Developmental Motor Scales Research Articles

Perfil motor de crianças e adolescentes com deficiência mental moderada

O controle motor de deficientes mentais é alterado pela insuficiência de informações entre os comandos aferente e eferente. Este estudo teve como objetivo avaliar o perfil motor de crianças portadoras de deficiência mental de grau moderado. O grupo de estudo foi constituído por 20 crianças, ambos os sexos, entre 7 e 15 anos, alunos das APAEs dos municípios de Biguaçu e Palhoça/SC, em 2005. Para a coleta de dados foi utilizada a Escala de Desenvolvimento Motor "EDM". O tratamento estatístico foi realizado com o programa Epi Info 6.0. A todas as habilidades motoras avaliadas foi atribuído nível "muito inferior". O quociente da motricidade fina obteve o menor déficit, sendo que ao quociente da organização temporal atribuiu-se o maior déficit. Tais resultados mostraram a estreita relação entre o potencial cognitivo e a conduta motora de deficientes mentais de grau moderado. Os déficits funcionais observados entre deficientes mentais podem ser conseqüentes à inadequação de suas habilidades psicomotoras, interferindo no desenvolvimento cognitivo, afetivo e social.

WHO Motor Development Study: Windows of achievement for six gross motor development milestones

AbstractAim:To review the methods for generating windows of achievement for six gross motor developmental milestones and to compare the actual windows with commonly used motor development scales.Methods:As part of the WHO Multicentre Growth Reference Study, longitudinal data were collected to describe the attainment of six gross motor milestones by children aged 4 to 24 mo in Ghana, India, Norway, Oman and the USA. Trained fieldworkers assessed 816 children at scheduled visits (monthly in year 1, bimonthly in year 2). Caretakers also recorded ages of achievement independently. Failure time models were used to construct windows of achievement for each milestone, bound by the 1st and 99th percentiles, without internal demarcations.Results:About 90% of children achieved five of the milestones following a common sequence, and 4.3% did not exhibit hands‐and‐knees crawling. The six windows have age overlaps but vary in width; the narrowest is sitting without support (5.4 mo), and the widest are walking alone (9.4 mo) and standing alone (10.0 mo). The estimated 1st and 99th percentiles in months are: 3.8, 9.2 (sitting without support), 4.8, 11.4 (standing with assistance), 5.2, 13.5 (hands‐and‐knees crawling), 5.9, 13.7 (walking with assistance), 6.9, 16.9 (standing alone) and 8.2, 17.6 (walking alone). The 95% confidence interval widths varied among milestones between 0.2 and 0.4 mo for the 1st percentile, and 0.5 and 1.0 mo for the 99th.Conclusion:The windows represent normal variation in ages of milestone achievement among healthy children. They are recommended for descriptive comparisons among populations, to signal the need for appropriate screening when individual children appear to be late in achieving the milestones, and to raise awareness about the importance of overall development in child health.

A study on the effects of sleep position and of body weight on motor development

Purpose:This study investigated how gross motor and fine motor development are influenced by sleep position. Methods:From December, 2003 to September, 2005, for a year and 9 months, 800 children aged from 3 months to 16 months, who visited the Presbyterian Medical Center, Chonju, Korea were surveyed for motor development scale, sleep position and body weight. Results:The sleep position came in order:79.3 percent of supine position, 10.0 percent prone position and 10.7 percent side position. Gross motor scale and fine motor scale were not connected with sex. The prone position indicated remarkable increase on gross motor scale from 5-6 months, but stayed the same after 7 months. Fine motor scale was not related to age and sleep position. Gross motor scale and fine motor scale were higher on group weighing more than under average weight group. Conclusion:This study showed that prone position did not influence gross motor scale after 7 months, affecting children of 5-6 months only. Hence, It is not recommended to use the prone position for a baby's fast gross motor development.

