Peabody Developmental Motor Scales-Second Edition Research Articles

Early recombinant human growth hormone treatment improves mental development and alleviates deterioration of motor function in infants and young children with Prader–Willi syndrome

BackgroundRecombinant human growth hormone (rhGH) therapy has shown to improve height and body composition in children with Prader–Willi syndrome (PWS), the evidence of early rhGH treatment on motor and mental development is still accumulating. This study explored the time effect on psychomotor development, anthropometric indexes, and safety for infants and young children with PWS.MethodsA phase 3, single-arm, multicenter, self-controlled study was conducted in six sites. Patients received rhGH at 0.5 mg/m2/day for first four weeks, and 1 mg/m2/day thereafter for up to 52 weeks. Motor development was measured using Peabody Developmental Motor Scales-second edition, mental development using Griffiths Development Scales-Chinese (GDS-C). Height standard deviation score (SDS), body weight SDS, and body mass index (BMI) SDS were also assessed.ResultsThirty-five patients were enrolled totally. Significant improvements were observed in height, body weight, and BMI SDS at week 52; GDS-C score showed significant improvement in general quotient (GQ) and sub-quotients. In a linear regression analysis, total motor quotient (TMQ), gross motor quotient (GMQ), and fine motor quotient were negatively correlated with age; however, treatment may attenuate deterioration of TMQ and GMQ. Changes in GQ and locomotor sub-quotient in < 9-month group were significantly higher than ≥ 9-month group. Mild to moderate severity adverse drug reactions were reported in six patients.ConclusionFifty-two-week treatment with rhGH improved growth, BMI, mental development, and lessened the deterioration of motor function in infants and young children with PWS. Improved mental development was more pronounced when instituted in patients < 9 months old.

Peabody Developmental Motor Scales-2: The Use of Rasch Analysis to Examine the Model Unidimensionality, Motor Function, and Item Difficulty

The Peabody Developmental Motor Scales-Second Edition (PDMS-2) is a valid and reliable instrument used in several countries, including Brazil, to assess gross and fine motor skills and identify motor deficits and eligibility for intervention for children with and without disabilities. However, the analysis of PDMS-2 items regarding the unidimensionality of the model, order of item difficulty, and whether the items portray the children's developmental trajectories still lacks investigation. Therefore, this study aims to: (1) analyze the unidimensionality of PDMS-2, (2) verify the model's capacity to explain the variance in the motor function responses, and (3) identify the level of difficulty of the items for Brazilian children. Children (n = 637; 51% girls) newborn to 71 months (M age = 21.7, SD = 18.6) were assessed using the PDMS-2. The Rasch analysis was conducted; the indexes of infit and outfit, and the point-biserial correlations coefficient were analyzed. The model unidimensionality was investigated using percentages of variance in the Rasch model (40% of variance). Results indicated that (1) for reflexes subscale, 62.5% of the items had correlations with the factor above 0.60, and two items had unadjusted infit and outfit; (2) for stationary subscale, 83.3% of the correlations of the items with the factor were above 0.50, and one item had unadjusted infit and outfit; (3) for locomotion subscale, 80.0% of the correlation of the items with the factor were above 0.50; all items had adequate infit and outfit; (4) for object manipulation subscale, 79.9% of the correlation of the items with the factor were above 0.50, and one item had unadjusted infit and outfit; (5) for grasping subscale, 92.3% of the correlation of the items with the factor were above 0.50, and one item had unadjusted infit and outfit; and (6) for the visual-motor integration subscale, 73.6% of the correlation of the items with the factor were above 0.50, and six items had unadjusted infit and outfit. The items with unadjusted fit were removed for further analysis. No changes in reliability and separation of items and people scores were observed without the unadjusted items; therefore, all items were maintained. A unidimensional model was found, and the reliability and discriminant capability of the items were adequate, and all items should be used to assess children. The PDMS-2 is appropriate for assessing Brazilian children.

