Minor neurological signs and developmental performance in high risk children at preschool age.
The aim of this study was to establish correlations between minor neurological findings and developmental performance. A cohort of 72 preschool children was studied (38 females, 34 males; mean age 3 years 8 months, SD 1 year 2 months, range 2 to 5 years) who were considered to be at high risk due to placental insufficiency. The cohort was divided into four categories of neurological status: (1) minimal cerebral palsy (MCP) with independent walking before age 2 years; (2) Amiel-Tison triad (ATT) including imbalance of passive axial tone, phasic stretch reflex in triceps surae, and cranial signs, particularly on the squamous suture; (3) intermediate with one or two of the three ATT signs; and (4) absence of neurological findings. Six subscales of the Griffiths Mental Developmental Scales assessing locomotion, eye-hand coordination, interpersonal skills, language, performance, and practical reasoning were administered. Significant differences were found according to neurological status in three specific domains of development: coordination (F=2.84, p=0.04), language (F=3.65, p=0.02), and practical reasoning (F=3.62, p=0.02). In addition, significant differences were also found in language (L) and practical reasoning (R) performances according to the side of the abnormal stretch reflex: bilateral stretches (L=87.8; R=75.3) or an isolated right stretch (L=95.3; R=83.6) are more strongly associated with impaired developmental performances than an isolated left stretch (L=101.3; R=88.2) with F=2.94; p=0.04 for language and F=3.00, p=0.04 for practical reasoning. We concluded that a short neurological examination, easily performed by pediatricians and family practitioners, can identify permanent markers of minor brain damage occurring before, during, or soon after birth and so anticipate consequences.
Gosselin
Julie
J
School of Rehabilitation, Faculty of Medicine, University of Montreal, Québec, Canada. Julie.Gosselin@umontreal.ca
Amiel-Tison
Claudine
C
Infante-Rivard
Claire
C
Fouron
Catherine
C
Fouron
Jean-Claude
JC
D002170:Canada / Q000453:epidemiology; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D003393:Cranial Sutures; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D009483:Neuropsychological Tests; D010927:Placental Insufficiency / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011597:Psychomotor Performance; D012021:Reflex, Abnormal; D012306:Risk