Stockholm preterm interaction-based intervention (SPIBI) - study protocol for an RCT of a 12-month parallel-group post-discharge program for extremely preterm infants and their parents.

BACKGROUND: Improved neonatal care has resulted in increased survival rates among infants born after only 22 gestational weeks, but extremely preterm children still have an increased risk of neurodevelopmental delays, learning disabilities and reduced cognitive capacity, particularly executive function deficits. Parent-child interaction and parental mental health are associated with infant development, regardless of preterm birth. There is a need for further early interventions directed towards extremely preterm (EPT) children as well as their parents. The purpose of this paper is to describe the Stockholm Preterm Interaction-Based Intervention (SPIBI), the arrangements of the SPIBI trial and the chosen outcome measurements. METHODS: The SPIBI is a randomized clinical trial that includes EPT infants and their parents upon discharge from four neonatal units in Stockholm, Sweden. Inclusion criteria are EPT infants soon to be discharged from a neonatal intensive care unit (NICU), with parents speaking Swedish or English. Both groups receive three initial visits at the neonatal unit before discharge during the recruitment process, with a strengths-based and development-supportive approach. The intervention group receives ten home visits and two telephone calls during the first year from a trained interventionist from a multi-professional team. The SPIBI intervention is a strengths-based early intervention programme focusing on parental sensitivity to infant cues, enhancing positive parent-child interaction, improving self-regulating skills and supporting the infant's next small developmental step through a scaffolding process and parent-infant co-regulation. The control group receives standard follow-up and care plus extended assessment. The outcomes of interest are parent-child interaction, child development, parental mental health and preschool teacher evaluation of child participation, with assessments at 3, 12, 24 and 36 months corrected age (CA). The primary outcome is emotional availability at 12 months CA. DISCUSSION: If the SPIBI shows positive results, it could be considered for clinical implementation for child-support, ethical and health-economic purposes. Regardless of the outcome, the trial will provide valuable information about extremely preterm children and their parents during infancy and toddlerhood after regional hospital care in Sweden. TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov in October 2018 (NCT03714633).

Associations Between Fundamental Motor Skill Domains and Physical Fitness Components in 5-11-Year-Old Children.

High competence in fundamental motor skills (FMS) and adequate physical fitness (PF) levels are a solid foundation for acquiring an active and healthy lifestyle during childhood and adolescence. In this cross-sectional study, we aimed to compare gender and age groups and identify correlations between FMS and PF in young elementary school students. We used a structured questionnaire to gather sociodemographic information from parents, and we characterized the children's economic profile with the Brazil Social Economic Status Criterion. We collected FMS data using the Furtado-Gallagher Children Observational Movement Pattern Assessment System (FG-COMPASS), and we used the Brazil Sports Project Battery Test to measure PF levels. Statistical analyses involved descriptive data and inferential tests to determine group differences in FMS and PF levels. Hierarchical regression helped identify the associations between FMS and PF, as controlled by sociodemographic factors. Participants were 720 students (and parents) of both genders (383 girls, 337 boys; M age = 8.8, SD = 1.52 years) from grades 1 to 5 in an elementary school in a municipality in the western region of the Paraná state in Brazil. The results showed significant differences in children's motor skills and PF based on gender and age. The hierarchical regression model showed different combinations of flexibility, abdominal resistance, upper limb strength, agility, speed, and lower limb strength, which explained 33.7% of the variability in the global FMS index, 41% of the variability in manipulative skills, and 12.7% of the variability in locomotor skills. In addition, there was a positive association between FMS and PF related to neuromuscular development for both sexes, regardless of age.

Reliability and Validity of the Trunk Control Measurement Scale in Children With Duchenne Muscular Dystrophy.

While trunk control is essential for daily activities and motor function, there is currently sparse information regarding the psychometric properties of the outcome measures used for assessing trunk control in Duchenne muscular dystrophy (DMD), characterized by proximal muscle weakness. The Trunk Control Measurement Scale (TCMS) was developed to assess trunk control in children with cerebral palsy. We aimed to examine the reliability and validity of the Turkish version of the TCMS for children with DMD. We determined the functional level of 52 children with DMD (median age: 8.83 years) with the Vignos Scale, and we further evaluated them with the Motor Function Measure (MFM), a gold standard for determining the validity of the TCMS. Internal consistency of the Turkish TCMS was excellent with a Cronbach's alpha of .95. Intraclass correlation coefficient (ICC) values for intra-rater reliability were between 0.90-0.96 and for inter-rater reliability were between 0.91-0.95. We reported positive moderate to strong correlations between the TCMS and trunk flexors strength (p < .001, r = 0.77), back extensors strength (p < .001, r = 0.68) and MFM (p < .001, r = 0.85). Thus, we found the Turkish version of TCMS to be a reliable and valid instrument for assessing trunk control of children with DMD in clinical and research settings.

Exploring Kinetic and Kinematic Finger Individuation Capability in Children With Hemiplegic Cerebral Palsy.