Circadian Rhythm Analysis Using Wearable Device Data: Novel Penalized Machine Learning Approach.

BackgroundWearable devices have been widely used in clinical studies to study daily activity patterns, but the analysis remains a major obstacle for researchers.ObjectiveThis study proposes a novel method to characterize sleep-activity rhythms using actigraphy and further use it to describe early childhood daily rhythm formation and examine its association with physical development.MethodsWe developed a machine learning–based Penalized Multiband Learning (PML) algorithm to sequentially infer dominant periodicities based on the Fast Fourier Transform (FFT) algorithm and further characterize daily rhythms. We implemented and applied the algorithm to Actiwatch data collected from a cohort of 262 healthy infants at ages 6, 12, 18, and 24 months, with 159, 101, 111, and 141 participants at each time point, respectively. Autocorrelation analysis and Fisher test in harmonic analysis with Bonferroni correction were applied for comparison with the PML. The association between activity rhythm features and early childhood motor development, assessed using the Peabody Developmental Motor Scales-Second Edition (PDMS-2), was studied through linear regression analysis.ResultsThe PML results showed that 1-day periodicity was most dominant at 6 and 12 months, whereas one-day, one-third–day, and half-day periodicities were most dominant at 18 and 24 months. These periodicities were all significant in the Fisher test, with one-fourth–day periodicity also significant at 12 months. Autocorrelation effectively detected 1-day periodicity but not the other periodicities. At 6 months, PDMS-2 was associated with the assessment seasons. At 12 months, PDMS-2 was associated with the assessment seasons and FFT signals at one-third–day periodicity (P<.001) and half-day periodicity (P=.04), respectively. In particular, the subcategories of stationary, locomotion, and gross motor were associated with the FFT signals at one-third–day periodicity (P<.001).ConclusionsThe proposed PML algorithm can effectively conduct circadian rhythm analysis using time-series wearable device data. The application of the method effectively characterized sleep-wake rhythm development and identified the association between daily rhythm formation and motor development during early childhood.

A systematic review of upper limb activity measures for 5- to 18-year-old children with bilateral cerebral palsy.

To investigate measurement properties and feasibility of upper limb activity measures in children aged 5-18years with bilateral cerebral palsy (CP). Five electronic databases were searched to identify measures of upper limb activity with published psychometric data for children with bilateral CP aged 5-18years. Measures included both Patient-Reported Outcome Measures (PROMs) and observational measures. The COnsensus-based Standards for selection of health Measurement Instruments checklist was used to evaluate methodological quality of studies for each measure. Forty-eight measures were identified, eight of which met inclusion criteria for reliability and validity. Four PROMs were included: the ABILHAND-Kids and Children's Arm Rehabilitation Measure are parent questionnaires measuring overall manual ability; the ACTIVLIM-CP is a parent questionnaire measuring global activity (upper and lower extremity) performance, and, the Pediatric Upper Limb Measure, Short Form is a child self-report questionnaire. Four observational measures were included: the Both Hands Assessment (BoHA) is an observational measure of bimanual activity performance; the Melbourne Assessment of Unilateral Upper Limb Function and the Melbourne Assessment 2 measure quality of movement of each upper limb separately, and the Peabody Developmental Motor Scales-Second Edition assesses fine motor skill capacity in young children. Based upon available evidence, the most suitable PROM for evaluation of upper limb activity in children with bilateral CP is the ACTIVLIM-CP, and the most suitable observational measure is the BoHA. Selection of upper limb measures depend on clinical information required and available resources. The BoHA is the only observational-based assessment which measures bimanual upper limb activity performance in children with bilateral CP. Recommendation for future measurement studies include familiarisation with the standards required for excellence, which include adequate sample size and content validity studies for PROMs.