Growth and Diet Quality Are Associated with the Attainment of Walking in Rural Guatemalan Infants

The attainment of gross motor milestones is an important indicator of motor development in early life; however, little is known about factors affecting gross motor development in children from developing countries. The purpose of this study was to examine the relation of nutritional factors (physical growth and dietary intake) and morbidity during the first year of life to the age of walking without support. Multivariate regression models were used to analyze data collected prospectively between 1991 and 1999 in rural Guatemala. Attainment of children's gross motor milestones was assessed monthly by trained field workers using the 17-milestone Gross Motor Development Scale, morbidity was assessed by biweekly recall, and dietary intakes were measured at 9 and 12 mo of age using repeated 24-h dietary recalls. Median age of walking was 15 mo (range 10-24 mo; n = 174) with no differences by gender. Models were adjusted for birth order, gender, gestational age, maternal age and education, socioeconomic status, and community. Growth in length (-0.57 +/- 0.27 mo length for age Z-score; P = 0.04) and weight (-0.54 +/- 0.19 mo weight for age Z-score, P = 0.005) during the first year of life, rather than size at birth, predicted age of walking. Animal protein intake from complementary foods, while low (mean < 1 g/d) overall, was positively associated with earlier age of walking (P = 0.02). Morbidity during infancy was not associated with age of walking. These findings indicate the importance of prevention of postnatal growth retardation and improvement of diet quality for children's gross motor development.

Risk markers for poor developmental attainment in young children: results from a longitudinal national survey.

To evaluate social and environmental determinants of poor developmental attainment among preschool children by means of longitudinal data from a population-based sample of Canadian children. Secondary analysis of data from cycles 1 (1994-1995) and 2 (1996-1997) of the National Longitudinal Survey of Children and Youth using a cohort design with 2-year follow-up. A total of 4987 children aged 1 to 5 years at baseline, whose biological mother completed risk factor information and who were included in both cycles. Poor developmental attainment (developing unusually slowly) was defined as scores more than 1 SD below the age-standardized mean for the Motor and Social Development Scale, revised Peabody Picture Vocabulary Test, or Canadian Achievement Tests in mathematics and reading/comprehension, depending on the child's age. The prevalence of sustained poor developmental attainment after 2 years of follow-up was 4.6%. Factors found to be associated with poor developmental attainment included male sex (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.10-1.70), maternal depression (OR, 1.64; 95% CI, 1.25-2.15), low maternal education (OR, 1.57; 95% CI, 1.19-2.08), maternal immigrant status (OR, 1.93; 95% CI, 1.38-2.71), and household low income adequacy (OR, 1.43; 95% CI, 1.11-1.83). Having a mother who has symptoms of depression, has low education, or is an immigrant, and living in a household with low income adequacy increase the risk of poor developmental attainment in children aged 1 to 5 years. The notable risks associated with these factors indicate them as possible targets for screening and interventions to prevent poor developmental attainment.

P0117 PP BLOOD PLASMA ENKEPHALINASE ACTIVITY OF BREASTFEEDING AND BOTTLE-FEEDING INFANTS: INTERRELATIONSHIP WITH TEMPERAMENT

