Peabody Developmental Motor Scales Research Articles

Predictors of motor development in children prenatally exposed to cocaine

The current study examined the pattern of motor development across the first 18 months of life in infants with in utero exposure to cocaine to determine how prenatal drug effects and level of exposure relates to motor development. Motor development was examined at 1, 4, 12, and 18 months of age (corrected for prematurity). Infants were divided into cocaine exposed ( n=392) and comparison ( n=776) groups. Exposure status was determined by meconium assay and maternal self-report with alcohol, marijuana, tobacco, and opiates present in both groups. Motor skills were assessed at 1 month using the NICU Network Neurobehavioral Scale (NNNS), at 4 months using the posture and fine motor assessment of infants (PFMAI), at 12 months using the Bayley Scales of Infant Development-Second Edition (BSID-II), and at 18 months using the Peabody Developmental Motor Scales (PDMS). Examiners masked to exposure status performed all assessments. Motor scores were converted to standard ( z) scores, and hierarchical linear modeling (HLM) was used to examine the change in motor skills from 1 to 18 months of age. Infants with exposure to cocaine showed low motor skills at their initial status of 1 month but displayed significant increases over time. Both higher and lower levels of tobacco use related to poorer motor performance on average. Heavy cocaine use related to poorer motor performance as compared to no use, but there were no effects of level of cocaine use on change in motor skills.

Gross motor skills of premature, very low-birthweight Chinese children.

We investigated whether premature, very low-birthweight (VLBW) Asian children without major handicap had poor motor skills compared with their normal birthweight counterparts. We compared a cohort of 42 preterm babies with birthweights <1500 g who participated in a developmental stimulation programme with 69 children of normal birthweight matched for age, gender and paternal education. VLBW children participated in the programme for 3 years and were followed to the age of 5-7 years. The VLBW cohort had significantly lower scores in B- and C-rated skills of the Peabody Developmental Motor Scales. Their total score was also significantly lower. This is in agreement with studies in other populations that found that VLBW children had lower motor scores and that early interventions failed to ameliorate this motor disadvantage.

Cocaine, anemia, and neurodevelopmental outcomes in children: a longitudinal study.

This longitudinal study investigated the rates of iron-deficiency (ID) and iron-deficiency anemia (IDA) among prenatally cocaine-exposed and nonexposed two- and four-year-old children and assessed their relationships to neurodevelopmental outcomes. The sample consisted of 143 two-year-old (70 exposed and 73 nonexposed) and 274 four-year-old (139 exposed and 135 nonexposed) low socioeconomic status children recruited from an ongoing longitudinal study. Hematological assessments included hemoglobin, serum ferritin, mean corpuscular volume, transferrin saturation, and blood lead levels. The neurodevelopmental outcomes consisted of the Bayley Mental (MDI) and Motor (PDI) Development indices at two years, and the Wechsler Preschool and Primary Scales of Intelligence (WPPSI) and the Peabody Developmental Motor Scales (PDMS) at four years. The rate of IDA in four-year-old children was significantly greater among the cocaine-exposed compared to the nonexposed group (p =.026), while the rates at two years were not significant. Exposure to IDA at two years was associated with a significant decrease in concurrent motor scores (p =.011) after adjustment for relevant covariates. Peak exposure to IDA, defined as being anemic at 2 and/or 4 years of age, was associated with a significant (p <.05) decrease in Full Scale IQ after adjustment. Cocaine exposure was not a significant predictor of Full Scale IQ with the inclusion of peak IDA and lead in the model. These findings indicate the need for greater pediatric surveillance of IDA and lead in cocaine-exposed infants, in order to reduce long-term neuropsychological deficits.