Early intervention at home in infants with congenital brain lesion with CareToy revised: a RCT protocol

BackgroundCongenital brain lesions expose infants to be at high-risk for being affected by neurodevelopmental disorders such as cerebral palsy (CP). Early interventions programs can significantly impact and improve their neurodevelopment. Recently, in the framework of the European CareToy (CT) Project (www.caretoy.eu), a new medical device has been created to deliver an early, intensive, customized, intervention program, carried out at home by parents but remotely managed by expert and trained clinicians. Reviewing results of previous studies on preterm infants without congenital brain lesion, the CT platform has been revised and a new system created (CT-R).This study describes the protocol of a randomised controlled trial (RCT) aimed to evaluate, in a sample of infants at high-risk for CP, the efficacy of CT-R intervention compared to the Infant Massage (IM) intervention.Methods/designThis RCT will be multi-centre, paired and evaluator-blinded. Eligible subjects will be preterm or full-term infants with brain lesions, in first year of age with predefined specific gross motor abilities. Recruited infants will be randomized into CT-R and IM groups at baseline (T0). Based on allocation, infants will perform an 8-week programme of personalized CareToy activities or Infant Massage. The primary outcome measure will be the Infant Motor Profile. On the basis of power calculation, it will require a sample size of 42 infants. Moreover, Peabody Developmental Motor Scales-Second Edition, Teller Acuity Cards, standardized video-recordings of parent-infant interaction and wearable sensors (Actigraphs) will be included as secondary outcome measures. Finally, parents will fill out questionnaires (Bayley Social-Emotional, Parents Stress Index). All outcome measures will be carried out at the beginning (T0) and at end of 8-weeks intervention period, primary endpoint (T1). Primary outcome and some secondary outcomes will be carried out also after 2 months from T1 and at 18 months of age (T2 and T3, respectively). The Bayley Cognitive subscale will be used as additional assessment at T3.DiscussionThis study protocol paper is the first study aimed to test CT-R system in infants at high-risk for CP. This paper will present the scientific background and trial methodology.Trial registrationNCT03211533 and NCT03234959 (www.clinicaltrials.gov).

Outcomes of utilizing early intervention services on the motor development of children with undefined developmental delay

ABSTRACTThe study aimed to investigate the utilization rates and outcomes of early intervention services on motor development of children with undefined developmental delay, and examine the potential factors associated with children’s motor development. A two time period comparison of 129 children with undefined developmental delays was conducted using the data from a developmental assessment unit in a medical center in southern Taiwan from 2011 to 2015. The Peabody Developmental Motor Scales-Second Edition was used to identify the children’s motor development. Paired t tests were performed to examine changes in motor status between the two time periods. A logistic regression analysis was conducted to examine the associations between improvements in gross and fine motor development and potential factors. Utilization of early intervention services significantly increased after the initial evaluation from 0% to 92.2%. Approximately, 42.6% of the children showed significant improvement in gross and fine motor development between the two time periods. Normal cognitive development and utilization of occupational therapy services accounted for variability in the improvement of gross motor developmental problems. The crucial indicators of changes in fine motor development were normal cognitive development and preschool attendance. Utilization of early intervention services, such as occupational therapy, was positively correlated with improvements in motor development. It is crucial to offer caregivers comprehensive resources related to early intervention services, especially in regard to motor development.

High risk of motor development delay in children with congenital muscular torticollis