Introduction: Breast milk is an unique product in providing optimal infant’s development. Breastfeeding was reported to provide advantage for the development of intelligence and endocrine system maturation in infants. On the other hand, these processes depend on child personality and proceed under regulation by neurochemical systems. The influence of breastfeeding and bottle-feeding on the main peptidergic regulatory systems, endogenous opioid system, for example, in early postnatal period is not studied. The aim of our research was to evaluate enzymatic degradation of opioid peptide leuenkephalin in blood plasma of breastfed and bottle-fed infants and to estimated its possible interrelationship with children personality. Methods: 93 healthy infants (50 boys and 43 girls) at the age of 1 to 12 months were entered into the investigation. 33 (36%) of them were breastfed and 60 (64%) bottle-fed. The level of psychomotor development was estimated by means of the quantitative scale of mental and motor development for infants [Zhurba, Mastukova, 1981]. Temperament was studied by means of EITQ and ITQ questionnaires [W.B.Carey et al, 1986]. Enkephalinase activity in plasma was estimated in vitro by the rate of 3H-leu-enkephalin hydrolysis at low substrate concentration (half-life time of leu-enkephalin, t1/2). [Sokolov et al., 2000]. Results: It was found that t1/2 of leu-enkephaline was significantly less in infants than in adults. Between infants with normal psychomotor development t1/2 of leu-enkephaline was higher in girls comparing to boys (2.51+ 0.08 vs 2.26+ 0.06 min respectively, p<0.01) and higher in bottle-fed infants comparing to breastfed (2.15*0.07 vs 2.48*0.06 min respectively, p<0.001). In infants with delayed psychomotor development these differences were not detected. Nevertheless, there was no relationship between t1/2 and infants psychomotor development. We also demonstrated correlation of t1/2 with such characteristics of infant temperament as Activity, Approach, Threshold (p<0.05). We did not find any significant correlation between the temperament characteristics and the level of mental and motor development of infants. Conclusion: Our data showed that blood plasma enkephalinase activity is different in breastfed and bottle-fed infants. Probably, it might be one of mechanism of feeding type influence on opioid system in infants of first year of age. For the first time we demonstrated the correlation between enkephalinase activity and some characteristics of child temperament, but not psychomotor development.

Stress during pregnancy is associated with developmental outcome in infancy.

Animal studies show that prenatal maternal stress may be related to cognitive impairments in offspring. Therefore, we examined whether psychological and endocrinologic measures of stress during human pregnancy predicted developmental outcome of the infant at 3 and 8 months. Self-report data about daily hassles and pregnancy-specific anxiety and salivary cortisol levels were collected in 170 nulliparous women in early, mid- and late pregnancy in a prospective design, in which healthy infants born at term were followed up after birth. High levels of pregnancy-specific anxiety in mid-pregnancy predicted lower mental and motor developmental scores at 8 months (p < .05). High amounts of daily hassles in early pregnancy were associated with lower mental developmental scores at 8 months (p < .05). Early morning values of cortisol in late pregnancy were negatively related to both mental and motor development at 3 months (p < .05 and p < .005, respectively) and motor development at 8 months (p < .01). On average a decline of 8 points on the mental and motor development scale was found. All results were adjusted for a large number of covariates. Stress during pregnancy appears to be one of the determinants of delay in motor and mental development in infants of 8 months of age and may be a risk factor for later developmental problems. Further systematic follow-up of the present sample is needed to determine whether these delays are transient, persistent or even progressive.

Stability, Predictive Validity, and Sensitivity of Mental and Motor Development Scales and Pre-School Cognitive Tests among Low-Income Children in Developing Countries

This paper documents the stability, predictive power, and sensitivity of mental and motor development scales and pre-school cognitive tests in the context of economically impoverished populations in low-income countries. Stability and predictive power comprise forecasting; stability includes repeated measures using the same test, whereas predictive power includes different tests. Sensitivity is the track record of the test in discriminating among groups of children exposed to different nutritional interventions. Psychometric data from three longitudinal studies of the assessment of the impact of early supplementary feeding on child development were used. Two studies were conducted in West Java, Indonesia, and the third study was carried out in El Oriente, Guatemala. Repeated measures allowed for the calculation of stability and predictive correlation coefficients. the mental development scales administered up to about 18 months had modest stability but no predictive power. This trend changed during the second year of life as the strength of the stability and predictive power increased. the pre-school tests were good predictors of a child's enrollment and school achievement. the findings on infant scales and pre-school tests agree with what has been reported in other populations in industrialized countries. There is no reason to believe that the developmental risk of the subjects that were assessed in each of the three target studies strengthens the psychometric attributes that were evaluated.