Concurrent Validity of the Bayley Scales of Infant Development II Motor Scale and the Peabody Developmental Motor Scales-2 in Children with Developmental Delays

The purpose of this study was to explore concurrent validity of the age equivalent and standard scores of the Bayley Scales of Infant Development II (BSID II) Motor Scale and the Peabody Developmental Motor Scales-2 (PDMS-2), including correlations and clinical agreement between the scores of the two tests. One hundred ten children aged three to 41 months who were referred to an early childhood evaluation program because of concerns about their development were administered both the BSID II Motor Scale and the PDMS-2 as part of their developmental evaluations. The correlation coefficients were high to very high for age-equivalent scores, and the Locomotion Subscale had the closest agreement with the BSID II Motor Scale age equivalent. The correlation coefficients were moderate to high for standard scores, and there was only slight agreement between the tests for standard score categories. More than 75% of the 70 children in this study whose scores on the BSID II supported eligibility for services based on scores at least two SD below the mean of the test would not have qualified for services if the PDMS-2 standard scores alone were used to assess their eligibility. Approximately half the children who showed appropriate total motor performance on the PDMS-2 were classified as delayed on the BSID II Motor Scale. The study supports concurrent validity of the tests only for certain subscale age-equivalent scores, particularly the BSID II Motor Scale with the PDMS-2 Locomotion Subscale. The current findings suggest that the standard scores show poor agreement and have low concurrent validity. There are marked differences in the standard scores of the two tests that may affect a child's eligibility for services in some states, and therapists should be cautious when making clinical decisions based solely on standard scores of one test.

Motor and functional skills of children with developmental coordination disorder: A pilot investigation of measurement issues

This paper reports on the motor and functional outcomes of 20 children with developmental coordination disorder (DCD) aged 4–8 years consecutively referred to a pediatric physiotherapy service. Children with a Movement ABC (M-ABC) score less than the 15th percentile, and with no concurrent medical, sensory, physical, intellectual or neurological impairments, were recruited. The Motor Assessment Outcomes Model (MAOM) [Coster and Haley, Infants and Young Children 4 (1992) 11] provided the theoretical base for measurement selection, and preliminary findings at the activities and participation levels of the model are reported in this article. Children with DCD performed at the lower end of the normal range on the Peabody Developmental Motor Scales (fine motor total score) ( M=85.65, SD=12.23). Performance on the Visual Motor Integration Test (VMI) standard scores was within the average range ( M=96.15, SD=10.69). Videotaped observations of the children’s writing and cutting indicated that 29% were left-handed and that a large proportion of all children (31%) utilized unusual pencil grasp patterns and immature prehension of scissors. Measurement at the participation level involved use of the Pictorial Scale of Perceived Competence and Social Acceptance (PCSA) and Pediatric Evaluation of Disability Inventory (PEDI). Overall, these young children rated themselves towards the more competent and accepted end of the PCSA over the dimensions of physical and cognitive competence and peer and maternal acceptance. The PEDI revealed generally average performance on social ( M=49.98, SD=16.62) and mobility function ( M=54.71, SD=3.99), however, self-care function was below the average range for age ( M=38.01, SD=12.19). The utility of the MAOM as a framework for comprehensive measurement of functional and motor outcomes of DCD in young children is discussed.

Abstract 5: Constraint-induced movement therapy in pediatric hemiplegia: A case series

Setting: Tertiary children’s hospital. Patients: 5 children with hemiplegia and learned nonuse of the affected upper extremity. Case Descriptions: Patients included a 3-year-old boy with left hemiplegia from right schizencephaly, 4-year-old girl and 6-year-old boy with right hemiplegic cerebral palsy, 5-year-old girl with right hemiplegia following viral encephalitis at age 3 weeks, and 8-year-old boy with left hemiplegia 15 months after traumatic brain injury. All children had wrist extension of at least 20° and digit extension of at least 10° in the affected extremity. The constraint-induced movement therapy (CIMT) intervention in all children included provision of either a solid or bivalved cast for the unaffected upper extremity for a duration of 2 or 4 weeks, to force use of the affected extremity. For 4 children, 3 daily sessions of forced practice were provided as a home exercise program. Activities used were individually selected following baseline evaluation by the research occupational therapist and modified during the child’s usual weekly occupational therapy visit. The length of each daily practice session was 15 minutes for 1 patient, 30 minutes for 1 patient, and 1 hour for 2 patients. Measures at baseline and postintervention included standardized subtests of the Bruininks-Oseretsky Test of Motor Proficiency and Peabody Developmental Motor Scales, the Jebsen Hand Function Test, and videotaping. Assessment/Results: In all cases, individual motor function trajectories showed improvements in the chronically affected upper extremity greater than those expected by development over the period of intervention. Discussion/Conclusion: This exploratory evaluation of modifications in the standard adult CIMT protocol for children with hemiplegia suggests that varied protocols of CIMT can be effective. Further prospective evaluation of variations in protocols for CIMT in pediatric hemiplegia with more subjects, controls, and longer-term follow-up is indicated to identify the most therapeutically and cost-effective intervention.

