Screening preschool children for fine motor skills: environmental influence

Developmental delay and its associated factors among children of 9 months and of 18 months attending primary health facilities in an urban resettlement area of East Delhi

Background

Early identification of developmental delay in children can help in making early intervention for its management. Routine developmental screening is not being practised in India due to lack of trained field workers, lack of awareness among parents and lack of feasible assessment screening tool. There is lack of studies that focuses on home environment provided to the children as it is associated with developmental delay.

Methods

A cross sectional study was conducted in immunization clinic of two Maternal and Child Welfare (MCW) centres of Nand Nagari, an urban resettlement colony in East Delhi among children of 9 months and 18 months of age. New Delhi Development Status Questionnaire (ND-DSQ) was used for assessment of developmental status. Data on socio-demographic profile, home stimulation of the child and anthropometric measurements including weight, height was collected. Chi-square test was used for univariate analysis and binary logistic regression was used to find out the predictors of developmental delay.

Results

The prevalence of DD was found to be 17.7% in children 9 m of age, and 10% in 18 m. On univariate analysis preterm gestation, low-birth weight of the child, lower mother's education status and presence of complications at birth were significantly associated with developmental delay. The independent predictors of DD were presence of complications at birth, preterm gestation, lower mother's education status and underweight children.

Conclusion

This study reports a higher prevalence of DD. More follow up studies on DD is needed to see the course of achievement of developmental milestones. Screening for developmental milestones can be done during visit for immunization.

Identifying fine motor difficulties in children with acute lymphoblastic leukemia: a scoping review

PURPOSE

Survival rates for children diagnosed with acute lymphoblastic leukemia (ALL) have increased significantly over recent decades, and thus attention shifted toward understanding the adverse effects of cancer treatment. Chemotherapy has side effects that could affect muscle state and diminish motor performance. This scoping review was conducted to map the breadth of evidence for different tools used in fine motor skills assessment, the extent of upper extremity strength, and fine motor performance, highlighting the potential risk factors that may influence these skills.

METHODS

In March 2023, full-text studies that examined fine motor performance and/or upper extremity strength were identified via searches in PubMed, Science Direct, Scopus, Web of Science, and PEDro databases. The titles and abstracts of selected studies were screened according to the inclusion and exclusion criteria.

RESULTS

The search yielded initial 418 citations and 26 peer-reviewed articles were finally included in the review. Considerable heterogeneity was observed regarding the methods of evaluating fine motor skills. The results of this review indicate that children and adolescents with ALL experienced fine motor limitations and upper extremity weakness either during or after cessation of treatment.

CONCLUSION

This scoping review presents a broad overview of the literature addressing fine motor difficulties in the pediatric population with ALL. Results accentuate the need to incorporate strengthening and occupational therapy training to preserve muscle strength and minimize future fine motor problems along the course of chemotherapeutic treatment. Little evidence was reported regarding the risk factors that may impair muscle strength and motor performance.

Family and developmental history of female versus male adolescents with ADHD: diagnosis-specific overlap, few gender/sex differences

Background

Gender and sex differences in the development of children and adolescents are commonly found in the psychiatric examination. Family and developmental history is an important part of the clinical diagnostic interview, the basic examination technique. Attention-deficit/hyperactivity disorder (ADHD) is associated with diagnosis-specific markers in family and development history. However, it is unclear to what extent ADHD-specific signs and narratives differ between females and males. The aim of this study was to assess and to compare the family and developmental history profiles of female versus male adolescents with ADHD.

Methods

Data were collected using the clinical diagnostic interview technique from parents of female and male patients diagnosed with ADHD (ICD-10  F90.0, F90.1 and F98.8) between the ages of 12 and 17  years (n = 92). The two groups were matched in pairs for sex, IQ and ICD-10 diagnosis (F90.0, F90.1 and F98.8). Interview data were operationalized in three categories: 0 - physiological marker, 1 - subclinical marker, 2 - clinical marker. The two groups were compared with two-way ANOVA.

Results

Information about female in comparison to male adolescents were reported in the parental interview with few differences.

Conclusion

Our study suggests that family and developmental history of the neurodevelopmental disorder ADHD is only poorly influenced by gender or sex.

