Complementary feeding approach and maternal responsiveness in 8- and 12-month-old Italian infants: A longitudinal study.

In Western countries, infants are usually introduced to solids through spoon-fed puréed foods (parent-led weaning, PLW). However, an alternative approach known as "baby-led weaning" (BLW), in which infants usually participate in family meals and eat independently, is becoming increasingly popular. We investigated the relationship between the type of complementary feeding approach and maternal responsiveness to infant feeding cues in a longitudinal sample of 178 infants observed at 8 and 12 months. Mothers reported the complementary feeding method used and, from video-recorded meals, we coded the proportion of time infants self-fed and rated maternal responsiveness by means of the Responsiveness to Child Feeding Cues Scale (Hodges et al., 2013). Responsiveness to infant receptiveness and fullness cues were significantly correlated at 8 months, but not at 12 months, when unresponsiveness decreased for receptiveness but remained stable for fullness cues. Thus, as infants got older, mothers were increasingly tuned in to their receptiveness cues. However, we did not observe the same pattern for fullness cues, perhaps because mothers were concerned that their infants did not eat enough. Moreover, at both time points, mothers were more responsive to infants' receptiveness than fullness cues, possibly due to an evolutionary drive to protect infants from starvation. Finally, responsiveness to fullness, but not responsiveness to receptiveness, was positively related to the proportion of infant self-feeding, but there were no significant differences in responsiveness depending on the self-reported complementary feeding approach. Thus, a weaning style that emphasizes independent feeding, regardless of whether this is labeled as BLW, may promote more infant-centered maternal responses at the end of the meal, with potential implications for promoting infant self-regulation not only at mealtimes, but also in other domains.

Early factors associated with risk of developmental coordination disorder in very preterm children: A prospective area-based cohort study in Italy.

BACKGROUND: Developmental coordination disorder (DCD) is a motor disorder of unknown aetiology that may have long-term consequences on daily activities, and psychological and physical health. Studies investigating risk factors for DCD have so far provided inconsistent results. OBJECTIVES: To assess, using a parent-report screening tool, risk of DCD in school-age very preterm children born in Italy, and investigate the associated early biomedical and sociodemographic factors. METHODS: A prospective area-based cohort (804 children, response rate 73.4%) was assessed at 8-11 years of age in three Italian regions. Perinatal data were abstracted from medical records. DCD risk was measured using the Italian-validated version of the Developmental Coordination Disorder Questionnaire (DCDQ-IT). For this study, children with cognitive deficit (i.e. intelligence quotient <70), cerebral palsy, severe vision and hearing disabilities, and other impairments affecting movement were excluded. A total of 629 children were analysed. We used inverse probability weighting to account for loss to follow-up, and multilevel, multivariable modified Poisson models to obtain adjusted risk ratio (aRR) and 95% confidence interval (CI). Missing values in the covariates were imputed. RESULTS: 195 children (weighted proportion 31.8%, 95% CI 28.2, 35.6) scored positive on the DCDQ-IT, corresponding to the 15th centile of the reference Movement-ABC test. Factors associated with overall DCD risk were male sex (aRR 1.35, 95% CI 1.05, 1.73), intrauterine growth restriction (aRR 1.45, 95% CI 1.14, 1.85), retinopathy of prematurity (aRR 1.62, 95% CI 1.07, 2.45), and older maternal age at delivery (aRR 1.39, 95% CI 1.09, 1.77). Complete maternal milk feeding at discharge from the neonatal unit and higher parental socio-economic status were associated with decreased risk. CONCLUSIONS: Both biomedical and sociodemographic factors increase DCD risk. These findings can contribute to elucidating the origins of this disorder, and assist in the identification of children at risk for early referral and intervention.

Handwriting in Children with Developmental Coordination Disorder: Is Legibility the Only Indicator of a Poor Performance?

Research on the use of speed, as an indicator of motor handwriting problems, is controversial and the legibility of the text is the measure mostly examined in children. This case-control study compared handwriting legibility and speed in 25 children with Developmental Coordination Disorder (DCD) and 75 typically developing peers matched by school grade (third and fourth grade). Children with DCD achieved significantly lower scores than their peers in both legibility and speed measures, overall and in the third and in the fourth grade independently. These measures represent a good insight into children's writing abilities and could be both used to screen and monitor.