EFFECTS OF AN AQUATIC THERAPY PROGRAM ON MOTOR DEVELOPMENT AND WATER ORIENTATION IN CHILDREN WITH HYPOTONIA

Aquatic therapy has been widely used as an alternative therapy in the treatment of children with neurological and developmental disorders. It has been reported to have positive effects on sensation, muscle tone, range of motion, strength, motor control, coordination, gait, balance, endurance, and function. PURPOSE Was to examine the effects of aquatic therapy on function (gross motor development, water orientation, and swimming skills) in children with hypotonia. METHODS Four children aged 36 to 60 months with diagnosed hypotonia participated in this study. Upon admission to the study, each child's gross motor development level, water orientation and swimming skills were assessed utilizing the Peabody Developmental Motor Scales (PDMS) and the Aquatic Orientation Checklist (AOC), respectively. Following this testing, aquatic therapy intervention was provided in a group setting on a weekly basis for 45-minute sessions for a seven week period. RESULTS At the conclusion of the treatment period, each of the abilities was reassessed. Pre-treatment and post-treatment PDMS testing results were converted into age equivalent scores and scaled scores and were compared using a t-test. A t-test was also utilized to compare pre-test and post-test scores and percentage scores of the AOC. The results demonstrated a statistically significant difference between pre-test and post-test PDMS age equivalent scores, PDMS scaled scores, AOC raw scores and AOC percentage scores. CONCLUSIONS These results support that this group aquatic therapy program had a beneficial effect in children with hytonia.

Stability of serial assessments of motor and communication abilities in typically developing infants--implications for screening.

Neuromaturational theory and dynamic systems theory make different assumptions about the rate of development of motor and communication skills. The stability of fine motor, gross motor, and communication scores of infants was evaluated to test these assumptions. This longitudinal descriptive study evaluated infants in their homes at 9, 11, 13, 16, and 21 months of age. One hundred and two Canadian children of English-speaking parents classified as typically developing at 23 months of age using the Diagnostic Inventory for Screening Children Preschool Screen were included. The Peabody Developmental Motor Scales and the Communication Symbolic Behavior Scales-Developmental Profile were used to assess development at each time. Scores were stable if the 95% confidence intervals around the scores overlapped across all assessments. Correlations evaluated the relationship of scores in a domain over time (normative stability) as well as the relationship of scores between domains (ipsative stability). There was large variability in scores within an infant, among infants and across developmental domains. Typical development is nonlinear rather than occurring at a constant rate. Fine motor, gross motor, and communication skills appear to develop independently. These results have implications both for developmental screening policies and for early intervention programs. Screening should include multiple domains and multiple time points before referrals are made to early intervention programs.

Brief assessment of motor function: reliability and concurrent validity of the Gross Motor Scale.

The Brief Assessment of Motor Function (BAMF) is a series of 10-point ordinal scales developed for rapid description of gross motor, fine motor, and oral motor performance. We examined interrater and intrarater reliability and concurrent validity of the BAMF Gross Motor Scale. This validation study included 48 children (age, 5 mo to 17 yr) with a wide range of gross motor capability. Ten children with varied diagnoses participated in the reliability study. For concurrent validity, the BAMF performance of 38 children with osteogenesis imperfecta was compared with scores on the Peabody Developmental Motor Scales, laboratory gait analysis, and manual muscle testing. Reliability values for intraclass correlations were 0.996 (interrater) and 1.00 (intrarater). Significant relationships were identified between the BAMF and gait speed ( r = 0.68, P < 0.0001), stride length (r = 0.71, P < 0.0001), duration of double-limb support ( r = -0.40, P < 0.03), number of weak muscles (r = -0.74, P< 0.0001), and the Peabody Developmental Motor Scales (r = 0.95, P < 0.0001). Number of weak muscles was the strongest predictor of BAMF score R2 = 0.5080, F = 24.77, P < 0.0001). The BAMF demonstrates good reliability for children with a range of diagnoses and acceptable concurrent validity with gross motor development, muscle strength, and formal gait assessment in children with osteogenesis imperfecta.

