The development of motor behavior

Assessing Infant Gross Motor Performance With an At-Home Wearable

BACKGROUND

Early development of gross motor skills is foundational for the upcoming neurocognitive performance. Here, we studied whether at-home wearable measurements performed by the parents could be used to quantify and track infants' developing motor abilities.

METHODS

Unsupervised at-home measurements of the infants' spontaneous activity were made repeatedly by the parents using a multisensor wearable suit (altogether 620 measurements from 134 infants at age 4-22 months). Machine learning-based algorithms were developed to detect the reaching of gross motor milestones (GMM), to measure times spent in key postures, and to track the overall motor development longitudinally. Parental questionnaires regarding GMMs were used for developing the algorithms, and the results were benchmarked with the interrater agreement levels established by World Health Organization (WHO). A total of 97 infants were used for the algorithm development and cross-validation, whereas an external validation was done using 37 infants from an independent recruitment in the same hospital.

RESULTS

The algorithms detected the reaching of GMMs very accurately (cross-validation: accuracy, 90.9%-95.5%; external validation, 92.4%-96.8%), which compares well with the human experts in the WHO reference study. The wearable-derived postural times showed strong correlation to parental assessments (ρ = .48-.81). Individual trajectories of motor maturation showed strong correlation to infants' age (ρ = .93).

CONCLUSIONS

These findings suggest that infants' gross motor skills can be quantified reliably and automatically from unsupervised at-home wearable recordings. Such methodology could be used in health care practice and in all developmental studies for gaining real-world quantitation and tracking of infants' motor abilities.

What are my muscles up to? The contribution of surface electromyography to clinical decision-making

Muscles move the body. The varying levels of movement precision needed daily results from a complex interplay within the central nervous system, muscles and sensory feedback, referred to as neuromechanics. This neuromechanical interplay is often impaired in pathology. Although, diagnosis and therapy would benefit from information about the patient's specific neuromechanical control, no procedures have yet been established in clinical practice that allow this information to be fully recorded. Surface electromyography (sEMG) links neuronal input and muscle function and helps to understand how the CNS orchestrates the multitude of possibilities the neuromusculoskeletal system has at its disposal to solve a movement task. This 2024 Basmajian-Lecture-Paper will highlight sEMG applications in physiological and pathological conditions, to illustrate the potential contribution of sEMG to clinical decision-making. Focussing first on infants' motor development, it will contribute to the discussion on how neuromechanics and motor skills develop. Continuing with considerations on motor unit activation in health and disease and describing the difference between physiological and pathological muscle coordination in dynamic conditions, it aims to address the possibilities but also the limitations of sEMG in clinical applications. Finally, the influence of robotic support on neuromechanical control and thus on re-learning of motor skills are discussed.

Developmental Screening and Family Resilience for Infants and Toddlers in Homeless Shelters

This study investigated motor and language development among infants and toddlers staying in family homeless shelters. We tested contributors to resilience and maladaptation, while also considering characteristics of developmental screening. Participants were 128 children (2-week to 35 months old; M = 8.54 months; 73% Black/African American) and their parents staying in eight urban family shelters. Data spanned time points about 2 months apart, involving an interview, parent-child play task, and a repeated, standardized observational screening measure. On average, this sample showed motor delays relative to age-based norms, and language delays for toddlers but not infants, a finding that may signal challenges in assessing language in young infants. Parent depression symptoms predicted lower gains in language, and parent education predicted higher gains in language. Positive parenting predicted gains in motor scores and a non-significant trend for language. We interpreted results as evidence of complex developmental processes of resilience and risk. Parent functioning is a key predictor of resilience and should be included in developmental screening of very young children who experience adversity. Shelter design, policy, and practices also should reflect consideration of early childhood development and parent empowerment.

Effects of Horseback Riding on the Postural Control of Autistic Children: A Multiple Baseline Across-subjects Design

The aim of this research was to study the effect of a horseback-riding programme on postural control in a group of autistic children (ASD). Nine children aged 9 to 12 years participated in this study through a multiple baseline across subjects design. The whole programme took place over nine months. Participants followed a previously developed specific horseback-riding programme, consisting of 45-minute sessions held twice a week for at least three months. To evaluate postural control, the average velocity of the centre of pressure displacement was measured by means of a posturographic platform. Results indicated that this intervention with horses had a positive effect on the postural control in children with ASDs.

The Ontogeny of the Human Calcaneus: Insights From Morphological and Trabecular Changes During Postnatal Growth

OBJECTIVES

To investigate the developmental changes in the human calcaneal internal and external morphology linked to the acquisition of mature bipedal locomotion.

METHODS

Seventy seven micro-CT scans of modern juvenile calcanei (from perinates to 15 years old) are employed. The chronological period spans from the Middle/Late Neolithic (4800-4500 BCE) to the 20th century. Through a comprehensive approach that comprises geometric morphometric methods and whole-bone trabecular analysis, the calcaneal growing morphology has been explored.

RESULTS

Morphological changes reflect the development of bipedal locomotion, showing its potential when tracking the major locomotor milestones. The calcaneal shape is immature and almost featureless during the first year of life. The internal architecture is dense and isotropic with numerous thin trabeculae closely packed together. The internal architecture changes to better adapt to variations in load stimulated by a more mature gait by increasing bone mass and alignment, with fewer and thicker struts. The external morphology shows its plasticity by increasing the surface area where greater strain is expected and changing the orientation of the articular facets.

CONCLUSIONS

Analysis of morphological changes in the growing calcaneus highlights the importance of an integrative methodology when exploring developmental bone plasticity. The changes in calcaneal internal and external morphologies reflect the different loading patterns experienced during growth, gradually shifting from a more generalized morphology to a more adult-like one, reflecting major locomotor achievement. Our research shows that although initially genetically driven, calcaneal plasticity may display mechanical influences and provide precious information on tracking the main locomotor milestones.

Early Independent Wheeled Mobility in Children with Cerebral Palsy: A Norwegian Population-Based Registry Study

Background: The aim was to explore independent wheeled mobility in children with CP, and identify predictors of early independent wheeled mobility and changes over time across birth cohorts. Methods: We included data from the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP) comprising 11,565 assessments of 1780 children born in 2002-2019. Variables included demographic data, Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels, wheelchair use, and independent wheeled mobility. Cox proportional hazard regression was used to identify predictors for early independent wheeled mobility. Kaplan-Meier survival curves were used to compare birth cohorts. Results: Of 769 (43%) children who used a wheelchair, 511 (67%) had independent wheeled mobility. Two thirds of the children (n = 337) achieved independent wheeled mobility before age 7. Most children with independent wheeled mobility used powered wheelchairs. Children at GMFCS levels III and IV were more likely to reach independent wheeled mobility at an early age. Children at MACS levels III-V had a lower probability of early independent wheeled mobility. The average age of achieving independent mobility decreased from 9.5 to 4.0 years between birth years 2002 and 2019. Conclusions: Two in three children were independent wheelchair users before 7 years of age, and the age of obtaining independent wheeled mobility has decreased over the last 20 years. Children with better hand function were more likely to obtain early independent wheeled mobility. Early intervention programs to promote mobility, development and participation should include powered mobility, adapted steering options, and interventions for hand function.

Effect of Family-Centered Care Interventions on Motor and Neurobehavior Development of Very Preterm Infants: A Systematic Review and Meta-Analysis

AIM

To assess the effectiveness of family-centered care (FCC) interventions on motor and neurobehavior development of very preterm infants.