Congenital muscular torticollis (CMT) is one of the most common congenital cervical deformities in children. CMT is a result of excessive shortening of the sternocleidomastoid muscle, which leads to an imbalance of muscle function around the neck. Previous studies found that postural torticollis may lead to motor development delay. However, few studies have been carried out on the study of CMT concurrent motor development delay. The purpose of this study was to investigate the prevalence of motor development delay in children with CMT. Peabody developmental motor scales-second edition (PDMS-2) was used to evaluate motor developmental levels in 54 children with CMT, whose average age was 8.50 ± 6.76 months (2∼27 months). PDMS-2 is an assessment tool to evaluate children motor development, consisting of 6 subscales, including reflection, posture, movement, object manipulation, grasping and visual motor integration, a total of 249 items. The final results were expressed by gross motor development quotient (GMQ), fine motor development quotient (FMQ). The higher the quotient, the better the motor development. The normal value of the developmental quotient is 90∼110, while below 90 representing motor development delay. The average GMQ and FMQ were 94.48 ± 9.69, 98.70 ± 8.26 respectively, and the GMQ was significantly lower than FMQ in children with CMT ( P < 0.01). Among them, 24 patients (37%) existed motor development delay, while 18 patients (33%) in gross motor development delay, and 6 patients (11%) in fine motor development delay. There was no significant difference of GMQ, FMQ in gender or different affected sides of CMT. Thirty-seven percent of children with CMT have motor development delay. Children with CMT have the separation of gross motor development and fine motor development. The gross motor of children with CMT may fall behind the fine motor. Therefore, physicians and physiotherapists should pay more attention to the motor development of children with CMT.

Effects of television exposure on developmental skills among young children

BackgroundLiterature addressing the effects of television exposure on developmental skills of young children less than 36 months of age is scarce. This study explored how much time young children spend viewing television and investigated its effects on cognitive, language, and motor developmental skills. MethodsData were collected from the Pediatric Clinics at University Medical Center in Southern Taiwan. The participants comprised 75 children who were frequently exposed to television and 75 children who were not or infrequently exposed to television between 15 and 35 months old. The age and sex were matched in the two groups. The Bayley Scales of Infant Development-second edition and Peabody Developmental Motor Scales-second edition were used to identify developmental skills. Independent t-tests, χ2 tests, and logistic regression models were conducted. ResultsAmong 75 children who were frequently exposed to television, young children watched a daily average of 67.4min of television before age 2, which was excessive according to the American Academy of Pediatrics. Viewing television increased the risk of delayed cognitive, language, and motor development in children who were frequently exposed to television. Cognitive, language, and motor delays in young children were significantly associated with how much time they spent viewing television. The type of care providers was critical in determining the television-viewing time of children. ConclusionWe recommend that pediatric practitioners explain the impacts of television exposure to parents and caregivers to ensure cognitive, language, and motor development in young children. Advocacy efforts must address the fact that allowing young children to spend excessive time viewing television can be developmentally detrimental.

Reliability and Validity of the Peabody Developmental Motor Scales-Second Edition for Assessing Motor Development of Low Birth Weight Preterm Infants

BackgroundMotor developmental impairment is a common symptom in low birth weight neonates. The Peabody Developmental Motor Scales-second edition is an instrument for measuring motor abilities in these infants. This study aimed to validate the Peabody Developmental Motor Scales-second edition in Iran. MethodsThis was a prospective clinical validation study. The reliability and validity of the original measure were performed in accordance with published guidelines. To collect data, a total of 88 infants including 58 LBW infants and 30 normal birth weight control patients were included in the study, and the measure was completed for them. The Bayley Scales of Infant Development, second edition, and the Motor Scale (Psychomotor Development Index) also were completed for the study samples. To test reliability, the internal consistency was assessed by Cronbach alpha coefficient. Test-retest reliability was performed using Intraclass Correlation Coefficient at 1-week interval. Validity was evaluated using known groups comparison and criterion validity (convergent validity). ResultsThe Cronbach alpha coefficient for the Peabody Developmental Motor Scales-second edition was 0.92. Further analysis also indicated that test-retest reliability was excellent (Intraclass Correlation Coefficient = .98). Validity as performed by known groups comparison indicated satisfactory result. The instrument well discriminated among subgroups of the study samples that differed in birth weight. The Psychomotor Development Index score correlated strongly with the Peabody Developmental Motor Scales-second edition (r for Fine Motor Scale = .91, P < 0.001 and r for the Peabody Developmental Motor Scales-second edition Gross Motor Scale = .93, P < 0.001). ConclusionsThe findings suggest that the Iranian version of Peabody Developmental Motor Scales-second edition is a reliable and valid measure. It can now be used in clinical settings for assessing motor development in low birth weight infants.

