforts are required to expedite and elucidate the identification and referral of children with genetic disorders in Saudi Arabia. IMPLICATIONS FOR REHABILITATION The process of referring children with genetic disorders to physical therapy (PT) is not clearly understood by caregivers. Providing caregivers with information about the benefits of PT for children with genetic disorders is needed to encourage adherence to PT sessions and rehabilitation plan. Caregivers expressed the need for further education on the wide spectrum of genetic disorders. Caregivers experienced costly and lengthy genetic testing process that often lead to inconclusive results which could delay the referral process. Alternative solutions should be considered to provide these children with early access to rehabilitation services including PT. One of these solutions could be implementing regular screening and monitoring as well as parent education to aid in detecting delays and expedite the referral process.

Bi-allelic variants in INTS11 are associated with a complex neurological disorder

The Integrator complex is a multi-subunit protein complex that regulates the processing of nascent RNAs transcribed by RNA polymerase II (RNAPII), including small nuclear RNAs, enhancer RNAs, telomeric RNAs, viral RNAs, and protein-coding mRNAs. Integrator subunit 11 (INTS11) is the catalytic subunit that cleaves nascent RNAs, but, to date, mutations in this subunit have not been linked to human disease. Here, we describe 15 individuals from 10 unrelated families with bi-allelic variants in INTS11 who present with global developmental and language delay, intellectual disability, impaired motor development, and brain atrophy. Consistent with human observations, we find that the fly ortholog of INTS11, dIntS11, is essential and expressed in the central nervous systems in a subset of neurons and most glia in larval and adult stages. Using Drosophila as a model, we investigated the effect of seven variants. We found that two (p.Arg17Leu and p.His414Tyr) fail to rescue the lethality of null mutants, indicating that they are strong loss-of-function variants. Furthermore, we found that five variants (p.Gly55Ser, p.Leu138Phe, p.Lys396Glu, p.Val517Met, and p.Ile553Glu) rescue lethality but cause a shortened lifespan and bang sensitivity and affect locomotor activity, indicating that they are partial loss-of-function variants. Altogether, our results provide compelling evidence that integrity of the Integrator RNA endonuclease is critical for brain development.

Determinant Factors of Child Development in Various Ecosystem Zones in Papua

Background: The negative impact of malnutrition is generally associated with impaired motor development, behavioural and cognitive development which results in decreased learning achievement and social skills. Aim: The purpose of this study was to examine the situation of child development and to assess the role of various factors related to the development of children under five years of age in various ecosystem zones in Papua Province. Method: The research was carried out in four districts in Papua representing three ecosystem zones, namely the mainland coast, the middle plains and the mountains. Data was collected through structured interviews, observations and field measurements. Analysis of the differences in variables between ecosystem zones used the smallest significant difference test and the Kruskal Wallis test. Meanwhile, the analysis of the impact of malnutrition on children's development used Structural Equation Modelling-Regression with a partial least square approach using the SmartPLS version 3.2.9 application. Findings: The prevalence of Papuan children suffering from developmental delays reached 77.7%, especially in language development, fine motor adaptive, and personal social. An increase in the degree of malnutrition in the form of stunting suppresses the development of children to be low, while an increase in the degree of sickness in children has the potential to worsen the degree of malnutrition by suppressing the nutritional intake of children to be low.

Nanobody-mediated modulation of HCN1 channels in epileptic disorders.