Daily motor characteristics in children with developmental coordination disorder and in children with specific learning disorder.

An association between learning disorders and coordination problems has been reported in several studies over the last few decades. In this study, we have investigated daily motor characteristics in children with a diagnosis of specific learning disorder (SLD) and compared them with those of children with developmental coordination disorder (DCD) and those of typically developing controls. Ninety-six children aged 5 to 12 years were included: 29 with a diagnosis of SLD, 33 of DCD, and 34 controls. The Italian version of the Developmental Coordination Disorder Questionnaire 2007 (DCDQ-Italian) was used to measure children's coordination in everyday functional activities. The mean DCDQ-Italian total score was significantly lower in both SLD and DCD groups as compared with controls. Regarding subscores, both clinical groups scored significantly lower than controls on "Fine motor/handwriting" skills and on "General coordination." The DCD group scored also significantly lower than controls on "Control during movement." Moreover, clinical groups differed from each other, with SLD children scoring significantly higher on "Control during movement" and "General coordination" subscores. SLD children diverged from typically developing children in some motor skills during ordinary activities, and although this discrepancy was not as severe as in DCD children, it could have an impact on self-esteem and sport inclusion.

Sleep in children with neurodevelopmental disabilities.

This review describes recent research in pediatric sleep disorders associated with neurodevelopmental disabilities (NDDs) and their treatment. NDDs affect more than 2% of the general population and represent more than 35% of the total cases of children referred to a neuropsychiatric center for sleep problems. Specific clinical and therapeutic aspects of sleep disorders associated with Down syndrome, Fragile X syndrome, Prader-Willi syndrome, Angelman syndrome, Rett syndrome, Smith-Magenis syndrome, cerebral palsy, and autism spectrum disorders are described. Furthermore, the drugs commonly used for sleep disorders in children with NDDs are described. The review clearly highlighted that children with NDDs are often affected by sleep disorders that require appropriate clinical and therapeutic approach to improve quality of life in both patients and families.

MBL2 gene polymorphisms increase the risk of adverse neurological outcome in preterm infants: a preliminary prospective study.

BACKGROUND: As described in animal models, the lectin-complement pathway is central to the propagation of ischemia-reperfusion injuries in many tissues, including the brain. Similarly, it might affect the genesis of brain damage in preterm infants. MBL2 gene single-nucleotide polymorphisms (SNPs), regulating mannose-binding lectin (MBL) serum levels, could predict the risk of adverse neurological outcome in these infants. METHODS: To evaluate the association between SNPs of the MBL2 gene and long-term neurological outcomes in preterm infants, 75 infants (gestational age (GA) ≤ 32 wk) were observed in a prospective longitudinal study and assessed by clinical and instrumental exams at 12 and 24 mo of corrected age (CA). They were genotyped for the promoter polymorphism -221 and for the exon-1 variant alleles (at codons 52, 54, and 57) of the MBL2 gene. RESULTS: The MBL2 exon-1 OO genotype was more frequent in children with an adverse neurological outcome (5/35; 7%) than in controls (0/40; 0%), P = 0.045. The risk of intraventricular hemorrhage in carriers of the genotype OO was marked, without reaching statistical significance (odds ratio: 8.67; 95% confidence interval: 0.87-86.06; P = 0.07). CONCLUSION: Preterm infants who are carriers of MBL2 exon-1 OO genotype are exposed to an increased risk of adverse neurological outcomes.

Validation of the Concise Assessment Scale for Children's Handwriting (BHK) in an Italian Population.