The Relationships between Sibling Characteristics and Motor Performance in 3- to 5-Year-Old Typically Developing Children

Siblings have been hypothesized to positively impact the motor performance of children by acting as examples and by providing a safe environment, but they may also negatively impact motor performance because they could compete for the parent’s time and care. Therefore, this study investigates the relationship between several sibling characteristics and motor performance in 3- to 5-year-old children. The sample consisted of 205 3- to 5-year-old children (mean age 50.9 ± 10.0 months, 52.2% boys). The Movement Assessment Battery for Children-2 was used to measure motor performance. The sibling variable was operationalized as the number of siblings present, the age difference between a child and its siblings, and the birth order position of a child. The confounding variables that were taken into account were the age, sex, and behavioral problems of the child and maternal education level. None of the investigated sibling variables were related to the total motor performance of a child after controlling for possible confounding variables. The absence of any associations between the sibling variables and motor performance might be explained by the characteristics of the study sample, the possibility that there is no linear relationship, or the presence of still unknown moderating or mediating factors.

The Relationship between Social Environmental Factors and Motor Performance in 3- to 12-Year-Old Typically Developing Children: A Systematic Review

Motor performance during childhood is important for prosperity in life, and the social environment may contain potentially important and modifiable factors associated with motor performance. Therefore, the aim of this systematic review was to identify social environmental factors associated with motor performance in 3- to 12-year-old typically developing children. Four electronic databases were searched, which resulted in 31 included studies. The methodological quality was determined using the Quality of Prognosis Studies in Systematic Reviews tool. Most studies were conducted in 3-6-year-old children. In the home environment, parental beliefs in the importance of physical activity and parental behaviors matching these beliefs were related to better motor performance of children, although these relationships were often sex-dependent. The school and sports environments were investigated much less, but some preliminary evidence was found that being better liked by peers, attending a classroom with a smaller age range, having more interaction with the teacher and classmates, and having a higher educated teacher was related to better motor performance. Further research is required to further unravel the relationship between the social environment and motor skills, with a specific focus on 6-12-year-old children and environments outside of the home environment.

Validating the Neurodevelopmental Domain of Neurodevelopmental Ecological Screening Tool: An Ecological Screener for Use With 3-5 Year-Old Children Impacted by Poverty and Homelessness

The Neurodevelopmental Ecological Screening Tool (NEST) is a new instrument to screen children for developmental challenges. This article describes the validation of the NEST neurodevelopmental domain. Data were collected from a nationwide purposely restricted sample of caregivers of children aged 3–5 years ( n = 231) living in poverty and experiencing homelessness. We used Rasch-based Rating Scale Models to select items with good fit. Cronbach’s alpha was used to measure the internal consistency validity of the entire neurodevelopmental domain. Construct validity and dimensional structure were obtained using confirmatory factor analysis. Interclass correlations were used to measure the test–retest reliability of the subdomains. Neurodevelopmental Ecological Screening Tool scores were compared to results on clinician-administered gold standard measures for a subsample ( n = 48). The neurodevelopmental domain score represents a single overarching risk construct with some variance attributable to distinct developmental constructs and validly and reliably identifies a child’s level of developmental risk.

Prevalence and risk factors of pre-schoolers' fine motor delay within vulnerable Australian communities

AIM

This study examined the prevalence and risk factors of fine motor delay in Australian pre-school children from low-income communities.

METHODS

Children from the Early Start Baseline Study completed the Ages and Stages Questionnaire (3rd edn.). Age, sex, executive function and family characteristics were assessed and associations with fine motor skills analysed.

RESULTS

Data were available for 700 children (M_age 54.0 ± 8.6 months, 53.1% boys) of which 77.4% were typically developing, 12.1% at risk and 10.4% delayed for fine motor skill. Children had higher odds of being delayed if they were male (odds ratio (OR) 3.30, 95% confidence interval (CI) 2.22-4.90) or indigenous (OR 3.31, 95% CI 2.12-5.16) and had lower self-regulatory (OR 2.17, 95% CI 1.31-3.58). Higher vocabulary (OR 0.92, 95% CI 0.89-0.94), higher family income (OR 0.22, 95% CI 0.05-0.90) and family education (OR 0.25, 95% CI 0.08-0.74) were associated with lower odds of delay.

