bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuromotor ability in 5‐ to 7‐year‐old children with very low or extremely low birthweight
Authors: Keller Heidemarie , Ayub Beatriz V. , Saigal Saroj , Bar‐Or Oded
Published: July 2010

This study was intended to determine the effects of extremely low birthweight (ELBW, 500 to 999 g) and very low birthweight (VLBW, 1000 to 1499 g) on neuromotor ability in 5‐ to 7‐year‐old children. Fourteen ELBW and 20 VLBW children were compared with 24 term control children of normal birthweight (NBW, >2500g). Using quantitative assessment instruments, the following data were collected: maximal cycling speed during 30 seconds of cycling at ‘zero’ resistance, simple reaction time of the legs, and performance on components of a whole‐body coordination test. The main findings were a slower reaction time, lower maximal cycling speed, and lower coordination scores in the ELBW group compared with the NBW group and, for some variables, with the VLBW group. The reduced motor performance in these children appears for the most part to be a reflection of impaired neuromotor control and motor development, rather than merely a smaller body or muscle size.
Is the long‐term outcome of children following febrile convulsions favorable?
Authors: Kölfen W. , Pehle K. , Konig S.
Published: July 2010

The study comprised 80 children aged 6 to 9 years with a history of febrile convulsions. A neurological examination, an interview to assess psychiatric anomalies, and a series of neuropsychological tests were performed on patients with previous febrile convulsions and on matched healthy controls. Children with non‐febrile seizures or CNS infections were excluded. Recurrence of febrile seizures in the study group was 41% (N=33), 18 children (22%) had prolonged febrile convulsions, six (7.5%) patients and two controls showed discrete neurological abnormalities. Behavioral anomalies were exhibited by 22% of the patients and 6% of the healthy children. The neuropsychological test results did not demonstrate significant differences between the children with febrile convulsions and the healthy controls. However, in children with prolonged febrile convulsions, non‐verbal intelligence was found to be significantly lower as compared with children with simple febrile seizures and with controls. None of the other parameters tested yielded any differences between patients and controls. Children with multiple recurrences of febrile convulsions performed poorer in all tests when compared with children with only one febrile seizure or with controls. Other factors such as a positive family history of epilepsy, age at onset of febrile convulsions, or duration of the seizure were not found to be of prognostic significance.
Eye‐movement disorders and visual‐perceptual impairment in diplegia children born preterm: a clinical evaluation
Authors: Fedrizzi Ermellina , Anderloni Adriana , Bono Renata , Bova Stefania , Farinotti Mariangela , Inverno Michelina , Savoiardo Silvia
Published: July 2010

The visual‐motor behaviour of 15 preterm diplegic children and 50 control children (age range 4 to 7 years) was recorded on video as they performed a visual‐perceptual task (an adaptation of the Animal House subtest of the Wechsler Preschool Primary Scale of Intelligence). The following parameters were analysed and scored: time to perform task; omissions; figure‐colour association; sequence direction; sequential scanning order; accuracy of fitting target; and number of anticipatory saccadic movements to next target. The ability of the control children to perform the task improved significantly with age, as measured by performance time, mistakes in sequence direction and scanning order, accuracy of target fitting, and number of anticipatory saccadic movements. The scores of children with diplegia were not related to age and were poorer overall than those of the control group. Children with diplegia made significantly more mistakes of sequence direction and scanning order, and significantly fewer anticipatory saccadic movements than the control group. These results indicate that visual‐perceptual impairment in diplegic children born preterm is not attributable only to sensory visual loss and to fine manipulation difficulties but is also related to difficulties in eye movements and in using anticipatory control to process information.
Linear growth velocity in children with cerebral palsy
Authors: Samson‐Fang Lisa , Stevenson Richard D.
Published: July 2010

Retrospective analysis of an anthropometric database collected prospectively in children with cerebral palsy (CP) was carried out to evaluate linear growth velocity and identify risk factors for poor linear growth. Growth velocity measures were compared with published norms for prepubertal growth velocity and z scores were calculated. Mean growth velocity z score (Gvz) was ‐0.97 ± 1.9. Boys grew more slowly than girls (mean Gvz = ‐1.5 ± 1.9 versus ‐0.3 ± 1.7 P=0.003). Gvz did not correlate with type of CP or presence/absence of microcephaly. Young age was a risk factor for poor linear growth (mean Gvz = ‐2.40 ± 2.6 for children under 2 years of age versus ‐0.76 ± 1.9 ages 2 to 6 and ‐0.77 ± 1.6 ages 6 to 10, P=0.04). Children at nutritional risk (triceps skinfold thickness ≤5%) grew poorly (mean Gvz = ‐1.46 ± 1.5 versus ‐0.30 ± 1.8, P=0.01). For children over 2 years, those with cognitive impairments grew more slowly than those with normal cognition (mean Gvz = ‐1.25 ± 1.9 versus ‐0.12 ± 1.8, P=0.02) and non‐ambulatory children grew more slowly than ambulatory children (mean Gvz = ‐1.20 ± 1.5 versus ‐0.35 ± 1.9, P=0.03). Prepubertal children with CP grow more slowly than expected compared with age‐ and sex‐based standards. Sex, age, cognitive impairment, ambulatory status, and nutritional state are factors which may contribute to slow growth. These results add to the growing data that children with CP have unique growth patterns. Further study is needed to clarify the factors which contribute to poor linear growth in this population.
Evaluating motor function in children with Down syndrome: validity of the GMFM
Authors: Russell Dianne , Palisano Robert , Walter Stephen , Rosenbaum Peter , Gemus Maryan , Gowland Carolyn , Galuppi Barbara , Lane Mary
Published: July 2010

