Normal Motor Development Research Articles

CPMP rescue of a neonate with severe molybdenum cofactor deficiency after serendipitous early diagnosis, and characterisation of a novel MOCS1 variant

We report the first, and so far, only index patient with neonatal onset MoCD type A who was diagnosed and treated early enough with cPMP to avoid severe brain injury and disability. The child presented with hypoglycemia at the age of 10 h and was diagnosed because of the incidental finding of severely decreased L-cystine in plasma. Due to a high level of awareness and excellent co-operation between metabolic laboratory and clinical services, cPMP substitution could be initiated before severe encephalopathy set in, and the child subsequently had a normal motor development. The child has been continued on daily substitution with cPMP until today (age 7 years) and has shown a satisfying long-term developmental outcome. Long-term follow-up, however, revealed significant communication difficulties and cognitive abilities in the range of mild to moderate learning disability. The severity of the metabolic disease was confirmed by the extent of biochemical abnormalities and further functional characterisation of the underlying genetic variants. This case provides further evidence that cPMP substitution does significantly alter the disease course when applied early enough. Postnatal treatment in this case was not sufficient to enable an entirely normal cognitive development, despite sustained complete normalization of the biochemical abnormalities.

The Predictive Value of Amplitude-Integrated Electroencephalography for the Neurodevelopmental Outcomes of Preterm Newborns at 12 Months Corrected Age.

In clinical practice, it is crucial to identify diagnostic methods that can forecast the neurodevelopmental outcomes of very preterm neonates. Our study aimed to assess the predictive significance of amplitude-integrated electroencephalography (aEEG) for the neurodevelopmental outcomes of preterm infants at 12 months corrected age and to establish the cut-off score that could indicate potential neurodevelopmental impairments. Preterm neonates born before 32 weeks of gestational age between June 2020 and July 2022 were included in a prospective manner. Amplitude-integrated electroencephalography recordings were conducted at five age intervals (days 1-3; first, second, third and fourth weeks). Recordings were analyzed using the Burdjalov scoring system. The neurodevelopment assessment with Bayley Scales of Infant Development-Second Edition was carried out at 12 months corrected age. A total of 140 newborns were included in the study. Neurodevelopment was assessed in 108 infants at 12 months corrected age. Higher total aEEG Burdjalov scores were observed in groups with normal cognitive and motor development. The most sensitive and specific score for prediction of cognitive impairment in 12 months corrected age was an aEEG evaluation of 5.5 according to Burdjalov score within the first three days. The most sensitive and specific score for prediction of motor impairment was 8.5 within the first week. According to our research there is currently not enough data to accurately foresee the development of newborns at 12 months corrected age according to early aEEG test results. However, conducting a research with bigger sample size and repeated evaluations at a later age might increase the prognostic value of aEEG. In this study cut-off scores of aEEG performed early in life to predict later neurodevelopment outcomes were determined.

Motor development of stable born healthy foals during the first 24 hours

The motor development of 14 healthy foals was observed using continuous video-recording from birth to 24 h of age. An ethogram was made of behaviours of interest with behaviour quantification using CowLog software. Behaviours were divided into six main classes: main activities, attempts to get up or lie down, nursing, playing and other skills, being helped by a human, and the foal not being visible. First-time behaviours (mean, range) of early motor development after birth included going into sternal position (5.4 min, 0-34.5 min), attempting to get up (7.6 min, 0.5-34.6 min), successfully getting up (56.4 min, 27.7 min - 1 h 43.3 min), walking (1 h 1.9 min, 28.1 min - 1 h 43.4 min), nursing (1 h 49.1 min, 1 h 10.3 min - 2 h 29.7 min), shaking (31.9 min, 0.2 min - 2 h 32.7 min), running (2 h 55.6 min, 1h 33.2 min - 6 h 12.1 min), walking backwards (4 h 12.8 min, 56.9 min - 12 h 50.6 min), frolicking (4 h 52.5 min, 2 h 3 min - 15 h 18.8 min), and autogrooming (7 h 30.3 min, 43.3 min - 14 h 40.1 min). All foals made several attempts before they were able to get up for the first time (61.9, 14-103). During the first 24 h the overall duration of lying down was highest, followed by standing and walking. This information adds to the basic information for assessing normal motor development in these animals, with the potential to identify delayed development.