CONCLUSION

Almost one in four children from vulnerable communities experience fine motor difficulties, highlighting the importance of early screening and targeting key child and environmental risk factors.

The effects of touch-screen technology usage on hand skills among preschool children: a case-control study

Background: Little is known on how time spent on touch-screen technology affects the hand skills development of preschool children. This study aimed to investigate the effects of touch-screen technology usage on hand skills among preschool children.

Methods: Case-control design was employed to compare the hand skills of children who were engaged in touch-screen technology. A total of 128 participants aged between five and six years old who attended preschool were recruited and divided into two groups: high usage touch-screen technology (HUTSTG) and, low usage touch-screen technology (LUTSTG). Children's Hand Skills ability Questionnaire (CHSQ) and Assessment of Children's Hand Skills (ACHS) were used to evaluate the children's hand skills.

Results: There were significant differences in the hand skills of preschool children between HUTSTG and LUTSTG. Results showed that preschool children in LUTSTG had better hand skills in all domains of CHSQ (p≤0.001) and ACHS (p<0.001) as compared to HUTSTG.

Conclusion: Frequent use of touch-screen technology might cause disadvantages to the development of hand skills among preschool children.

Socioeconomic Status and Child Developmental Delay: A Prospective Cohort Study

Background: Children with developmental delays are at higher risk of poor health, and lower educational attainment and wellbeing than the normal ones. Objectives: As previous studies had contradictory results regarding the association between socioeconomic status (SES) and child development, the current study aimed at determining this association at the age of 60 months. Methods: The current prospective cohort study was conducted in Shiraz, Iran, from summer 2011 to the end of 2016. The study was conducted on 640 mothers registered in the Fars Birth Cohort study. A checklist comprised of social and economic parts was employed. The children’s communication development was also assessed using the ages and stages questionnaire for 60-month-old children. In addition, SES was determined using 25 variables. Data analysis was performed using SPSS version 19.0 and partitioning around medoid (PAM) clustering in R 3.5.0 software; P value < 0.05 was considered as the level of significance. Results: The majority of the subjects (79.1%) were categorized as the moderate level of SES; 106 (16.56%) children had a delay in at least one developmental domain. The current study results showed that the education level of parents and the occupational status of mothers were significantly associated with delayed communication skills in children (P < 0.05). Delay in communication skills was significantly more prevalent among children whose parents had a low education level (P < 0.05). After controlling other confounders, the relative risk of delay in communication skills was 3.7 times higher among children in the moderate level of SES and almost 10 times higher among the ones in the low level of SES. Conclusions: Children brought up in families with low SES had the highest level of delay in communication skills, followed by the ones in families with moderate SES. Considering the importance of communication skills in children socialization, more attention should be paid to SES of the families with preschool kids. It seems quite reasonable if health policymakers put more emphasis on the communication skills of preschool children.

A comparison of child development, growth and illness in home-care and day-care center settings

Purpose

Childcare is an essential part of early life environment that has a significant influence on lifelong physical and mental health. This study aimed to examine the relationship between development, growth and frequency of illness in different types of care.

Design/methodology/approach

This cross-sectional study recruited 177 children aged 30–36 months and their caregivers. Of these 66 were being cared for at home and 111 were attending out-of-home day-care facilities. An interview form, growth measurement and the Denver Developmental Screening Test II were collected. The association between child developmental, growth and illness variables was analyzed with Chi-square, Fisher's exact and Mann–Whitney U tests.

Findings

This study found that the development and growth results did not show statistically significant differences between the home-care and day-care groups. The number of minor illnesses was significantly lower in home-care children than in day-care children (OR = 0.33, 95% CI = 0.15-0.72).

Research limitations/implications

This study indicated that the risk of infection is increased in the children attending day care. Provision of a healthy and safe childcare environment needs to be an essential health promotion strategy to improve family and child well-being.

