The Relationship between Motor Function and Behavioral Function in Infants with Low Birth Weight

How to Cite This Article: Amini M, Aliabadi F, Alizade M, Kalani M, Qorbani M. The Relationship between Motor Function and Behavioral Function in Infants with Low Birth Weight. Iran J Child Neurol. Autumn 2016; 10(4):49-55. AbstractObjectiveNowadays, the evaluation of all aspects of infant development is important. However, in practice, some of these assessments, especially those requiring more manipulation on high-risk infants, may impose additional stress on them.Therefore, sometimes it is essential to utilize the results of a developmental assessment for the prediction of some other aspects of development. This study evaluated the relationship between the scores of the behavioral tests and the motor function test. Materials & MethodsThis cross-sectional study and was undertaken in the Neonatal Intensive Care Center and Clinic of Shahid Akbar Abadi Hospital, Tehran, Iran. A group of 50 infants with low birth weights was selected based on the easy non-contingency method and the inclusion criteria, and served as the participants. In order to assess the motor function and the behavioral performance, the motor function test (a test of infant motor performance (TIMP)) and the neonatal behavioral assessment scale (neonatal behavioral assessment scale (NBAS)) were used respectively. TIMP has both stimulation and observation sections. The items include habituation, social interaction, motor system, state organization, state regulation, autonomic system, smile, supplementary items, and the reflex. ResultsNo significant association was found between the items of the habituation of behavioral testing and the observation of the movement test. There was no statistically significant relationship between the habituation and stimulation sections as well as between the system autonomous of the behavioral test and the observation section of the motor test (P>0.05). The relationship between other variables was statistically significant (P<0.05). ConclusionThe scores of some behavioral performance items could be a good predictor of the scores of the motor function items for low birth weight infants in the neonatal period. References1. Wright-Ott C. Mobility. In: Case-smith J, editors. Occupational Therapy for Children. 5th ed. USA: Mosbey; 2005.P. 657-684.2. Case-smith J. Fine motor outcomes in preschool children who receive occupational therapy services. Am J Occup Ther 1996;50(6):466-74.3. Soleimani F, Zaheri F, Abdi F. Long-term neurodevelopmental outcomes after preterm birth. Iran Red Crescent Med J 2014;16(6):1-8.4. Hunter JG. Neonatal Intensive Care Unite. In: Case-smith J, editors. Occupational Therapy for Children. 5th ed. USA: Mosbey; 2005.P. 688-754.5. Arpino C, Compagnone E, Montanaro ML, Cacciatore D, De Luca A, Cerulli A, Di Girolamo S, Curatolo P. Preterm birth and neurodevelopmental outcome: a review. Childs Nerv Syst 2010;50:10-20.6. Pedersen SJ, Sommerfelt K, Markestad T. Early motor development of premature infants with birthweight less than 2000 grams. Acta Pediatr 2000;89:1450-61.7. Aliabadi F, Amini M, Alizade M, Kalani M, Qorbani M. Prediction of infant motor performance through performance evaluation of behavior. J Modern Rehab 2011;5 (3): 54-59.8. Orton J, Spittle A, Doyle L, Anderson P, Boyd R. Do early intervention programs improve cognitive and motor outcomes for preterm infants after discharge: a systematic review. Dev Med Child Neurol 2009;51(11):851-9.9. Spittle AJ, Doyle LW, Boyd RN. A systematic review of clinimetric properties of neuromotor assessment for preterm infants during the first year of life. Dev Med Child Neurol 2008;50(10):254-66.10. Brazeltone B. Neonatal Behavioral Assessment Scale. 3rd ed. University of Masschusetts and Harvard Medical School: Mac Keit Press; 1995. 8-10, 67, P. 104-5.11. Falk B, Eliakim A, Dotan R, Liebermann DG, Regev R, Bar-Or O. Birth weight and physical ability in 5- to -8-yr old healthy children born prematurely. Med Sci Sports Exerc 1997;29(9):1124-30.12. Burns Y, O’Callaghan M, McDonell B, Rogers Y. Movement and motor development in ELBW infant at 1 year is related to cognitive and motor abilities at 4 years. Early Hum Dev 2004;80:19-29.13. Tavasoli A, Aliabadi F, Eftekhari R. Motor Developmental Status of Moderately Low Birth Weight Preterm Infants. Iran J Pediatr 2014;24 (5), 581-586.14. Islam M. The Effects of Low Birth Weight on School Performance and Behavioral Outcomes of Elementary School Children in Oman. Oman Med J 2015;30(4):241-51.15. Ohgi S, Arisawa K, Takahashi T, Kusumoto T, Goto Y, Akiyama T, Saito H. Neonatal behavioral assessment scale as a predictor of later developmental disabilities of low-birth weight and/or premature infants. Brain Dev 2003;25:313-21.16. Ho YB, Lee RS, Chow CB, Pang MY. Impact of massage therapy on motor outcomes in very low-birth weight infants: Randomized controlled pilot study. Pediatr Int 2010; 52(3):378-85.17. Craciunoiu O, Holsti L. A Systematic Review of the Predictive Validity of Neurobehavioral Assessments During the Preterm Period. Phys Occup Ther Pediatr 2016; 17:1-16.18. Tirosh E, Abadi J, Berger A, Cohen A. Relationship between neonatal behavior and subsequent temperament. Acta Pediatr 1992;81(8):29-31