METHOD

Randomized and quasi-randomized trials assessing the effect of FCC on motor and neurobehavioral outcomes in very preterm infants (28-32 wk gestation) were included. Five electronic databases and grey literature were searched from January 2010 to August 2022. Two reviewers independently screened the titles/abstracts and full texts, assessed the risk of bias, and extracted data. The Cochrane Risk of Bias 2.0 Tool and GRADE were used for risk and evidence certainty assessments. Meta-analysis or narrative synthesis was performed based on data availability and heterogeneity.

RESULTS

Seventeen trials with 21 publications were included. GRADE showed low to moderate evidence. At 24 months, FCC interventions improved motor development (Mean Difference (MD):5.00, 95% CI: 2.58-7.42), cognitive development (MD: 3.64, 95% CI: 1.15-6.12), and behavior development (MD: -2.40, 95% CI: -4.32, -0.48) compared to control groups. Further, the FCC showed minimal or inconclusive effects on language, communication, and personal social development measured anytime between newborn and 24 months of age.

CONCLUSIONS

Early initiated FCC interventions can be a promising approach to improve motor, cognition, and behavioral development in very preterm infants.

Validity of the Alberta Infants Motor Scale in Norwegian infants aged 6-9 months through comparison with Canadian and Dutch scores

Introduction

The Alberta Infant Motor Scale (AIMS) is widely used to assess infant motor development but has shown limited cross-cultural validity in various populations. The distribution of the original AIMS scores has not been cross-culturally validated for Norwegian infants. This study aimed to evaluate the applicability of the Canadian AIMS norm reference for Norwegian infants aged 6-9 months and compare their percentile rankings with the Canadian and Dutch norms.

Methods

In this cross-sectional study, AIMS scores from a sample of 189 Norwegian infants aged 6-9 months were compared to the Canadian and Dutch norms. Total raw scores from the Canadian norms were compared to those of the Norwegian sample, and the percentiles of the Canadian and Dutch sample were compared to tentative Norwegian percentiles.

Results

Norwegian infants aged 6-9 months consistently scored lower on the AIMS than their Canadian counterparts (p < 0.001), with 81% scoring at or below the 50th percentile and 18% falling at or below cut-off indicating possible motor delay. Using the Dutch norms, 20% of the Norwegian sample scored at or below the 50th percentile, while only 1% scored at or below the cut-off. A comparison of the percentile ranks showed that Canadian norms had the highest ranks for all age groups, followed by the Norwegian sample and subsequently the Dutch norms. The observed difference is considered clinically significant.

Conclusion

Neither Canadian nor Dutch AIMS norms are valid for Norwegian infants due to the Canadian norms being too stringent and the Dutch norms being too lenient. A thorough cross-cultural validation for infants 0-18 months to establish Norwegian-specific AIMS norms is recommended.

Marker-Less Video Analysis of Infant Movements for Early Identification of Neurodevelopmental Disorders

Background/Objectives: The early identification of neurodevelopmental disorders (NDDs) in infants is crucial for effective intervention and improved long-term outcomes. Recent evidence indicates a correlation between deficits in spontaneous movements in newborns and the likelihood of developing NDDs later in life. This study aims to address this aspect by employing a marker-less Artificial Intelligence (AI) approach for the automatic assessment of infants' movements from single-camera video recordings. Methods: A total of 74 high-risk infants were selected from the Italian Network for Early Detection of Autism Spectrum Disorders (NIDA) database and closely observed at five different time points, ranging from 10 days to 24 weeks of age. Automatic motion tracking was performed using deep learning to capture infants' body landmarks and extract a set of kinematic parameters. Results: Our findings revealed significant differences between infants later diagnosed with NDD and typically developing (TD) infants in three lower limb features at 10 days old: 'Median Velocity', 'Area differing from moving average', and 'Periodicity'. Using a Support Vector Machine (SVM), we achieved an accuracy rate of approximately 85%, a sensitivity of 64%, and a specificity of 100%. We also observed that the disparities in lower limb movements diminished over time points. Furthermore, the tracking accuracy was assessed through a comparative analysis with a validated semi-automatic algorithm (Movidea), obtaining a Pearson correlation (R) of 93.96% (88.61-96.60%) and a root mean square error (RMSE) of 9.52 pixels (7.29-12.37). Conclusions: This research highlights the potential of AI movement analysis for the early detection of NDDs, providing valuable insights into the motor development of infants at risk.

Days-old zebrafish rapidly learn to recognize threatening agents through noradrenergic and forebrain circuits

Animals need to rapidly learn to recognize and avoid predators. This ability may be especially important for young animals due to their increased vulnerability. It is unknown whether, and how, nascent vertebrates are capable of such rapid learning. Here, we used a robotic predator-prey interaction assay to show that 1 week after fertilization-a developmental stage where they have approximately 1% the number of neurons of adults-zebrafish larvae rapidly and robustly learn to recognize a stationary object as a threat after the object pursues the fish for ∼1 min. Larvae continue to avoid the threatening object after it stops moving and can learn to distinguish threatening from non-threatening objects of a different color. Whole-brain functional imaging revealed the multi-timescale activity of noradrenergic neurons and forebrain circuits that encoded the threat. Chemogenetic ablation of those populations prevented the learning. Thus, a noradrenergic and forebrain multiregional network underlies the ability of young vertebrates to rapidly learn to recognize potential predators within their first week of life.

Object exploration is facilitated by the physical and social environment in center-based child care

Object exploration is considered a driver of motor, cognitive, and social development. However, little is known about how early childhood education and care settings facilitate object exploration. This study examined if children's exploration of objects during free play was facilitated by the use of particular spatial components (floor, tables, and activity centers) and types of play (solitary, social, and parallel). Participants were 61 children (aged 11 to 48 months and 50.8% boys, socioeconomic levels representative of the Dutch population). Intraindividual variability in children's object exploration was predicted by the use of particular spatial components and the social setting, with small-to-medium effect sizes. Solitary and parallel play were positively associated with complex object exploration, especially when sitting or standing at child-height tables. During social play, object exploration was mostly absent.

Novel rehabilitation technologies in pediatric rehabilitation: knowledge towards translation

Purpose: Knowledge translation (KT) refers to the process of applying the most promising research outcomes into practice to ensure that new discoveries and innovations improve healthcare accessibility, effectiveness, and accountability. The objective of this perspective paper is to discuss and illustrate via examples how the KT process can be implemented in an era of rapid advancement in rehabilitation technologies that have the potential to significantly impact pediatric healthcare.

Methods: Using Graham et al.'s (2006) Knowledge-to-Action cycle, which includes the knowledge creation funnel and the action cycle, we illustrate its application in implementing novel technologies into clinical practice and informing healthcare policy changes. We explore three successful applications of technology research: powered mobility, head support systems, and telerehabilitation. Additionally, we examine less clinically mature technologies such as brain-computer interfaces and robotic assistive devices, which are hindered by cost, robustness, and ease-of-use issues.

Conclusions: The paper concludes by discussing how technology acceptance and usage in clinical settings are influenced by various barriers and facilitators at different stakeholder levels, including clients, families, clinicians, management, researchers, developers, and society. Recommendations include focusing on early and ongoing design partnerships, transitioning from research to real-life implementation, and identifying optimal timing for clinical adoption of new technologies.

