Fine Motor Developmental Delay and Associated Factors among Children Aged 3-5 Years in Surabaya

AbstractAbnormal maternal gestational weight gain (GWG) increases the risk of obstetric-related complications. This investigation examined the impact of GWG on infant neurodevelopmental abnormalities at 12 months of age using the data of a nationwide Japanese cohort study. Questionnaire data were obtained from the ongoing Japan Environment and Children’s Study cohort study. Maternal GWG was subdivided as below, within, or above the reference values of the Institution of Medicine pregnancy weight guidelines. The Ages and Stages Questionnaire, third edition (ASQ-3) is a parent-reported developmental screening instrument for children across five domains: communication, gross motor, fine motor, problem-solving, and personal–social. Multiple logistic regression analysis was employed to identify correlations between GWG and developmental delay defined as ASQ-3 scores of less than two standard deviations below the mean. A total of 30,694 mothers with singleton live births and partners who completed the questionnaire were analyzed. The prevalence of mothers below, within, and above the GWG guidelines was 60.4% (18,527), 32.1% (9850), and 7.5% (2317), respectively. We recorded 10,943 infants (35.7%) who were outliers in at least one ASQ-3 domain. After controlling for covariates, GWG below established guidelines was associated with a significantly higher risk of developmental delay for the communication (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.09–1.34), gross motor (OR 1.14, 95% CI 1.05–1.24), fine motor (OR 1.13, 95% CI 1.04–1.24), problem-solving (OR 1.09, 95% CI 1.01–1.18), and personal–social (OR 1.15, 95% CI 1.07–1.24) domains.Conclusion: This large survey revealed a possible deleterious effect of insufficient maternal GWG on infant neurodevelopment.Trial registration: The Japan Environment and Children’s Study (JECS) was registered in the UMIN Clinical Trials Registry on January 15, 2018 (number UMIN000030786). What is Known:• Inappropriate maternal gestational weight gain may cause obstetric complications and adverse birth outcomes.• Excess maternal weight gain may result in gestational diabetes, hypertension, eclampsia, caesarean delivery, and macrosomia, while insufficient maternal weight gain has been associated with pre-term birth and small for gestational age. What is New:• This study provides important information on a possible adverse effect of insufficient maternal gestational weight gain on offspring neurodevelopment at 12 months of age.• Our findings indicate a need to reconsider the optimal body mass index and gestational weight gain for women desiring pregnancy.

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A Journey Towards 1st Step of Life – A Case Report on Vision Therapy for A Patient with Global Developmental Delay and Nystagmus

Vision Development & Rehabilitation ◽

10.31707/vdr2019.6.4.p295 ◽

2020 ◽

pp. 295-303

Keyword(s):

Case Report ◽

Developmental Delay ◽

Motor Skills ◽

Treatment Plan ◽

Fine Motor ◽

Global Developmental Delay ◽

Additional Support ◽

Age Range ◽

Vision Therapy

Introduction: Children with Global Developmental Delay (GDD) fail to achieve developmental milestones expected for their age range as compared to their peers. They typically have visual problems in addition to poor gross and fine motor skills. Developmental delays extend to speech, language, cognition, and personal-social domains, and impact activities of daily living. Case Summary: A 4-year-old child presented with chief concerns from his parents that he had difficulty making eye contact was unable to stand and walk. He was not making adequate progress in physiotherapy. Neuro-developmental assessment resulted in a diagnosis of GDD. Visual Evoked Potential showed decreased visual acuity, and nystagmus. Comprehensive examination showed that the patient had a face tilt and head turn. Spectacle lenses with prism was prescribed. A therapy treatment plan was recommended and it was divided into three phases, with the primary goal of improving visual functions through vision therapy. At the end of the therapy, the child developed the confidence to stand and walk without any support. Conclusion: This case report demonstrates the importance of vision therapy in improving the patient’s overall visual performance. In particular, it demonstrates the role of visual intervention in aiding motor skills to the extent that standing and walking was enabled without the need for additional support.

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Developmental examination

The MRCPCH Clinical Exam Made Simple ◽

10.1093/oso/9780199587933.003.0017 ◽

2011 ◽

Author(s):

Stanley Tamuka Zengeya ◽

Tiroumourougane V Serane

Keyword(s):