Schizencephaly: Etiopathogenesis, Classification, Therapeutic, and Rehabilitative Approach

AbstractSchizencephaly is an uncommon anomaly in neuronal migration characterized by complete clefts that extend from the pia mater to the ependymal surface of the ventricular system. These clefts are encompassed by displaced gray matter and filled with cerebrospinal fluid. Typically, they are found most often in the frontal lobe or the area around the lateral sulcus and can occur on one or both sides. The size, location, and type of these clefts carry significant clinical and prognostic implications. Moreover, they are frequently associated with other central nervous system malformations, including the absence of the septum pellucidum, septo-optic dysplasia, optic nerve hypoplasia, pachygyria, polymicrogyria, cortical dysplasia, heterotopia, and dysplasia of the corpus callosum. Occurrence of schizencephaly is almost always sporadic but its etiopathogenesis is yet to be fully understood. Most likely environmental factors, including exposure to teratogens, viral infections, and maternal factors, operate jointly with genetic defects. To date COL4A1, EMX2, SHH, and SIX3 are the genes identified as possible pathogenetic target. It is interesting to notice that schizencephaly is commonly seen in abandoned or adopted children, as proof of causative effect of intrautero insults. Clinical presentations widely vary and symptoms include a spectrum of cognitive impairment, limb paresis/tetraparesis, and epileptic seizures either with early or late onset; anyway, none of these symptoms is ever-present and patients with schizencephaly can also have normal neurocognitive and motor development. Diagnostic gold standard for schizencephaly is magnetic resonance imaging, which allows to identify and characterize typical clefts. Treatment of schizencephaly is symptomatic and supportive and depends on the severity of morbidity resulting from the malformation. Therapy includes antiepileptic drugs, psychomotor rehabilitation, and in selected cases surgical approach.

Appropriate Vestibular Stimulation in Children and Adolescents-A Prerequisite for Normal Cognitive, Motor Development and Bodily Homeostasis-A Review.

The structural development of the vestibular part of the inner ear is completed by birth but its central connections continue to develop until adolescence. Their development is dependent on vestibular stimulation-vestibular experience. Studies have shown that vestibular function, modulated by experience and epigenetic factors, is not solely an instrument for body position regulation, navigation, and stabilization of the head and images but also influences cognition, emotion, the autonomous nervous system and hormones. To emphasize the importance of appropriate vestibular stimulation, we present a literature review of its effect on bodily homeostasis, cognition and emotion.

THE RELATIONSHIP OF TUMMY TIME WITH NORMAL BABIES' GROSS MOTOR DEVELOPMENT IN THE DENPASAR ASI COMMUNITY IN 2022

Introduction: Infant motor development is crucial because it bridges the movements that occur during life, produces perceptual information, provides a means to gain knowledge about the world, and allows social interaction. If the basic motor stage is not passed, then there will be obstacles in motor development. Early stimulation will be needed to optimize the growth and development of children according to their stages naturally. Tummy time is one obvious form of early stimulation for muscle tone, posture, and later development. Objective: To determine the relationship between tummy time and gross motor development of normal infants in the breastfeeding community in Denpasar. Methods: An observational study using an analytical cross-sectional study, involving 30 respondents from the breastfeeding mother community in Denpasar. Primary data was obtained through a google form using the WhatsApp blast. Data analysis used Spearman rank correlation test. Results: Showed a significant relationship between the variable doing tummy time and the variable gross motor development sitting in normal infants, whether it was seen from the strong or not the correlation (with very strong results because the correlation coefficient was close to 1), the significance of the correlation results was 0.000 (less than 0.01 and 0.05) and the direction of the correlation is positive. So, Ho is rejected and H1 is accepted. Conclusion: Tummy time is proven to have a close relationship with the achievement of normal infant gross motor development with reference to the ability to sit at the age of six months. Based on the results of the study, it is recommended to do tummy time as a form of stimulation to achieve gross motor development of babies that the public needs to know.