A Developmental Function of Motor Activity among Nutritionally At-Risk Children

Learning about the dynamics of early childhood development in the context of poverty and malnutrition is an effective way to identify the periods of highest psychosocial vulnerability and the role of timing in the differential responsivity of young children to interventions. Motor activity under natural conditions is one area of development that requires further study because of its biological and psychological developmental importance. This paper presents an estimate of the development function of motor activity among poorly nourished children whose ages ranged from 12 to 30 months. It also focuses on the longitudinal relationship between the nature, level of motor development, and intensity of motor actions, on the one hand, and physical growth, dietary intake, and motor activity, on the other. Two cohorts (12 and 18 months old) of rural West Javanese children were studied. Motor activity, energy intake, physical growth, and motor development were measured every two months. A motor activity score was calculated based on the estimated energy cost and intensity of each activity and their frequency and duration during each of the periods of observation. Intensity was classified according to a three-point scale (high = 1.25, moderate = 1.0, low = 0.75). the Bayley Scale of Motor Development and a scale of motor milestones were used to assess motor development (e.g., crawling, creeping, walking, and running). The developmental function of activity was curvilinear. It showed a moderately fast acceleration from 12 to about 18 to 20 months; at that point the curve reached a plateau. the functions of growth and energy intake were linear. the average motor behaviour of these children was characterized by its low level of intensity. Although the relationship between motor activity and motor development was relatively close up to about 20 months, thereafter the motor activity and motor development scores were independent of each other. the changes in activity level were primarily determined by a significant decline of involvement in activities having a low energy cost and an increase in activities having moderate or high energy cost. the decline of motor activity observed at 18 months is reminiscent of the decline in growth velocity observed during the first six months of life among malnourished children. It is plausible that the pattern of activity observed could be explained by either contextual or cultural factors.

Early Supplementary Feeding, Child Development, and Health Policy

We carried out a meta-analysis of six field studies that assessed the effects of supplementary feeding on infants’ performance on mental and motor development scales— conducted in nutritionally at-risk populations in Colombia, Guatemala, Indonesia, Jamaica, Taiwan, and the United States—which showed that early high energy and protein supplementary feeding has a beneficial effect on motor development in young infants (8–15 months old) and on both motor and mental development in older infants (1824 months old) who are nutritionally at risk. These findings provide justification for food assistance programmes targeted to young at-risk children. However, positive findings in field studies do not guarantee that similar results will be achieved by large-scale programmes, as complex bureaucracies and inadequate infrastructure are often obstacles to success.

A protocol for structured observation of motor performance in preterm and term infants.

A new protocol for structured observation of motor performance has been designed for assessment of the progress and quality of motor development in preterm and term infants. A detailed scale of motor development based on the present knowledge of motor development in healthy term infants has been constructed. The motor performance is observed in each part of the infant's body in the supine and prone positions and in the whole body with the infant sitting, standing and during locomotion, and is evaluated in relation to defined levels of motor performance. If the quality of motor performance is optimal for a certain level, no deviation is noted. Any deviation from the motor performance described in the protocol for the level in question is graded as suspected or clear and classified by type. All observations are recorded on videotape for documentation. In a study of inter- and intraobserver agreement, such recordings from 17 infants were reassessed on two occasions more than one year apart. The interobserver agreement ranged between 73 and 87% and the intraobserver consistency between 77 and 88%. The protocol is currently being used in a follow-up study.

Psychomotor disturbances in psychiatric patients as a possible basis for new attempts at differential diagnosis and therapy