Handwriting difficulties represent a common complaint among children and may cause a significant delay in motor skills achievement. The Concise Assessment Scale for Children's Handwriting (BHK) assesses handwriting skill in clinical and experimental settings, providing a quick evaluation of handwriting quality and speed through a copying text. The aim of the present study was to validate the Italian adaptation of the BHK in a representative primary school population. Overall, 562 children aged 7-11 from 16 public primary schools of Rome were included and asked to copy a text in 5 min using cursive handwriting. Handwriting quality and copying speed were measured. The included population followed a normal distribution for the BHK quality scores. Sex influenced the total quality scores, whereas school level influenced the copying speed. The BHK quality score was higher in girls (p < 0.05) and resulted as a stable parameter along the school years, without significant variations with regard to the years spent in handwriting exercise (p = 0.76). The handwriting speed was influenced by school level, and significant differences were found for each of the grades from the second to the fifth (p < 0.05), but not for gender (p = 0.47). Both BHK measures represent a helpful tool for the characterization and assessment of children with handwriting difficulties. The present study confirms that sex influences total BHK quality score, while school level influences handwriting speed.

Quantitative ultrasonographic examination of cerebral white matter by pixel brightness intensity as marker of middle-term neurodevelopment: a prospective observational study.

Non-cystic white matter (WM) injury has become prevalent among preterm newborns and is associated with long-term neurodevelopmental impairment. Magnetic resonance is the gold-standard for diagnosis; however, cranial ultrasound (CUS) is more easily available but limited by subjective interpretation of images. To overcome this problem, we enrolled in a prospective observational study, patients with gestational age at birth < 32 weeks with normal CUS scans or grade 1 WM injury. Patients underwent CUS examinations at 0-7 days of life (T0), 14-35 days of life (T1), 370/7-416/7 weeks' postmenstrual age (T2), and 420/7-520/7 weeks' postmenstrual age (T3). The echogenicity of parieto-occipital periventricular WM relative to that of homolateral choroid plexus (RECP) was calculated on parasagittal scans by means of pixel brightness intensity and its relationship with Bayley-III assessment at 12 months' corrected age was evaluated. We demonstrated that: (1) Left RECP values at T1 negatively correlated with cognitive composite scores; (2) Right RECP values at T2 and T3 negatively correlated with language composite scores; (3) Left RECP values at T1 and T2 negatively correlated with motor composite scores. Thus, this technique may be used as screening method to early identify patients at risk of neurodevelopmental issues and promptly initiate preventive and therapeutic interventions.

Neurodevelopmental outcome in one-year-old children born preterm: differences between low birth weight and very low birth weight.

BACKGROUND: In preterm infants, low birth weight represents one of the major risk factors for health and developmental issues. In Italy, most of the studies are focused on extremely preterm or Very and Extremely Low Birth Weight (VLBW, ELBW) children, whereas little data are available on the neurodevelopmental outcome of Low Birth Weight (LBW) children. We aimed to study the developmental profile of a group of preterm children at 12 months of corrected age, comparing cognitive, language and motor performances between LBW and VLBW. METHODS: We assessed 108 children born preterm (53 LBW and 55 VLBW) at 12 months of corrected age (M= 12.9 months; SD = .95) with Bayley-III. We compared the mean scores between and within groups and the rates of mild and severe delay using the Italian norms. RESULTS: LBW children performed better than VLBW peers, particularly in the cognitive and gross motor areas. No differences between groups were found in relation to language subscales. The rate of mild and severe delay is elevated in both groups, resulting significantly higher in the VLBW group only in the motor area. CONCLUSIONS: These results strongly suggest the need of a multidisciplinary follow-up to monitor the development of premature newborns, including those with birth weights above 1500 g. The early identification of cognitive, language and motor problems is essential to promote children's well-being and intervention prior to school entry.

Motor characteristics in children with developmental coordination disorder and attentiondeficit/hyperactivity disorder: intergroup comparison and predictors.