The role of the opponent's head in perception of kick target location in martial arts

Athletes in Martial Arts must anticipate the target of their opponent's kick or strike to avoid contact. Findings suggest that features, e.g., head and face may play a greater role in predicting opponent action intent compared to global movement information, however little research has explored the role of the head in action anticipation. The aim of this study was to examine the role of the head in predicting the target of a kicking action in martial arts. N = 76 volunteer participants (n = 32 athletes > 5 years of experience, n = 36 non-athletes with no experience) were asked to watch a series of video clips depicting various kicking techniques with differing levels of spatial occlusion of the head. These clips were also temporally occluded compelling participants to predict the landing target of each kick (i.e., head or chest). The hypothesis of the current study is that athletes would be more accurate than non-athletes, but there was no significant effect of expertise on accuracy. Both athletes and non-athletes performed well above chance level performance. Head occlusion did not significantly influence performance and did not interact with expertise, suggesting head and face information did not play a role in predicting opponent action intent. Across participants the landing target of the roundhouse kick was identified with greater accuracy than the front or the back kick. Additionally, participants identified kicks from the rear leg with greater accuracy than the front leg. These findings have significant implications for combat sports where athletes are required to anticipate the action intent of their opponent to formulate an effective defensive response.

Neurodevelopment in the first year of children exposed to SARS-CoV-2 during intrauterine period: systematic review

OBJECTIVE

To identify, in the literature, the implications of gestational exposure to SARS-CoV-2 on neurodevelopment in the first postnatal year, focusing on changes in the motor, personal-social, socio-emotional, and communication and language domains.

METHOD

Systematic review with narrative synthesis, considering neurodevelopmental outcomes, categorized according to gross and fine motor skills, personal-social interaction, socio-emotional aspects, and communication and language. Searches were conducted in PubMed, LILACS/BIREME, and EMBASE databases between January 2020 and June 2023. Two independent researchers performed selection by reading the title and abstract and applying the inclusion and exclusion criteria. Cohort studies that evaluated children up to one year old, exposed to SARS-CoV-2 in utero, were included. The Newcastle-Ottawa scale was used to assess methodological quality.

RESULTS

Seventeen articles were included, with methodological quality ranging from intermediate to good. The most frequently used instrument to characterize neurodevelopment was the Ages & Stages Questionnaires. Infants aged 0 to 3 months had lower scores for fine and gross motor skills. Infants aged 3 to 12 months had more fine motor, social and communication and language impairments.

CONCLUSION

Most infants exposed to SARS-CoV-2 showed development as expected, however delays were identified in the motor, personal-social, socio-emotional and communication and language domains according to the age group.

Quantifying spontaneous infant movements using state-space models

Over the first few months after birth, the typical emergence of spontaneous, fidgety general movements is associated with later developmental outcomes. In contrast, the absence of fidgety movements is a core feature of several neurodevelopmental and cognitive disorders. Currently, manual assessment of early infant movement patterns is time consuming and labour intensive, limiting its wider use. Recent advances in computer vision and deep learning have led to the emergence of pose estimation techniques, computational methods designed to locate and track body points from video without specialised equipment or markers, for movement tracking. In this study, we use automated markerless tracking of infant body parts to build statistical models of early movements. Using a dataset of infant movement videos (n = 486) from 330 infants we demonstrate that infant movement can be modelled as a sequence of eight motor states using autoregressive, state-space models. Each, motor state Is characterised by specific body part movements, the expression of which varies with age and differs in infants at high-risk of poor neurodevelopmental outcome.

An update of the development of motor behavior

This primer describes research on the development of motor behavior. We focus on infancy when basic action systems are acquired-posture, locomotion, manual actions, and facial actions-and we adopt a developmental systems perspective to understand the causes and consequences of developmental change. Experience facilitates improvements in motor behavior and infants accumulate immense amounts of varied everyday experience with all the basic action systems. At every point in development, perception guides behavior by providing feedback about the results of just prior movements and information about what to do next. Across development, new motor behaviors provide new inputs for perception. Thus, motor development opens up new opportunities for acquiring knowledge and acting on the world, instigating cascades of developmental changes in perceptual, cognitive, and social domains. This article is categorized under: Cognitive Biology > Cognitive Development Psychology > Motor Skill and Performance Neuroscience > Development.

How bipedalism shapes humans' actions with hand tools

The task for an embodied cognitive understanding of humans' actions with tools is to elucidate how the human body, as a whole, supports the perception of affordances and dexterous action with objects in relation to other objects. Here, we focus on the relationship between humans' actions with handheld tools and bipedal posture. Posture plays a pivotal role in shaping animals' perception and action dynamics. While humans stand and locomote bipedally, other primates predominantly employ quadrupedal postures and locomotion, relying on both hands and feet to support the body. Drawing upon evidence from evolutionary biology, developmental psychology and performance studies, we elucidate the influence of bipedalism on our actions with objects and on our proficiency in using tools. We use the metaphor of cascades to capture the dynamic, nonlinear transformations in morphology and behaviour associated with posture and the use of tools across evolutionary and developmental timescales. Recent work illustrates the promise of multifractal cascade analysis to reveal nonlinear, cross-scale interactions across the entire body in real-time, supporting the perception of affordances for actions with tools. Cascade analysis enriches our comprehension of real-time performance and facilitates exploration of the relationships among whole-body coordination, individual development, and evolutionary processes.This article is part of the theme issue 'Minds in movement: embodied cognition in the age of artificial intelligence'.

Sensorimotor variability distinguishes early features of cognition in toddlers with autism

The potential role of early sensorimotor features to atypical human cognition in autistic children has received surprisingly little attention given that appropriate movements are a crucial element that connects us to other people. We examined quantitative and observation-based movements in over 1,000 toddlers diagnosed with autism spectrum disorder (ASD) with different levels of cognitive abilities (intelligence quotient, IQ). Relative to higher-IQ ASD toddlers, those with lower-IQ had significantly altered sensorimotor features. Remarkably, we found that higher IQ in autistic toddlers confers resilience to atypical movement, as sensorimotor features in higher-IQ ASD children were indistinguishable from those of typically developing healthy control toddlers. We suggest that the altered movement patterns may affect key autistic behaviors in those with lower intelligence by affecting sensorimotor learning mechanisms. Atypical sensorimotor functioning is a key feature in lower-IQ early childhood autism. These findings have implications for the development of individualized interventions for subtypes of autism.

Effective Nature-Based Outdoor Play and Learning Environments for below-3 Children: A Literature-Based Summary

Early childhood (0-8 years) is a time of rapid brain development supported by spontaneous and informal learning from the surrounding environment. Meaningful contact with nature (a dynamic and varied source of informal learning) during the early years of life sets up rich scopes for such spontaneous learning-especially in the first three years, a period in life that determines all future learning, behavior, and health. Besides its learning affordances, nature-based environments provide numerous health and developmental benefits. Considering that more than 13 million children under 5 years of age in the US spend most of their waking hours in care facilities, the potential benefits of having a nature-based outdoor area in their primary care environments are immense. However, guidelines and assessment standards for designing nature-based outdoor environments for below-three children (infants and toddlers) are almost non-existent. This three-phase research holds the promise of addressing this issue. Phase 1 reviews the available limited literature on below-three children's outdoor play and learning environments and summarizes their design implications. Phase 2 extracts effective design guidelines and identifies assessment indicators from the Phase 1 studies. In Phase 3, empirical data (environmental assessment data) are collected to compare the existing and proposed design environment conditions of below-3 outdoor play and learning environments in a selected childcare facility. This phase highlights evidence-based assumptions of new criteria, guidelines, and indicators to assess any below-3 nature-based childcare outdoor environments. This research provides new information and insights for designing nature-based outdoor play and learning environments for below-3 children to increase their meaningful connections with natural elements while attending a care facility.