HUBUNGAN PIJAT BAYI DENGAN PERKEMBANGAN MOTORIK KASAR PADA BAYI USIA 3-6 BULAN DI NARESWARA MOM AND BABY CARE KUDUS 2022

Baby massage can stimulate the development of baby's gross motor skills, which is part of motor activity that involves large or gross muscle skills. The ability to use large muscles for babies is a basic movement ability. The purpose of this study is to analyze the relationship between infant massage and gross motor development in infants aged 3-6 months at Nareswara Mom and Baby Care Kudus. This study uses a quantitative method with a cross-sectional approach. The research sample consisted of 50 infants aged 3-6 months at Nareswara Mom and Baby Care, Kudus, with the sampling technique using total sampling. Analysis of research data using univariate and bivariate analysis using chi square. The results of the univariate analysis showed that there were 33 babies (66%) aged 3-6 months who were in the routine category, while there were 17 babies (34%) who were in the non-routine category. Furthermore, gross motor development was normal in 24 infants (48%), gross motor development in question was in 17 infants (34%), and gross motor development was deviant in 9 infants (18%). The results of the bivariate analysis showed that 22 respondents (44%) had normal gross motor development for infants aged 3-6 months who had regular massages, 9 respondents had doubts (18%), and 2 respondents had deviations (4%). Furthermore, infants aged 3-6 months in the non-routine category with normal gross motor development were 2 respondents (4%), doubtful 8 respondents (16%), and deviant 7 respondents (14%). Then the results of the chi square test show the sig. Asyim (P-Value) of 0.000 is less than 0.05 (0.000 <0.05). Statistically, there is a relationship between infant massage and gross motor development for infants aged 3-6 months at Nareswara Mom and Baby Care, Kudus. Thus it is hoped that mothers who have babies routinely provide baby massage stimulation in order to improve the baby's gross motor development.

5 Years Analysis of Therapeutic Hypothermia for HIE Neonates in NICUs of Ain Shams University

Background Therapeutic hypothermia (TH) is a standard of care for neonatal Hypoxic Ischemic Encephalopathy (HIE) in developed countries. Most data come from High income countries (HIC). Recently, experts suggest that the safety and efficacy data on cooling from HIC should not be extrapolated to Low and Middle Income Countries (LMIC). Aim of the Work Evaluation of the outcome of neonates with HIE treated with TH as a neuroprotective treatment who were admitted to NICUs of Ain Shams University from 1/2016 to 12/2020. Patients and Methods All HIE babies who were treated with TH were included. Retrospectively, patients’ medical paper notes of included babies were reviewed, recorded, and analyzed. Survived neonates were approached by telephone interview regarding parental views on their neurodevelopment and were offered a formal neurodevelopmental assessment for their babies using Bayley Scales III. Results A total 37 neonates (17 survived and 20 died) were included: 2 mild HIE (survived), 13 severe HIE (all died) and 22 moderate HIE (15 survived and 7 died) (mortality 54.1%). The most common causes of death are pulmonary hemorrhage (24.3%) and shock (18.9%). Of the 17 survivors, 6 patients couldn’t be reached while 9 patients had satisfactory neurodevelopmental progression as per their parents while 2 patients had poor outcome. Bayley III was done for only 3 babies: All had normal cognitive and language development. 2 of them had normal motor development while 1 patient had mild to moderate motor delay. Conclusion TH might not improve outcome of sever HIE but of great value on outcome of moderate HIE. Prospective RCTs are recommended to assess the role of TH as a neuroprotective agent for neonates with HIE in a low resource setting.

Difficult Diagnosis in a Patient with Phenylketonuria (PKU) and Metachromatic Leukodystrophy (MLD)

Abstract Introduction Since phenylalanine level was included in the national newborn screening program in Egypt, patients with phenylketonuria (PKU) were early diagnosed and management and have better outcome with nearly normal motor and mental development. Neuro-regression or poor cognition is never recognized in compliant patients. Case presentation Herein we present an Egyptian child who was diagnosed by neonatal screening as PKU who was compliant on dietary treatment and normal development. After the age of 18 months, he started to loose previously acquired developmental milestones. Because of his average phenylalanine levels all through, a second neurodegenerative disease was suspected. Several investigations were done and the diagnosis of metachromatic leukodystrophy was suspected and was later confirmed by molecular testing showing homozygous frame shift mutation in ARSA gene c.583del, p. (Trp 195Glyfs*5) in addition to homozygous Missense mutation in PAH gene c.842C>T, p. (Pro281 Leu). Conclusion The presence of two genetic diseases in the same family should be suspected in consanguineous communities like ours especially if the clinical data of the primary disease does not fit.