Effects of Tactile–Kinesthetic Stimulation on Low Birth Weight Neonates

Objective: Low Birth Weight [LBW] (1500gr≤Birth Weight≤2499 gr) is one of the most serious health problems in neonates. These neonates need complementary interventions (e.g. tactile-kinesthetic stimulation) to promote development. This study was conducted to determine the effect of Tactile-Kinesthetic Stimulation (TKS) on physical and behavioral development of Low Birth Weight neonates. Methods: This was a randomized controlled trial with equal randomization (1:1 for two groups) and parallel group design. Forty LBW neonates were randomly allocated into test (n=20) and control (n=20) groups. TKS was provided for three 15 minute periods per day for 10 consecutive days to the test group, with the massages consisting of moderate pressure strokes in supine and prone position and kinesthetic exercises consisting of flexion and extension of limbs. All measurements were taken before and after completion of the study with the same equipment (Philips electronic weighing scale with an accuracy of ±5 grams and Brazelton Neonatal Behavioral Assessment) and by the same person. Findings: There was a trend towards increased daily weight gain, but without statistical significance. On the Brazelton scale, the test group showed statistically significant improved scores on the 'motor' (P-value <0.001) and 'regulation of state' (P-value=0.039) clusters after the 10 days TKS. Conclusion: TKS has no adverse effects on physiologic parameters and gives better adaptive behavior of LBW neonates compared to those without TKS

Effect of Tactile-Kinesthetic Stimulation on Motor Development of Low Birth Weight Neonates

Objectives: Low Birth Weight neonates need complementary interventions (e.g. tactile kinesthetic stimulation) to promote their development. This study was conducted to determine the effect of Tactile- Kinesthetic Stimulation (TKS) on motor development of Low Birth Weight neonates. Methods: In this clinical trial study, sample was made out of 40 inborn LBW neonates who were divided into two groups randomly. TKS was provided for three 15-minute periods per day for 10 consecutive days to the test group, with the massages consisting of moderate of pressure strokes in prone position and kinesthetic exercises consisting of flexion and extension of limbs in supine position. All measurements were taken before and after completion of the study with the same equipment and by the same person. Results: Results indicated that motor behavior in the intervention group was significantly higher than the control group after the 10 days TKS (P-Value&le;0.0001). Discussion: TKS could be an effective intervention in development of motor behavior of LBW neonates. Because very little is known about neonate's behavior, it seems to need more studies in other aspects of behavior in LBW neonates

Fine Motor Development of Low Birth Weight Infants Corrected Aged 8 to 12 Months

Objectives: The aim of this study was to compare the fine motor development between Low Birth Weight (LBW) infants and Normal Birth Weight infants (NBW) at the age of 8-12 months by using the Peabody Developmental Motor Scale-2 (PDMS-2) . Methods: This was a non experimental and cross sectional study which was conducted on the 18 LBW infants and 14 normal infants. By referring to the profile of infants in NICU of Aliasghar Hospital, those with defined inclusion criteria was recognized (case group). The normal weight infants, randomly selected from Health Center of that hospital, matched with case group for date of birth. After completing the questionnaire about demographic variables, their gross motor development was assessed with PDMS-2. Finally the scores of the motor quotient were analyzed by independent t-test statistical method. Results: There was a significant difference between Fine motor quotient of groups (P=0.007). Discussion: This study showed that LBW infants are significantly lower than normal weight infants in attaining Fine motor skills. It means that the LBW infants are more prone to developmental difficulties

Prevalence of Flat Foot: Comparison between Male and Female Primary School Students

Objectives: The aim of this study was to determine the prevalence of flat foot in a population of 7-12 year old students and to investigate the relationship between flat foot and age and sex. Methods: In this cross-sectional study, a total of 945 students (460 girls and 485 boys) were examined. The presence of flatfoot and the degree of its severity according to Tachdjian's system of grading for flatfoot was assessed. Results: The data showed that the overall prevalence of flat foot was 74% out of which 23% were mild, 34% were moderate and 17% were severe. The prevalence of flat foot in girl and boy students were 75.2% and 72.6% respectively, but this difference was not significant. Moreover, no significant relationship was observed between the prevalence of flat foot and age. Discussion: This study showed that flat foot is a common problem among primary school students and should be addressed by responsible organizations