The Gross Motor Function Measure (GMFM) was developed and validated originally by Russell and colleagues as an evaluative assessment of gross motor function in children with cerebral palsy (CP). The present study reports the results of reliability and validity testing of the GMFM for use with children with Down syndrome (DS). One hundred and twenty‐three children with DS were assessed twice over a 6‐month period, using the GMFM and the motor scale of the Bayley Scales of Infant Development ‐ second edition (BSDD‐II). In addition to the usual method of scoring the GMFM using only observed motor behaviours (standard score), parent reports of children's activities not seen by the assessor on the day of testing were also obtained and a second score (reported score) was calculated for each GMFM assessment. Test‐retest and interrater reliabilities were excellent (all > 0.90). Observed correlations between change on GMFM and judgements of change made independently by parents, intervenors, and masked video raters were lower than hypothesized. However, the pattern of change scores in predefined age and severity subgroups supported the contention that the GMFM was able to detect differential amounts of change as predicted. The GMFM was shown to be relatively more responsive to change in gross motor function than the motor scale of the BSID‐II. The ‘reported’ scores on the GMFM demonstrated better evidence of reliability, validity, and responsiveness than the standard scoring method and this approach is recommended for use when assessing children with DS.
Epilepsy in very preterm infants: neonatal cranial ultrasound reveals a high‐risk subcategory
Authors: Amess PN , Baudin Jenny , Townsend Janice , Meek Judith , Roth S C. , Neville B G R. , Wyatt J S. , Stewart Ann
Published: July 2010

The aim of this study was to investigate the association between epilepsy and perinatal brain injury in a cohort of 610 infants born preterm at <33 weeks' gestation. The prevalence of epilepsy in this cohort was 4.3% as determined by a postal questionnaire survey. Most children with epilepsy (16 of 24) had high‐risk cranial ultrasound lesions including haemorrhagic parenchymal infarction (HPI), posthaemorrhagic hydrocephalus, and cystic periventricular leukomalacia (PVL). Of all the children in our cohort with high‐risk brain lesions, those with epilepsy were more likely to have HPI and significantly less likely to have cystic PVL, although it is possible that PVL was not noticed in some cases. Children with epilepsy and high‐risk cranial ultrasound lesions also showed more cognitive impairment than children with high‐risk lesions but no epilepsy, which suggested more cortical grey‐matter damage. We suggest that brain injury has occurred outside the confines of the periventricular white matter in this group of preterm infants with epilepsy.
Attention deficits and clumsiness in Swedish 7‐year‐old children
Authors: Kadesjö Björn , Gillberg Christopher
Published: July 2010

A population study of 409 seven‐year‐old children in a middle‐sized Swedish town was performed. All children were examined by the same doctor and evaluated by means of parent interview, motor examinations, and teacher reports on behaviour in the classroom. Follow‐up was carried out 8 months later. The rate of severe problems in the fields of attention deficit‐hyperactivity disorder (ADHD), developmental coordination disorder (DCD), and deficits in attention, motor control, and perception (DAMP) (the combination of ADHD and DCD) was 6.1%, with boys being affected more frequently than girls. There was considerable overlap between ADHD and DCD, with about half of each diagnostic group also meeting criteria for the other diagnosis. Attention deficits at diagnosis strongly predicted attention deficits at follow‐up. If parents had noted attention deficits in the home setting, then teachers almost always independently agreed that there were similar problems in the classroom. However, the reverse did not always apply. Clumsiness also showed striking stability over time. The diagnosis of DAMP, particularly severe DAMP, had a stronger association with classroom dysfunction and with high Conners scores than did diagnoses of ADHD or DCD. It is concluded that DAMP may be a clinically valid diagnostic construct.
Visual, cognitive, and neurodevelopmental outcome at 5½ years in children with perinatal haemorrhagic‐ischaemic brain lesions
Authors: Van den Hout B M. , Eken P. , Van der Linden D. , Wittebol‐Post D. , Aleman S. , Jennekens‐Schinkel A. , Van der Schouw Y T. , De Vries L S , Van Nienwenhuizen O
Published: July 2010

To determine predictive values of early visual and neurocognitive assessment in children with perinatally acquired haemorrhagic or ischaemic brain lesions selected on the basis of ultrasound, 63 children (37 boys, 26 girls), who had been followed and examined until the age of 18 months, were reexamined at 5½ years. Good correlations between visual and neurodevelopmental assessments at 18 months and at 5½ years were found. When ultrasound abnormalities were combined with early visual and neurocognitive assessment data, good predictive values, especially for the group of children who had grade 2 to 4 leukomalacia, were found for visual acuity and neurodevelopment.
Glutaric aciduria type I with high residual glutaryl‐CoA dehydrogenase activity
Authors: Pineda M. , Ribes A. , Busquets C. , Vilaseca M A. , Aracil A. , Christensen E.
Published: July 2010

