title: Gross motor performance in children prenatally exposed to alcohol and living in remote Australia.
abstract: OBJECTIVE
  This study aimed to determine the gross motor (GM) performance of Aboriginal children living in remote Australia. The relationship between GM skills, prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorders (FASD) was explored.
  
  
  METHODS
  A population-based observation study was conducted in 2011 to assess motor performance in children living in the Fitzroy Valley, Western Australia, using the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). BOT-2 data were retrospectively analysed using recently developed software enabling separation of fine and GM outcomes.
  
  
  RESULTS
  A total of 108 children (98.1% Aboriginal; 53% male, mean age: 8.7 years) were assessed. Half (52.2%) were exposed to at least 'risky' levels of PAE, and 21 (19%) were diagnosed with an FASD. The mean GM composite score of the cohort (47.0 ± 8.4) approached the BOT-2 normative mean (50.0 ± 10) and was similar between children with and without PAE (P = 0.27). This mean score, however, was significantly lower in children with FASD than without (mean difference: -5.5 ± 20.6; P = 0.006). Compared with children without FASD, children with FASD had significant impairment in subtests for running speed and agility (mean difference ± standard deviation (SD): -2.4 ± 8.1; P = 0.003) and strength (mean difference ± SD:-2.8 ± 9.9; P = 0.004) and (ii) a higher proportion than expected had overall GM impairment (≤2 SD: 9.5%; ≤1 SD: 23.8%). In groups with PAE, no PAE and no FASD, GM function approached expected population norms.
  
  
  CONCLUSIONS
  A higher than expected proportion of children with FASD had GM scores that indicated impairment and need for therapy. Evaluation of GM performance should routinely be included in FASD assessment to determine strategies to optimise child development.
authors.affiliation: Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Poche Centre for Indigenous Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Physiotherapy Department, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Barbara R
authors.initials: BR
authors.lastname: Lucas
authors.affiliation: The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Latimer
authors.affiliation: School of Public Health, Curtin University, Perth, Western Australia, Australia.
authors.forename: Robyn
authors.initials: R
authors.lastname: Doney
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Rochelle E
authors.initials: RE
authors.lastname: Watkins
authors.affiliation: Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Tracey W
authors.initials: TW
authors.lastname: Tsang
authors.affiliation: Derby Allied Health Service, Western Australian Country Health Services, Perth, Western Australia, Australia.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Hawkes
authors.affiliation: Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: James P
authors.initials: JP
authors.lastname: Fitzpatrick
authors.affiliation: Marninwarntikura Women's Resource Centre, Perth, Western Australia, Australia.|University of Notre Dame, Broome, Western Australia, Australia.
authors.forename: June
authors.initials: J
authors.lastname: Oscar
authors.affiliation: Nindilingarri Cultural Health Services, Kimberley, Western Australia, Australia.
authors.forename: Maureen
authors.initials: M
authors.lastname: Carter
authors.affiliation: Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|The George Institute for Global Health, Musculoskeletal Division, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.|University of Notre Dame, Broome, Western Australia, Australia.|The Sydney Children's Hospital Networks (Westmead), Sydney, New South Wales, Australia.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Elliott
mesh_terms: D002648:Child; D002657:Child Development / Q000187:drug effects*; D003955:Diagnostic Tests, Routine; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000187:drug effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D012189:Retrospective Studies; D012424:Rural Population
keywords: Aborigine; Australian; child development; fetal alcohol spectrum disorder; motor skill; prenatal exposure delayed effect