Visuo-Spatial Attention in ADHD Children: Investigating the Asymmetry

Objectives: The purpose of the present study was comparing visuo-spatial attention between children with Attention Deficit Hyperactivity Disorder-Inattentive (ADHD-I) type and normal children. Methods: In this cross-sectional study fifteen (7-10 years of age) children were classified with ADHD-I type and 15 normal children were matched for age, sex, and IQ. They were selected trough simple random sampling. Measurement tools were Wechsler Intelligence Scale for children 4th edition (WISC-IV), the Edinburgh Handedness Inventory and the Star Cancellation Test. Results: The results suggest that there is no significant difference between ADHD-I and normal children from the visuo-spatial standpoint (P>0.05). But three ADHD-I children exhibited signs of unilateral neglect. Discussion: Although, in this study the visuo-spatial attention was not different between ADHD-I group and normal group, considering this form of attention as an item in assessment and therapeutic interventions should not be neglected

Validation of the Comprehensive ICF Core Set for young Children with Cerebral Palsy: An Occupational Therapy Perspective from Iran

ObjectiveEvidence has shown that because of the multiplicity and diversity of the symptoms of cerebral palsy, integration between different specialists in evaluating the function of this population does not exist. Comprehensive ICF Core Set of cerebral palsy including a set of functions of these children and the aim of this study was to determine the validity of this version based on Iranian Occupational Therapists’ perspectives. Materials &amp; MethodsThis study was a qualitative study using expert panels and Delphi survey. Experts were the academic staff of the universities that were selected through convenience sampling. Content validity was done by them. Then a Delphi survey was used for generating consensus on the final version. Participants were 50 clinical Occupational Therapists who were invited via email from across the country. An agreement of 75% was considered as the cut-off for inclusion of each code-category. ResultsAfter expert panels and rounds of Delphi, 60% of the code–categories of comprehensive version of ICF Core Set of cerebral palsy approved by Occupational Therapists. In the final version, 82 code-categories were listed that included 21 code-categories for Body Functions, 40 for Activity/Participation, and 21 for Environmental Factors. This indicates that Occupational Therapists pay more attention to the activity/ participation component.ConclusionThe validity of the Iranian ICF Core Set for children with CP aged 0–6 years was supported by Iranian Occupational Therapists. It could be the basis for evaluation of this population in Occupational Therapy. 

Quality of Developmental screening of 3-12-month infants through comparing with screening by Bayley Infant Neurodevelopmental Screener II

Objectives: Monitoring development in infancy results in early detection of developmental delay, and early intervention can prevent sever complications of developmental disorders. The purpose of this study was to determine quality of developmental screening of 3-12 months infants referred to Tehran Health Centers, through comparing with screening by Bayley Infant Neurodevelopmental Screener II (BINS II). Method: This was a cross-sectional study. 155 infants of 3-12 months old, recourse to Tehran Health Centers, screened developmentally with BINS II and its results was compared with results of routine clinical examination of Tehran Health Centers. Results: Kappa agreement between results of BINS II and results of routine developmental screening of Tehran Health Centers&apos; clinical examination of 3-12-month old infants was poor (0.18). Discussion: Routine clinical examination in Tehran Health Centers, in compare with applying standard screening tools, cannot screen all infants at risk of developmental delay and ignores many of them which should be considered either for follow up or for receiving early intervention services

Electrophysiologic and Behavioral Assessment of Hearing Status in Children with Spastic Diplegia

Background and Aim: High incidence of speech disorders in children with cerebral palsy could be related to a deficiency in processing of auditory stimuli. So it is vital to check out any peripheral or central disorders in auditory system using behavioral and electrophysiological auditory tests.Methods: In a cross-sectional study, 15 children with spastic diplegia, mean age 5.77, SD 2.26 years, and 15 normal children, mean age 5.33, SD 1.80 years, were tested using pure tone audiometry, immittance and auditory brainstem responses. The results were compared between the two groups.Results: Hearing thresholds and middle ear status were in normal range in all participants; however, contralateral acoustic reflex thresholds were mostly elevated. Comparing absolute latency and interpeak latency intervals of auditory brainstem responses between the two groups, absolute latency interval of later waves, and in specific the V wave, was significantly longer in diplegic children (p=0.04) resulting in a longer III-V interpeak latency intervals (p=0.02).Conclusion: Neurological disorders in ponto-reticulo-spinal pathway, pontine reticular nuclei and upper pons which are adjacent to auditory nuclei of lateral leminiscus and inferior colliculus result in auditory dys-synchrony and increased latency intervals in latter waves of auditory brainstem responses. This could also attributed to functional disorders in wave-generating sites in these patients