Parental knowledge of children’s motor development: A cross-sectional study in Saudi Arabia

BackgroundThis study was undertaken to explore parental knowledge of normal motor development. In addition, the association between parental knowledge and characteristics was investigated. MethodsA cross-sectional design was adopted for this study. An online survey was used to administer a four-part questionnaire designed for this study. The first part of the questionnaire focused on demographic information, such as age, age at birth of first child, and educational level. The second part consisted of questions about birth-related information sources, and the third part included questions about normal motor development. The fourth part was directed to participants who had children with DDs. The data were analysed descriptively and reported using absolute and relative frequencies. Linear regression was used to investigate the association between parental knowledge level and gender, age, education, age at first birth, number of children, and self-rated knowledge level. ResultsA total of 4081 participants responded to the survey. Most participants were found to have low levels of parental knowledge, as 88.87% answered ≤ 50% of the developmental milestone questions correctly. Being a female and having a university education were significantly associated with high knowledge levels (p < 0.001 for both variables). Further, undergoing an awareness programme about normal child development was significantly associated with high knowledge levels (p = 0.02). No association was found between the factors of age, age at first birth, number of children, and knowledge rating and the level of parental knowledge about normal physical development. Conclusion(s)There is a lack of appropriate knowledge about normal motor development among parents in Saudi Arabia, which raises serious concerns about children’s health in the country. ImplicationsEffective health education programmes on normal developmental milestones should be implemented by the Ministry of Health to improve the developmental outcomes of children in Saudi Arabia.

A new neurodevelopmental disorder linked to heterozygous variants in UNC79

PurposeThe “NALCN channelosome” is an ion channel complex that consists of multiple proteins, including NALCN, UNC79, UNC80, and FAM155A. Only a small number of individuals with a neurodevelopmental syndrome have been reported with disease causing variants in NALCN and UNC80. However, no pathogenic UNC79 variants have been reported, and in vivo function of UNC79 in humans is largely unknown. MethodsWe used international gene-matching efforts to identify patients harboring ultrarare heterozygous loss-of-function UNC79 variants and no other putative responsible genes. We used genetic manipulations in Drosophila and mice to test potential causal relationships between UNC79 variants and the pathology. ResultsWe found 6 unrelated and affected patients with UNC79 variants. Five patients presented with overlapping neurodevelopmental features, including mild to moderate intellectual disability and a mild developmental delay, whereas a single patient reportedly had normal cognitive and motor development but was diagnosed with epilepsy and autistic features. All displayed behavioral issues and 4 patients had epilepsy. Drosophila with UNC79 knocked down displayed induced seizure-like phenotype. Mice with a heterozygous loss-of-function variant have a developmental delay in body weight compared with wild type. In addition, they have impaired ability in learning and memory. ConclusionOur results demonstrate that heterozygous loss-of-function UNC79 variants are associated with neurologic pathologies.

Clinical and genetic characteristics and an algorithm for the differential diagnosis of progressive muscular dystrophies that manifest after a period of normal motor development

Background. Progressive muscular dystrophies (PMD) are a group of genetically heterogeneous diseases that manifest in the age range from early childhood to adulthood. Depending on the predominant topography of the muscular lesion, there are: limb-girdle, distal, oculopharyngeal, facial-shoulder-scapular-peroneal variants of PMD.Aim. Creation of algorithms for the differential diagnosis of PMD with multiple topography of muscle lesions.Materials and methods. We observed 192 patients aged 1.5 to 66 years with PMD with a debut after a period of normal motor development. The diagnosis was established on the basis of genealogical analysis, neurological examination, assessment of non-muscular manifestations, results of instrumental, biochemical molecular genetic studies.Results. Four groups of patients were identified, differing in the topography of muscle damage and 19 genetic variants of PMD were diagnosed. An algorithm for diagnosing PMD that manifest after a period of normal motor development is proposed, which is based on the frequency of occurrence of individual genetic variants and their proportion in the analyzed sample, the presence of major mutations in causal genes, the features of phenotypic characteristics, the gender of the patient and the possibility of conducting etiopathogenetic therapy developed by for some genetic variants.Conclusion. The use of the proposed algorithm in clinical practice can significantly reduce the economic and time costs for confirmatory molecular genetic diagnosis, and promptly recommend etiopathogenetic therapy for some genetic variants of this group of diseases.