Originality/value

As the number of women's participation in the labor market has increased rapidly over the past decades, so did the number of children in nonparental care. The study findings reflect that the development of a day-care center for children was unclear, whereas the risk of infection was increased. Therefore, provision of a healthy and safe childcare environment needs to be an essential health promotion strategy to improve family and child well-being.

Establishing normative data for the Functional Dexterity Test in typically developing children aged 3-5 years

STUDY DESIGN

Cross-sectional.

INTRODUCTION

The Functional Dexterity Test (FDT) is a timed pegboard hand dexterity test. Normative data have been developed primarily in adults with some studies in the pediatric population. The present study will complement the existing pediatric data and make the FDT a stronger assessment for use in this population.

PURPOSE OF THE STUDY

The primary aim of this study was to collect normative data in typically developing children aged 3-5 years in the Greater Montreal area; the secondary aim was to evaluate the intrarater and interrater reliabilities of the FDT.

METHODS

The FDT was administered to typically developing children aged 3-5 years, who were recruited from various geographical locations and socioeconomic status levels across the Greater Montreal area. Descriptive statistics, t-tests, and analysis of variance were used to compare age-gender groups. The intraclass correlation coefficient (ICC) was calculated to determine intrarater and interrater reliabilities.

RESULTS

Normative data were collected from 267 children (137 females) from 18 daycares. Statistically significant differences in FDT scores were found across all age bands (P < .01). Total time decreased with increasing age (P < .01). No significant differences were found between genders. The FDT showed excellent interrater (ICC = 0.89-0.98) and intrarater (ICC = 0.83-0.99) reliabilities.

CONCLUSIONS

The clear and standardized pediatric instructions, scoring sheet, and normative data table developed in this study provide health care professionals with quick and easy tools to facilitate scoring and clinical interpretation of hand dexterity in preschool-aged children. Future studies should include school-aged children and adolescents from a larger geographic area.

Avaliação do desenvolvimento motor infantil e sua associação com a vulnerabilidade social

RESUMO O objetivo deste estudo foi avaliar o desenvolvimento motor de crianças de quatro a 17 meses e investigar sua associação com fatores de risco sociodemográficos. Estudo transversal, descritivo, composto por crianças de quatro a 17 meses provenientes da unidade de internação pediátrica de um hospital público de Porto Alegre (RS), clinicamente estáveis e com alta breve prevista. Para a avaliação dos fatores de risco sociodemográficos foi utilizado um questionário elaborado pelas pesquisadoras, que abordou fatores biológicos, sociais e ambientais. Para a avaliação do desenvolvimento motor foi utilizada a Alberta Infant Motor Scale na versão traduzida, adaptada e validada para a população brasileira. Para a análise estatística foi utilizado o teste t de Student e o teste qui-quadrado, com nível de significância de 5% (p≤0,05). De um total de 110 crianças avaliadas, o desempenho motor se mostrou aquém do esperado em mais da metade delas (63,6%, n=70). Houve associação estatisticamente significativa entre o desenvolvimento motor e vacinas atrasadas (p=0,005), convivência com tabagistas em casa (p=0,047) e recebimento de benefício socioeconômico (p=0,036). Conclui-se que esses fatores sociais podem estar associados a fatores de risco ao desenvolvimento motor de crianças de quatro a 17 meses.

Assessment of risk factors for developmental delays among children in a rural community of North India: A cross-sectional study

BACKGROUND

Initial formative years in every children's life are critical for their optimal development, as these frame the foundation of future well-being. With a varied prevalence of developmental delays (DDs) in the world and most of the studies representing the hospital-based data. The present study was aimed to find the prevalence and risk factors for DDs (domain wise) in children aged 2 months to 6 years in the rural area of North India.

METHODS

This was a cross-sectional study in which a multistage random sampling technique was used. From 30 Anganwadi centers, 450 children aged 2 months-6 years were taken in the study. Rashtriya Bal Swasthya Karyakram screening tool developed by the Ministry of Health and Family Welfare, India, was used for developmental screening. Binary logistic regression analysis was done to identify the predictors for DDs (domain wise).