BACKGROUND: Children with Attention-Deficit/Hyperactivity (ADHD) and/or Developmental Coordination Disorder (DCD) show high rates of motor difficulties in daily activities. This study aimed to examine the validity and reliability of the Developmental Coordination Disorder Questionnaire (DCDQ) in identifying motor characteristics in daily activities, differentiating children with ADHD-only, with DCD-only and with ADHD and DCD comorbidity. METHODS: Thirty-three children with ADHD-only, 30 with DCD-only, 33 with ADHD/DCD, and 35 controls participated to the study. Diagnosis satisfied DSM-5 criteria for ADHD and DCD. The DCDQ was administered to all children; moreover, the association between DCDQ scores and ADHD symptoms, measured by SNAP-IV, and motor coordination severity, measured by M-ABC subscales, was examined. RESULTS: The DCDQ subscale scores were significantly lower in all clinical groups than in controls, but only minimal differences were found between the clinical groups. Principal Component Analysis (PCA) of DCDQ identified five components showing the best adaptability and accounting for 71% of the variance. Both ADHD-only and ADHD/DCD achieved a better performance than DCD-only in the "Motor control in running/jumping". Conversely, children with DCD-only performed better in "General coordination". ADHD-only reached better mean scores than ADHD/DCD in "Motor control with the ball" and, than DCD, in "Planning". Inattention, hyperactivity-impulsivity at SNAP-IV, and balance at M-ABC, represented the main predictors for ADHD-only, ADHD/DCD and DCD-only, respectively. CONCLUSIONS: DCDQ may represent a useful measure to detect the different areas of difficulties in children with neurodevelopmental disorders and provides suggestions for identifying distinct altered processes underlying ADHD and DCD, alone or in comorbidity.

Online Assessment of Motor, Cognitive, and Communicative Achievements in 4-Month-Old Infants.

Remote methods for data collection allow us to quickly collect large amounts of data, offering several advantages as compared to in-lab administration. We investigated the applicability of an online assessment of motor, cognitive, and communicative development in 4-month-old infants based on several items of the Bayley Scales of Infant Development, 3rd edition (BSID-III). We chose a subset of items which were representative of the typical developmental achievements at 4 months of age and that we could administer online with the help of the infant's caregiver using materials which were easily available at home. Results showed that, in a sample of infants tested live (N = 18), the raw scores of the BSID-III were significantly correlated with the raw scores of a subset of items corresponding to those administered to a sample of infants tested online (N = 53). Moreover, for the "online" participants, the raw scores of the online assessment did not significantly differ from the corresponding scores of the "live" participants. These findings suggest that the online assessment was to some extent comparable to the live administration of the same items, thus representing a viable opportunity to remotely evaluate infant development when in-person assessment is not possible.

Early neurodevelopmental outcomes in children with asymptomatic congenital CMV infection.

BACKGROUND: Approximately 85-90% of congenital cytomegalovirus infections (cCMV) are asymptomatic. Few studies have investigated early and long-term neurodevelopmental outcomes in children with asymptomatic cCMV (acCMV), and the data is contradictory. In the present study, we did investigate the effect of cCMV asymptomatic infection on neurological outcomes and in cognitive, language and motor development at 6 months of age. METHODS: Fifty-six children with cCMV asymptomatic infection were followed for 6 months, as part of a long-term surveillance program, examining their neurological and developmental outcomes. Neurological examination and Bayley-III Scales were performed. RESULTS: Clinical evaluation revealed that early neurological outcomes were essentially normal, with minor neurological deficits (i.e., tone abnormalities) in a subgroup of patients. Bayley-III scores were substantially in the normal range, with 14% showing a score less than 85 (-1SD) in the Motor Scale. Children's neurological and neurodevelopmental outcomes at 6 months of age did not differ according to the trimester of infection. CONCLUSIONS: Some infants with cCMV asymptomatic infection may present minor neurological abnormalities in early stages of life. It seems useful to monitor this population for early and late neurodevelopmental sequelae.

Infant sleep and development: Concurrent and longitudinal relations during the first 8 months of life.