While fine manual dexterity develops over time, the extent to which children show independent control of their digits in each hand and the impact of perinatal brain injury on this individuation have not been well quantified. Our goal in this study was to assess and compare finger force and movement individuation in 8-14 year old children with hemiplegic cerebral palsy (hCP; n = 4) and their typically developing peers (TD; n = 10). We evaluated finger force individuation with five independent load cells and captured joint movement individuation with video tracking. We observed no significant differences in individuation indices between the dominant and non-dominant hands of TD children, but individuated force and movement were substantially reduced in the paretic versus non paretic hands of children with hCP (p < 0.001). In TD participants, the thumb tended to have the greatest level of independent control. This small sample of children with hCP showed substantial loss of individuation in the paretic hand and some deficits in the non-paretic hand, suggesting possible benefit from targeted training of digit independence in both hands for children with CP.

Quantitative Assessment of Prewriting Skills in Children: The Development and Validation of a Tablet Assessment Tool.

Our purpose in this study was to determine the feasibility of assessing children's prewriting with a new tablet tool, the Quantitative Assessment of Prewriting Skills (QAPS), while determining the validity of the QAPS for identifying visual motor skill differences. We recruited 10 children who were receiving occupational therapy (OT) services for visual motor deficits from a local OT clinic and 10 age-matched typically developing (TD) children from the local community. The QAPS assesses the accuracy of copying patterns on a tablet that records the child's finger position on the tablet, and the data are then analyzed for different dimensions of pattern copying. We found a large effect size difference in the QAPS total score between our two participant groups, with the OT group showing poorer performance than TD children; and, among nine assessment dimensions, roundness of a drawn circle showed the largest effect size difference between groups. The QAPS appears to be a promising tool for assessing visual motor skills, and it warrants additional testing in larger participant samples.

Associations Between Children's Physical Activity, Pain and Injuries.

Our aim in this study was to investigate the relationships between physical activity (PA), pain, and injury among children. Secondarily, we examined whether these relationships differed between children with normal versus excessive weight or obesity. This was a cross-sectional study of 102 children (57 girls) aged 8-12 years old. We assessed the prevalence of moderate and vigorous PA using accelerometry over a seven-day period. We examined the associations between moderate PA, vigorous PA, pain presence, and injury presence using generalized estimating equations with a logit link and binomial distribution. We adjusted the obtained models for potential confounders and explored the moderating effect of weight status. We found no association between moderate PA and pain, but time spent in vigorous PA was associated with pain. Neither moderate or vigorous PA were associated with injury, and there was no moderating effect of weight status in these relationships. In summary, we found that objectively measured vigorous PA is associated with pain among 8-12 year old children. While these results should be replicated in longitudinal studies, they suggest that an association between vigorous PA and pain should be considered when developing PA interventions for children.

Time Spent in Sedentary Activity Is Related to Gross Motor Ability During the Second Year of Life.

Sedentary activity occupies a substantial amount of time during early childhood, with these habits influenced by changing trends in screen time for very young children. Among school-aged children, motor ability is inversely related to sedentary activity. However, the concept of sedentary activity is rarely investigated in toddlers, and thus little is known concerning its relationship with motor development during this rapidly changing and early period of life. Among two groups of toddlers, aged 18 months (N = 26) and aged 24 months (N = 16), this study investigated cross-sectional correlations of motor development (Bayley Scales of Infant Development-III) with daily sedentary activity (accelerometers). In both groups, gross motor ability, but not fine motor ability, was inversely correlated with time spent in sedentary activity. At 18 months, gross motor raw scores inversely correlated significantly with time in sedentary activity (r = -.533, p < .001) but fine motor raw scores did not (r = .182, p = .441). Also, at 24 months, gross motor raw scores inversely correlated with time in sedentary activity (r = -.563, p = .029), while fine motor raw scores did not (r = -.112, p = .425). These findings add important missing knowledge to the empirical literature regarding sedentary activity in toddlers and its relationship to emerging motor development. Future work might investigate best practices for measuring sedentary activity in this age-group and mechanisms behind its relationship with gross motor skills.

Childhood Motor Coordination and Adult Affective Experience Among Extremely Low Birth Weight Survivors.

Poor motor coordination in childhood has been associated in adulthood with more negative affect, less positive affect, and an increased risk of psychopathology. While survivors of extremely low birth weight (ELBW; < 1,000 grams) are more likely to manifest poor motor coordination than people born at normal birth weight (NBW; > 2,500 g), they have had better mental health outcomes than those with NBW who have motor difficulties. How emotion is experienced is an important risk factor for mental illness; yet, little is known about the affective experience of survivors of ELBW who also have poor motor coordination. In this longitudinal study, we examined interactions between birth weight status and childhood motor coordination on affective experience among 88 ELBW and 89 NBW participants. We first assessed childhood motor coordination at eight years of age, using the Bruininks-Oseretsky Test of Motor Proficiency, and we later gathered self-report data regarding affective style, using the Positive and Negative Affect Scedule and the Affective Styles Questionnaire, when these participants were 30-35 years of age. We found a statistically significant interaction between motor coordination and birth weight status. As motor coordination worsened among ELBW survivors, positive affect increased, while we observed the opposite trend in NBW participants (p < 0.05). There was no interaction for negative affect. Positive affect may contribute to previous findings of better relative adult mental health among ELBW survivors with poor childhood motor coordination. Strategies aimed at optimizing positive affect may be fruitful for optimizing mental health outcomes among preterm survivors and others with reduced motor proficiency.