TAY-SACHS DISEASE IN A CHILD: A RARE CASE REPORT ,GGH KURNOOL

The neurodegenerative condition known as Tay-Sachs disease is inherited in an autosomal recessive pattern and is caused by an abnormal accumulation of the cell membrane glycolipid and GM2 ganglioside within the lysosomes of affected cells. A lack of the isoenzyme -hexosaminidase A, which is synthesised in the endoplasmic reticulum, is the root cause of this condition. In patients who have Tay-Sachs disease, the first few months of life are characterised by normal motor development, followed by gradual weakening and loss of motor abilities beginning around 2 to 6 months of life. Due to the irreversible nature of neurodegeneration, death typically occurs between the ages of 4 and 5 years. The hexosaminidase enzyme assay and DNA analysis of the HEXA gene are two methods that can be used to diagnose TaySachs disease. On the other hand, there is no specific treatment that has been established. We discuss here a case of TaySachs disease found in an 9-month-old male child who presented with loss of milestones and seizure symptoms. Upon examination of the fundus, it was found that this patient had cherry red spot in the macula. In the enzymatic assay, the hexosaminidase A activity was zero percent, and DNA analysis revealed a mutation in which glutamine was replaced by a stop codon at position 390

The Relationship Between Knowledge and Role Parents in Stimulating The Development of Gross Motoric Childern Age 3-24 Months at The Cabangbungin Bekasi District Health Center Year 2022

Health development is carried out by making human resources healthy as early as possible, this is to improve the quality of life of children with optimal growth and development both physically (motor), mental, cognitive and social. The process of growth and development in children takes place very naturally, to realize children's motoric development according to their age, parents must have knowledge about child development and the role of parents in parenting to stimulate children to be confident in their basic motor development. The purpose of this study was to determine the relationship between knowledge and the role of parents in stimulating gross motor development in children aged 3–24 months. This research method uses an analytic survey with a cross sectional design. The sample in this study were parents who had children aged 3–24 months as many as 53 respondents, the sampling technique was simple random sampling. Data analysis using chi square. The results showed that there were 55.6% of parents with good knowledge and normal children's gross motor development, then 75% of parents had a good role with normal children's gross motor development. The results of the bivariate analysis of knowledge showed no significant relationship (p= 0.777), while the role of parents had a significant relationship (p = 0.002). There is a need for education and outreach to increase parental knowledge and play an involved role in stimulating children's development to achieve optimal

Genetics and clinical phenotypes of epilepsy associated with chromosome 2q24.3 microdeletion

Objective: To summarize the genetics and clinical phenotypes of epilepsy children with 2q24.3 microdeletion. Methods: All the patients with 2q24.3 microdeletion were retrospectively collected at the Pediatric Department of Peking University First Hospital from March 2017 to July 2022. The features of clinical manifestations, electroencephalogram (EEG), and neuroimaging were analyzed. Results: There were 13 patients with 2q24.3 microdeletion were included. All 13 patients had de novo copy number variation (CNV) with a deletion size ranged 0.18-7.31 Mb. The main pathogenic genes in the region were SCN3A, SCN2A, TTC21B, SCN1A and SCN9A genes. Among the 13 patients, 7 were boys, and 6 were girls. The onset age of epilepsy was 3.3(2.5, 6.0) months. Multiple seizure types were observed, including focal seizures in 13 patients, generalized tonic-clonic seizures (GTCS) in 6 patients, myoclonic seizures in 3 patients, epileptic spasm in 2 patients, and tonic seizures in 2 patients. Seizures were fever sensitivity in 9 patients. Status epilepticus was observed in 6 patients. One case had normal mental motor development and 12 cases had different degrees of developmental delay. Six patients had craniofacial abnormality, 1 had six-finger deformity of the right thumb, and 1 had multiple system abnormalities. EEG showed focal discharge in 3 cases, multifocal discharges in 5 cases, multifocal and generalized discharges in 1 case. Brain magnetic resonance imaging (MRI) showed enlargement of subarachnoid spaces in the frontal and temporal region in 4 patients, enlargement of lateral ventricle in 4 patients and delayed myelination of white matter in 1 patient. Dravet syndrome was diagnosed in 5 cases. The age at the last follow-up were 2.5(1.4,5.5) years, 1 patient was seizure free longer than 1 year, and 12 patients still had seizures. Conclusions: The epilepsy associated with 2q24.3 microdeletion is mainly induced by the deletion of SCN3A, SCN2A and SCN1A genes. The seizure onset age of 2q24.3 microdeletion related epilepsy was in infancy. Multiple seizure types are observed and the common seizure types include focal seizures and GTCS. Most patients have fever sensitivity and status epilepticus. Most patients have developmental delay. The phenotype of patients with deletion of SCN3A and SCN2A gene is more severe than that of patients with deletion of SCN1A gene only.

