Manual exploratory behaviors in six-month-old infants at environmental and biological risk.

BACKGROUND: Exploratory behaviors are essential and may improve different skill development. Different risk factors may negatively impact neuromotor development, such as biological risk and environmental risk. OBJECTIVE: Assess and discriminate exploratory behaviors of infants at environmental or biological risk and infants at non-risk. METHODS: Sixty-four six-month-old infants were divided into three independent groups: Group 1 (G1), 28 healthy full-term infants; Group 2 (G2), 21 full-term infants of low socioeconomic status (SES); Group 3 (G3), 15 very preterm infants. Nine exploratory behaviors were assessed: fingering, mouthing, waving, tapping, banging, transferring, rotating, alternating, and squeezing. RESULTS: For the malleable object, fingering (p = 0.005) and transferring (p = 0.046) behaviors were different between G2 and G3 whereas waving behavior (p = 0.041) differed between G1 and G3 and transferring (p = 0.003) between G1 and G2. For the rigid object, waving was different between G1 and G3 (p = 0.018) whereas transferring behavior differed between G2 and G3 (p = 0.019). Total number of behaviors was significantly different between G1 and G2 for malleable (p = 0.019) and rigid objects (p = 0.009). Intragroup analysis revealed differences between malleable and rigid objects for transferring (p = 0.013), squeezing (p < 0.0001), fingering (p < 0.0001), and banging (p = 0.013) behaviors in infants from G1. Fingering and squeezing (p < 0.0001) were different between malleable and rigid objects in G2 (p = 0.009 and p < 0.0001) and G3 (p = 0.004 and p < 0.0001). CONCLUSION: Risk factors and object properties influence exploratory behaviors, mainly in low SES infants. Fingering and banging behaviors are favored by rigid objects, while squeezing is favored by malleable objects.

Screening and Evaluation of Neurodevelopmental Impairments in Infants Under 6 Months of Age with Congenital Heart Disease.

Clinical evaluation of neurodevelopmental impairments before 6 months of age is needed in congenital heart disease (CHD) to promote early referral to developmental interventions. The objective was to identify the risk of cerebral palsy (CP) and to compare neurodevelopment outcomes in infants with and without CHD. In a longitudinal study, 30 infants with CHD and 15 infants without CHD were assessed at 1 month, 3 months, and 6 months of age. Included measures were General Movement Assessment (GMA), Test of Infant Motor Performance (TIMP) and the Bayley Scale of Infant Development, third edition (Bayley-III), selected to identify the risk of CP, document neurodevelopmental impairments and infants' eligibility for early intervention services. Abnormal GMA categories were found in the CHD group where 48% had poor repertoire and 15% were at high risk of CP. At 3 months of age, CHD group had significantly lower TIMP scores compared to infants without CHD [t(41) = 6.57, p = 0.01]. All infants in the study had higher Bayley-III scores at 6 months than at 3 months of age. Infants with CHD had lower gross motor, fine motor and cognitive Bayley-III scores compared to their peers without CHD. Over time infants without CHD outperformed the CHD group in the gross motor skills [F(1,41) = 11.76, p = .001]. Higher prevalence of abnormal GMs, lower TIMP and Bayley-III were found in infants with single ventricle physiology compared to two-ventricle physiology. The risk of CP exists in infants with CHD, and these infants have worse outcomes compared to their peers without CHD. These differences are intensified in the single ventricle population.Clinical Trial Registration National Institute of Health, Unique identifier: NCT03104751; Date of registration-April 7, 2017.

Reaching skills in six-month-old infants at environmental and biological risk.

OBJECTIVES: To assess kinematic parameters and proximal and distal reaching adjustments of infants at biological or environmental risk and compare with reaching performance of six-month-old full-term infants without known risk factors. METHODS: This blinded cross-sectional study included 62 infants at six months of age divided into three independent groups: Group with no known risk factor (NRF), 28 full-terms with no risk factors; Low SES group (LSES):19 full-terms classified as low socioeconomic status and no biological risk; Very preterm group (VPT), 15 very preterm infants at six months corrected age and no environmental risk. Infants were placed in a reclined baby chair at 45°, and a malleable and unfamiliar object was presented to the infant at 5-second intervals to elicit reaching movements. RESULTS: Infants from LSES presented reaching duration (p = 0.032, Cohen's f = 0.349) and movement unit (p = 0.033, Cohen's f = 0.351) significantly higher than VPT group. Horizontal hand orientation was moderately associated with infants at environmental risk (p = 0.031; Cramer's V = 0.30). CONCLUSION: Infants of low socioeconomic status perform less functional reaching movements than very preterm infants at six months corrected age. Socioeconomic status may impact more on reaching skills than biological risk. Given the importance of reaching for infant development, low-cost public health strategies are needed to identify possible delays.

Analysis of sensory processing in preterm infants.

BACKGROUND: Premature birth suggests condition of biological vulnerability, predisposing to neurological injuries, requiring hospitalization in Neonatal Intensive Care Units, which, while contributing to increase the survival rates, expose infants to sensory stimuli harmful to the immature organism. AIMS: To evaluate the sensory processing at 4 and 6months' corrected age. SUBJECTS AND METHODS: This was a descriptive cross-sectional study with a sample of 30 infants divided into an experimental group composed of preterm infants (n=15), and a control group composed of full-term infants (n=15). The infants were assessed using the Test of Sensory Functions in Infants. RESULTS: The preterm infants showed poor performance in the total score of the test in reactivity to tactile deep pressure and reactivity to vestibular stimulation. When groups were compared, significant differences in the total score (p=0.0113) and in the reactivity to tactile deep pressure (p<0.0001) were found. CONCLUSION: At 4 and 6months of corrected age, the preterm infants showed alterations in sensory processing. These changes were most evident in reactivity to tactile deep pressure and vestibular stimulation.

Motor development and sensory processing: A comparative study between preterm and term infants.

Infants born preterm and/or with low birth weight may present a clinical condition of organic instability and usually face a long period of hospitalization in the Neonatal Intensive Care Units, being exposed to biopsychosocial risk factors to their development due to decreased spontaneous movement and excessive sensory stimuli. This study assumes that there are relationships between the integration of sensory information of preterm infants, motor development and their subsequent effects. OBJECTIVE: To evaluate the sensory processing and motor development in preterm infants aged 4-6 months and compare performance data with their peers born at term. METHOD: This was a cross-sectional and comparative study consisting of a group of preterm infants (n=15) and a group of term infants (n=15), assessed using the Test of Sensory Functions in Infants (TSFI) and the Alberta Infant Motor Scale (AIMS). RESULTS: The results showed no significant association between motor performance on the AIMS scale (total score) and sensory processing in the TSFI (total score). However, all infants who scored abnormal in the total TSFI score, subdomain 1, and subdomain 5 presented motor performance at or below the 5th percentile on the AIMS scale. CONCLUSION: Since all infants who presented definite alteration in tolerating tactile deep pressure and poor postural control are at risk of delayed gross motor development, there may be peculiarities not detected by the tests used that seem to establish some relationship between sensory processing and motor development.