Developmental motor profile in preschool children with primary stereotypic movement disorder

Aim. Different neuropsychological dysfunctions have been described in children with primary Stereotypic Movement Disorder (SMD), mainly attention or motor coordination problems. Up to now with no study has evaluated psychomotor functions in preschoolers primary SMD. The aim of this observational study was to gather information on the motor profiles of SMD patients in this age range in comparison with typically developing children. Patients and Methods. Twenty-six children (four girls) aged 36 to 76 months (mean= 53 ±10) with primary SMD were assessed by a structured evaluation including the Movement Assessment Battery for Children-Second Edition (MABC-2), the Beery-Buktenica Developmental test of Visual-Motor Integration (VMI), the Repetitive Behaviour Scale-Revised (RBS-R), the Motor Severity Stereotypy Scale (MSSS), and the Child Behaviour Checklist (CBCL). The diagnoses of Intellectual Disability or Autism Spectrum Disorder were exclusion criteria from the study. A comparison group of twenty-seven (four girls) typically developing children without stereotypies aged 36 to 59 months (mean= 48 ±7) was also examined. Results. The MABC-2 total score was lower than 15th percentile in fifteen children with SMD (58%); the worst performances were observed in Balance and Manual Dexterity subtests. The motor coordination score of VMI was lower than 15th percentile in ten children (38%). The majority of the children with low scores at MABC-2 also had low scores at the motor coordination subscale of VMI. MABC-2 standard scores of the clinical group were significantly lower than those of controls on MABC-2 Total, Balance, and Ball Skills subtests. Conclusion. The finding of widespread dysfunction of gross and fine motor abilities in preschoolers with primary SMD seems to delineate a peculiar phenotype and could provide new approaches to the management of this neurodevelopment disorder

Lo Studio SCoPre (Sviluppo Cognitivo e Prematurità): dati preliminari sullo sviluppo dei “Late Preterms” in età scolare

Background. In Italy, children born Late Preterm (LPs, 34-36 weeks of gestational age) represent about 4% of all births. LPs have a higher risk of mortality, repeated hospitalizations in early life, chronic illnesses and functional limitations, compared to children born at term. Moreover, LPs are more likely to experience difficulties in their neurodevelopment, which may impair adaptation, especially at school. This study explores the developmental and behavioural outcomes of LPs compared to those of “Very Preterm” (VPs) or “Full Term” (FTs) peers. Methods. The paediatricians involved, recruited, among their patients, all VPs and LPs aged 7-10 years and a number of FTs twice that of the LPs. Mothers of children filled in a protocol consisting of a medical history form and three questionnaires. Results. 554 questionnaires were collected and processed (39 VPs, 183 LPs and 332 FTs). The three groups were significantly different in terms of birth weight (p < .001), twin pregnancy (p < .001), type of delivery (p <.001), type of pregnancy (p < .001) and gender (p < .05). FTs show better school achievements than VPs and LPs (p < .001). The LPs showed more symptoms of anxiety (p < .05) and aggressive behaviours (p < .001) than the FTs and, together with VPs, social problems (p < .001). VPs score significantly lower than FTs in the fine motor (p < .05) and in the general coordination abilities (p = .01). Mothers of the LPs reported a lower mental and physical wellbeing than mothers of FTs (p = .06). Conclusions. These data show that preterm children are more vulnerable that counterparts born at term in some developmental areas. Particularly, LPs present more difficulties in school achievements and in some behaviour, compared to FTs, often similarly to VPs. Mothers of the LPs perceive more mental and physical discomfort than mothers of FTs

Isolated auditory neuropathy at birth in congenital cytomegalovirus infection

BACKGROUND: Congenital cytomegalovirus (cCMV) infection is the most frequent non-genetic cause of sensorineural hearing-loss (SNHL) (i.e., hearing loss due to a cochlear and/or auditory nerve damage). It is widely accepted that SNHL at birth, when associated to cCMV symptomatic infection involving the central nervous system, benefits from antiviral therapy started in the neonatal period. Conversely, there is no consensus for antiviral treatment in congenitally infected infants diagnosed with isolated SNHL (i.e., SNHL in an otherwise asymptomatic infant) at birth. Our aim was to assess the frequency and the auditory outcome of isolated SNHL at birth due to auditory neuropathy (AN) (i.e., SNHL in a patient with normal cochlear function and auditory nerve dysfunction) in infants with cCMV infection. METHODS: We retrospectively reviewed the clinical history of 60 infants, born at term, with cCMV asymptomatic infection, without additional risk factors for SNHL, and exhibiting bilateral "pass" otoacustic emissions (OAE). None of them underwent antiviral therapy. Hearing thresholds were assessed by means of Auditory Brainstem Responses (ABR). AN affected children were followed up until possible normalization of the hearing thresholds or definitive diagnosis of AN. Each infant diagnosed with monolateral or bilateral AN was classified according to the worst ear threshold. RESULTS: In our population, the first ABR was performed at a mean age of 5.00 ± 2.79 (SD) months and AN was diagnosed in 16/60 (26.67%) infants; in 4 infants the AN was defined as mild (4/4 monolateral), moderate in 11 (5/11 bilateral), and severe in 1 (bilateral). The mean age at first ABR was 3.69 ± 2.80 (SD) months in the 16 babies with AN and 5.48 ± 2.66 (SD) months in the 44 infants with normal hearing (p = 0.007). All AN cases spontaneously recovered a normal auditory threshold over time. The mean length of the audiological follow-up was 32.44 ± 17.58 (SD) months (range 5-60 months). CONCLUSION: A delayed maturation of the auditory pathways should be considered when a mild/moderate isolated AN at birth is detected in cCMV infected infants. Prospective studies conducted on larger populations, and with a longer audiological follow-up, are needed to confirm our findings