Measurement Properties of Fine Motor Scale of Peabody Developmental Motor Scales-Second Edition

To investigate the measurement properties (including rating scale performance, unidimensionality, and differential item functioning) of the fine motor scale of the Peabody Developmental Motor Scales-Second Edition in children, by using the Rasch analysis. A total of 419 children (including 342 typically developing children and 77 children with fine motor delays or difficulties) were recruited in Taiwan for this prospective study. Each child was evaluated with the Peabody Developmental Motor Scales-Second Edition that consists of 26-item grasping and 72-item visual-motor integration subtests. Partial credit Rasch analysis was used for all analyses. The Rasch analysis indicated that middle rating category for 19 grasping and 52 visual-motor integration items could be collapsed to allow only dichotomous response categories. Item fit analysis and principal component analysis suggested that the unidimensionality of the grasping and visual-motor integration subtests could be achieved after removal of two grasping and eight visual-motor integration misfitting items. All but 13 items in the composite scale could form a unidimensional construct of overall fine motor ability. Furthermore, only a few items were found to show differential item functioning across sex (ten items) or fine motor status (seven items). However, significant ceiling effects were found in the Peabody Developmental Motor Scales-Second Edition subtests and composite scale when applied to these typically developing children. Our results suggest grounds for the revision of the Peabody Developmental Motor Scales-Second Edition in a subsequent edition. Simplifying the rating scales and reducing the misfitting items in the subtests and composite scales might result in a unidimensional assessment of children's fine motor ability. Clinicians and researchers could use the reduced Peabody Developmental Motor Scales-Second Edition as a criterion-referenced outcome measure to document changes; however, further work is needed to reduce the ceiling effects.

Screening for motor deficits using the Pediatric Evaluation of Disability Inventory (PEDI) in children with language impairment

Objective: To evaluate the association between the Pediatric Evaluation of Disability Inventory (PEDI) motor and self-care domains with the Peabody Developmental Motor Scales-second edition (PDMS-2) gross motor and fine motor sub-scales.Methods: Forty children (35–62 months) with primary language impairment (PLI) were recruited. The PEDI was completed at admission and the PDMS-2 was administered within 1 month by an OT, who was unaware of the PEDI results.Results: Correlation between PEDI mobility and PDMS-2 gross motor domains was r = 0.23 (p = 0.15) and between PEDI self-care and PDMS-2 fine motor domains was r = 0.12 (p = 0.47). Associations between PEDI and PDMS-2 scores for age, gender and severity of language impairment sub-groups were poor-to-moderate.Conclusion: Findings indicate the PEDI is not sufficiently accurate to screen for motor deficits in children with PLI. More sensitive measures of motor performance are needed to detect subtle motor deficits in children with PLI.

A Study on Gross Motor Skills of Preschool Children

The purpose of this study was to investigate the effects of a creative movement program on gross motor skills of preschool children. Sixty children between the ages of 3 to 5 were drawn from the population of a preschool in Taichung, Taiwan. An experimental pretest-posttest control-group design was utilized. The children enrolled in the experimental group participated in a creative movement program twice a week for 30 minutes each time. Meanwhile, the children enrolled in the control group participated in unstructured free play. Data were collected from the administration of a pretest and posttest to both groups to investigate the effects of a creative movement program on the scores of the Peabody Developmental Motor Scales-Second Edition (PDMS-2). Analysis of covariance was utilized to test four questions to investigate the effects of the creative movement program on gross motor skills. Results of this study showed that students participating in the creative movement program in gross motor skills (p < .05) scored significantly higher than those in the control group. There also was a higher significant difference in locomotion score (p < .05) on the PDMS-2 test in the experimental group than those in the control group. In addition, there was no significant difference in object manipulation (p > .05) and stationary (p > .05) scores on the PDMS-2 test between the two groups.