Title | Hand Function at 18-22 Months Is Associated with School-Age Manual Dexterity and Motor Performance in Children Born Extremely Preterm. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | Duncan AF, Bann CM, Maitre NL, Peralta-Carcelen M, Hintz SR |
Corporate Authors | Eunice Kennedy Shriver National Institute of Child Health and Development Neonatal Research Network |
Journal | J Pediatr |
Volume | 225 |
Pagination | 51-57.e3 |
Date Published | 2020 10 |
ISSN | 1097-6833 |
Keywords | Child, Educational Status, Female, Hand, Humans, Infant, Infant, Extremely Premature, Infant, Newborn, Linear Models, Longitudinal Studies, Male, Motor Skills, Movement, Prospective Studies, Psychomotor Performance, Regression Analysis |
Abstract | OBJECTIVES: To determine associations between hand function at age 18-22 months (early) and scores on the Movement Assessment Battery for Children, 2nd edition (MABC) at 6-7 years of age (school age) in extremely preterm children. STUDY DESIGN: Prospective multicenter cohort of 313 extremely preterm children with early hand function assessment and school-age MABC testing. Early hand function was compared with "definite deficits" (MABC <5th percentile) and MABC standard scores. Early hand function was categorized as "no deficit" vs "any deficit." Mixed-effects regression models were used to evaluate the association of early hand function with MABC deficits, controlling for multiple demographic, neonatal, and childhood factors. RESULTS: Children with early hand function deficits were more likely to have definite school-age deficits in all MABC subtests (Manual Dexterity, Aiming and Catching, and Balance) and to have received physical or occupational therapy (45% vs 26%; P < .001). Children with early hand function deficits had lower Manual Dexterity (P = .006), Balance (P = .035), and Total Test (P = .039) scores. Controlling for confounders, children with early hand function deficits had higher odds of definite school-age deficits in Manual Dexterity (aOR, 2.78; 95% CI, 1.36-5.68; P = .005) and lower Manual Dexterity (P = .031) and Balance (P = .027) scores. When excluding children with cerebral palsy and those with an IQ <70, hand function deficits remained significantly associated with manual dexterity. CONCLUSION: Hand function deficits at age 18-22 months are associated with manual dexterity deficits and motor difficulties at school age, independent of perinatal-neonatal factors and the use of occupational or physical therapy. This has significant implications for school success, intervention, and rehabilitative therapy development. |
DOI | 10.1016/j.jpeds.2020.05.048 |
Alternate Journal | J Pediatr |
PubMed ID | 32474029 |
PubMed Central ID | PMC7652574 |
Grant List | U10 HD021385 / HD / NICHD NIH HHS / United States U10 HD053124 / HD / NICHD NIH HHS / United States U10 HD053119 / HD / NICHD NIH HHS / United States U10 HD021364 / HD / NICHD NIH HHS / United States U10 HD040461 / HD / NICHD NIH HHS / United States U10 HD027904 / HD / NICHD NIH HHS / United States UL1 RR025744 / RR / NCRR NIH HHS / United States U10 HD027851 / HD / NICHD NIH HHS / United States UL1 RR025008 / RR / NCRR NIH HHS / United States U24 HD095254 / HD / NICHD NIH HHS / United States U10 HD053089 / HD / NICHD NIH HHS / United States U10 HD027856 / HD / NICHD NIH HHS / United States U10 HD021373 / HD / NICHD NIH HHS / United States U10 HD027880 / HD / NICHD NIH HHS / United States U10 HD053109 / HD / NICHD NIH HHS / United States U10 HD040689 / HD / NICHD NIH HHS / United States U10 HD040492 / HD / NICHD NIH HHS / United States U10 HD034216 / HD / NICHD NIH HHS / United States U10 HD036790 / HD / NICHD NIH HHS / United States |