The Assessment of Postural-Motor, Coordination, and Reflex Functions in Children and Adolescents with a History of Premature Verticalization and Ontogeny Disorders in Their First Year of Life

(1) Background: Contracting diseases or being exposed to adverse environmental factors in the first year of life may impair the development of body posture and motor coordination. The purpose of this study was to evaluate the correlation between data on the speed of passive verticalization, the number of risk factors and the quality of development in the first year of life, and the results of the functional examination of these individuals in adolescence. (2) Methods: Two groups of 60 volunteers, aged 9-14 years, were examined by performing functional tests and the retrospective analysis of their development up to the age of 1 year. The first group consisted of patients diagnosed with postural defects. The control group consisted of healthy people of the same age who volunteered for this study. (3) Results: Statistical analysis showed statistically significant differences between groups in terms of posture (p = 0.001), motor coordination (p = 0.001), and accumulated primitive reflexes (p = 0.001), as well as a high correlation between these disorders and the quality of development in the first year of life. In the first group, for the ages of 3-6 months (r = 0.96; p = 0.001), 6-9 months (r = 0.871; p = 0.001), and 9-12 months (r = 0.806; p = 0.001), no significant correlations were found with the age of 0-3 months. In the second group, the results were as follows: 0-3 months (r = 0.748; p = 0.001), 3-6 months (r = 0.862 p = 0.001), 6-9 months (r = 0.698; p = 0.001), and 9-12 months (r = 0.740; p = 0.001). In the group of adolescents with posture defects, we observed an earlier time of passive verticalization and sitting, as well as more frequent use of loungers, seats, and walkers (p = 0.026). (4) Conclusions: The analysis of this study's data indicates that the development of body posture and motor coordination may be impaired due to accelerated and passive verticalization in the first year of life.

The Effect of Screen Habits and Alternative Activities on Tactile Exploration Skills in 6- to 36-Month-Old Toddlers

BACKGROUND/OBJECTIVES

With the rising ubiquity of digital media and screens in everyday life, toddlers are increasingly exposed to different screens from an early age (i.e., television, computer, tablet, phone). However, few studies have examined the effect of these screens on toddlers' perceptual development. Since tactile exploration skills are necessary for environmental discovery and overall development, the current research investigates the links between screen-use habits and the tactile exploration skills (with visual control) of 6- to 36-month-old toddlers.

METHODS

The study involved observing the interactions of 135 toddlers with various objects and assessing the complexity of their visuo-tactile exploration strategies through two original experimental tasks. Data concerning screen habits and other relevant factors, such as socio-economic level, were collected using a parental questionnaire.

RESULTS

Toddlers with greater screen exposure time demonstrated weaker tactile exploration skills and employed less age-appropriate exploration strategies. Socio-economic factors and parental engagement in alternative activities significantly influenced these developmental outcomes.

CONCLUSIONS

These findings emphasize the importance of reducing screen time and promoting interactive co-viewing and alternative activities to mitigate the negative effects of screen exposure. Further longitudinal research is needed to determine the long-term impacts of early screen exposure on tactile exploration and overall psychological development.

Seeing the Forest but Naming the Trees: An Object-Over-Place Bias in Learning Noun Labels

Objects and places are foundational spatial domains represented in human symbolic expressions, like drawings, which show a prioritization of depicting small-scale object-shape information over the large-scale navigable place information in which objects are situated. Is there a similar object-over-place bias in language? Across six experiments, adults and 3- to 4-year-old children were asked either to extend a novel noun in a labeling phrase, to extend a novel noun in a prepositional phrase, or to simply match pictures. To dissociate specific object and place information from more general figure and ground information, participants either saw scenes with both place information (a room) and object information (a block in the room), or scenes with two kinds of object information that matched the figure-ground relations of the room and block by presenting an open container with a smaller block inside. While adults showed a specific object-over-place bias in both extending novel noun labels and matching, they did not show this bias in extending novel nouns following prepositions. Young children showed this bias in extending novel noun labels only. Spatial domains may thus confer specific and foundational biases for word learning that may change through development in a way that is similar to that of other word-learning biases about objects, like the shape bias. These results expand the symbolic scope of prior studies on object biases in drawing to object biases in language, and they expand the spatial domains of prior studies characterizing the language of objects and places.

The Relationship Between Postural Torticollis Abnormalities and Plagiocephaly on the Early Motor Development Milestones of Lying and Rolling Activities in Infants: A Retrospective Study

The study examined how neck muscle imbalance and plagiocephaly affect the lying and rolling activities in 118 infants aged 4 to 6 months with postural torticollis. Outcome measures included age, sex, cervical movement, and plagiocephaly severity. Neck muscle function was assessed with the Muscle Function Scale (MFS), and infant motor abilities in lying and rolling were evaluated through the corresponding dimensions of the Gross Motor Function Measure (GMFM). Multiple regression analysis showed that a better MFS score of the affected neck was significantly associated with improved lying and rolling activities in the GMFM (p < .01), and importantly, the interaction between the plagiocephaly and the MFS scores of the affected neck muscle in these activities was found to be significant (p < .05). These results highlight the need for early intervention in infants with torticollis to address muscle imbalance and plagiocephaly, crucial for early motor development (KCT0008367).

A Review on Autism Spectrum Disorder Screening by Artificial Intelligence Methods

PURPOSE

With the increasing prevalence of autism spectrum disorders (ASD), the importance of early screening and diagnosis has been subject to considerable discussion. Given the subtle differences between ASD children and typically developing children during the early stages of development, it is imperative to investigate the utilization of automatic recognition methods powered by artificial intelligence. We aim to summarize the research work on this topic and sort out the markers that can be used for identification.

METHODS

We searched the papers published in the Web of Science, PubMed, Scopus, Medline, SpringerLink, Wiley Online Library, and EBSCO databases from 1st January 2013 to 13th November 2023, and 43 articles were included.

RESULTS

These articles mainly divided recognition markers into five categories: gaze behaviors, facial expressions, motor movements, voice features, and task performance. Based on the above markers, the accuracy of artificial intelligence screening ranged from 62.13 to 100%, the sensitivity ranged from 69.67 to 100%, the specificity ranged from 54 to 100%.

CONCLUSION

Therefore, artificial intelligence recognition holds promise as a tool for identifying children with ASD. However, it still needs to continually enhance the screening model and improve accuracy through multimodal screening, thereby facilitating timely intervention and treatment.

The effect of novel Head and Trunk Control Rehabilitation (HATCoRe) device in children with cerebral palsy: Single-Subject multiple baseline protocol

Objective

Head and trunk control is essential for enhancing engagement and participation by improving visual integration, respiration, oromotor skill, arm control, and self-care. Our study protocol aims to investigate the effect of novel Head And Trunk Control Rehabilitation (HATCoRe) device on promoting head and trunk control in children with Cerebral Palsy (CP).

Method

This single subject multiple baseline design trial will include six children with CP aged two to 10 years, exhibiting delayed head and trunk control, having Gross Motor Function Classification System level IV and V will be enrolled. Participants will be randomly assigned to 4-, 6-, or 8-weeks baseline phases followed by 16-week intervention phase with HATCoRe device, for 30-45 min thrice weekly; and follow-up phase of 9 weeks. The study will span for 29 to 33 weeks. An experienced pediatric physiotherapist, blinded to the baseline duration, will assess the outcome measures through 15 to 19 observations. Structured visual analysis will be used supplemented with the celeration line approach to detect statistically significant change.

Impact

HATCoRe device can enable health-care professionals to objectively measure head movement trajectories in children with CP. If proven effective, clinicians may utilize this device to create interactive and child engaging sessions.