Developmental Delay ◽

Motor Skills ◽

Comprehensive Evaluation ◽

Fine Motor ◽

Global Developmental Delay ◽

Developmental Assessment ◽

Gross Motor ◽

Social And Emotional ◽

Developmental Regression ◽

Developmental Domains

All doctors working with children should have good knowledge of normal developmental milestones, as early diagnosis of developmental problems and appropriate intervention is desirable to improve the outcome. Candidates should be able to identify key warning signals and know the practical relevance of the milestones. ‘Developmental assessment’ is the comprehensive evaluation of a child’s physical, intellectual, language, emotional, and social development, and is an area where most candidates lack competence and confidence. It should be distinguished from ‘developmental screening’, which is a brief, formal, standardized evaluation for the early identification of children at risk of a developmental disorder. In the developmental assessment station, a candidate can be assessed in different ways: a developmental history with the parent and child; assessment of specific developmental domains (such as gross motor skills, fine motor skills, speech, language skills, etc.); or global assessment of an infant or older child. Occasionally, the candidate might be asked to just ‘observe the child’s play’ and comment on the development. The candidate should anticipate and be prepared for these scenarios. In the exam, a detailed assessment of development is impossible, as it is complicated and time consuming. Ideally, observations of the child should take place with several people in varied settings, which is not feasible in the exam. However, useful assessment of a child’s development can be easily performed as part of routine examination. The main purpose of the developmental assessment in the exam is to identify the child’s strengths and weaknesses, the developmental problem, and, if possible, the cause of the problem. The candidate is expected to give an approximate developmental age at the end of the assessment. Before we continue, it is important to understand the commonly used terminology. A child is said to have ‘developmental delay’ when he or she shows a significant lag (more than two standard deviations) in acquiring milestones in one or more domains. Global developmental delay is defined as a delay in two or more developmental domains. ‘Developmental deviance’ occurs when a child develops milestones outside or apparently ahead of the typical acquisition sequence. ‘Developmental regression’ is the loss of previously acquired milestones. Children develop skills in various areas, also called developmental domains: gross motor, speech and language, fine motor, cognitive, personal–social, and emotional.

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Neurodevelopmental Testing of Children Born to Human Immunodeficiency Virus Type 1 Seropositive and Seronegative Mothers: A Prospective Cohort Study in Kigali, Rwanda

PEDIATRICS ◽

10.1542/peds.92.6.843 ◽

1993 ◽

Vol 92 (6) ◽

pp. 843-848

Author(s):

Philippe Msellati ◽

Philippe Lepage ◽

Deo-Gratias Hitimana ◽

Christiaan Van Goethem ◽

Philippe Van de Perre ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Cohort Study ◽

Developmental Delay ◽

Motor Development ◽

Pediatric Hiv ◽

Fine Motor ◽

Gross Motor ◽

Immunodeficiency Virus ◽

Immunodeficiency Syndrome ◽

Hiv Seropositive

Objective. The results of developmental testing of 218 children born to human immunodeficiency virus (HIV)-seropositive mothers and infected or uninfected themselves were compared with those of 218 children born to HIV-seronegative mothers in an ongoing cohort study in Kigali, Rwanda. Methods. When the children were 6, 12, 18, and 24 months of age, a specific neurodevelopmental examination was performed blindly by study physicians assessing gross motor development, fine motor development, language acquisition, and social contacts. Results. Only one acute severe HIV-related encephalopathy was identified among the 50 infected children. The proportion of abnormal neurologic examinations in HIV-infected children varied from 15% to 40% according to age and was always higher than in HIV-uninfected children born to HIV-seropositive and seronegative mothers (≤5% or less of abnormal examinations at each time period). fter excluding those children with clinical ac-quired immunodeficiency syndrome (AIDS) from the analysis, the proportion of abnormal examinations in infected children was 12.5% at 6 months, 16% at 12 months, 20% at 18 months, and 9% at 24 months of age and was still more frequent than in HIV-uninfected children. The developmental delay was principally due to significantly lower gross motor scores. Conclusions. HIV-1-infected children are more frequently developmentally delayed than uninfected children during the first 2 years of life in this African population. This developmental delay is related to the AIDS stage of pediatric HIV infection.

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Sleep Patterns and Development of Children with Atopic Dermatitis

International Archives of Allergy and Immunology ◽

10.1159/000509402 ◽

2020 ◽

Vol 181 (11) ◽

pp. 871-878

Author(s):

Emine Gulsah Torun ◽

Aysegul Ertugrul ◽

Doga Ceren Tekguc ◽

Ilknur Bostanci

Keyword(s):

