Kristina Persson

Effects of group motor skill intervention on five- to six-year-old children with developmental coordination disorder

The purpose of this study was to determine whether group motor skill intervention is an effective form of treatment when added to consultative services in 5− to 6-year-old children with developmental coordination disorder (DCD). An experimental group of DCD children (n = 17) was compared with a DCD control group without intervention (n = 20). The intervention was conducted once a week for 10 weeks. No significant differences between the groups in either Movement ABC motor test or the Movement ABC checklist were found before or after this intervention. When subgroups with different categories of motor difficulties were compared, significantly more children with borderline motor difficulties in the experimental group than in the control group had changed (improved) their category after intervention. It is concluded that children with definite motor difficulties do not benefit from this type of intervention. Future research should include comparison of well-defined subgroups of children with DCD.

Structured Observation of Motor Performance (SOMP-I) applied to preterm and full term infants who needed neonatal intensive care. A cross-sectional analysis of progress and quality of motor performance at ages 0–10 months

A new protocol for Structured Observation of Motor Performance in Infants, SOMP-I, designed to describe both progress and quality of motor performance, was evaluated concerning its ability to describe and to discriminate between the motor performance observed in different groups of infants. Sixty-eight infants born at < 32 completed weeks (c.w.) of gestation formed group I, 81 infants born at 32-37 c.w. group II and 77 infants born at > 37 c.w. group III. Seventy-two neonatally healthy full term infants served as controls (group IV). The detailed assessment of level (progress) of motor development at 0, 2, 4, 6 and 10 months of age corrected for preterm birth disclosed few differences in mean level between the groups. Most were found between group I and the control group. In contrast, the quality of motor performance, expressed as proportion of infants with deviations, type of deviation, and total number of deviations per infant, showed many differences, especially between groups I and III, respectively, and the control group. Thus, the SOMP-I protocol permits a detailed assessment both of the level of motor development and the quality of motor performance but has a better discriminative ability for the latter.

Children with Developmental Co-ordination Disorder: A Qualitative Study of Parents' Descriptions

The aim of the study was to analyse parents descriptions of their observations, feelings and actions concerning developmental co-ordination disorder in their children. Thirty-seven parents were interviewed, all of whom had a child who had failed both in the Child Health Centre motor screening test for children 5-6 years old and in the Movement ABC motor tests. The subjects mentioned by the parents at the interviews could be condensed into five themes: motor behaviours in specific situations, overall impression of behaviours, communicative and physical observations, emotions concerning parenthood, and support in physical activities. Parents of children with definite motor difficulties were particularly supportive of their children in physical activities and reported worry and uncertainty in parenthood. Professionals should explicitly ask parents about comparisons between their children and others regarding development and learning. It may be essential to find out whether parents concerns have reference to one area or to more, as an indication of the childrens difficulties. Parents whose children are unwilling to participate in physical activities may need information and an opportunity to observe training organised to encourage motor learning and development in their children.

Structured observation of motor performance (SOMP-I) applied to neonatally healthy fullterm infants at the ages of 0–10 months

A new protocol for structured observation of motor performance in infants, SOMP-I, was applied to 72 neonatally healthy fullterm infants at 0, 2, 4, 6 and 10 months of age. It contains 13 items, formed as ascending scales, consisting of detailed descriptions of motor performance in different body positions and body parts. The observed motor performance is assessed regarding level of development (progress), and degree and type of deviation from the described performance (quality). When observed according to the new protocol, the infants motor performance corresponded to higher levels of motor development with increasing age and agreed with descriptions in other standardized developmental scales. With age, the motor performance observed was distributed over more levels in the different scales and the number of infants with deviations from the described performance increased in most positions, but decreased in the prone position. The item for the head, at 2 months, showed the largest number of infants with deviations. The total number of deviations in each infant was small. In conclusion, the SOMP-I protocol can describe motor performance in a group of infants who were healthy at birth and is detailed enough to identify differences regarding progress of motor development and quality of motor performance. The assessment is easily performed.

Short-term outcome of perinatal care in a Swedish county

Improvements in obstetrical and neonatal care during the last decades have led to a marked increase in survival rate of preterm and term infants. In order to study the short- and long-term outcome in infants who survived neonatal intensive care (NIC) and were born in the county of Uppsala between January lst 1986 and April 30‘” 1989, a prospective long-term follow-up study was conducted. Epidemiological data on all infants born in the county during the study period and the shoitterm outcome, measured as overall neuromotor function at term and at 2, 4, 6 and 10 months of corrected age in 245 infants surviving NIC and 72 healthy control infants are presented. The infants’ neuromotor function was evaluated with different clinical neurological methods. In the study population of NIC infants 85.9% survived the neonatal period. The early infant mortality was high in this group 11.6% compared to that of all infants born in the county of Uppsala (0.30%). Only a minority of the infants showed abnormal neuromotor function. A comparison of the results of the overall evaluation of neuromotor function at 10 months of age with those of the examinations made at an earlier age showed poor correspondence in individual infants, especially in preterm and very preterm infants.