Hyperpolarization-activated cyclic-nucleotide gated 1 (HCN1) channels contribute to the cationic Ih current in neurons and are involved in the control of neuronal excitability. Several mutations in the HCN1 gene have been correlated with the insurgence of Early Infantile Epileptic Encephalopathy (EIEE), a severe form of epilepsy characterized by recurrent seizures with impaired cognitive and motor development with onset in the first year of life, that doesn’t have a targeted treatment yet. In search of modulators that can reduce, and possibly abolish, HCN1-related phenotypes, nanobodies (NBs) represents a future therapeutic tool with great potential. By screening a synthetic library, we have isolated several nanobodies that specifically target HCN channel subtypes. We show here that nanobody #5 is able to revert the phenotype, 8 mV right shift in voltage-dependency, caused by the pathogenic R548H mutation of the hHCN1 channel. Notably, the nanobody acts from the extracellular side of the channel presumably binding to the voltage sensor, while the mutation, previously characterized, affects cAMP binding to the intracellular Cyclic Nucleotide Binding Domain (CNBD) of the channel. This result opens valuable therapeutical perspectives for EIEE patients and further highlights that in HCN channels voltage sensing at the membrane and ligand binding at the cytosolic domain are mutually interconnected.

Neurodevelopmental outcome of children with severe acute malnutrition

Background: Severe acute malnutrition is known to be a major risk factor for impaired motor, cognitive, and socio-emotional development. Not much work has been done to study the neuro development of these patients. The aim of this study was to assess the neurodevelopment and outcome of children between 1 and 30 months with diagnosis of SAM Methods: The study was an observational prospective study conducted from November 2018 to April 2020. A total of 61 patients were enrolled in our study. Patients admitted in NRC with diagnosis of SAM were assessed for neurodevelopment after stabilization. Developmental assessment scale of Indian infants was used to calculate the motor developmental quotient and mental developmental quotient. Patients were followed till 6 months and after 6 months, they were again assessed by DASII to see the improvement in neurodevelopment status. Developmental quotient of less 70 was taken as delayed. Results: Mean DMeQ after stabilization and at 6 months after discharge was 53.672 and 72.591 respectively. Mean DMoQ after stabilization and at 6 months after discharge was 50.50 and 68.23 respectively. Mean DQ after stabilization and at 6 months after discharge was 52.186 and 70.4105 respectively. Conclusions: Severe acute malnutrition results in neurodevelopmental impairment in children but early and effective intervention results in significant improvement in neurodevelopment status.

MODERN APPROACHES TO VOIT DIAGNOSTICS AND VOJT THERAPY

The article evaluates the use of Vojt diagnostics and Vojt therapy during rehabilitation in modern conditions for adults and children.&#x0D; Reflex-locomotor therapy was developed by Vaclav Vojta as a diagnostic and therapeutic tool. At the very beginning of the study, V. Vojta described two different motor complexes, reflex crawling and reflex turning, which are triggered by adequate location and stimulation of the corresponding trigger zones. Due to this activation, a global reflex response is triggered, which contains innate motor programs associated with locomotion patterns in human ontogeny (rolling, crawling, walking).&#x0D; To date, neurokinesiology according to Vaclav Vojta allows to diagnose impaired motor development in children from the newborn period, even before the absence of clear neurological symptoms during a classic examination, and to prescribe early therapy.&#x0D; The essence of Vojt diagnostics is not only passive observation of the child, but also an active examination method using appropriate functional tests (loads, provocations). And Vojta therapy is a neurophysiological method used to obtain reflex responses in muscles after stimulation of certain activation zones. Such therapy stimulates the brain through selected areas of the body, activating stored innate motor programs that are exported as coordinated movement and contraction of trunk and limb muscles.&#x0D; The novelty of V. Vojt contribution in this field lies in the strict focus on genetically determined, species-specific movement development programs. The existence of ideal patterns of movements as a basic characteristic of human motor behavior to date is practically not reflected in the problems of motor rehabilitation in general, that is, the standard given "by nature" or determined by evolution still remains largely unknown, therefore the purpose of this study is to assess the impact the approach of Vojt diagnostics and Vojt therapy in the rehabilitation of children and adults in modern conditions.&#x0D; Vojta described 10 different zones that are available for stimulation of movement patterns of reflex locomotion. Light pressure on a specific stimulation zone (muscle or bone) and resistance to the current movement is used to induce an involuntary motor response from the patient and to perform certain movement patterns.&#x0D; The best results of Vojt therapy are achieved when the patient has not yet developed and established any so-called replacement movement patterns. In patients with established "substitute motor activity", the goal of treatment is to activate and maintain physiological movement patterns, as well as to reduce unestablished abnormal movement patterns and integrate them into normal movement processes, until the mastery of conscious movement activity is completed.&#x0D; In the beginning, Vojta therapy was used to rehabilitate children with movement disorders and infants at risk of developing cerebral palsy. Years later, this method was successfully applied to adults with neurological and movement problems.&#x0D; Today, Vojta therapy is used for various pathologies and in different age groups, from infants to adults, and is a safe and effective conservative alternative method of rehabilitation.

