Specific characteristics of abnormal general movements are associated with functional outcome at school age

Background: Assessing the quality of general movements (GMs) is a non-invasive tool to identify at early age infants at risk for developmental disorders. Aim: To investigate whether specific characteristics of definitely abnormal GMs are associated with developmental outcome at school age. Study design: Observational cohort study (long-term follow-up). Subjects: Parents of 40 children (median age 83 years, 20 girls) participated in this follow-up study. In infancy (median corrected age 10 weeks), the children (median gestational age 303 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). Outcome measures: 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. (C) 2016 Elsevier Ireland Ltd. All rights reserved.