Assessment of motor behaviour in high-risk-infants at 3 months predicts motor and cognitive outcomes in 10 years old children.

BACKGROUND: The general movement assessment has mainly been used to identify children with cerebral palsy (CP). A detailed assessment of quality of infant motor repertoire using parts of the "Assessment of Motor Repertoire - 3 to 5 Months" which is based on Prechtl's general movement assessment can possibly identify later motor and cognitive problems in children without CP.

AIMS: This study aims to determine whether analysis of quality of infant motor repertoire has predictive value for motor and cognitive outcomes at age 10 in children at risk for later neurological impairment.

STUDY DESIGN: A longitudinal study design was used.

SUBJECTS: Video-recordings of 40 "neurologically high-risk" infants at 14 weeks post-term age were analysed with respect to motor repertoire.

OUTCOME MEASURES: Fidgety movements were classified as present or absent. Quality of concurrent motor repertoire was classified as normal if smooth and fluent and abnormal if jerky, monotonous or stiff. Poor motor outcome was defined as a score ≤ 5th centile on the Movement-Assessment-Battery-2, while poor cognitive outcome as total IQ <85 on Wechsler Intelligence Scale-III.

RESULTS: Among the high-risk children with presence of fidgety movements, poor motor and/or cognitive outcome at 10 years was identified by abnormal concurrent motor repertoire at 14 weeks post-term age in 86% (95% CI: 0.60-0.96) of the children. On the other hand, 71% (95% CI: 0.47-0.87) of those with normal motor and cognitive outcomes were identified by presence of fidgety movements and normal motor repertoire.

CONCLUSIONS: Assessment of quality of infant motor repertoire may be a valuable early clinical marker for later impaired motor and cognitive outcomes in high-risk children who do not develop CP.