Repeatability of three fine motor tests

This study evaluated the repeatability of three fine motor tasks in normal children aged nine years. Using set procedures and well defined scoring categories, finger drumming, sequential finger/thumb opposition and finger tapping were shown to be repeatable quantitatively and qualitatively. Drumming and finger tapping (but not opposition) showed differences between hands, and movement in the easy direction was better than that in the difficult direction for drumming and opposition. Children demonstrate a preferred or easy direction of movement for drumming and for opposition, which must be considered when assessing hand function. This study has provided repeatability information for three tests, as well as baseline data against which children with motor impairment can be evaluated

Use of the auditory clap task in physiotherapy developmental assessment

This study assessed the test-retest reliability of the auditory clapping task in normal children. This task forms part of the physiotherapy neurodevelopmental assessment for children over five years of age, and is an auditory sequential short term memory (STM) test which is not language biased. Trends associated with age, gender and type of rhythm were also examined in five, seven and nine year old children. Results suggest that this is a reliable test, with significant increase in STM performance demonstrated with increasing age. Girls performed significantly better than boys, and significantly longer rhythmic than non-rhythmic sequences were recalled

Characteristics of infants with positional abnormal head shapes and their physiotherapy service at an Australian community health facility

Purpose: There is limited biographic information regarding infants presenting with abnormal head shape in Australia and little discussion of the effect of different cutoff values for diagnosis of plagiocephaly. This study aimed to 1) describe the biographic characteristics of infants with positional abnormal head shapes referred for physiotherapy management; 2) explore their access to physiotherapy services and intervention outcomes; and 3) explore the impact of using different modified Cranial Vault Asymmetry Index (mCVAI) cutoff points in plagiocephaly classification.Patients and methods: This retrospective community health record audit included the total cohort of infants referred over concerns about abnormal head shape to a pediatric physiotherapy service at a community health center in Australia from January 2004 to December 2007 (N=126 valid cases). Data retrieved included: demographic data; birth history; positioning; initial physiotherapy assessment; and factors associated with physiotherapy intervention and outcomes.Results: Of the 126 charts (65 males), 106 infants (84.1%) presented with plagiocephaly, ten (7.9%) with brachycephaly, and ten (7.9%) with combined deformities. Most biographic data from this study were similar to those reported in the literature. The mean age +/- standard deviation (SD) of infants at referral was 11.29 +/- 7.84 weeks, with about 4-weeks wait for assessment. For the plagiocephalic group, there was significant reduction in mCVAI mean value from assessment (- 5.44%+/- 2.95%) to discharge (-4.41%+/- 2.66%) (t([df= 60]) =-5.396; 95% confidence interval [CI]: -1.66%, -0.76%;

A clinical tool to measure plagiocephaly in infants using a flexicurve: a reliability study

Purpose: There has been an increasing incidence of infants presenting with plagiocephaly in the last two decades. A practical, economical, and reliable clinical plagiocephaly measure is essential to assess progression and intervention outcomes. This study investigated the reliability of a modified cranial vault asymmetry index using a flexible curve in infants.Measurement: A flexicurve was molded to the infant's head and its shape maintained as it was placed onto paper to trace the head shape. Using a small modification of Loveday and De Chaplain's procedure to measure a cranial vault asymmetry index, a pair of diagonals were drawn at 30 degrees through the midpoint of the central line to their intersection with the traced head outline. The difference in length of the paired diagonals was divided by the short diameter then multiplied by 100%, yielding the modified cranial vault-asymmetry index.Patients and methods: Infants referred to a community health physiotherapist for assessment due to suspected abnormal head shape were included. To explore intrarater reliability, 34 infants aged 3-14 months were measured twice (T-1/T-1') at the beginning, and 21 of these remeasured twice at the end (T-2/T-2') of their physiotherapy sessions. Test-retest reliability used matchedaverage data (T1/T1') and (T2/T2') from 21 infants. To explore interrater reliability, 18 healthy infants aged 2-6 months were recruited. Each infant was measured once by each rater.Results: For intrarater reliability, the intraclass correlation coefficient with 54 degrees of freedom (ICCdf54) was 0.868 (95% confidence interval [CI] 0.783-0.921); for test-retest reliability, ICCdf20 = 0.958 (95% CI 0.897-0.983); and for interrater reliability, ICCdf17 = 0.874 (95% CI 0.696-0.951).Conclusion: The modified cranial vault asymmetry index using flexicurve in measuring plagiocephaly is a reliable assessment tool. It is economical and efficient for use in clinical settings

Impact of parent practices of infant positioning on head orientation profile and development of positional plagiocephaly in healthy term infants

The influence of infant positioning on the development of head orientation and plagiocephaly is not clear. This study explored the relationship between infant body and head positioning, with the development of asymmetrical head orientation and/or positional plagiocephaly.\ua0Methods: Clinician measurement of head orientation profile and parent-reported infant positioning data were collected for 94 healthy term infants at 3, 6, and 9 weeks of age. Plagiocephaly was measured at 9 weeks with the modified Cranial Vault Asymmetry Index.More severe plagiocephaly was associated with longer supine-sleep-maximum (p = 0.001) and longer supine-lying-total (p = 0.014) at 6 weeks. Prone positioning was not associated with plagiocephaly. Parent-reported head asymmetry during awake and sleep time at 3 weeks identified infants with clinician-measured head asymmetry at 9 weeks. Better symmetry in head turning was associated with more side-lying-total time by 9 weeks (p = 0.013).Our results showed that infant positioning is associated with early head orientation and plagiocephaly development. Early parent-reported asymmetry during awake and sleep time is an important indicator for the need for professional assessment and advice. A Plagiocephaly Prevention Strategy and Plagiocephaly Screening Pathway are provided for clinicians and parents

The comparison of perceived health-related quality of life between Australian children with severe specific language impairment to age and gender-matched peers

Abstract Background Children with specific language impairment often present with multiple comorbidities, which may adversely affect both participation in play and academic performance, potentially impacting a child’s health-related quality of life. This study 1) explored the suitability of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales (PedsQL™) for use with a typically developing Australian control group, and 2) compared the health-related quality of life between a control group and Australian children with severe specific language impairment. Methods Health-related quality of life data collected as part of a broader study of 43 children with severe specific language impairment (males = 35, age range 5–16, mean age = 8.79+/− 2.92) enrolled at a special school were used to explore previously unreported findings. Typically developing gender and age matched (+/− 3 months) peers were recruited from local schools. The PedsQL™ child self-report and proxy-report were individually or interviewer-administered to the control group as required, and then compared to the group with specific language impairment. Results The PedsQL™ was reliable and feasible for use with the control group (N = 43, males = 35, age range = 5–16 years, mean age = 8.74+/− 2.94 years). Control group performance was as expected as per the manual. Parents of the control group scored their children significantly higher than did the children themselves on all scales except the emotional functioning scale. Both the control group children and their parents scored themselves significantly higher on all scales, compared to children with severe specific language impairment and their parents. Conclusions The PedsQL™ was suitable for use with the control group. Further, the recruitment of a control group provided additional clarity on the extent a severe specific language impairment impacts on an Australian child’s perceived health-related quality of life, compared to the manual cut-off scores. Severe specific language impairment significantly impacts negatively on the health-related quality of life of Australian children across all domains, particularly when compared to an age and gender-matched group of peers. These results warrant the inclusion of health-related quality of life evaluations in the assessment of these children along with a multidisciplinary approach