Risk Factors ◽

Atopic Dermatitis ◽

Developmental Delay ◽

Motor Skills ◽

Sleep Problems ◽

Receptive Language ◽

Fine Motor ◽

Sleep Patterns ◽

Cross Sectional ◽

Increased Risk

Introduction: Atopic dermatitis (AD) is a chronic inflammatory disease that begins in early childhood. Sleep problems have increased in children with AD. The aim of this study was to evaluate sleep patterns and the development of children with AD at an early age. Methods: This is a cross-sectional study consisting of a total of 80 children aged 0–36 months with AD. Patients were evaluated by the Brief Infant Sleep Questionnaire and International Guide for Monitoring Child Development. Results: The median age (IQR) of the patients was 6 (4.25–9) months, 63.7% of them were male and 50% of them had sleep problems. Male sex (OR: 3.78, p = 0.024, 95% CI, 0.083–0.837), patients with AD who were in the first 3 months after diagnosis (OR: 3.56; 95% CI, 1.220–10.43, p = 0.020), and moderate-severe AD (OR: 5.09; 95% CI, 1.649–15.748, p = 0.005) were determined as risk factors for sleep problems. In all, 12.5% of the patients needed support for one or more developmental areas (gross motor skills, expressive language and communication, receptive language, fine motor skills, relationship, and play). Developmental delay was higher in patients with sleep problems (p = 0.037). Multiple siblings (OR: 14.381; 95% CI, 1.557–132.871, p = 0.019) and the presence of sleep problems (OR: 8.011; 95% CI, 1.764–36.387, p = 0.024) were found to be risk factors for developmental delay. Conclusion: Boys with moderate-severe AD within the first 3 months of diagnosis were at increased risk for sleep problems. Children with AD who have multiple siblings and sleep problems should be evaluated for developmental delay and monitored closely.

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Visual Perception, Fine Motor, and Visual-Motor Skills in Very Preterm and Term-Born Children before School Entry–Observational Cohort Study

Children ◽

10.3390/children7120276 ◽

2020 ◽

Vol 7 (12) ◽

pp. 276

Author(s):

Anne-Kathrin Dathe ◽

Julia Jaekel ◽

Julia Franzel ◽

Thomas Hoehn ◽

Ursula Felderhoff-Mueser ◽

...

Keyword(s):

Visual Perception ◽

Developmental Delay ◽

Motor Skills ◽

School Entry ◽

Fine Motor ◽

Research Attention ◽

Preterm Children ◽

Very Preterm ◽

Visual Motor ◽

Before School

Very preterm children (<32 weeks gestation at birth; VP) are at risk of developmental difficulties. Specific functional difficulties and delays in visual perception, fine motor, and visual-motor skills have received little research attention, although they are critical for daily life and school readiness. Our aim was to assess these skills in a contemporary cohort of 60 VP and 60 matched term-born children before school entry. We administered the Movement Assessment Battery for Children (M-ABC-2) and the Developmental Test of Visual Perception (DTVP-2). Linear and logistic regressions were run to test group differences in performance and rates of developmental delay in visual perception, fine motor, and visual-motor skills. Very preterm children had lower scores than term-born children in visual perception (β = −0.25; p = 0.006), fine motor (β = −0.44; p < 0.001), and visual-motor tasks (β = −0.46; p < 0.001). The rate of developmental delay (<−1 SD) was higher among VP in visual perception (odds ratio (OR) = 3.4; 95% confidence interval (CI 1.1–10.6)), fine motor (OR = 6.2 (2.4–16.0)), and visual-motor skills (OR = 13.4 (4.1–43.9)) than in term-born controls. VP children are at increased risk for clinically relevant developmental delays in visual perception, fine motor, and visual-motor skills. Following up VP children until preschool age may facilitate early identification and timely intervention.

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Pathogenic variants in TNRC6B cause a genetic disorder characterised by developmental delay/intellectual disability and a spectrum of neurobehavioural phenotypes including autism and ADHD

Journal of Medical Genetics ◽

10.1136/jmedgenet-2019-106470 ◽

2020 ◽

Vol 57 (10) ◽

pp. 717-724

Author(s):

Jorge Luis Granadillo ◽

Alexander P.A. Stegmann ◽

Hui Guo ◽

Kun Xia ◽

Brad Angle ◽

...

Keyword(s):