Hand preference trajectories as predictors of language outcomes above and beyond SES: Infant patterns explain more variance than toddler patterns at 5 years of age

Prior studies found hand preference trajectories predict preschool language outcomes. However, this approach has been limited to examining bimanual manipulation in toddlers. It is not known whether hand preference during infancy for acquiring objects (i.e., reach-to-grasp) similarly predicts childhood language ability. The current study explored this motor-language developmental cascade in 90 children. Hand preference for acquiring objects was assessed monthly from 6 to 14 months and language skill was assessed at 5 years. Latent class growth analysis identified three infant hand preference classes: left, early right, and late right. Infant hand preference classes predicted 5-year language skills. Children in the left and early right classes, who were categorized as having a consistent hand preference, had higher expressive and receptive language scores relative to children in the inconsistent late right class. Consistent classes did not differ from each other on language outcomes. Infant hand preference patterns explained more variance for expressive and receptive language relative to previously reported toddler hand preference patterns, above and beyond socioeconomic status (SES). Results suggest that hand preference, measured at different time points across development using a trajectory approach, is reliably linked to later language.

Babies in the Corporeal Turn: The Cognitive Embodiment of Early Motor Development and Exploration in the Brazilian Context of Early Childhood Education

The corporeal turn in developmental psychology has rekindled interest regarding how early motor development contributes to and enhances cognitive development across the first years of life. By highlighting embodied perceptual-motor engagement with the world, embodied cognitive learning emphasizes the importance of experience and perceptual-motor mechanisms in modulating the development of person-environment systems. The field currently calls for research that combines such conceptual frameworks with the complex everyday material and sociocultural landscapes that resource infants' developmental trajectories. We, therefore, aim to connect the conceptual refinement of bodily-anchored exploration to the contextual reality of everyday settings of early childhood education (ECE)-here situated in the Brazilian context-as relevant social and cultural suppliers and modulators of the developmental trajectories of babies. Secondarily, we ponder on the premises of national pedagogical curricula and their role in mediating the quality of experiences and systems of person-environment relations more closely. Cultural-historical psychology, in dialogue with the principles of Ecological Psychology, constitutes the theoretical framework that underpins the microgenetic analyses conducted. By analyzing episodes of exploratory actions of a focal baby situated in the ECE context, we seek to apprehend motor-perceptual indicators of embodied cognitive processing by considering the modes of appropriation entailed in episodes of embodied exploration. We reflect on pedagogical implications considering official national documents of early childhood education. This work contributes by providing complementary insights into the nature of infants' everyday sociocultural embodied experiences and their development in pedagogically oriented settings.

E-BabyNet: Enhanced Action Recognition of Infant Reaching in Unconstrained Environments

Machine vision and artificial intelligence hold promise across healthcare applications. In this paper, we focus on the emerging research direction of infant action recognition, and we specifically consider the task of reaching which is an important developmental milestone. We develop E-babyNet, a lightweight yet effective neural-network-based framework for infant action recognition that leverages the spatial and temporal correlation of bounding boxes of infants' hands and objects to reach for to determine the onset and offset of the reaching action. E-babyNet consists of two main layers based on two LSTM and a Bidirectional LSTM (BiLSTM) model, respectively. The first layer provides a pre-evaluation of the reaching action for each hand by providing onset and offset keyframes. Then, the biLSTM model merges the previous outputs to deliver an outcome of the reaching actions detection for each frame including the reaching hand. We evaluated our approach against four other lightweight structures using a dataset comprising 5,865 annotated images resulting in 16,337 bounding boxes from 375 distinctive infant reaching actions performed while sitting by different subjects in unconstrained (home/clinic) environments. Results illustrate the effectiveness of our approach and ability to provide reliable reaching action detection and offer onset and offset keyframes with a precision of one frame. Moreover, the biLSTM layer can handle the transition between reaching actions and help reduce false detections.

Western, Healthful, and Low-Preparation Diet Patterns in Preschoolers of the STRONG Kids2 Program

OBJECTIVE

Identify and describe diet patterns of children during early childhood using confirmatory factor analysis (CFA).

DESIGN

Longitudinal data were drawn from the STRONG Kids 2 program.

PARTICIPANTS

Mothers were surveyed about their child's diet at 24 (n = 337), 36 (n = 317), and 48 (n = 289) months old.

VARIABLES MEASURED

The Block Food Frequency Questionnaire for children aged 2-7 years was used to derive diet patterns; 23 food groups were created for analyses.

ANALYSIS

Principal component analysis was used to obtain preliminary factor loadings, and loadings were used to form a priori hypotheses for CFA-derived diet patterns. Independent samples t tests were used to compare food groups, nutrient intakes, and child and family characteristics by CFA pattern scores above vs at/below the median.

RESULTS

Three diet patterns consistently emerged: (1) processed meats, sweets, and fried foods; (2) vegetables, legumes, and starchy vegetables; and (3) grains, nuts/seeds, and condiments (only 24 and 36 months). Patterns were related to differences in added sugars, dietary fiber and potassium intakes, maternal education, and household income.

CONCLUSIONS AND IMPLICATIONS

Opposing healthful vs Western patterns, extant in child and adult literature, were observed across all ages. The third pattern differed between 24/36 and 48 months, representing a potential shift in food choices or offerings as children age.

Controlling the input: How one-year-old infants sustain visual attention

Traditionally, the exogenous control of gaze by external saliencies and the endogenous control of gaze by knowledge and context have been viewed as competing systems, with late infancy seen as a period of strengthening top-down control over the vagaries of the input. Here we found that one-year-old infants control sustained attention through head movements that increase the visibility of the attended object. Freely moving one-year-old infants (n = 45) wore head-mounted eye trackers and head motion sensors while exploring sets of toys of the same physical size. The visual size of the objects, a well-documented salience, varied naturally with the infant's moment-to-moment posture and head movements. Sustained attention to an object was characterized by the tight control of head movements that created and then stabilized a visual size advantage for the attended object for sustained attention. The findings show collaboration between exogenous and endogenous attentional systems and suggest new hypotheses about the development of sustained visual attention.

Visuomotor tracking strategies in children: associations with neurodevelopmental symptoms

Children with neurodevelopmental disorders (NDDs) often display motor problems that may impact their daily lives. Studying specific motor characteristics related to spatiotemporal control may inform us about the mechanisms underlying their challenges. Fifty-eight children with varying neurodevelopmental symptoms load (median age: 5.6 years, range: 2.7-12.5 years) performed an interactive tablet-based tracking task. By investigating digit touch errors relative to the target's movement direction, we found that a load of neurodevelopmental symptoms was associated with reduced performance in the tracking of abrupt alternating directions (zigzag) and overshooting the target. In contrast, reduced performance in children without neurodevelopmental symptoms was associated with lagging behind the target. Neurodevelopmental symptom load was also associated with reduced flexibility in correcting for lateral deviations in smooth tracking (spiral). Our findings suggest that neurodevelopmental symptoms are associated with difficulties in motor regulation related to inhibitory control and reduced flexibility, impacting motor control in NDDs.

Relationship between trunk control and gross motor development of infants in the first year of life: A systematic review

OBJECTIVE

to verify the relationship between the level of trunk control and the acquisition of gross motor skills in the first year of life.

METHODS

a searching strategy was developed using the PICO tool and performed in the databases PubMed, Cochrane Library, Virtual Library in Health, Embase, and Scopus, from September 2020 to July 2022. The methodological quality of the articles was evaluated by the Ottawa Quality Assessment Scale Cohort Studies (NOS).

RESULTS

six studies that evaluated the level of trunk control and gross motor development in infants aged 4 to 12 months were found. Four studies evaluated full-term infants, and only two studies evaluated preterm infants comparing them to full-term ones. Five studies showed high methodological quality and one study, low methodological quality. Most studies found significant correlation between the levels of segmental trunk control (static, active, and reactive), by the Segmental Assessment Trunk Control (SATCo), and gross motor development (prone, supine, sitting, standing, and walking) by the Alberta Infant Motor Scale (AIMS).

CONCLUSION

trunk control is directly related to gross motor development in different postures in infants between 7 and 12 months.