Sleep is an essential function of human life, underlying both biological and cultural processes. Dramatic changes in sleep occur during infancy, in terms of night awakenings, which tend to diminish over time, and day/night sleep duration, with newborns sleeping up to 16-17 h per day and gradually decreasing to 9-13 h between 6 and 11 months of age. Remarkably, research indicates that changes in infant sleep are in interaction with important acquisitions in other domains of child development. In the present study, we aimed at investigating concurrent and longitudinal relations between sleep and cognitive maturation during infancy, by collecting data on 156 infants at 4 and 8 months of age. Infants' sleep was assessed through the Brief Infant Sleep Questionnaire (BISQ; Sadeh, 2004), whereas cognitive maturation was evaluated using the Developmental Profile™ 3 (Alpern 2007). We also examined infants' language understanding through the short form of the Italian version of the MacArthur-Bates Communicative Development Inventory (MCDI-SF): Words and Gestures (Caselli, Bello, Rinaldi, Stefanini, & Pasqualetti, 2015; Fenson et al., 2000). Finally, information about infants' temperament and maternal practices potentially relevant for sleep quality, such as the use of a pacifier at nighttime, co-sleeping and exclusive breastfeeding, was detected. Results showed that night and day sleep were differently related to infants' development at 4 and 8 months of age, but there were no robust longitudinal relationships.

Parenting stress and children with cerebral palsy: a European cross-sectional survey.

AIM: The aim of this study was to describe stress in the parents of children with cerebral palsy and investigate associations with very high stress. METHOD: A cross-sectional survey was conducted of parents of 818 children aged 8 to 12 years from nine regions in Europe. Families were eligible to participate if they were living in one of the specified geographic areas. Parental stress was captured using the Parenting Stress Index Short Form, which has 36 items and takes 10 minutes to complete. Parents rate items on a 5-point Likert scale, with higher scores indicating higher stress. The Short Form yields scores on three subscales and a Total Stress score. A trained research associate administered the questionnaire in the child's home and visits lasted 90 to 120 minutes. All data collected were reported by parents unless otherwise stated. RESULTS: The Total Stress score on the Parenting Stress Index was dichotomized into scores of less than 99 or 99 or more, the latter indicating 'very high' stress. Most respondents were mothers (94%), and 26% reported very high stress levels. The parents of children with communication impairment had higher odds for very high stress (odds ratio [OR] 1.9; 95% confidence interval [CI] 1.2-3.0) than those whose child had no such impairment; the parents of children with moderate or severe pain had higher odds for very high stress (OR 1.7 [95% CI 1.1-2.4] and 2.5 [95% CI 1.5-4.3] respectively) than those whose child had no pain; and the parents of children with an intellectual impairment had higher odds for very high stress (OR 1.8; 95% CI 1.2-2.9) than those whose child had none. There was no association between very high stress and motor impairment. The subscales 'parent-child dysfunctional interaction' and 'difficult child' contributed most to the Total Stress score. INTERPRETATION: Parents of children with communication difficulties, intellectual impairment, or pain are at very high risk of stress. The final model explained 12% of the observed variation in very high stress.

Executive functions in preschool children with chronic insomnia.

STUDY OBJECTIVES: Executive functions (EFs) in children with insomnia have not been sufficiently assessed in the literature. This study aimed to describe sleep patterns and habits and EF abilities in preschool children with insomnia, compared to healthy control patients, and to evaluate the relationships between sleep patterns and EFs. METHODS: Two groups of children were recruited: 45 preschoolers with chronic insomnia (28 boys), aged 24-71 months and 167 healthy preschool children (81 boys) aged 24-71 months. Parents of all children completed two questionnaires to assess their children's sleep habits and disturbances, and their EFs with the Behavior Rating Inventory of Executive Function - Preschool Version. RESULTS: Children with chronic insomnia were found to wake up earlier, sleep less during the night, have more nighttime awakenings, and higher nocturnal wakefulness, compared to the control group. The chronic insomnia group showed significant impairment in all the EFs domains. Nocturnal sleep duration, nighttime awakenings, and nocturnal wakefulness correlated with inhibit, plan/organize, working memory, inhibitory self-control, emergent metacognition, and the global executive composite scores in the chronic insomnia group. In the control group, the number of nighttime awakenings correlated with inhibition, inhibitory self-control, and the global executive composite. Regression analyses showed a predominant role of insomnia factor in the association with EFs in both clinical and control groups. CONCLUSIONS: Our findings confirm the link between sleep and "higher level" cognitive functioning. The preschool period represents a critical age during which transient sleep problems also might hamper the development of self-regulation skills and the associated neural circuitry.

Isolated auditory neuropathy at birth in congenital cytomegalovirus infection.