RESULTS

Seventy-three (16.2%) children were found to have DDs and 60 (13.3%) children had the global DDs. About 84/421 (20.0%) children had cognitive delay, followed by 43/450 (9.6%) children who had delay in speech and language area. About 17/190 (8.9%) children had social delay while 26/407 (6.4%) children had hearing and vision impairment. Gross motor delay was seen in 24/450 (5.3%) children and 16/300 (5.3%) children had fine motor delay. Gestational age (adjusted odds ratio [AOR] - 13.30), complications during delivery (AOR - 25.79), meconium aspiration (AOR - 12.81), and child never breastfed (AOR - 8.34) were strong predictors for the delay in different domains of developmental milestones.

CONCLUSION

Socio-economic, ante-natal, natal and post-natal factors should be considered for prompt identification and initiation of intervention for DDs.

RECOMMENDATION

There is a need for increasing awareness and knowledge of parents regarding the achievement of developmental milestones according to the age. A multipronged approach to the holistic treatment of developmentally delayed children for early intervention is required.

Prenatal and childhood exposure to phthalates and motor skills at age 11 years

BACKGROUND

Previous reports suggest that prenatal phthalate exposure is associated with lower scores on measures of motor skills in infants and toddlers. Whether these associations persist into later childhood or preadolescence has not been studied.

METHODS

In a follow up study of 209 inner-city mothers and their children the concentrations of mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBzP), monoisobutyl phthalate (MiBP), monomethyl phthalate (MEP), mono-carboxy-isooctyl phthalate (MCOP), and four di-2-ethylhexyl phthalate metabolites (ΣDEHP) were measured in spot urine sample collected from the women in late pregnancy and from their children at ages 3, 5, and 7 years. The Bruininks-Oseretsky Test of Motor Proficiency short form (BOT-2) was administered at child age 11 to assess gross and fine motor skills.

RESULTS

The total number of children included in the study was 209. Of the 209 children, 116(55.5%) were girls and 93 were (45%) boys. Among girls, prenatal MnBP(b=-2.09; 95%CI: [-3.43, -0.75]), MBzP (b=-1.14; [95%CI: -2.13, -0.14]), and MiBP(b=-1.36; 95%CI: [-2.51, -0.21] and MEP(b=-1.23 [95%CI: -2.36, -0.11]) were associated with lower total BOT-2 composite score. MnBP (b= -1.43; 95% CI: [-2.44, -0.42]) was associated with lower fine motor scores and MiBP(b = -0.56; 95% CI: [-1.12, -0.01]) and MEP (b = -0.60; 95% CI: [-1.14, -0.06])was associated with lower gross motor scores. Among boys, prenatal MBzP (b = -0.79; 95% CI: [-1.40, -0.19]) was associated with lower fine motor composite score. The associations between MEP measured at age 3 and the BOT-2 gross motor, fine motor and total motor score differed by sex. In boys, there was an inverse association between ΣDEHP metabolites measured in childhood at ages 3 (b = -1.30; 95% CI: [-2.34, -0.26]) and 7 years (b = -0.96; 95% CI: [-1.79, -0.13]), and BOT-2 fine motor composite scores.

CONCLUSIONS

Higher prenatal exposure to specific phthalates was associated with lower motor function among 11- year old girls while higher postnatal exposure to ΣDEHP metabolites was associated with lower scores among boys. As lower scores on measures of motor development have been associated with more problems in cognitive, socioemotional functioning and behavior, the findings of this study have implications related to overall child development.

Maternal intelligence quotient and motor development in early childhood: The mediating role of mother's education

AIM

To examine the association between maternal intelligence quotient (IQ) and early childhood motor development and whether maternal education mediates this relationship.

METHODS

Data were collected prospectively in the Ma'anshan Birth Cohort study. Maternal IQ was assessed using the Wechsler Adult Intelligence Scale-Revised by China (WAIS-RC). Information on baseline characteristics and maternal education was obtained from questionnaires and medical records. The study outcome was motor development evaluated at 18 months by the Third Edition of Ages and Stages Questionnaire. Logistic regression analyses and mediation analyses were used.