The Effect of Conductive Education, Intensive Therapy, and Special Education Services on Motor Skills in Children with Cerebral Palsy

Purpose: The purpose of this study was to compare the effects of intensive therapy, conductive education, and special education on function in 19 children with cerebral palsy.Methods: Subjects participated in a five-week program of conductive education, intensive therapy, or special education. Professionals, blinded to group assignment, administered the Pediatric Evaluation of Disability Inventory (PEDI), the Gross Motor Function Measure (GMFM), and the Fine Motor Scale of the Peabody Developmental Motor Scales before and after intervention. Professionals providing treatment and parents completed a survey about their perceptions of change in the children.Results: ANOVA showed no statistically significant differences between groups before or after treatment. Using t-tests, statistically significant within group changes were found only for the intensive therapy group on the PEDI Self-care and Social Function scales and the Crawling and Kneeling scale of the GMFM. Individual changes from preto post-test were also examined and are discussed. Surveys revealed that both parents and professionals perceived improvement in all children.Conclusions: Greatest improvements were noted in the group receiving intensive therapy, with children in all groups showing some improvement in function.

Longitudinal motor development of "apparently normal" high-risk infants at 18 months, 3 and 5 years.

Motor development appears to be more affected by premature birth than other developmental domains, however few studies have specifically investigated the development of gross and fine motor skills in this population. To examine longitudinal motor development in a group of "apparently normal" high-risk infants. Developmental follow-up clinic in a perinatal centre. Longitudinal observational cohort study. Fifty-eight infants born less than 29 weeks gestation and/or 1000 g and without disabilities detected at 12 months. Longitudinal gross and fine motor skills at 18 months, 3 and 5 years using the Peabody Developmental Motor Scales. The HOME scale provided information of the home environment as a stimulus for development. A large proportion (54% at 18 months, 47% at 3 years and 64% at 5 years) of children continued to have fine motor deficits from 18 months to 5 years. The proportion of infants with gross motor deficits significantly increased over this period (14%, 33% and 81%, p<0.001), particularly for the 'micropreemies' (born <750 g). In multivariate analyses, gross motor development was positively influenced by the quality of the home environment. A large proportion of high-risk infants continued to have fine motor deficits, reflecting an underlying problem with fine motor skills. The proportion of infants with gross motor deficits significantly increased, as test demands became more challenging. In addition, the development of gross and fine motor skills appears to be influenced differently by the home environment.

Cord Serum Ferritin Concentrations and Mental and Psychomotor Development of Children at Five Years of Age

There is clear evidence that iron deficiency in early life can lead to enduring delay in mental and psychomotor development. Trials of iron supplementation have, however, failed to consistently demonstrate benefit. The authors assessed fetal iron status by determining the umbilical-cord serum ferritin concentration by radioimmunoassay in 278 children and related the findings to full-scale intelligence quotient (FSIQ), language ability, fine and gross motor skills, attention, and tractability at age 5 years. Participants took part in a study designed to identify risk factors for small-for-gestational-age (SGA) infants. Mothers completed the Home Screening Questionnaire, a measure of the home environment for children, as well as the Peabody Picture Vocabulary Test, a measure of cognitive function. In addition to the FSIQ, children completed the Test for Auditory Comprehension of Language (TACL), the Peabody Developmental Motor Scales, and the Yale Children's Inventory for attention and tractability (the ability to obey rules of decorum). The mothers were predominantly African-American and had scores typical of a resource-poor inner city population. The prevalence of preterm birth before 37 weeks' gestation was 13%, and that of SGA infants was 22%. Birth weights were lower for those in the lowest quartile of serum ferritin. After adjusting for gender, birth weight, and smoking, cord ferritin levels correlated significantly but weakly with maternal serum ferritin levels at 36 weeks' gestation. Children in the lowest quartile of cord blood ferritin scored the lowest in all tests, and had significantly lower scores on the TACL and the test of fine motor function than did those in the two median quartiles. There were no such differences in FSIQ or gross motor function scores. In no respect did the children in the highest ferritin quartile differ from those in the median quartiles. Analyzing test scores below the 15th percentile, the chance of a low score on any of the tests was increased by at least 60% for children in the lowest ferritin quartile. Children in the highest ferritin quartile were more than 3 times as likely as those in the two median quartiles to have a FSIQ score lower than 70 (the 15th percentile cutoff score). These findings suggest that poor iron status at birth is associated with impaired performance on mental and psychomotor evaluation at age 5 years. The finding that high ferritin levels correlate with low FSIQ scores remains unexplained.