Two brothers with dystonia and slight MRI changes in the basal ganglia had normal urinary glutaric acid excretion, but slightly increased 3‐hydioxyglutarate and conjugated glutarate excretions. Both siblings have high residual glutaryl‐CoA dehydrogenase activity, and are compound heterozygotes for two mutations ‐ R227P and V400M ‐ reported to be disease‐causing in patients with glutaric aciduria type I.
HIV‐1 and the developing central nervous system
Authors: Tardien Mare
Published: July 2010

HIV‐1 infection can be transmitted from an infected mother to her offspring. The infant will develop a chronic infection leading, in some patients, to a severe infantile disease with major neurological symptoms. This description, however, which is often presented by the mass media, can be misleading. In fact, infection of the infant occurs in only a low percentage of births and 60% of HIV‐1 infected children will be alive and pursuing a normal school curriculum at the age of 10 years1–6.
Reading ability and processing in Duchenne muscular dystrophy and spinal muscular atrophy
Authors: Billard Catherine , Gillet Patrice , Barthez Marie‐Anne , Hommet Caroline , Bertrand Philippe
Published: July 2010

We analysed the reading abilities and processing of 21 children with Duchenne muscular dystrophy (DMD), 11 matched children suffering from spinal muscular atrophy (SMA) and 42 children receiving normal education. The principal result observed was that the DMD children exhibited a reading age which was significantly lower than the SMA children compared with their chronological age. These learning disabilities were not related to a deficit in non‐verbal performance intelligence, but psycholinguistic evaluation showed a deficit in verbal intelligence, especially in the Similarities and Arithmetic WISC‐R subtests, in phonological abilities, oral word repetition, and in digit span score. The results for the DMD children were heterogeneous, and ranged from normal to greater or lesser involvement. In an attempt to clarify the nature of this reading impairment in DMD children, the three groups (DMD, SMA, and normal control children) were tested by reading aloud a list of single words and non‐words. The DMD children were significantly impaired in reading non‐words, suggesting reading disability similar to dysphonetic dyslexia, the most frequent subtype of developmental dyslexia. These results are discussed in the light of psychometric data available for our DMD population and in the light of previous studies. The practical consequences of diagnosis on rehabilitation are very important. The precise description of the cognitive deficits seen in DMD is of value for future clinical and genetic studies.
Neuropsychological analysis of the visuomotor problems in children born preterm at 32 weeks of gestation: a 5‐year prospective follow‐up
Authors: Luoma Laila , Herrgård Eila , Martikainen Anneli
Published: July 2010

Forty‐six intellectually normal children born preterm (32 weeks of gestation) without major neurological disabilities and a control group of term children matched for age, sex, and parental educational and occupational status were assessed at the age of 5 years using neuropsychological tests emphasizing perceptual and visuomotor functions. The results show that in terms of cognitive functions these preterm children are a very heterogenous group, but many of them still have problems in visuospatial and sensorimotor functions. The preterm children achieved lower mean scores in tests where coordination and voluntary control of hands in combination with tactile, kinaesthetic, and visuospatial perception were needed. They had most difficulty with drawing directions of lines and in integrating two or more forms. They also had problems with 3‐dimensional constructions as well as visual perception of rotated shapes or slopes of lines.
Retesting for fragile X syndrome in cytogenetically normal males
Authors: MSc Paul Gringras MBChB MRCP , MSc Angela Barnicoat MBChB MRCP
Published: July 2010

This case series describes four males who presented with learning and behavioural difficulties. In each case, the diagnosis of fragile X syndrome was delayed because of an initial false‐negative cytogenetic result. Although most children are currently investigated for fragile X syndrome using highly sensitive and specific molecular techniques, there still remain a large number of older children who have been tested using only cytogenetic analysis. The clinical presentation of these four children and the reason for the occurrence of the false‐negative results are considered. In addition, there is a discussion and illustration of how a screening checklist can be used to help clinicians to decide which children should be retested.
Is ACTH a key to understanding anticonvulsant action?
Authors: O'Regan ME , DCH JK Brown MB FRCP
Published: July 2010

Adrenocorticotrophin hormone (ACTH) has been used as an anticonvulsant for many years. In this paper, the use of ACTH in 23 children with intractable epilepsies is described. It was found that ACTH worked most effectively when the EEG showed benzodiazepine sensitivity. A mechanism of action of ACTH is proposed.
Spatial grouping activity in children with early cortical and subcortical lesions
Authors: Vicari Stefano , Stiles Joan , Stern Catherine , Resca Alessandra
Published: July 2010

Spatial construction skills were examined in 3‐ to 5‐year‐old children with prenatal or perinatal focal brain injury. In earlier work, a dissociation was reported between children with injury to the right hemisphere and the left hemisphere, right‐hemisphere injury resulting in significantly lower levels of performance. In the current paper, the effect of isolated unilateral subcortical injury was explored. Thirty‐four children with early focal brain injury were tested in a task which required them to copy a series of simple block constructions. There were approximately equal numbers of children with right‐hemisphere and left‐hemisphere injury; within each of these groups approximately half of the children had injury involving only subcortical regions. Consistent with the earlier work, children with right‐hemisphere injury performed significantly below children with left‐hemisphere injury and the normal controls. Importantly, no differences were observed between the children with isolated subcortical injury and children with injury involving both cortical and subcortical brain areas.
Delayed visual maturation: an update
Authors: Russell‐Eggitt; Isabelle , Harris; C M. , Kriss; A.
Published: July 2010

