Relationship between infant neuromotor assessment and preschool motor measures

Evaluation of neuromotor function in infancy-A systematic review of available methods

OBJECTIVE

Neuromotor function in infancy can be evaluated in various ways. Assessment instruments are used for early detection of children with a high risk for developmental disorders. Early detection enables clinicians to provide intervention at a young age when plasticity of the nervous system is high. The assessments may also be used to monitor intervention. The present article will review the psychometric properties of methods to assess neuromotor function in infancy.

METHOD

A literature search was performed in PubMed, Medline, and PsycINFO (1966-2007) on instruments to assess neuromotor functioning of infants.

RESULTS

Fifteen instruments were included and classified into 4 groups: (1) Comprehensive neurological examinations (n = 4). These techniques are widely used, though little is known about their reliability. Their validity in predicting major developmental disorders such as cerebral palsy is good; their predictive validity for minor motor disorders is moderate at best. (2) Procedures with standardized scoring (n = 7). These have good reliability, but only moderate predictive validity for major developmental disorders. No data available for prediction of minor developmental disorders. (3) Observation of milestones (n = 2). Its predictive validity for major developmental disorders is only moderate, whereas reliability is good. (4) Assessment of quality of motor behavior or motor patterns (n = 2). These instruments have the best predictive validity for major and minor developmental motor disorders, but current methods are only useful under the age of 4 months.

CONCLUSION

Prediction of developmental outcome at an early age is difficult. In medical evaluations of high-risk infants, the best predictions are achieved through a combination of multiple, complementary tools, that is, achieved milestones, neurological examination and assessment of the quality of motor behavior.

The Movement Assessment of Infants (MAI) as a predictor of two-year neurodevelopmental outcome for infants born at term who are at social risk

PURPOSE

This prospective longitudinal study was designed to evaluate whether the four-month Movement Assessment of Infants (MAI), predicted two-year cognitive and motor developmental status measured by the Mental (MDI) and Psychomotor (PDI) Scales of the Bayley Scales of Infant Development (BSID).

METHODS

The subjects were 134 infants born at term who were considered at developmental risk due to biological and social risk factors. Different masked examiners assessed the infants at each age.

RESULTS

Infants' average MAI total risk scores (MAI TRS) at four months were negatively correlated with their BSID MDI scores (r = -0.23, p = 0.007) but not PDI scores at two years. Infants classified as high risk on the MAI (TRS >13) were approximately three times more likely than infants with a lower risk MAI classification (TRS < or =13) to have a high-risk MDI (< or =84) classification. Lower MAI risk status at four months was a predictor of cognitive functioning falling within normal limits for age (MDI >84) at two years, with 76% negative and 50% positive predictive values.

CONCLUSION

The MAI appears to be valid for use with infants born at term who are at risk of developmental delay and may be a useful tool to help clinicians make decisions about intervention services.

Posttraumatic recovery of traumatized newborns: effects on neuromotor and cognitive development during their first 6 months

Recovery after perinatal cerebral traumatism was studied in a group of 20 traumatized infants. The effects on the sequence of development during the next 6 months were observed for both motor and cognitive development and were compared with a control group of 20 normal babies. Results showed a significant delay for the abnormal group and a different recovery pattern between these two aspects of development. Motor development reached a normal level at 4 months, whereas cognitive development was still impaired at 6 months. These results were discussed in terms of possibly longer effects of perinatal traumatism on higher cortical functions than on motor functions.