This study investigates the presence and course of motor symptoms in endogenous (n = 42) and non-endogenous (n = 15) depressed patients (both medicated and unmedicated) in comparison to 15 healthy control persons. As in our previous studies on schizophrenic and depressed patients, we used a motor test battery, which consisted of the Motorische Leistungsserie, a modified version of the Lincoln Oseretzky Motor Development Scale and the motor subtest of the Luria Nebraska Neuropsychological Battery. Previous findings had suggested the existence of a psychotic motor syndrome (PMS) in endogenous depressed patients (and schizophrenics), involving disturbances of the lips and tongue, fine and gross movements of the dominant right hand and the complex motor coordination of the extremities. We re-confirmed the PMS in acute endogenous depressed patients, both medicated and unmedicated. Such a motor syndrome did not exist in healthy controls, or in non-endogenous depressed patients, irrespective of the severity of the depressive syndrome. This PMS showed a clear improvement with the amelioration of the depressive symptoms in endogenous depressed patients towards the end of the hospital treatment period and disappeared entirely in patients in a symptom free interval. This may be suggestive of a possible role for the PMS as a state marker for endogenous depression, in contrast to the persistence of the PMS in schizophrenics (trait marker), described previously. The results of factorial analyses on motor performance did not reveal differences in the factorial structure between depressives, schizophrenics and normals. However, they indicated disturbances on a general motor factor, which may account for the performance deficits in psychotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Neurologic and psychosocial disorders in children with brain tumors

We studied 15 tumor-free patients, that had already finished treatment at the university-hospital Essen. Beside from a neurological check-up our complete assessment included the following tests: CMM (Columbia Mental Maturity Scale), BM and CM (Raven Test), PPVT (Peabody Picture Vocabulary Test), BA (Following Directions), KP (Dotting), d2, HAWIK-Test (Mathematical part), LOS (Lincoln Oseretzky Motor Development Scale) and GFT (Göttinger Formreproduktionstest). A half structured interview of parents was performed, too. All, but two patients, had neurological disorders of different degrees. All these 13 patients had signs of ataxia. For the intelligence- and development-tests (CMM, BA, BM, CM and PPVT) the results for all patients were better than the 50th percentile, for the KP and LOS-test worse (40-47%). A diminished ability for concentration and slowness shows the d2-reached only a rate of 22 percent. The results of the HAWIK-test shows a test-age-equivalent, which is 3,4 years above the actual age. From the results of the GFT you can conclude, that these disorders are caused by brain damage. Parents mentioned during the interviews abnormalities in behaviour, interaction-problems between siblings and inadequate emotional reactions. For all these reasons we want to point out, that for an overall assessment of these patients and there families a well-planed therapeutical procedure including rehabilitive measures is necessary for diminishing the described disturbances as far as possible.

The effects of infantile malnutrition on behavioral development: a follow-up study

Thirty-one children and young adults who had been severely malnourished in infancy due to intestinal disease, were compared with sibling controls for psychometric intelligence, academic performance as judged by teacher ratings, and developmental history as judged by parental questionnaires. Older members of the sample were also examined on the Lincoln-Oseretzky Motor Development Scale and by a brief psychiatric interview. There were no significant differences between patients and controls on any outcome measure. Furthermore, previously malnourished individuals were performing at or above age equivalent norms on all psychological tests. The findings suggest that the adverse behavioral effects of severe infantile malnutrition observed in children below the age of 5 yr are, to a large extent, compensated during development when the children are raised in supportive home and school environments.

Motor and cognitive proficiency of learning disabled and normal children

Motor and cognitive skills of learning disabled ( N = 32) and normal ( N = 32) boys were compared on the Modified Lincoln-Oseretsky Motor Development Scale and on the WISC-R Vocabulary and Block Design subtests. Eight learning disabled and eight normal boys were tested at four age levels from 8 to 11 years. All boys were of normal intelligence. Motor and cognitive skills of the learning disabled boys were significantly below those of the normal boys and below those of the normative group. Chronological age was not a significant factor in relationship to either motor or cognitive skills. Intercorrelations indicated that in the learning disabled group Block Design, but not Vocabulary, was significantly related to motor scores at the 8- and 9-year ages. These results suggest that a common factor relating to perceptual-motor coordination and efficiency may be involved on the Lincoln-Oseretsky and Block Design subtest for young learning disabled children but not for older learning disabled children or for normal children.

Aminocentesis: its impact on mothers and infants. A 1-year follow-up study.