Two infants with mild, atypical clinical features of Kagami-Ogata syndrome caused by epimutation

Kagami-Ogata syndrome (KOS) is an imprinting disorder characterized by polyhydramnios, bell-shaped thorax with coat-hanger appearance (curved ribs), respiratory distress, abdominal wall defects, and distinct facial features, together with intellectual developmental delay with special needs. Abnormal expression of the imprinted genes on chromosome 14q32.2 causes KOS. Epimutation with aberrant hypermethylation of the MEG3/DLK1: intergenic differentially methylated region (MEG3/DLK1:IG-DMR) and the MEG3:TSS-DMR is one of the etiologies of KOS. We report two infants with KOS caused by epimutation presenting with some characteristic clinical features, mild clinical course, and almost normal motor and intellectual development. Methylation analysis for ten DMRs related to major imprinting disorders using pyrosequencing with genomic DNA (gDNA) extracted from leukocytes showed abnormally increased methylation levels of the MEG3/DLK1:IG-DMR and MEG3:TSS-DMR in both patients, but lower than those in patients with paternal uniparental disomy chromosome 14 (upd(14)pat). The methylation levels in the DMRs other than both DMRs were within normal range. We also conducted methylation analysis for the MEG3/DLK1:IG-DMR and MEG3:TSS-DMR with gDNA extracted from nails and buccal cells of both patients. Methylation levels in the MEG3:TSS-DMR, particularly in buccal cells, were closer to normal range compared to those in leukocytes. Microsatellite analysis for chromosome 14 and array comparative hybridization analysis showed no upd(14)pat or microdeletion involving the 14q32.2 imprinted region in either patient. A differential mosaic ratio of cells with aberrant methylation of DMRs at the 14q32.2 imprinted region among tissues (connective tissue, lung, and brain) might have led to their atypical clinical features. Further studies of patients with epimutation should further expand the phenotypic spectrum of KOS.

Approach to the Treatment of Pediatric Dystonia

Dystonia is the most common movement disorder in the pediatric population. It can affect normal motor development and cause significant motor disability. The treatment of pediatric dystonia can be very challenging as many children tend to be refractory to standard pharmacological interventions. Pharmacological treatment remains the first-line approach in pediatric dystonia. However, despite the widespread use of different ani-dystonia medications, the literature is limited to small clinical studies, case reports, and experts’ opinions. Botulinum neurotoxin (BoNT) is a well-established treatment in adults with focal and segmental dystonia. Despite the widespread use of BoNT in adult dystonia the data to support its use in children is limited with the majority extrapolated from the spasticity literature. For the last 2 decades, deep brain stimulation (DBS) has been used for a wide variety of dystonic conditions in adults and children. DBS gained increased popularity in the pediatric population because of the dramatic positive outcomes reported in some forms of genetic dystonia and the subsequent consensus that DBS is generally safe and effective. This review summarizes the available evidence supporting the efficacy and safety of pharmacological treatment, BoNT, and DBS in pediatric dystonia and provides practical frameworks for the adoption of these modalities.