A position statement on the post gene-therapy rehabilitation of aromatic I-amino acid decarboxylase deficiency patients

Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare genetic disorder of monoamine neurotransmitter synthesis that presents with a range of symptoms, including motor dysfunction and limited attainment of developmental motor milestones. The approval of eladocagene exuparvovec, a gene therapy for AADC deficiency with demonstrated efficacy for motor improvements, now expands the range of motor outcomes possible for patients with this disorder. However, recommendations and guidelines for therapy following treatment with gene therapy are lacking. To ensure patients can reach their full potential following treatment with gene therapy, it is essential they receive rehabilitation therapies designed specifically with their impairments and goals in mind. Therefore, we highlight specific rehabilitative needs of patients following gene therapy and propose a set of recommendations for the post-treatment period based on collective experiences of therapists, physicians, and caregivers treating and caring for patients with AADC deficiency who have been treated with gene therapy. These recommendations include a focus on periods of intensive therapy, facilitating active movements, training for functional abilities, cognitive and communication training, parent/caregiver empowerment, collaboration between therapists and caregivers to develop in-home programs, and the incorporation of supplemental forms of therapy that patients and their families may find more enjoyable and engaging. Many of these rehabilitative strategies may be employed prior to gene therapy. However, these recommendations will be valuable for therapists, caregivers, and wider treatment teams as they prepare for the post-treatment journey with these patients. Furthermore, the considerations and recommendations presented here may prove beneficial outside the AADC deficiency community as gene therapies and other treatments are developed and approved for other rare diseases.

Difficulties in social cognitive functioning among pediatric patients with muscular dystrophies

Introduction

Pediatric muscular dystrophies (MDs) are a heterogeneous group of rare neuromuscular diseases characterized by progressive muscle degeneration. A neuropsychosocial approach is crucial for these patients due to associated cognitive, behavioral, and psychiatric comorbidities; however, the social cognitive domain has not been adequately addressed.

Methods

This study aimed to analyze on social cognition performance in a pediatric MD patient cohort. This cross-sectional study included 32 pediatric patients with MD and 32 matched-healthy controls. The Social Perception Domain of the NEPSY-II, the Reading the Mind in the Eyes Test-Child and Happé's Strange Stories Test were administered. General intelligence and behavioral and emotional symptoms were controlled for to eliminate covariables' possible influence. The assessments were performed remotely.

Results

Children with MDs performed significantly worse on most of the social cognition tasks. The differences found between the groups could be explained by the level of general intelligence for some aspects more related to theory of mind (ToM) (TM NEPSY-II: F = 1.703, p = .197; Verbal task: F = 2.411, p = .125; RMET-C: F = 2.899, p = .094), but not for emotion recognition. Furthermore, these differences were also independent of behavioral and emotional symptoms.

Discussion

In conclusion, social cognition is apparently impaired in pediatric patients with MD, both for emotion recognition and ToM. Screening assessment in social cognition should be considered to promote early interventions aimed at improving these patient's quality of life.

Development of postural-motor, coordination, and reflex functions in children in the first year of life

OBJECTIVE

Aim: This paper discusses the development of postural-motor, coordination, and reflex functions in children during their first year of life. It proceeds in an orderly manner in stages in which the child actively acquires new psychomotor skills (developmental milestones). These milestones are permanent and have a lifelong impact on health and fitness..

PATIENTS AND METHODS

Materials and Methods: An analysis of data from literary sources on child development in the first year of life was carried out. The review was based on the PubMed online database using keywords related to child development in the first year of life, childcare principles, and infant rehabilitation. The discussion follows an orderly progression through stages where children actively acquire new psychomotor skills, known as developmental milestones. Attention has been paid to the balance organ, which plays a significant role in the development of brain coordination and the disappearance of primitive reflexes. The analysis revealed that the development of postural-motor, coordination, and reflex functions follows a predictable pattern. Key developmental milestones include the gradual disappearance of primitive reflexes and the acquisition of new motor skills. The balance organ plays a crucial role in brain coordination and motor development.

CONCLUSION

Conclusions: Monitoring child development in the first year of life by specialists and guidance for caregivers is important to ensure optimal life-long physical and mental development. The dexterity and physique of an adult result from the harmonious course of development during the first year of life.

Neural networks need real-world behavior

Bowers et al. propose to use controlled behavioral experiments when evaluating deep neural networks as models of biological vision. We agree with the sentiment and draw parallels to the notion that "neuroscience needs behavior." As a promising path forward, we suggest complementing image recognition tasks with increasingly realistic and well-controlled task environments that engage real-world object recognition behavior.

Bursting with Potential: How Sensorimotor Beta Bursts Develop from Infancy to Adulthood

Beta activity is thought to play a critical role in sensorimotor processes. However, little is known about how activity in this frequency band develops. Here, we investigated the developmental trajectory of sensorimotor beta activity from infancy to adulthood. We recorded EEG from 9-month-old, 12-month-old, and adult humans (male and female) while they observed and executed grasping movements. We analyzed "beta burst" activity using a novel method that combines time-frequency decomposition and principal component analysis. We then examined the changes in burst rate and waveform motifs along the selected principal components. Our results reveal systematic changes in beta activity during action execution across development. We found a decrease in beta burst rate during movement execution in all age groups, with the greatest decrease observed in adults. Additionally, we identified three principal components that defined waveform motifs that systematically changed throughout the trial. We found that bursts with waveform shapes closer to the median waveform were not rate-modulated, whereas those with waveform shapes further from the median were differentially rate-modulated. Interestingly, the decrease in the rate of certain burst motifs occurred earlier during movement and was more lateralized in adults than in infants, suggesting that the rate modulation of specific types of beta bursts becomes increasingly refined with age.SIGNIFICANCE STATEMENT We demonstrate that, like in adults, sensorimotor beta activity in infants during reaching and grasping movements occurs in bursts, not oscillations like thought traditionally. Furthermore, different beta waveform shapes were differentially modulated with age, including more lateralization in adults. Aberrant beta activity characterizes various developmental disorders and motor difficulties linked to early brain injury, so looking at burst waveform shape could provide more sensitivity for early identification and treatment of affected individuals before any behavioral symptoms emerge. More generally, comparison of beta burst activity in typical versus atypical motor development will also be instrumental in teasing apart the mechanistic functional roles of different types of beta bursts.

The construct validity and reliability of the Motor Development List for the assessment of motor skills in children with profound intellectual and multiple disabilities: The next step?

BACKGROUND

There are no psychometrically validated instruments available to measure motor skills of children with profound intellectual and multiple disabilities (PIMD). In this study, the construct validity and reliability (Rho) of the Motor Development List for children with PIMD (MDL-PIMD), a proxy-reported measure, was investigated.

METHODS

The MDL-PIMD was filled in by parents of 52 children with PIMD every six months over a period of two years. The items of the original MDL were categorised into subscales. A Mokken scale analysis for polytomous items was conducted for five subscales (Posture, Locomotion, Reaching, Grabbing and Facial Actions).

RESULTS

Several items were deleted to improve scalability. All scales showed good scalability (range scale H .66-.78) and reliability (range Rho .92-.98).

CONCLUSIONS

The MDL-PIMD seems to be a valid and reliable instrument for assessing the motor skills of children with PIMD, although more research is needed to confirm the factorial structure.