Intellectual Disability ◽

Developmental Delay ◽

Genetic Disorder ◽

Retrospective Chart Review ◽

Autistic Traits ◽

Clinical Findings ◽

Fine Motor ◽

Chromosomal Microarray ◽

Motor Delay ◽

Phenotypic Characterisation

BackgroundRare variants in hundreds of genes have been implicated in developmental delay (DD), intellectual disability (ID) and neurobehavioural phenotypes. TNRC6B encodes a protein important for RNA silencing. Heterozygous truncating variants have been reported in three patients from large cohorts with autism, but no full phenotypic characterisation was described.MethodsClinical and molecular characterisation was performed on 17 patients with TNRC6B variants. Clinical data were obtained by retrospective chart review, parent interviews, direct patient interaction with providers and formal neuropsychological evaluation.ResultsClinical findings included DD/ID (17/17) (speech delay in 94% (16/17), fine motor delay in 82% (14/17) and gross motor delay in 71% (12/17) of subjects), autism or autistic traits (13/17), attention deficit and hyperactivity disorder (ADHD) (11/17), other behavioural problems (7/17) and musculoskeletal findings (12/17). Other congenital malformations or clinical findings were occasionally documented. The majority of patients exhibited some dysmorphic features but no recognisable gestalt was identified. 17 heterozygous TNRC6B variants were identified in 12 male and five female unrelated subjects by exome sequencing (14), a targeted panel (2) and a chromosomal microarray (1). The variants were nonsense (7), frameshift (5), splice site (2), intragenic deletions (2) and missense (1).ConclusionsVariants in TNRC6B cause a novel genetic disorder characterised by recurrent neurocognitive and behavioural phenotypes featuring DD/ID, autism, ADHD and other behavioural abnormalities. Our data highly suggest that haploinsufficiency is the most likely pathogenic mechanism. TNRC6B should be added to the growing list of genes of the RNA-induced silencing complex associated with ID/DD, autism and ADHD.

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Vaccination Behavior among Children with Developmental Delay and their siblings: A cross sectional study from Kerala

10.1101/2020.05.11.20095026 ◽

2020 ◽

Author(s):

Salah Basheer ◽

Uvais NA

Keyword(s):

Public Health ◽

Developmental Disabilities ◽

Developmental Delay ◽

Associated Factors ◽

Vaccination Rate ◽

Typically Developing ◽

Cross Sectional ◽

Public Health Strategies ◽

Sibling Group ◽

Children With Developmental Disabilities

Background and Aim: Despite multiple scientific evidence to the contrary, parental concerns with respect to association of vaccination and development of Autism Spectrum Disorder (ASD) persist. Mental health professionals work closely with families with developmental disabilities. Greater understanding regarding the vaccination status in siblings of children with developmental disabilities and its associated factors will help them to contribute to public health strategies in combating infectious diseases. The aim of this study was to study the vaccination uptake and its associated factors in sibling of children with developmental disabilities. Materials and Methods: The study design was cross sectional in nature. The families of children with developmental disabilities were recruited into the study from three child developmental centres. The data was collected using a semi-structured questionnaire. The recruitment of participants into the study was done from December 2017 to February 2018. Results: 189 families with children with developmental disabilities were recruited into the study. In total, these children had 114 typically developing elder siblings and 50 typically developing younger sibling. The proportion of overall complete vaccination among children with developmental disabilities group and the younger sibling group were significantly lower than their older sibling group (P<0.01). The proportion of MMR vaccination among children with developmental disabilities group and the younger sibling group were significantly lower than their older sibling group (P<0.001). Conclusions: Findings from this study suggest that the reduced vaccination uptake is a general trend in families of children with developmental delay. Such a significant fall in the vaccination rate in this group of children will make them vulnerable in case of outbreaks. This emphasise the need to have public health strategies targeted to improve the vaccination rate in families of children with developmental disabilities.

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Neuropsychomotor development in children born preterm at 6 and 12 months of corrected gestational age

Revista Paulista de Pediatria ◽

10.1590/1984-0462/2022/40/2020199 ◽

2022 ◽

Vol 40 ◽

Author(s):

Nathália Faria de Freitas ◽

Cynthia Ribeiro do Nascimento Nunes ◽

Thalyta Magalhães Rodrigues ◽

Gislene Cristina Valadares ◽

Fernanda Lima Alves ◽

...

Keyword(s):

Developmental Delay ◽

Gestational Age ◽

Motor Development ◽

Categorical Variables ◽

Fine Motor ◽

P Value ◽

Test Results ◽

Motor Score ◽

Maternity Hospitals ◽

The Mean

ABSTRACT Objective: To assess the incidence of neuropsychomotor developmental delay at 6 and 12 months of corrected gestational age in children born at 32 gestational weeks or less. Methods: A descriptive and prospective study was carried out at two public maternity hospitals. Between April 2017 and January 2019, we assessed 133 children without any known risk factors for neuropsychomotor developmental delay. The Bayley III scale was used to evaluate cognitive and motor development. The p value of the numerical variables was calculated using the Mann-Whitney test, whereas proportions of categorical variables were compared using the Z-test. Results: The mean maternal age was 26±6.9 years,78.8% were from middle and lower economic classes, and 57.1% of the analyzed children were female. Children presented with a higher incidence of delay at 12 months than at 6 months (10.3 and 2.3% at 12 and 6 months, respectively, for the cognitive score; 22.7 and 12% at 12 and 6 months, respectively, for the composite motor score; and 24.7 and 8.4% at 12 and 6 months, respectively, for the fine motor score). Conclusions: Cognitive and motor developmental delays were significant, with the highest incidence at 12 months. The results of this study encourage further research on this topic, since the exclusion criteria were comprehensive and the delays in neuropsychomotor development were significant.

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