The term ‘delayed visual maturation’ (DVM) can be applied either in a broad sense to all infants who appear to be blind yet subsequently develop some vision, or, more specifically, to a group with normal ocular and systemic clinical examination whose visual behaviour markedly improves by 4 to 6 months of age and whose visual acuity is subsequently normal. The term DVM is used both as a diagnostic label in this latter group (as there is no more specific diagnosis) or as a descriptive term of a behavioural phenomenon in its broad definition. Without a consensus on usage there is therefore some confusion in the literature. Those who favour the broad approach subclassify DVM into type 1, which corresponds to the latter specific group; type 2, in which there is neurological abnormality and/or learning disability and in which visual function is often, but not invariably, permanently impaired to some degree; and type 3, where there is an ocular abnormality and nystagmus develops with visual improvement (Uemera et al. 1981). Fielder and Mayer (1991) further expanded the classification by limiting type 3 to albinism and idiopathic congenital nystagmus, and separating severe ocular disorders into type 4.
The genetics of learning disabilities
Authors: Hodgson Shirley V.
Published: July 2010

Moderate and severe learning disabilities are defined as conditions in which intellectual capacity is compromised, with the likelihood that there will be no catch‐up development.
The prevalence of Tourette syndrome in a mainstream school population
Authors: Anne Mason BSc  , Sube Banerjee MD MSc MRCPsych  , Valsamma Eapen PhD, MRCPsych  , Harry Zeitlin MD FRCP, FRCPsych  , Mary M Robertson MD, FRCPsych
Published: July 2010

The aim of this study was to ascertain accurately the prevalence of Tourette syndrome (TS) in a mainstream school population. All year 9 pupils (aged 13 to 14 years) in a mainstream secondary school were investigated using a two‐stage procedure. Standardized questionnaires were completed by parents, teachers, and pupils. Class observations were also carried out to identify tics. Those pupils identified as having tics underwent a semistructured interview to determine whether they had TS according to DSM‐III–R criteria. Data were available from at least one source (parent, teacher, or self‐reports) on 166 of the 167 pupils in the year. Five subjects were identified as having TS according to DSM‐III‐R criteria, yielding a prevalence estimate of 299 per 10 000 pupils in this age group. The results of this study suggest that TS in the community as a whole is more common and milder than those prevalence estimates and descriptions of the disorder based on TS encountered in secondary or tertiary health‐care service settings.
Relation between blindness due to retinopathy of prematurity and autistic spectrum disorders: a population‐based study
Authors: Ulla Ek MSc  , Elisabeth Fernell MD, PhD  , Lena Jacobson MD  , Christopher Gillberg MD, PhD
Published: July 2010

Children with blindness due to retinopathy of prematurity (ROP) ‐ who are at greatly increased risk of cerebral damage ‐ have been noted to have a high rate of autistic symptoms, but systematic controlled studies have been lacking. A controlled population‐based study was performed; one group was blind due to ROP (N=27) and the other was congenitally blind due to hereditary retinal disease (N=14). Fifteen of the 27 children with ROP had autistic disorder. All these children were mentally retarded and about one‐third of them had cerebral palsy. In the comparison group, two of the 14 children had autistic disorder. It is concluded that there is a strong association between ROP and autistic disorder. The association is most probably mediated by brain damage and is largely independent of the blindness per se.
Visual outcome at 5 years of newborn infants at risk of cerebral visual impairment
Authors: Jackie van Hof‐van Duin MD, PhD  , Giovanni Cioni MD  , Bertuccelli Barbara , Barbara Fazzi MD  , Carlo Romano MD  , Antonio Boldrini MD
Published: July 2010

Visual development at 5 years of age was tested in a group of 39 children who had shown severe neonatal encephalopathy or perinatal brain lesions, documented by medical history, cranial ultrasound, or MRI. In all children, grating acuity was tested during the first 2 years of life. The assessment protocol at 5 years included various visual functions (grating and resolution acuity, visual field size, depth perception, optokinetic nystagmus, and ocular motility), and neurological and cognitive development. The majority of the children showed visual disorders of different type and degree, which were not due to ophthalmological abnormalities. Visual defects correlated well with the results of early visual assessment and of neuroimaging. Visual outcome could be predicted by grating acuity at 1 to 2 years in 27 of the 39 children, by neonatal cranial ultrasound in 26 of the 32 cases examined by this technique, and by later MRI in 23 out of 27. Moreover, a significant correlation was found between visual, motor, and cognitive impairment.
Assessment of preterm infants in the intensive‐care unit to predict cerebral palsy and motor outcome at 6 years
Authors: Joan L Lacey MAPA  , David J Henderson‐Smart MB PhD FRACP
Published: July 2010