Gross motor trajectories of pre-term and full-term infants under different parental educational approaches

This study aimed to explore motor trajectories of Brazilian pre-term and full-term infants from 3 to 12 months old whose parents participated in an educational program and had received guidance on gross motor development. Forty-eight Brazilian infants aged 3 months old were divided into Group 1 (full-term infants and their parents who received only verbal guidance, n = 14), Group 2 (full-term infants with parents who received an educative folder in addition to the same verbal guidance, n = 23), and Group 3 (preterm infants with parents who received the same verbal guidance and educative folder, n = 11). The folder had similar information to the verbal guidance; nonetheless, it helped to teach parents and allowed later consultation at home. We applied Alberta Infant Motor Scale, Affordances in Home Environment for Motor Development-Infant Scale, and a questionnaire about infants' information at 3-, 6-, 9-, and 12-months old. In longitudinal comparison, all groups showed a significant difference for AIMS variables on total score and subscales; all subitems of AHEMD-IS; and time spent in prone, supine, sitting, and standing positions. In general, no differences were found between groups. Motor trajectory, home opportunities, and parental positioning practices were similar between full-term and preterm infants with different guidance approaches.

How babies use their hands to learn about objects: Exploration, reach-to-grasp, manipulation, and tool use

Object play is essential for infant learning, and infants spend most of their day with objects. Young infants learn about objects and their properties through multimodal exploration facilitated by caregivers. They figure out how to transport their hands to where objects are, and how to grasp objects in increasingly complex ways. Building on earlier experiences, they learn how to use their hands collaboratively to act on objects, and how to use objects to act on other objects in instrumental ways. These changes in how infants use their hands occur during the most rapid period of motor development and may have important downstream implications for other domains. Recent research findings have established the importance of effective fine motor skills for later academic skills, yet our understanding of the factors that influence the early development of hand skills is sparse at best. Latest research on reaching, grasping, object manipulation, hands collaboration, and tool use is reviewed and connections among these developments are explained from the perspective of developmental cascades. This article is categorized under: Psychology > Motor Skill and Performance Psychology > Development and Aging.

Gut Microbiome Dysbiosis as a Potential Risk Factor for Idiopathic Toe-Walking in Children: A Review

Idiopathic toe walking (ITW) occurs in about 5% of children. Orthopedic treatment of ITW is complicated by the lack of a known etiology. Only half of the conservative and surgical methods of treatment give a stable positive result of normalizing gait. Available data indicate that the disease is heterogeneous and multifactorial. Recently, some children with ITW have been found to have genetic variants of mutations that can lead to the development of toe walking. At the same time, some children show sensorimotor impairment, but these studies are very limited. Sensorimotor dysfunction could potentially arise from an imbalanced production of neurotransmitters that play a crucial role in motor control. Using the data obtained in the studies of several pathologies manifested by the association of sensory-motor dysfunction and intestinal dysbiosis, we attempt to substantiate the notion that malfunction of neurotransmitter production is caused by the imbalance of gut microbiota metabolites as a result of dysbiosis. This review delves into the exciting possibility of a connection between variations in the microbiome and ITW. The purpose of this review is to establish a strong theoretical foundation and highlight the benefits of further exploring the possible connection between alterations in the microbiome and TW for further studies of ITW etiology.

Validation of remote assessment of preschool children's anthropometrics and motor skills

Introduction

Remotely delivered treatment and research procedures were rapidly adopted in response to the COVID-19 pandemic. However, it is unclear if these measures are valid. The purpose of this study was to compare the validity of anthropometry and motor skill proficiency measurements collected in a remote-setting to in-person setting among a sample of children ages 3-4 years.

Methods

Child anthropometry and motor skill performance were measured in-person by trained assessors and by parents at home with remote supervision via videoconference by trained assessors. The following measures from the National Institutes of Health Toolbox were collected: anthropometry (height and weight), manual dexterity/manipulation (9-hole pegboard), motor coordination and agility (supine timed up and go), lower body strength (standing long jump), and postural stability (one-leg standing balance). Differences in expert and parent-based measurements were assessed using Bland-Altman plots, paired samples t-tests, and Pearson correlations.

Results

A total of n = 14 children completed the assessments. No significant differences were observed between measurement locations for weight and motor skills (p > .05). Remote measurement of height (M = 101.1 cm, SD = 5.40) was significantly greater than in-person measurements (M = 98.2 cm, SD = 5.16); p < .0001.

Discussion

Remote measurements of motor skills and weight are valid assessments for researchers and clinicians to utilize in young children. Remote assessment with guidance offers comparable and valid estimates as in-person assessment, potentially offering a solution to resource-constricted barriers in research and access to care. There is an opportunity for researchers to fine-tune remote height and individual-level assessment strategies.

Case report: An evaluation of early motor skills in an infant later diagnosed with autism

Researchers and clinicians are increasingly interested in understanding the etiology of autism spectrum disorder (ASD) and identifying behaviors that can provide opportunities for earlier detection and therefore earlier onset of intervention activities. One promising avenue of research lies in the early development of motor skills. The present study compares the motor and object exploration behaviors of an infant later diagnosed with ASD (T.I.) with the same skills in a control infant (C.I.). There were notable difference in fine motor skills by just 3 months of age, one of the earliest fine motor differences reported in the literature. In line with previous findings, T.I. and C.I. demonstrated different patterns of visual attention as early as 2.5 months of age. At later visits to the lab, T.I. engaged in unique problem-solving behaviors not demonstrated by the experimenter (i.e., emulation). Overall, findings suggest that infants later diagnosed with ASD may show differences in fine motor skills and visual attention to objects from the first months of life.

The fundamental need for unifying phenotypes in sudden unexpected pediatric deaths

A definitive, authoritative approach to evaluate the causes of unexpected, and ultimately unexplained, pediatric deaths remains elusive, relegating final conclusions to diagnoses of exclusion in the vast majority of cases. Research into unexplained pediatric deaths has focused primarily on sudden infant deaths (under 1 year of age) and led to the identification of several potential, albeit incompletely understood, contributory factors: nonspecific pathology findings, associations with sleep position and environment that may not be uniformly relevant, and the elucidation of a role for serotonin that is practically difficult to estimate in any individual case. Any assessment of progress in this field must also acknowledge the failure of current approaches to substantially decrease mortality rates in decades. Furthermore, potential commonalities with pediatric deaths across a broader age spectrum have not been widely considered. Recent epilepsy-related observations and genetic findings, identified post-mortem in both infants and children who died suddenly and unexpectedly, suggest a role for more intense and specific phenotyping efforts as well as an expanded role for genetic and genomic evaluation. We therefore present a new approach to reframe the phenotype in sudden unexplained deaths in the pediatric age range, collapsing many distinctions based on arbitrary factors (such as age) that have previously guided research in this area, and discuss its implications for the future of postmortem investigation.

Case report: training neck and head control in children with chronic paralysis due to acute flaccid myelitis

Background

Acute flaccid myelitis (AFM) occurs rarely in children and adolescents when damage to spinal motor neurons rapidly causes flaccid paralysis of limb, trunk, and neck muscles and potentially respiratory failure. When neck muscles are weakened or paralyzed, a child loses head control, severely compromising engagement with their environment. Compensation for lack of head control is achieved with external support devices attached to a wheelchair, but there is no indication in the AFM literature of therapeutic efforts to restore head control. In this case series, we explore the possibility of the recovery of head control when children with AFM received activity-based restorative therapies (ABRTs) guided by principles targeting motor control.

Case description

Three children, two male and one female, aged 6, 9, and 7, with a history of AFM-onset at 5, 7, and 4 years respectively, enrolled in an activity-based restorative therapies outpatient program targeting activation of the neuromuscular system below the lesion. Each of them lacked head control, was either ventilator-dependent or had a tracheostomy, and was a power wheelchair user via hand/foot control.

Methods

Activity-based restorative therapies were provided 5 days/week: 1.5 h of activity-based locomotor training and 1.5 h of activity-based neuromuscular electrical stimulation.