MOTOR DEVELOPMENT OUTCOMES OF CHILDREN WHO HAVE UNDERGONE THERAPEUTIC HYPOTHERMIA: WITH PARENTS’ VIEWS

Objective: Neurodevelopmental follow-up of infants with hypoxic ischemic encephalopathy (HIE) and supporting their development have great importance for the later years of their life. The aim of this study was to evaluate motor development outcomes of children with HIE who have undergone therapeutic hypothermia (TH) in Turkey with an objective assessment and the point of view of the parents, and to compare these two assessment methods. Materials and Methods: Twenty two cases (11 girls, 11 boys) with HIE who have undergone TH were included. Sixteen (72.7%) of the cases were classified as Sarnat Stage-2, and six (27.3%) of the cases were classified as Sarnat Stage-3. Motor development of the cases were evaluated by the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Parents’views on their children’s development were examined with The Ages and Stages Questionnaire-2 (ASQ-2). Results: 68.2% (n=15) of the cases had normal motor development, 18.2% (n=4) had mild-moderate motor delay and 13.6% (n=3) had severe motor delay according to the Bayley-III motor scale results. When looking at the sub-areas of motor development, 68.2% (n=15) of the cases had normal gross motor development and 86.4% (n=19) of the cases had normal fine motor development. Additionally, 68.2% (n=15) of the cases demonstrated normal gross motor &amp; fine motor development according to ASQ-2 results. Conclusion: Although there are some parallels in the results of the objective assessments and parental views regarding gross motor development, they differ in terms of fine motor development. However, ASQ-2 can be helpful for follow-up of children with HIE in situations where access to a clinician is limited or difficult and also it can provide an opinion to parents about their children’s development.

HUBUNGAN STATUS GIZI DENGAN PERKEMBANGAN MOTORIK KASAR PADA ANAK USIA 1-3 TAHUN DI POSYANDU SYUKUR NIKMAT DESA SUNGAI DUREN

Toddler age children are children aged 12-36 months (1-3 years). In this period children are trying to find out how things work and how to control others through anger, rejection, and stubbornness. at this time it will cause irreversible damage and can have an impact on brain development. This research is an analytic study with a cross sectional design. The purpose of this study was to determine the relationship between nutritional status and gross motor development in children aged 1-3 years. The population in this study were children aged 1-3 years totaling 123 and the sample in this study was 123 using the total sampling technique. The study was conducted from January 2021 to September 2021. The statistical test used in this study was to use the chi-square test. The results of the study showed that 110 (89.4%) respondents had good nutritional status, as many as 111 (90.2%) respondents had normal gross motor development, there was a relationship between nutritional status and gross motor development in children aged 1-3 years with a p value = 0.000 For this reason, nutritional status is important for children's gross motor development so that children can grow and develop according to their age It is hoped that the Syukur Nikmat Posyandu can provide health education about balanced nutrition for children aged 1-3 years so that children can meet body nutrition so that children's development can be optimal.

DIFFERENCE BETWEEN GROSS MOTOR SKILLS OF INFANTS RECEIVING BREASTMILK AND RECEIVING BREASTMILK-FORMULA MILK

Introduction: Development is the process of changing the functional capacity of the body's organs to a state that is increasingly organized and according to their respective functions. There are gross motor skills, fine motor skills, social skills, emotional abilities, language skills, and knowledge in the development domain. Gross motor movement is the ability to change various body positions using large muscles. Gross motor development begins before a child continues the developmental stage to the next domain. One of the factors in infant development is breastfeeding. Breastfeeding can be done as a solution to prevent delays in motor development in children. Purpose: To determine the difference between the gross motor skills of infants receiving breastmilk and receiving breastmilk-formula milk in Gotong Royong Hospital. Method: This study used an observational analytic study with a research design retro cross-sectional. The sampling technique was carried out by random sampling. The data collection procedure was carried out by collecting secondary data based on medical records from the main study, "The Impact of Early Initiation of Breastfeeding on the Health Profile of Mother and Infant in Gotong Royong Hospital". In this study, using the statistical test Chi-square then data analysis was performed using software SPSS on the computer. Results: Based on the analysis test, there was no difference in gross motor development of infants aged three months who were breastfed and those who were breastfed and received formula milk with a value of p = 1,000 (p &lt;0,05). Babies who experienced gross motor development were suspected (42%), while those who experienced normal gross motor development were (58%). Conclusion: There is no difference in gross motor development of infants aged three months receiving breastmilk and breastmilk-formula milk in Gotong Royong Hospital.