One hundred and fifty‐three infants were assessed by a method specific to preterm infants and appropriate to the intensive‐care nursery environment. The presence or absence of six atypical features (coarse jitters, dominant asymmetrical tonic neck reflex, paucity of movement, ‘contradictory’ development, hypotonia, or hypertonia) resulted in neonatal classification. There were 116 ‘usual’ (an absence of atypical features with progressive development), 26 ‘unusual’ (a transient occurrence of any atypical feature), and 11 ‘suspect’ (dominance of one or more atypical features). At 6 years of age the motor subsystems of balance, coordination, fine and gross motor, and associated movements were assessed. Nine of 11 children with cerebral palsy had neonatal categories of ‘suspect’ (7) and ‘unusual’ (2), of the remaining four other ‘suspect’ children, two failed two motor subsystems and two failed motor items. A ‘usual’ neonatal assessment predicted normal motor outcome for 72 of 116 (62%) whereas a ‘suspect’ assessment predicted major motor dysfunction for seven of 11 of the children.
Are skinfold measurements suitable to compare body fat between children with spastic cerebral palsy and healthy controls?
Authors: Rita J G van den Berg‐Emons PhD  , Marleen A van Baak PhD  , Klaas R Westerterp PhD
Published: July 2010

The aim of this study was to assess whether percentage of body fat (BF) can be predicted adequately from skinfold measurements in comparative studies of children with spastic cerebral palsy (CP) and healthy control children. The deuterium dilution technique (D2O) was used as a reference method. In contrast with what was expected, %BF predicted from skinfold measurements was considerably lower than that determined by the D2O method in children with CP, whereas in the controls this was not seen. A proportionally large internal fat deposit and a different distribution of subcutaneous fat in children with CP may be responsible for this. It was concluded that skinfold measurements are not suitable for predicting %BF in comparative studies of children with CP and control children. For evaluation of diet‐or exercise‐related interventions in children with CP, the use of skinfold measurements seems to be justified. However, it may be more appropriate to use skinfold thicknesses without converting them to BF.
Development of perioral muscle activity during suckling in infants: a cross‐sectional and follow‐up study
Authors: Yasuo Tamuia DDS, PhD  , Shigeru Matsushita DDS, PhD  , Keiji Shinoda DDS, PhD  , Sadahiro Yoshida DDS, PhD
Published: July 2010

The activity of the perioral muscles during breastfeeding in infants was investigated using EMGs. Fifty‐six infants aged from 1 to 5 months were classified into five groups according to month of age in the cross‐sectional study. Follow‐up was carried out on 18 infants whose mean age was 2.5 months at the initial examination, and 4.8 months at the second. During suckling, EMGs were recorded unilaterally from the temporalis (TM), the masseter (MM), the orbicularis oris (OM), and the suprahyoid (SM) muscle groups. The activity of the SM increased significantly with age, while there was no appreciable increase in the activity of the TM, MM, and OM in either the cross‐sectional study or the follow‐up. However, total muscle activity was shown to increase significantly in both parts of the study. These findings suggest that the active tongue‐ and jaw‐lowering movement may play a primary role in increasing sucking strength during the suckle‐feeding period in infants.
How much brain does a mind need? Scientific, clinical, and educational implications of ecological plasticity
Authors: Joseph Lebeer MD, PhD
Published: July 2010

Plasticity is defined as the brain's capacity to modify its structure or function as a reaction to learning and to brain damage. The term has a variety of meanings: sometimes only microanatomic changes are regarded as neuroplastic1, but some authors use plasticity in its broadest sense to mean the capacity of an organism to adapt, as opposed to being a static, fixed structure2. Although Lashley4 can be seen as one of the research pioneers of plasticity as far back as 1944, neurobiological understanding is fairly recent. The number of plasticity studies is rising exponentially: from seven studies between 1966 and 1974, to 1139 between 1995 and 1997. Mechanisms of plasticity include: an increase in synaptic connections, axon sprouting and thickening, neurochemical moditications, construction of new functional pathways4‐8, and neuroprotein synthesis9. These phenomena also occur in normal brain development associated with learning9. However, plasticity need not necessarily imply an anatomical change, as in functional compensation10, 11. In this case an impaired function is compensated for by another system, for example, orientation by a blind man through compensatory auditory attention. Functional repair is a term reserved to indicate restoration of functional neural connections after injury. In this article, the tern plasticity is used in its broadest sense.
Developmental correlates of school‐age children with a history of benign congenital hypotonia
Authors: Parush Shula , Yehezkehel Idit , Tenenbaum Alex , Tekuzener Esther , Bar‐Efrat/Hirsch Idit , Jessel Adam , Ornoy Asher
Published: July 2010

In order to clarify the prognosis of benign congenital hypotonia (BCH), 25 children aged 6 to 8 years who had been diagnosed with BCH as infants were examined on a variety of sensory, perceptual‐motor, and behavioural measures and compared with 26 control children. There were no significant differences between the two groups on any of the medical or neurological measures of the Touwen Neurological Examination (Touwen 1979), nor were there significant overall differences on any of the sensory or behavioural measures. However, the BCH group showed inferior gross motor performance on the Bruininks‐Oseretsky Test of Motor Proficiency (Bruininks 1978). They scored significantly lower on the Gross Motor Composite, and performed worse on each of the four Gross Motor Subtests, reaching significance on two: Bilateral Coordination and Strength. The follow‐up of children with BCH should continue even after the apparent resolution of the hypotonia, with particular attention to the gross motor aspects of performance.
Development of bilateral motor control in children with developmental coordination disorders
Authors: Huh Jinyoung , Williams Harriet G , Burke Jeanmarie R
Published: July 2010