Results

An approach to addressing head/neck control developed iteratively across disciplines, from complete compensation with passive external head support to emerging head control during diverse tasks, e.g., sitting, reaching, driving a power chair, sit-to-stand, standing, stepping on a treadmill, and walking. Key principles identified and employed were (a) passive facilitation, (b) external head support, (c) posterior head support, (d) graded manual facilitation, and (e) independent head control.

Discussion

The recovery of head control in children with paralysis due to AFM may be accelerated when executing a step-wise progression to effectively target and challenge head control in parallel with activity-based restorative therapies. In treating three children with a chronic lack of head control, a therapeutic strategy was iteratively developed guided by scientific principles, e.g., segmental assessment of control, to promote recovery of head control. While this strategy is encouraging, gaps in sensitive and responsive measurement instruments and treatment technologies persist in guiding assistance, challenging, and promoting independent head control.

In utero arsenic exposure and early childhood motor development in the New Hampshire Birth Cohort Study

Introduction

High-level prenatal and childhood arsenic (As) exposure characteristic of several regions in Asia (e.g., Bangladesh), may impact motor function. However, the relationship between lower-level arsenic exposure (characteristic of other regions) and motor development is largely unstudied, despite the potential for deficient motor skills in childhood to have adverse long-term consequences. Thus, we sought to investigate the association between prenatal As exposure and motor function among 395 children in the New Hampshire Birth Cohort Study, a rural cohort from northern New England.

Methods

Prenatal exposure was estimated by measuring maternal urine speciated As at 24-28 weeks of gestation using high-performance liquid chromatography (HPLC) inductively coupled plasma mass spectrometry (ICP-MS) and summing inorganic As, monomethylarsonic acid, and dimethylarsinic acid to obtain total urinary As (tAs). Motor function was assessed with the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition (BOT-2) at a mean (SD) age of 5.5 (0.4) years.

Results

Children who completed this exam were largely reported as white race (97%), born to married mothers (86%) with a college degree or higher (67%). The median (IQR) gestational urine tAs concentration was 4.0 (5.0) µg/L. Mean (SD) BOT-2 scores were 48.6 (8.4) for overall motor proficiency and 48.2 (9.6) for fine manual control [standard score = 50 (10)], and were 16.3 (5.1) for fine motor integration and 12.5 (4.1) for fine motor precision [standard score = 15 (5)]. We found evidence of a non-linear dose response relationship and used a change-point model to assess the association of tAs with overall motor proficiency and indices of fine motor integration, fine motor precision, and their composite, fine manual control, adjusted for age and sex. In models adjusted for potential confounders, each doubling of urine tAs decreased overall motor proficiency by -3.3 points (95% CI: -6.1, -0.4) for tAs concentrations greater than the change point of 9.5 µg/L and decreased fine motor integration by -4.3 points (95% CI: -8.0, -0.6) for tAs concentrations greater than the change point of 17.0 µg/L.

Discussion

In summary, we found that levels of prenatal As exposure above an empirically-derived threshold (i.e., the change point) were associated with decrements in childhood motor development in a US population.

Caregiver-reported newborn term and preterm motor abilities: psychometrics of the PediaTracTM Motor domain

BACKGROUND

Approximately 5-10% of children exhibit developmental deviations in motor skills or other domains; however, physicians detect less than one-third of these abnormalities. Systematic tracking and early identification of motor deviations are fundamental for timely intervention.

METHODS

Term and preterm neonates were prospectively assessed at the newborn (NB) period in a study of the psychometric properties of the Motor (MOT) domain of PediaTracTM v3.0, a novel caregiver-based development tracking instrument. Item response theory graded response modeling was used to model item parameters and estimate theta, an index of the latent trait, motor ability. Exploratory factor analysis (EFA) was conducted to examine the dimensionality and factor structure.

RESULTS

In a cohort of 571 caregiver/infant dyads (331 term, 240 preterm), NB MOT domain reliability was high (rho = 0.94). Item discrimination and item difficulty of each of the 15 items could be reliably modeled across the range of motor ability. EFA confirmed that the items constituted a single dimension with second-order factors, accounting for 43.20% of variance.

CONCLUSIONS

The latent trait, motor ability, could be reliably estimated at the NB period.

IMPACT

The caregiver-reported Motor domain of PediaTrac provides a reliable estimate of the latent trait of motor ability during the newborn period. This is the first known caregiver-reported instrument that can assess motor ability in the newborn period with high reliability in term and preterm infants. Item response theory methods were employed that will allow for future characterization of developmental subgroups and motor trajectories. The PediaTrac Motor domain can support early identification of at-risk infants. Including caregivers in digital reporting and child-centered monitoring of motor functioning may improve access to care.

Curcumin-loaded cockle shell-derived calcium carbonate nanoparticles ameliorates lead-induced neurotoxicity in rats via attenuation of oxidative stress

A substantial global health burden is associated with neurotoxicity caused by lead (Pb) exposure and the common mechanism of this toxicity is mainly via oxidative damage. Curcumin has remarkable pharmacological activities but remains clinically constrained due to its poor bioavailability when orally administered. Currently, cockle shell-derived calcium carbonate nanoparticle (CSCaCO3NP) is gaining more acceptance in nanomedicine as a nanocarrier to various therapeutics. This study aimed at investigating the ameliorative effect of curcumin-loaded CSCaCO3NP (Cur-CSCaCO3NP) on lead-induced neurotoxicity in rats. A total of 36 male Sprague-Dawley rats were randomly assigned into five groups. Each group consists of 6 rats apart from the control group which consists of 12 rats. During the 4 weeks induction phase, all rats received a flat dose of 50 mg/kg of lead while the control group received normal saline. The treatment phase lasted for 4 weeks, and all rats received various doses of treatments as follows: group C (Cur 100) received 100 mg/kg of curcumin, group D (Cur-CSCaCO3NP 50) received 50 mg/kg of Cur-CSCaCO3NP, and group E (Cur-CSCaCO3NP 100) received 100 mg/kg of Cur-CSCaCO3NP. The motor function test was carried out using the horizontal bar method. The cerebral and cerebellar oxidative biomarker levels were estimated using ELISA and enzyme assay kits. Lead-administered rats revealed a significant decrease in motor scores and SOD activities with a resultant increase in MDA levels. Furthermore, marked cellular death of the cerebral and cerebellar cortex was observed. Conversely, treatment with Cur-CSCaCO3NP demonstrated enhanced ameliorative effects when compared with free curcumin treatment by significantly reversing the aforementioned alterations caused by lead. Thus, CSCaCO3NP enhanced the efficacy of curcumin by ameliorating the lead-induced neurotoxicity via enhanced attenuation of oxidative stress.

Movement, Play, and Games-An Essay about Youth Sports and Its Benefits for Human Development

The acknowledgment of the qualities and features of the world is made through the body, movement, and imagination. During their development, children learn new skills, complexify their thoughts, and become more autonomous. The progressive increase in motor repertoire in children reflects a more unified and solid self. Nowadays, there is a generalized restriction of the movement of children. It starts at home when parents establish rigid and/or phobic attachments with their children; it can be also observed at school which is more and more based on rigid learning rhythms and obsessive ideas about students' performance, and finally in urban areas where free and outdoor play has considerably decreased during recent decades. The current lifestyles in Western societies resulted in a decrease in play among children. The culture influences the dominant types of psychopathology and, during childhood, mental suffering is often expressed with the increase (turmoil) or decrease (inhibition) of the body movement. Sports are underpinned by movement and play; they are a powerful tool in health promotion and an excellent way to assign meaning to movement. This work is an essay about the importance of play and youth sports in child development.