RESULTS

Of 2739 valid subjects (84% follow-up), the rate of developmental delay was 3.1% in the gross motor domain and 6.2% in the fine motor domain. The mean value for maternal IQ was 96.2 (standard deviation 10.6). About 40.3% of the mothers had secondary education or less, while 59.7% had a college education. Mothers with higher IQ had a significantly higher educational level and had children with better motor development. Maternal education significantly mediated the association between maternal IQ and fine motor development. There was a direct effect of maternal IQ on gross motor development, but the mediation effect of maternal education was not found.

CONCLUSIONS

Maternal IQ was associated with motor development. Maternal education played an important role in reducing the disparities in fine motor development among children of different maternal IQs.

Avaliação do crescimento e desenvolvimento infantil na consulta de enfermagem

Objetivo: Analizar la evaluación del crecimiento y desarrollo infantil en la consulta de enfermería.Metodología: Estudio descriptivo con enfoque cualitativo. Los participantes del estudio fueron cuatro enfermeros que realizaban la consulta de enfermería a los niños de manera programática en unidades de salud de familia en Cuiabá, Mato Grosso, Brasil. La recolección de los datos se llevó a cabo mediante la observación participante de 21 consultas de enfermería entre enero y febrero de 2012. Los datos se analizaron con la técnica de análisis de contenido.Resultados: A partir del análisis de los datos, surgieron las siguientes dos categorías: Evaluación del crecimiento infantil en la consulta de enfermería y Evaluación del desarrollo infantil en la consulta de enfermería. Los enfermeros evaluaron el crecimiento infantil en todas las consultas, utilizando las curvas contenidas en la libreta personal de registro médico del niño. Sin embargo, el desarrollo infantil sólo fue evaluado parcialmente en la mayoría de las consultas observadas.Conclusión: Entre los aspectos más significativos de las consultas de enfermería se destacan la evaluación del crecimiento y desarrollo en todas ellas; y el uso de la libreta personal de registro médico del niño como instrumento de orientación para las madres y como estrategia de seguimiento del crecimiento y desarrollo infantil.

Development of finger force coordination in children

Coordination is often observed as body parts moving together. However, when producing force with multiple fingers, the optimal coordination is not to produce similar forces with each finger, but rather for each finger to correct mistakes of other fingers. In this study, we aim to determine whether and how this skill develops in children aged 4-12 years. We measured this sort of coordination using the uncontrolled manifold hypothesis (UCM). We recorded finger forces produced by 60 typically developing children aged between 4 and 12 years in a finger-pressing task. The children controlled the height of an object on a screen by the total amount of force they produced on force sensors. We found that the synergy index, a measure of the relationship between "good" and "bad" variance, increased linearly as a function of age. This improvement was achieved by a selective reduction in "bad" variance rather than an increase in "good" variance. We did not observe differences between males and females, and the synergy index was not able to predict outcomes of upper limb behavioral tests after controlling for age. As children develop between the ages of 4 and 12 years, their ability to produce negative covariation between their finger forces improves, likely related to their improved ability to perform dexterous tasks.

All Tapped Out: Touchscreen Interactivity and Young Children's Word Learning

Touchscreen devices differ from passive screen media in promoting physical interaction with events on the screen. Two studies examined how young children's screen-directed actions related to self-regulation (Study 1) and word learning (Study 2). In Study 1, 30 2-year-old children's tapping behaviors during game play were related to their self-regulation, measured using Carlson's snack task: girls and children with high self-regulation tapped significantly less during instruction portions of an app (including object labeling events) than did boys and children with low self-regulation. Older preschoolers (N = 47, aged 4-6 years) tapped significantly less during instruction than 2-year-olds did. Study 2 explored whether the particular way in which 170 children (2-4 years of age) interacted with a touchscreen app affected their learning of novel object labels. Conditions in which children tapped or dragged a named object to move it across the screen required different amounts of effort and focus, compared to a non-interactive (watching) condition. Age by sex interactions revealed a particular benefit of dragging (a motorically challenging behavior) for preschool girls' learning compared to that of boys, especially for girls older than age 2. Boys benefited more from watching than dragging. Children from low socioeconomic status families learned more object names when dragging objects versus tapping them, possibly because tapping is a prepotent response that does not require thoughtful attention. Parents and industry experts should consider age, sex, self-regulation, and the physical requirements of children's engagement with touchscreens when designing and using educational content.