BACKGROUND: Congenital cytomegalovirus (cCMV) infection is the most frequent non-genetic cause of sensorineural hearing-loss (SNHL) (i.e., hearing loss due to a cochlear and/or auditory nerve damage). It is widely accepted that SNHL at birth, when associated to cCMV symptomatic infection involving the central nervous system, benefits from antiviral therapy started in the neonatal period. Conversely, there is no consensus for antiviral treatment in congenitally infected infants diagnosed with isolated SNHL (i.e., SNHL in an otherwise asymptomatic infant) at birth. Our aim was to assess the frequency and the auditory outcome of isolated SNHL at birth due to auditory neuropathy (AN) (i.e., SNHL in a patient with normal cochlear function and auditory nerve dysfunction) in infants with cCMV infection. METHODS: We retrospectively reviewed the clinical history of 60 infants, born at term, with cCMV asymptomatic infection, without additional risk factors for SNHL, and exhibiting bilateral "pass" otoacustic emissions (OAE). None of them underwent antiviral therapy. Hearing thresholds were assessed by means of Auditory Brainstem Responses (ABR). AN affected children were followed up until possible normalization of the hearing thresholds or definitive diagnosis of AN. Each infant diagnosed with monolateral or bilateral AN was classified according to the worst ear threshold. RESULTS: In our population, the first ABR was performed at a mean age of 5.00 ± 2.79 (SD) months and AN was diagnosed in 16/60 (26.67%) infants; in 4 infants the AN was defined as mild (4/4 monolateral), moderate in 11 (5/11 bilateral), and severe in 1 (bilateral). The mean age at first ABR was 3.69 ± 2.80 (SD) months in the 16 babies with AN and 5.48 ± 2.66 (SD) months in the 44 infants with normal hearing (p = 0.007). All AN cases spontaneously recovered a normal auditory threshold over time. The mean length of the audiological follow-up was 32.44 ± 17.58 (SD) months (range 5-60 months). CONCLUSION: A delayed maturation of the auditory pathways should be considered when a mild/moderate isolated AN at birth is detected in cCMV infected infants. Prospective studies conducted on larger populations, and with a longer audiological follow-up, are needed to confirm our findings.

Developmental Motor Profile in Preschool Children with Primary Stereotypic Movement Disorder.

AIM: Different neuropsychological dysfunctions have been described in children with primary Stereotypic Movement Disorder (SMD), mainly attention or motor coordination problems. Up to now with no study has evaluated psychomotor functions in preschoolers primary SMD. The aim of this observational study was to gather information on the motor profiles of SMD patients in this age range in comparison with typically developing children. PATIENTS AND METHODS: Twenty-six children (four girls) aged 36 to 76 months (mean= 53 ±10) with primary SMD were assessed by a structured evaluation including the Movement Assessment Battery for Children-Second Edition (MABC-2), the Beery-Buktenica Developmental test of Visual-Motor Integration (VMI), the Repetitive Behaviour Scale-Revised (RBS-R), the Motor Severity Stereotypy Scale (MSSS), and the Child Behaviour Checklist (CBCL). The diagnoses of Intellectual Disability or Autism Spectrum Disorder were exclusion criteria from the study. A comparison group of twenty-seven (four girls) typically developing children without stereotypies aged 36 to 59 months (mean= 48 ±7) was also examined. RESULTS: The MABC-2 total score was lower than 15th percentile in fifteen children with SMD (58%); the worst performances were observed in Balance and Manual Dexterity subtests. The motor coordination score of VMI was lower than 15th percentile in ten children (38%). The majority of the children with low scores at MABC-2 also had low scores at the motor coordination subscale of VMI. MABC-2 standard scores of the clinical group were significantly lower than those of controls on MABC-2 Total, Balance, and Ball Skills subtests. CONCLUSION: The finding of widespread dysfunction of gross and fine motor abilities in preschoolers with primary SMD seems to delineate a peculiar phenotype and could provide new approaches to the management of this neurodevelopment disorder.

Risk of Developmental Coordination Disorder in Italian very preterm children at school age compared to general population controls.