This research examined behavioral (i.e. movement time) and neuromuscular (EMG) characteristics of unilateral and bilateral aiming movements of children with normal motor development and children with developmental coordination disorders (DCD). Two age groups of children were studied: 6 to 7, and 9 to 10 year olds. Bilateral aiming movements involved moving the two hands to targets of either (1) the same amplitude ‐ symmetrical bilateral movements, or (2) different amplitudes ‐ asymmetrical bilateral movements. Unilateral aiming movements involved moving one hand to either near or far targets associated with that hand. In general, unilateral and bilateral movement times were slower in younger than older children, and in children with DCD than children with normal motor development. Our neuromuscular data suggest that the faster movement times that typically accompany increasing age in children may be the result of a change in the capacity to initiate antagonist muscle contractions. The prolonged burst of agonist activity and delayed onset of antagonist activity observed in children with DCD may contribute to their inability to produce fast, accurate unilateral movements. On both symmetrical and asymmetrical bilateral aiming movements, children with DCD had more performance errors and greater temporal inconsistencies between neuromuscular (EMG) parameters and behavioral (movement time) parameters than children with normal motor development. These new neuromuscular data suggest that there are important differences in the way the motor control systems of children with and without DCD organize bilateral aiming responses.
Assessment of gross motor skills of at‐risk infants: predictive validity of the Alberta Infant Motor Scale
Authors: Darrah Johanna , Piper Martha , Watt Man‐Joe
Published: July 2010

The Alberta Infant Motor Scale (AIMS) is a norm‐referenced measure of infant gross motor development. The objectives of this study were: (1) to establish the best cut‐off scores on the AIMS for predictive purposes, and (2) to compare the predictive abilities of the AIMS with those of the Movement Assessment of Infants (MAI) and the Peabody Developmental'Gross Motor Scale (PDGMS). One hundred and sixty‐four infants were assessed at 4 and 8 months adjusted ages on the three measures. A pediatrician assessed each infant's gross motor development at 18 months as normal, suspicious, or abnormal. For the AIMS, two different cut‐off points were identified: the 10th centile at 4 months and the 5th centile at 8 months. The MAI provided the best specificity rates at 4 months while the AIMS was superior in specificity at 8 months. Sensitivity rates were comparable between the two tests. The PDGMS in general demonstrated poor predictive abilities.
Inappropriate use of carbamazepine and vigabatrin in typical absence seizures
Authors: Parker A P J , Agathonikou A. , Robinson RO , Panayiotopoulos CP
Published: July 2010

Carbamazepine and vigabatrin are contraindicated in typical absence seizures. Of 18 consecutive referrals of children with resistant typical absences only, eight were erroneously treated with carbamazepine either as monotherapy or as an add‐on. Vigabatrin was also used in the treatment of two children. Frequency of absences increased in four children treated with carbamazepine and two of these developed myoclonic jerks, which resolved on withdrawal of carbamazepine. Absences were aggravated in both cases where vigabatrin was added on to concurrent treatment. Optimal control of the absences was achieved with sodium valproate, lamotrigine, or ethosuximide alone or in combination.
What constitutes cerebral palsy?
Authors: Badawi Nadia , Watson Linda , Petterson Beverly , Blair Eve , Slee Jennie , Haan Eric , Stanley Fiona
Published: July 2010

Cerebral palsy (CP) is a term of convenience applied to a group of motor disorders of central origin defined by clinical description. It is not a diagnosis in that its application infers nothing about pathology, aetiology, or prognosis. It is an umbrella term covering a wide range of cerebral disorders which result in childhood motor impairment. The precise inclusion criteria vary with the objectives for using the term. For meaningful comparison of rates of CP, as performed by and between CP registers, it is important that the rates should be generated using the same criteria. As generally understood there must be motor impairment, and this impairment must stem from a malfunction of the brain (rather than spinal cord or muscles). Furthermore, the brain malfunction must be non‐progressive and it must be manifest early in life. For the purposes of comparisons of rates across time even when the condition meets all the above criteria, it must not historically have been excluded from the category of CP. This paper addresses the problem of standardizing the inclusion criteria for selecting people included on CP registers with particular reference to this last criterion.
Kinematic and kinetic analysis of running in children with cerebral palsy
Authors: Davids Jon R , Bagley Anita M , Bryan Matthew
Published: July 2010

Computer‐based analysis of gait was used to study walking and running in 19 children with spastic‐diplegic cerebral palsy (CP) and 15 healthy control children. Temporospatial parameters, kinematic and kinetic data were compared and contrasted between groups for both types of gait. The majority of children with diplegic CP, who are independent ambulators, are able to run. These children increase their velocity by increasing their cadence, a mechanism that is distinct (and presumably less energy efficient) from that used by healthy children. Sagittal‐plane kinematic and kinetic profiles at the ankle in children with CP were more similar to normal profiles in running than in walking, suggesting that the primary deviations at the ankle associated with CP are better tolerated at greater velocities. Relative power analysis showed that, like healthy children, those with CP depend more upon the proximal musculature about the hip for power generation as the velocity of gait increases. Children with CP achieve energy transfer between adjacent joints during walking and running in a manner comparable to unaffected children. Running is an important activity for children and should be considered in the functional assessment of those with CP.
Hand function in children with cerebral palsy after upper‐limb tendon transfer and muscle release
Authors: Eliasson Ann‐Christin , Ekholm Catarina , Carlstedt Thomas
Published: July 2010