Neuropsychologic and motor function in small-for-gestation preschoolers

The aim of this study was to evaluate neuropsychologic and motor performance in term small-for-gestation preschool children. A patient-based sample of 311 5-year-old children with birth weights less than the fifteenth percentile for gestation was compared with a random sample of 321 appropriate-for-gestation control subjects. The main assessment tools were subscales from the Wechsler Preschool and Primary Scale of Intelligence Revised, subscales from the Illinois Test of Psycholinguistic Abilities, tests of manual dexterity and figure copying, and the Peabody Developmental Motor Scales. The small-for-gestation children had mean scores on tests of visuospatial and visuomotor abilities that were one fourth standard deviation lower than appropriate-for-gestation control subjects and slightly lower scores on manual dexterity. The small-for-gestation children were comparable to appropriate-for-gestation children regarding motor performance. We therefore conclude that the neuropsychologic and neuromotor performance in preschool years of term small-for-gestation children is reassuring.

Impact of Selective Posterior Rhizotomy on Fine Motor Skills

Suprasegmental effects following selective posterior rhizotomy have been frequently reported. However, few studies have used validated functional outcome measures to report the surgical results beyond 3 years. The authors analyzed data obtained from the McGill Rhizotomy Database to determine the long-term impact of lumbosacral dorsal rhizotomy on fine motor skills. The study population comprised children with debilitating spasticity who underwent SPR and were evaluated by a multidisciplinary team preoperatively, at 6 months and 1 year postoperatively. Quantitative standardized assessments of upper extremity function were obtained using the fine motor skills section of the Peabody Developmental Motor Scales (PDMS) test. Of 70 patients who met the entry criteria for the study, 45 and 25 completed the 3- and 5-year assessments, respectively. Statistical analysis demonstrated significant improvements in grasping, hand use, eye-hand coordination, and manual dexterity at 1 year after SPR. More importantly, all improvements were maintained at 3 and 5 years following SPR. This study supports that significant improvements in upper extremity fine motor function using the PDMS evaluative measure are present after SPR and that these suprasegmental benefits are durable.

Effects of an Increased Number of Practice Trials on Peabody Developmental Gross Motor Scale Scores in Children of Preschool Age with Typical Development

The purpose of this study was to analyze the effects of an increased number of practice trials on scores on the Gross Motor Scale of the Peabody Developmental Motor Scales (PDMS) among preschoolers who are typically developing. Performance-based assessment tools such as the PDMS generally allow for limited practice. Nineteen children between the ages of 48 and 68 months participated in the study. The PDMS was administered to each subject on a single test occasion, with up to five trials allowed and scored for each task. Analysis included the percentage of change in scores, identification of differences among mean scores per number of trials using multivariate analysis of variance, and potentially clinically significant change using confidence intervals. All mean raw gross motor domain and total scores with three to five practice trials were significantly different (p < 0.001) from scores attained with standard administration of the PDMS. The largest score increases occurred in the domain of receipt and propulsion. Almost 50% of the subjects demonstrated potentially clinically significant improvements with five trials. We question the validity of scores received by preschoolers for receipt and propulsion tasks used in the PDMS and suggest reexamination of such tasks. Allowing practice trials during administration of all tasks on the PDMS with preschoolers may allow them to achieve scores reflective of their optimal performance.