BACKGROUND: Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder that involves difficulties in goal-directed motor coordination, with ineffective control of fine and gross motor movements in the absence of sensory impairment or neurological condition. DCD is frequently reported in children born very preterm (VP) who survive without CP. AIMS: To measure the risk of DCD at school age in a large area-based cohort of VP children and general population controls, adjusting for gender, birth weight by gestational age and age at assessment. METHODS: VP children (N = 608) were part of a prospective cohort study in Italy. Controls (N = 370) were participants in the DCDQ-Italian validation study in the same age range. The Italian version of Developmental Coordination Disorder Questionnaire (DCDQ-Italian) was used to measure the performances in motor coordination during ordinary activities from the parental point of view. Multivariable regression analysis was used to obtain adjusted risk ratios of screening positive for DCD. RESULTS: VP children had scores significantly lower than peers, and about 30% of them appeared at risk of DCD using the 15th percentile cut-off of the Italian validation study. Birth-weight <10th percentile for gestational age and male gender were significant predictors. A slight trend effect was present, with extremely preterm children (<28 weeks gestation) showing the highest risk. CONCLUSIONS: Our study confirmed the higher DCD risk in VP children, particularly when males and SGA.

Sleep Characteristics and Temperament in Preterm Children at Two Years of Age.

STUDY OBJECTIVES: We aimed to compare 2-year-old children born preterm with children born full term regarding: (1) sleep characteristics, (2) temperament, and (3) relations between sleep pattern and habits and temperament. METHODS: The study included 51 preterm children with normal cognitive, language, and motor development (mean = 20.94 months, standard deviation [SD] = 4.08) and 57 full-term children (mean = 21.19, SD = 4.32). To assess sleep-related difficulties and habits and child temperament, mothers completed the following questionnaires: the (1) Sleep Disturbance Scale for Children-adapted (SDSC); (2) Brief Infant Sleep Questionnaire (BISQ); and (3) Italian Temperament Questionnaires-version 12-36 months (QUIT). RESULTS: Preterm children needed less support to fall asleep and fell asleep more often alone in their own bed compared to those born at full term; however, preterm children showed more frequent sleep difficulties, such as restlessness and breathing problems during the night. In addition, preterm children had lower scores in the temperamental dimension of attention and higher scores in negative emotionality than full-term children. Finally, sleep problems were correlated with higher motor activity, lower social orientation and attention, and increased negative emotionality; a shorter nocturnal sleep duration was related to higher motor activity and lower inhibition to novelty whereas an earlier rise time was associated with lower attention and social orientation. CONCLUSIONS: Preterm children showed sleep pattern problems and disturbance, predominance of attention problems, and negative emotionality related to sleep disruption.

Neurodevelopmental outcome of Italian preterm children at 1year of corrected age by Bayley-III scales: An assessment using local norms.

BACKGROUND: Premature birth is often associated with neurodevelopmental difficulties throughout childhood. In the first three years of life, the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) constitute one of the most used tools for assessing child development. Since Bayley-III original norms are based on United States (US) population, it remains uncertain whether their use in other countries (e.g., European) is appropriate. AIMS: This research aimed to examine neurodevelopment of preterm infants and full-term infants, using Bayley-III US norms in comparison to Italian (IT) norms. Patterns of developmental outcomes for both infant groups were also explored. METHODS: 104 preterm and 58 full-term infants were included in the study. Bayley-III was used for neurodevelopmental assessment at 1year of corrected age, considering both IT and US norms for scores computation. RESULTS: Comparing scores obtained with IT vs US norms, differences in means were all significant across five subscales (p<0.05 at least) for preterm infants, whereas for full-term peers significant differences were found only for Receptive Language and Fine Motor subscales (p<0.001). Effect size (η2) ranged from 0.22 to 0.94. Within each group, significant discrepancies across subscales were found. Moreover, Italian preterm infants had significantly lower performances than full-term peers, excepting for Expressive Language and Gross Motor subscales. CONCLUSIONS: As regards to Italian 1-year children, our study seems to provide evidence for the tendency of Bayley-III US norms to overestimate development compared to IT norms. These findings emphasize the need to early detect children at risk for developmental delay and to plan early intervention.