Impaired motor development in children with familial high risk of schizophrenia or bipolar disorder and the association with psychotic experiences: a 4-year Danish observational follow-up study

Motor abnormalities have clinical relevance as a component of psychotic illness; they are not only a proxy of altered neurodevelopment, but also intimately related to psychotic risk. We aimed to assess motor development and its association with psychotic experiences in children with familial high risk (FHR) of schizophrenia or bipolar disorder compared with controls. The Danish High Risk and Resilience Study is a prospective longitudinal cohort study, for which participants were extracted from Danish registers. Children born in Denmark between Sept 1, 2004, and Aug 31, 2009, with no, one, or two parents born in Denmark with schizophrenia or bipolar disorder, could be included in the study. No ethnicity data were collected. Children with no biological parent diagnosed with schizophrenia spectrum disorder or bipolar disorder were matched to children with FHR of schizophrenia (one or two parents with schizophrenia spectrum disorder) on the basis of sex, age, and municipality. Children with FHR of bipolar disorder (one or two parents with bipolar disorder) were included as a non-matched group. We assessed motor function in children with FHR of schizophrenia, children with FHR of bipolar disorder, and children in the control group at approximately age 8 years (baseline; 2013-16) and age 12 years (follow-up; 2017-20) using the Movement Assessment Battery for Children-Second Edition (Movement ABC-2). Psychotic experiences were assessed using the psychosis section of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Raters were masked regarding familial risk status. Motor development from baseline to follow-up in the different groups was assessed using a linear mixed model. Logistic regression examined the relationship between definite motor problems (≤5th percentile on Movement ABC-2) and psychotic experiences. Between March 1, 2017, and June 30, 2020, we studied 437 children (234 [54%] boys, 203 [46%] girls; mean age 11·99 years [SD 0·26, range 11·08-12·86]). Children with FHR of schizophrenia showed stable motor developmental deficits in manual dexterity (difference in intercept -1·62 [95% CI -2·39 to -0·85], p<0·0001; difference in slope 0·17 [-0·48 to 0·81], p=0·61) and balance (difference in intercept -1·58 [-2·34 to -0·82], p<0·0001; difference in slope 0·32 [-0·34 to 0·99], p=0·34), and a developmental lag in aiming and catching (difference in slope -1·07 [-1·72 to -0·41], p=0·0015; difference in intercept -0·59 [-1·35 to 0·17], p=0·13) compared with controls. Children with FHR of bipolar disorder showed no motor developmental differences on a group basis. Compared with controls, children with FHR of schizophrenia were more likely to have definite motor problems (odds ratio [OR] 2·86 [95% CI 1·60 to 5·11], p=0·0004), as were children with FHR of bipolar disorder (OR 2·45 [1·28 to 4·70], p=0·0068). Children with definite motor problems across all groups were more likely (OR 1·90 [1·12 to 3·21, p=0·017] to have had psychotic experiences than children with no definite motor problems. Clinicians should be aware that motor impairment in childhood can reflect neurodevelopmental vulnerability to psychosis. Our findings contribute to the identification of early risk markers for severe mental illness, both for use by clinicians and for establishing a basis for future primary preventive intervention studies in the premorbid phase. The Independent Research Fund Denmark, the Mental Health Services of the Capital Region of Denmark, the Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, the Beatrice Surovell Haskell Fund, the Tryg Foundation, and the Innovation Fund Denmark. For the Danish translation of the abstract see Supplementary Materials section.