Deficits in motor co-ordination and attention at 3 years of age predict motor deviations in 6.5-year-old children who needed neonatal intensive care

BACKGROUNDnA total of 189 children without major impairments who needed neonatal intensive care (NIC) were followed up at ages 3 and 6.5 years.nnnAIMnTo determine the prevalence of different motor deviations at age 6.5 years and the co-occurrence of attention deficits; also, to analyse the predictive ability of motor co-ordination and attention assessments at age 3 years for motor deviations at 6.5 years.nnnMETHODnA combined assessment of motor performance and behaviour (CAMPB) was used at the 3-year examination. The Test of Motor Impairment (TOMI) and the Motor-Perceptual Development (MPU) were used together with the criteria of the diagnostic and statistical manual of mental disorders (DSM-IV-TR) to define motor deviations.nnnRESULTSnAt 6.5 years 64% of the children showed a motor deviation either as a delay according to MPU, a problem according to TOMI or Developmental Coordination Disorder (DCD) according to DSM-IV-TR. Higher proportions of children with attention deficit (50%) were found in the DCD group. The predictive ability of CAMPB was analysed in two ways: when all children with either a co-ordination or attention deficit, or both, at 3 years were considered to be at risk for motor deviations at 6.5 years, the sensitivity reached 78% and the specificity was 42%. But when only the 3 year olds with a combined deficit were considered to be at risk, the sensitivity was 37% and the specificity 89%; however, a positive predictive value of 86% was reached.nnnCONCLUSIONnAt 6.5 years of age a majority of NIC children with no major impairments showed motor deviations. To fulfil the DCD criteria in DSM-IV-TR, a strict definition of motor deviations is recommended. Attention deficits are more prevalent among children with DCD. Deficits in motor co-ordination and/or attention in 3-year-old children are strong predictors of motor deviations and, especially, of DCD at 6.5 years of age.

A Protocol for Structured Observation of Motor Performance in Preterm and Term Infants

A new protocol for structured observation of motor performance has been designed for assessment of the progress and quality of motor development in preterm and term infants. A detailed scale of motor development based on the present knowledge of motor development in healthy term infants has been constructed. The motor performance is observed in each part of the infants body in the supine and prone positions and in the whole body with the infant sitting, standing and during locomotion, and is evaluated in relation to defined levels of motor performance. If the quality of motor performance is optimal for a certain level, no deviation is noted. Any deviation from the motor performance described in the protocol for the level in question is graded as suspected or clear and classified by type. All observations are recorded on videotape for documentation. In a study of inter- and intraobserver agreement, such recordings from 17 infants were reassessed on two occasions more than one year apart. The interobserver agreement ranged between 73 and 87% and the intraobserver consistency between 77 and 88%. The protocol is currently being used in a follow-up study.

A Protocol for Structured Observation of Motor Performance in Preterm and Term Infants: Interobserver Agreement and Intraobserver Consistency

A new protocol for structured observation of motor performance, for use both in term and preterm infants, has been tested regarding interobserver agreement and intraobserver consistency. Ten different motor items are assessed concerning the developmental level as described in the protocol. Any deviations from the description of the level are noted. The two main observers twice reassessed video recordings of 17 infants who had primarily been assessed by them both in an ongoing follow-up study. The two observers arrived at the same level of development in 75% of the observed items at the first reassessment and in 81% at the second, and agreed concerning deviation in 73 and 79% of the observations at the two reassessments, respectively. Each observer arrived at the same level of development at all three assessments in 62% of the observed items. Thus when used by these two observers the protocol has an acceptable degree of interobserver agreement and intraobserver consistency.

A Model for Combined Assessment of Motor Performance and Behaviour in 3-year-old Children

This paper presents a new model for combined assessment of motor performance and behaviour (CAMPB) in 3-year-old children. It is intended for simultaneous use with a scale for assessment of motor-perceptual development. The childs performance is observed and compared with detailed descriptions of performance in gross and fine motor functions, and descriptions of coordination, attention and social behaviour, included in a protocol. An overall evaluation is also made. These assessments have been performed in a longitudinal follow-up study of children who needed intensive care neonatally and a control group of 72 neonatally healthy children. In this report the results from CAMPB assessments in the control group are presented. CAMPB together with the motor-perceptual scale was feasible in these 3-year-old children and CAMPB was sensitive enough to detect differences between children. The motor performance in most children conformed with the descriptions of gross and fine motor function in the protocol, and clear deviations were few. Seven per cent of the children had considerable problems in motor function and/or perception, in combination with a lack of attention, according to the overall evaluation.

Interobserver Agreement in Use of a New Protocol for Structured| Observation of Motor Performance in Infants (SOMP-I)

To further analyze the interobserver agreement in the use of a new protocol for Structured Observation of Motor Performance (SOMP-I), 35 infants between one and six months of corrected age were assessed by two physiotherapists. Twenty-seven preterm and full-term infants who consecutively attended a follow-up clinic were interspersed with five neonatally healthy infants and three infants admitted for physiotherapy. The protocol was designed to assess the level of motor development and the degree of deviation from the motor performance described at the achieved level of development. The assessment of levels of development showed good interobserver agreement when measured by the percentage agreement method (≥ 80%), by kappa statistics (≥ 0.62), and as the Spearman rank-order correlation coefficient (≥ 0.80). The majority of the assessments of degree of deviation showed agreement values from fair to good. Low-interobserver-agreement values were found for the items describing the sitting position (66%) and for the trunk in the supine and prone positions (66%). Thus, good interobserver agreements were achieved for most items on the SOMP-I.