The Prechtl's General Movement Assessment, Hammersmith Infant Neurological Examination and Sensory Profile-2
Condition: Infant Development; Sensory Disorder; Sensory Processing Disorder; Motor Delay; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Infant Asphyxia; Development Delay
MeSH terms: Sensation Disorders; Infant, Premature, Diseases; Birth Weight; Asphyxia
Study type: Observational

Summary: 
      In the Neonatal Intensive Care Unit (NICU), infants encounter many sensory stimuli (excessive
      noise, bright lights, painful medical applications, etc.) that are not present in the uterus.
      During the critical period of brain development, this sensory overload affects the
      physiological responses of infants; It can lead to sensory processing problems by causing
      negative changes in motor, neurological and sensory development. Sensory processing was
      explained by Dunn as the emergence of appropriate reactions and behaviors in neurological
      processes in which visual, auditory, tactile, oral, olfactory, vestibular, proprioceptive and
      kinesthetic inputs are regulated.
    

Detailed description: 
      There are interactions between an individual's neurological thresholds and emotional and
      behavioral responses or self-regulation strategies. Sensory modulation is an active
      processing process in which the brain adapts to sensory inputs from the environment by
      stimulating or inhibiting neurons as required by the current situation. Based on the
      interaction between an individual's neurological threshold and behavioral responses, Dunn
      developed four different response categories. These are sensation seeking, avoidance, low
      registration, and increased sensory sensitivity. From infancy, these processes show
      appropriate development with natural stimuli. However, sometimes there may be deviations in
      development from early infancy. One of them is the NICU, which is necessary to support vital
      functions. Decreased spontaneous movements for any reason and exposure to excessive sensory
      stimuli in this environment may cause negative consequences for the normal sensory and motor
      development of the baby.Babies who stay in the NICU for a long time stay away from natural
      sensory stimuli. Newborn preterm infants receive less tactile and vestibular stimulation in
      the NICU than does prenatal maternal movement. However, they are exposed to increased
      stimulus with other negative stimuli such as bright lights, high noise levels, excessive use
      and frequent painful interventions, which are not found in the intrauterine environment in
      the NICU. This can have lasting effects on the developing brain and affect the natural
      development of sensory systems. In the studies conducted, a significant difference was found
      between term babies and preterm babies in terms of sensory profile scores. Studies examining
      the relationship between sensory processing parameters and motor development in infants are
      limited in the literature. There is also a need for studies examining the relationship
      between sensory-motor development from the neonatal period. It is thought that preterm
      infants are exposed to these negative sensory stimuli longer. Neurodevelopmental follow-up is
      required after discharge in these infants with biological sensitivity and risk of
      neurological injury.The aim of this study is to examine the motor and sensory development of
      high-risk infants and compare them with their peers.
    

Intervention name(s): Measurements
Intervention type(s): Other
Intervention description(s): Demographic information of infants and parents, prenatal, postnatal and natal risk factors, Magnetic Resonance Images (MRI), General Movements (GMs) evaluations of babies with Prechtl method from NICU will be recorded. Video recordings for General Movements (GMs) analyzes with the Prechtl method will be taken at postterm 12th to 20th weeks. The infants' sensory processing (general, auditory, visual, tactile, movement, oral) will be evaluated with the adjusted Infant Sensory Profile-2 (ISP-2) family scale, which will be filled in by their mothers at the 3rd month. For motor assessments, the postterm corrected 3 month Hammersmith Infant Neurological Examination (HINE) will be used. A pediatric neurologist who was blinded to all testing made the diagnosis of CP in a 2-year-old child based on neuroimaging and clinical tests.
Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        High risk of infants and healty peer aged control group
      
Keywords: Motor development; Sensory development; High risk of Infants; Sensry disorder