title: Specific characteristics of abnormal general movements are associated with functional outcome at school age.
abstract: BACKGROUND
  Assessing the quality of general movements (GMs) is a non-invasive tool to identify at early age infants at risk for developmental disorders.
  
  
  OBJECTIVE
  To investigate whether specific characteristics of definitely abnormal GMs are associated with developmental outcome at school age.
  
  
  METHODS
  Observational cohort study (long-term follow-up).
  
  
  METHODS
  Parents of 40 children (median age 8.3 years, 20 girls) participated in this follow-up study. In infancy (median corrected age 10 weeks), the children (median gestational age 30.3 weeks; birth weight 1243 g) had shown definitely abnormal GMs according to Hadders-Algra (2004). Information on specific GM characteristics such as the presence of fidgety movements, degree of complexity and variation, and stiff movements, was available (see Hamer et al. 2011).
  
  
  METHODS
  A standardised parental interview (presence of CP, attendance of school for special education, Vineland Adaptive Behavior Scale to determine functional performance) and questionnaires (Developmental Coordination Disorder Questionnaire [DCD-Q] to evaluate mobility and Child Behavior Checklist to assess behaviour) were used as outcome measures.
  
  
  RESULTS
  Six children had cerebral palsy (CP), ten children attended a school for special education, and eight children had behavioural problems. Both the absence of fidgety movements and the presence of stiff movements were associated with CP (p=0.001; p=0.003, respectively). Stiff movements were also related to the need of special education (p=0.009). A lack of movement complexity and variation was associated with behavioural problems (p=0.007). None of the GM characteristics were related to DCD-Q scores.
  
  
  CONCLUSIONS
  The evaluation of fidgety movements and movement stiffness may increase the predictive power of definitely abnormal GMs for motor outcome--in particular CP. This study endorses the notion that the quality of GMs reflects the integrity of the infant's brain, assisting prediction of long-term outcome.
authors.affiliation: Department of Pediatrics, Division of Developmental Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Elisa G
authors.initials: EG
authors.lastname: Hamer
authors.affiliation: Department of Pediatrics, Division of Neonatology, University of Groningen, University Medical Center, Groningen, The Netherlands.
authors.forename: Arend F
authors.initials: AF
authors.lastname: Bos
authors.affiliation: Department of Pediatrics, Division of Developmental Neurology, University of Groningen, University Medical Center, Groningen, The Netherlands. Electronic address: m.hadders-algra@umcg.nl.
authors.forename: Mijna
authors.initials: M
authors.lastname: Hadders-Algra
mesh_terms: D002648:Child; D002657:Child Development; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D008297:Male; D009068:Movement
keywords: Cerebral palsy; Follow-up; General movements; High risk infants; Neurodevelopment; School age