Lamotrigine as a potential prevention of HIE.

Congresso Assis

Late-preterm: un gruppo di neonati a rischio per disturbi dello sviluppo cognitivo Revisione sistematica della letteratura e descrizione degli strumenti di valutazione

Vengono definiti late-preterm (LP) o “pretermine tardivi” i bambini che nascono a 34-36 settimane di gestazione. I LP hanno un rischio aumentato, rispetto ai neonati a termine, di mortalità e morbosità in epoca neonatale e nelle età successive. Solo da pochi anni lo sviluppo cognitivo dei LP è stato oggetto di attenzione nella letteratura medica. Il presente studio è un’analisi sistematica dei lavori pubblicati in lingua ingle- se da gennaio 2006 a giugno 2013, aventi per oggetto lo sviluppo cognitivo e neuropsi- cologico dei LP dal primo anno di vita all’età scolare. Sono stati selezionati i lavori che utilizzavano scale di sviluppo e questionari standardizzati. Gli studi inclusi nella revi- sione sono 19, 11 dei quali in età prescolare e 8 in età scolare. I risultati indicano che in età prescolare i LP raggiungono un livello cognitivo mediamente più basso dei bam- bini nati a termine, in generale e in specifiche capacità cognitive. Anche in età scolare i LP hanno maggiori difficoltà nell’apprendimento rispetto ai bambini nati al termine della gravidanza. I motivi delle minori capacità dei LP possono essere legati alla pre- maturità in sé, ma anche alle cause che hanno provocato la nascita prima del termine

Daily motor characteristics in children with developmental coordination disorder and in children with specific learning disorder

An association between learning disorders and coordination problems has been reported in several studies over the last few decades. In this study, we have investigated daily motor characteristics in children with a diagnosis of specific learning disorder (SLD) and compared them with those of children with developmental coordination disorder (DCD) and those of typically developing controls. Ninety-six children aged 5 to 12 years were included: 29 with a diagnosis of SLD, 33 of DCD, and 34 controls. The Italian version of the Developmental Coordination Disorder Questionnaire 2007 (DCDQ-Italian) was used to measure children's coordination in everyday functional activities. The mean DCDQ-Italian total score was significantly lower in both SLD and DCD groups as compared with controls. Regarding subscores, both clinical groups scored significantly lower than controls on “Fine motor/handwriting” skills and on “General coordination.” The DCD group scored also significantly lower than controls on “Control during movement.” Moreover, clinical groups differed from each other, with SLD children scoring significantly higher on “Control during movement” and “General coordination” subscores. SLD children diverged from typically developing children in some motor skills during ordinary activities, and although this discrepancy was not as severe as in DCD children, it could have an impact on self-esteem and sport inclusion

Handwriting readiness e abilità motorie: quale contributo nell’apprendimento della scrittura

Lo studio ha come obiettivi: (a) analizzare le caratteristiche grafo-motorie di bambini con sviluppo tipico e con sospetto Disturbo di coordinazione motoria di età prescolare e di I classe primaria b) individuare la relazione tra abilità motorie, grafo-motorie e scrittura a mano in bambini di I e II classe primaria seguiti longitudinalmente. Hanno partecipato 50 bambini di 5 anni anni e 39 bambini di I e di II classe primaria. Sono state proposte: una prova di Handwriting Readiness, il questionario DCDQ (Caravale e Baldi, 2014), le prove di velocità di scrittura (BVSCO-2, Tressoldi, Cornoldi e Re) e la copia di una frase in corsivo (DGM-P) per i bambini di I classe. I dati sono stati analizzati attraverso una serie di analisi correlazionali (Pearson) e di analisi di regressione semplice. I risultati mostrano una relazione significativa tra abilità motorie e scrittura a mano, sia rispetto a criteri di leggibilità che di velocità di scrittura

Profilo cognitivo e disturbi del neurosviluppo: un confronto tra bambini con DSA, DCD e DSL

I risultati mostrano che il profilo cognitivo può essere caratterizzato diversamente in base alla presenza di una specifica tipologia di Disturbo del neurosviluppo