Effects of an Increased Number of Practice Trials on Peabody Developmental Gross Motor Scale Scores in Children of Preschool Age with Typical Development

Purpose: The purpose of this study was to analyze the effects of an increased number of practice trials on scores on the Gross Motor Scale of the Peabody Developmental Motor Scales (PDMS) among preschoolers who are typically developing. Performance-based assessment tools such as the PDMS generally allow for limited practice. Methods: Nineteen children between the ages of 48 and 68 months participated in the study. The PDMS was administered to each subject on a single test occasion, with up to five trials allowed and scored for each task. Analysis included the percentage of change in scores, identification of differences among mean scores per number of trials using multivariate analysis of variance, and potentially clinically significant change using confidence intervals. Results: All mean raw gross motor domain and total scores with three to five practice trials were significantly different (p < 0.001) from scores attained with standard administration of the PDMS. The largest score increases occurred in the domain of receipt and propulsion. Almost 50% of the subjects demonstrated potentially clinically significant improvements with five trials. Conclusions: We question the validity of scores received by preschoolers for receipt and propulsion tasks used in the PDMS and suggest reexamination of such tasks. Allowing practice trials during administration of all tasks on the PDMS with preschoolers may allow them to achieve scores reflective of their optimal performance.

Motor Skill Development of Children with HIV Infection Measured with the Peabody Developmental Motor Scales

Improved health care for pregnant women who are HIV+has minimized complications during delivery and resulted in a measurable cohort of children entering the health care system who are HIV+ with potential for motor disorders. This study was designed to determine how gross and fine motor skills were affected by HIV infection in children aged five years and younger using the Peabody Developmental Motor Scales, and to follow a subsample of these children for one and a half years to determine if their relative skill performances changed over time. A sample of 143 children who were HIV+ was evaluated using the Peabody Developmental Motor Scales for their gross and fine motor skills. Their performance scores were compared with the Peabody normative values for age-matched healthy children. A subset of 22 children were reevaluated at six-month intervals (six months; one year;one year six months) to determine if their gross and fine motor skills would change. Raw scores and Peabody Developmental Motor Quotients (DMQ, normalized to the reference population) were calculated. The children who were HIV+ as a group performed below the 50th percentile of the normal reference population. During the one year six month study period, the children who were HIV+improved in raw scores but did not improve in relative (DMQ) scores. The exceptions were the fine motor skill subcategories of "grasping" and "hand use," for which the children who were HIV+performed comparably with the reference population. Clinicians working with children who are HIV+ should emphasize intervention strategies generally designed to develop all gross motor skills and the specific fine motor skills of "eye-hand coordination" and "manual dexterity."

Upper-limb function in Australian children with traumatic brain injury: A controlled, prospective study

Wallen MA, Mackay S, Duff SM, McCartney LC, O'Flaherty SJ. Upper-limb function in Australian children with traumatic brain injury: a controlled, prospective study. Arch Phys Med Rehabil 2001;82:642-9. Objective: To describe upper-limb function in children with mild and severe traumatic brain injury (TBI), by using both quantitative and qualitative measures. Design: Controlled, prospective cohort study with assessment points initially, at 6 months, and at 2 years after TBI. Setting: A tertiary pediatric trauma center in Australia. Patients: Fifty-one children, ranging in age up to 14 years, who were consecutive admissions with TBI. On the basis of initial and persisting abnormal coma score and persistence of posttraumatic amnesia, they were assigned to either a mild (n = 26) or a severely injured (n = 25) group. Thirty children admitted with non-TBI trauma were recruited as a control group. Main Outcome Measures: Quantitative measures included Bruininks-Oseretsky Test of Motor Proficiency and Peabody Developmental Motor Scales. Qualitative measures included Brunnstrom Recovery Stages (adapted), categoric scales of muscle tone, grasp used when handwriting, quality of writing product, bilateral activity, and splint use. Results: There was little difference between the groups on the standardized assessments for subjects who could complete the tests. Qualitative measures showed the severe TBI group to have more difficulties with gross arm control, hand control, and hand function. Conclusion: Children with severe TBI experience more and persisting difficulties with upper-limb function. It is essential to include both quantitative and qualitative measures in this type of research. © 2001 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Review of four tests of gross motor development

Review of four tests of gross motor development

Concurrent Validity of the Bayley Scales of Infant Development II Motor Scale and the Peabody Developmental Motor Scales in Two-Year-Old Children

Concurrent Validity of the Bayley Scales of Infant Development II Motor Scale and the Peabody Developmental Motor Scales in Two-Year-Old Children