Thirty‐two children with hand dysfunction due to cerebral palsy were examined before tendon transfer and muscle release, and 9 months postoperatively. All children improved their performance regardless of the degree of impaired hand function. The main advantage of surgery was a more functional position of the hand with increased wrist extension and forearm supination. There were also increased functionality of handgrips, grip strength, and dexterity. Impaired sensibility before surgery did not influence the outcome. Individual goals were set preoperatively. Individual functional goals outlined before surgery were met by most children. Children identified as having mild impairments gained new functional skills related to everyday activity (self‐care and leisure), while children with severely impaired hand function demonstrated enhanced grasping ability, as well as a better cosmetic appearance.
Movement disorders in association with herpes simplex virus encephalitis in children: a review
Authors: Hargrave DR , Webb DW
Published: July 2010

Movement disorders have been reported in association with herpes simplex virus (HSV) encephalitis in adults and children. The cause of this complication is unclear, although a number of proposed aetiologies have been suggested, including inadequate antiviral therapy1–3, a side effect of anticonvulsants4, or a possible postinfectious mechanism5–8. A child who presented with severe chorea associated with relapse of HSV encephalitis prompted us to review the clinical features, management, and outcomes of this condition.
Children with blindness due to retinopathy of prematurity: a population‐based study. Perinatal data, neurological and ophthalmological outcome
Authors: Jacobson Lena , Pernell Elisabeth , Broberger Ulf , Ek Ulla , Gillberg Christopher
Published: July 2010

A population‐based group of 27 children with total blindness due to retinopathy of prematurity (ROP), born in Sweden from 1980 to 1990, was examined. They constituted all but two of the total of 29 children with total blindness due to ROP known to the nationai register of visually impaired children when reviewed from 1980 to 1 January 1995. All children had a gestational age of less than 31 weeks and most had had a complicated perinatal period. The retinal disease was discovered late, most often after it had already progressed to bilateral retinal detachment. Repeated vitreoretinal surgery had been performed in most children, but postoperative visual function did not improve. Three‐quarters of the group had major neurological impairment (mental retardation, cerebral palsy, or epilepsy) at age 4 to 14 years. There was an impression that extensive ophthalmological efforts delayed nenrodevelopmental assessments and examinations as well as adequate habilitation.
Electrophysiological monitoring during selective dorsal rhizotomy, and spasticity and GMFM performance
Authors: Hays Ross M , McLaughlin John F , Bjornson Kristie F , Stephens Kari , Roberts Theodore S , Price Robert
Published: July 2010

The relation between abnormal electrophysiological responses to intraoperative stimulation during selective dorsal rhizotomy (SDR) and the degree of spasticity and motor dysfunction was explored in 92 children with spastic cerebral palsy (CP) who underwent SDR at a single center. The proportion of abnormally responding rootlets was compared with the degree of spasticity measured with the modified Ash worth Scale (MAS) and with the spasticity measurement system (SMS) at discrete segmental levels. Motor impairment measured with the Gross Motor Function Measure (GMFM) was also compared with the proportion of abnormally responding dorsal rootlets. A consistent relation between the proportion of abnormally responding rootlets and the degree of spasticity and gross motor abnormality at the corresponding muscles could not be demonstrated. There was also no consistent association between the proportion of rootlets ablated during SDR and the change in spasticity measured with the MAS and SMS, or to the change in motor function as measured with the GMFM. These data suggest that the intraoperative monitoring technique most commonly used for SDR is unlikely to identify accurately those neural elements which contribute to spasticity in children with CP.
Evaluation of selective dorsal rhizotomy for the reduction of spasticity in cerebral palsy: a randomized controlled trial
Authors: Wright F Virginia , Sheil Elizabeth M H , Drake James M , Wedge John H , Naumann Stephen
Published: July 2010

Selective dorsal rhizotomy (SDR) is widely used to treat spasticity in children with diplegic cerebral palsy (CP) but has never been shown conclusively to improve functional outcome. The study was designed to measure changes in gross motor function in children 1 year following rhizotomy compared with a control group receiving equivalent physiotherapy. (PT) and occupational therapy (OT) with the exception that the rhizotomy group initially underwent a 6‐week postoperative in‐patient therapy program. Twenty‐four children (mean age 58 months) with mild to moderate CP with spastic diplegia were randomly assigned to a therapy‐only control group (CG) (N=12) or rhizotomy and therapy group (RG) (N=12). The Gross Motor Function Measure (GMFM) was administered at the baseline, 6‐, and 12‐month assessments. Extremity tone, range of motion (ROM), biomechanics of the ankle‐stretch reflex, isometric contraction, and temporal gait components were also evaluated. GMFM scores in the RG improved by 12.1 percentage points versus 4.4 percentage points in the CG (P<0.02). RG knee arid ankle tone was significantly reduced (P<0.005), associated with increased passive ankle ROM (P<0.001), and decreased soleus EMG reflex activity on forced dorsiflexion (P<0.008). Foot‐floor contact pattern improved in the RG compared with the CG (P<0.05). In conclusion, SDR combined with PT and OT leads to significantly greater functional motor improvement at 1 year following surgery compared with PT and OT alone. This was achieved in part through reduced knee and ankle tone, increased ankle dorsiflexion ROM, and more normal foot‐floor contact during walking.
Can cerebral MRI at age 1 year predict motor and intellectual outcomes in very‐low‐birth weight children?
Authors: Skranes J , Vik T , Nilsen G , Smevik O , Andersson H W , Brubakk A M
Published: July 2010