In a 1-year follow-up study, the effects of amniocentesis for genetic diagnosis upon 22 infants and their mothers were assessed. The infants were tested at 1 year of age on the Bayley Infant Scale of Mental and Motor Development. No deviations from normal mental or motor development were found. The mothers were interviewed at the same time, in order to better understand the emotional aspects of the experience. Women between ages 35-39 with no previously affected child tended to accept amniocentesis easily, as an appropriate part of parnatal care. Mothers with a previous defective child tended to have more painful emotional reactions, including higher anxiety over the test and more conflict about a possible abortion. They needed more intensive and extended counseling. We suggest that the issue of abortion is important, even if manageable by most women, and that a chance to discuss it may be significant.

A modified Lincoln-Oseretsky Motor Development Scale: provisional standardization.

This study was designed to modify the Lincoln-Oseretsky Motor Development Scale into a brief instrument which would be easy to administer and to score and which would yield a set of norms against which to assess motor development/proficiency in deviant children of elementary school age. An earlier (31-item) modification of the Lincoln-Oseretsky (L-O) was administered to 210 essentially normal boys ranging in age from 5 through 11 yr. (K through 6th grade). This led to the provisional standardization of a modified scale (ML-O) of 26 items, arranged in approximate order of difficulty and dependence. In keeping with the objectives of the study, the scale: (a) reflected the developmental nature of motor proficiency, (b) demonstrated acceptable reliability and validity, and (c) required a total administration time of under 30 min. This provisional standardization yielded tentative age and percentile norms. Ongoing validation studies indicate that the modified scale discriminates between different clinical populations and the normative group and that it could usefully serve in the identification of neuromotor deviation among children. Future directions for increasing the precision of the norms are suggested.

Relationship and prediction of infant tests.

Summary This study was designed to evaluate how a series of measures made on 77 infants at ages 3, 6, 9, 12, 18, and 24 months could be used to predict measures made at about 5 years of age. The analytical procedures were selected to be sensitive to differences among individuals in the function that relates test performance to age. Neither evidence for such heterogeneity nor incremental validity of the measures made at 18 months and earlier was obtained. It is concluded that the Gesell Developmental Schedule, the Cattell Infant intelligence Scale, and the California Infant Scale of Motor Development, administered at 18 months and earlier, are invalid both as static indicators of later performance and as dynamic indicators of development.

Books

Abstract Sport and the Body: A Philosophical Symposium. Ellen W. Gerber. Philadelphia, Pennsylvania 19106: Lea and Febiger, 600 S. Washington Square. 1972, 322 pp. $10.00. —Reviewed by Francis Keenan, Sport Science Department, State University College, Brockport, New York 14420. Black Dance in the United States From 1619 to 1970. Lynne Fauley Emery. Palo Alto, California 94304: National Press, 850 Hansen Way. 1972. 370 pp. $8.95. —Reviewed by Richard J. Bushey, associate professor, Department of Physical Education, Russell Sage College, Troy, New York 12180. Developmental Activities for Children in Special Education. Cyntha C. Hirst and Elaine Michaelis. Springfield, Illinois 62703: Charles C Thomas, 301–327 East Lawrence Avenue. 1972. 258 pp. $15.75. The Teaching Research Motor-Development Scale for Moderately and Severely Retarded Children. H. D. Bud Fredericks, Victor L. Baldwin, Philip Doughty, L. James Walter. Springfield, Illinois 62703: Charles C Thomas, 301–327 East Lawrence Avenue. 1972. 64 pp. $7.00. —Reviewed by Martin L. Zwiren, coordinator of corrective therapy training and instructor, Arnold College Division, University of Bridgeport, Bridgeport, Connecticut.

Characteristic motor development of children with learning disabilities.

This study attempted to determine whether children classified as learning disabled also demonstrate specific or general motoric dysfunction characteristics which can be identified early. The Lincoln-Oseretsky Motor Development Scale was administered to 28 children aged 5.1 to 13.6 who were referred to the University of Kansas Perceptual Motor Clinic. The findings support Ayres' conclusion that children evidencing perceptual-motor dysfunction also demonstrate static balance problems.