This follow‐up study reports on cerebral MRI findings in 20 very‐low‐birthweight (VLBW) infants without disabilities at age 1 year in relation to motor, intellectual, and perceptual function at age 6 years. MRI findings, anthropometrics, and Bayley Scales of Infant Development scores at age 1 year as predictors of psychomotor status at age 6 years are also evaluated and compared. Outcome parameters were the Peabody Developmental Motor Scales and the Wechsler Preschool and Primary Scale of Intelligence. The results show that infants with myelin hyperintensities including the centrum semiovale or with occipital hyperintensities with associated ventricular dilatation at age 1 scored lower on the Peabody Gross Motor Locomotion Scale at age 6 than infants with normal myelination or with isolated occipital hyperintensities. This may indicate damage to motor fibers caused by perinatal periventricular leukomalacia. No relation was found between abnormal MRI findings at age 1 and later fine motor, intellectual, and perceptual function.

Comparing different age 1‐year predictors, an abnormality score defined by MRI was used as an independent predictor of gross motor locomotion function at age 6 years. However, the Bayley Mental Development Index scores and weight at age 1 were more important predictors of later motor and intellectual outcome, respectively, than MRI findings. It is recommended that cerebral MRI should not be used routinely to examine VLBW infants without disabilities at 1 year of age.
Transient nystagmus in delayed visual maturation
Authors: Bianchi P E , Salati R , Cavallini A , Fazzi E
Published: July 2010

Two infants who presented with wide‐amplitude and high‐frequency nystagmus and lack of visual awareness in the first 3 months of life were studied. No ocular abnormalities were found. Neurodevelopmental examination, visual evoked potentials and electroretinograms were normal. One infant underwent MRI which resulted in normal findings. Two months later both patients showed increased visual responsiveness and a gradual reduction of the nystagmus amplitude. By 5 months of age nystagmus was no longer detectable and both infants appeared to be visually, developmentally, and neurologically normal. Follow‐up at 3 years of age for subject 1 and at 11 months for subject 2 showed that both the infants maintained the normal ophthalmological and neurological assessments. We diagnosed delayed visual maturation with oculomotor involvement.
Sleep‐disordered breathing in patients with myelomeningocele: the missed diagnosis
Authors: Kirk Valerie G , Morielli Angela , Brouillette Robert T
Published: July 2010

Moderate to severe sleep‐disordered breathing (SDB) was identified in 20% (17 of 83) of children with spina bifida/myelomeningocele (SB/MM) at the Montreal Children's Hospital. The prevalence of SDB in patients with SB/MM elsewhere has not been determined. To establish current practices for identifying SDB in patients with SB/MM, questionnaires were sent to the coordinators of the 212 spina‐bifida clinics in Canada and in the United States. Eighty‐six (41%) questionnaires were returned, representing data on 13 349 patients. Although 67% of the responding centers reported availability of cardiorespiratory sleep studies, only 996 (7.5%) patients with SB/MM had been tested and only 418 (3.1%) patients had been diagnosed with SDB. Across clinics, the prevalence of SDB was directly related to the frequency of testing. Of 380 deaths over the past 10 years, SDB and sudden unexplained death during sleep were identified as the cause of death in 49 (12.8%) and 34 (8.9%) patients, respectively. Moderate to severe SDB may not have been identified in a significant number of patients with SB/MM because they have not been tested.
Sexual and reproductive health in young people with spina bifida
Authors: Sawyer Susan M , Roberts Kathryn V
Published: July 2010

This study aimed to identify the sexual and reproductive health knowledge, attitudes, and behaviour of young people, aged between 14 and 23 years, with spina bifida who had attended the Spina Bifida Clinic at a tertiary centre in Melbourne, Australia within the past 10 years. Subjects participated in a structured interview and their parents completed a written questionnaire. Fifty‐one (55%) of 93 eligible young people and 69 of 97 parents (71%) participated. Most young people were satisfied with the amount of general sex education they had received. However, 95% stated they had inadequate knowledge about sexual and reproductive health relating to spina bifida and 59% of parents considered they had inadequate knowledge. Thirty‐nine percent of young people and 30% of parents had discussed sexuality issues with a doctor. However, 93% of young people and 100% of parents said that they would definitely talk about these issues if the discussions were initiated by their doctor. A significant degree of sexual intimacy was reported, with 60% reporting an intimate relationship, and 25% (10 females, three males) reporting sexual intercourse. Thirty‐seven percent of females had experienced unwanted sexual attention, and 30% reported unwanted sexual touching. This study suggests that health professionals should pay greater attention to sexual and reproductive health issues in young people with spina bifida.