Skill-Based and Planned Active Play Versus Free-Play Effects on Fundamental Movement Skills in Preschoolers.

Fundamental movement skill interventions are important for promoting physical activity, but the optimal intervention model for preschool children remains unclear. We compared two 8-week interventions, a structured skill-station and a planned active play approach, to a free-play control condition on pre- and postintervention fundamental movement skills. We also collected data regarding program attendance and perceived enjoyment. We found a significant interaction effect between intervention type and time. A Tukey honest significant difference analysis supported a positive intervention effect showing a significant difference between both interventions and the free-play control condition. There was a significant between-group difference in group attendance such that mean attendance was higher for both the free-play and planned active play groups relative to the structured skill-based approach. There were no differences in attendance between free-play and planned active play groups, and there were no differences in enjoyment ratings between the two intervention groups. In sum, while both interventions led to improved fundamental movement skills, the active play approach offered several logistical advantages. Although these findings should be replicated, they can guide feasible and sustainable fundamental movement skill programs within day care settings.

Testing the Motor Competence and Health-Related Variable Conceptual Model: A Path Analysis.

The purpose of this study was to empirically test a comprehensive conceptual model linking gross motor skills, school day physical activity and health-related variables in a sample of sixth graders. Participants were a convenience sample of 84 sixth grade students (Mean age = 11.6 ± 0.6 years). Gross motor skills were assessed using the Test of Gross Motor Development-3rd Edition (TGMD-3), school day physical activity was assessed using pedometers, health-related fitness was assessed using Progressive Aerobic Cardiovascular Endurance Run (PACER) laps, perceived competence assessed using a validated questionnaire and the health-related outcome was assessed using Body Mass Index (BMI). The relationship between school day step counts and TGMD-3 scores was mediated through both perceived competence and PACER laps (p = 0.015) and the direct path coefficient between TGMD-3 scores and BMI was statistically significant (b = -0.22 kg/m2, p < 0.001). Overall there was good model fit with all indices meeting acceptable criteria (χ2 = 3.7, p = 0.293; Root Mean Square Error of Approximation (RMSEA) = 0.062, 90% Confidence Interval (C.I.): 0.00-0.23; Comparative Fit Index (CFI) = 0.98; Tucker-Lewis Index (TLI) = 0.96; Standardized Root Mean Square Residual (SRMR) = 0.052). The comprehensive conceptual model explaining the inter-relationships among motor competence and health-related variables was empirically validated with the relationship between physical activity and gross motor skills mediated through both perceived competence and cardiorespiratory endurance in a sample of sixth graders.

Effects of Polybrominated Diphenyl Ethers on Child Cognitive, Behavioral, and Motor Development.

Polybrominated Diphenyl Ether (PBDE) flame retardants are environmental chemicals that cross the placenta during pregnancy and have shown evidence of neurotoxicity. As the in utero period is a sensitive developmental window, such exposure may result in adverse childhood outcomes. Associations between in utero PBDE exposure and neurodevelopment are found in animal models and increasingly in human population studies. Here, we review the epidemiological evidence of the association between prenatal exposure to PBDEs and motor, cognitive, and behavioral development in infants and children. Published work suggests a negative association between PBDE concentrations and neurodevelopment despite varying PBDE congeners measured, bio-specimen matrix used, timing of the biological sampling, geographic location of study population, specific developmental tests used, age of children at time of testing, and statistical methodologies. This review includes 16 published studies that measured PBDE exposure in maternal blood during pregnancy or in cord blood at delivery and performed validated motor, cognitive, and/or behavioral testing at one or more time during childhood. We evaluate possible mediation through PBDE-induced perturbations in thyroid function and effect measure modification by child sex. While the majority of studies support an adverse association between PBDEs and neurodevelopment, additional research is required to understand the mechanism of action, possibly through the perturbations in thyroid function either in the pregnant woman or in the child, and the role of biologically relevant effect modifiers such as sex.

Multivariate Associations Among Health-Related Fitness, Physical Activity, and TGMD-3 Test Items in Disadvantaged Children From Low-Income Families.

Motor skills are needed for physical development and may be linked to health-related fitness and physical activity levels. No studies have examined the relationships among these constructs in large samples of disadvantaged children from low-income families using the Test for Gross Motor Development-3rd Edition (TGMD-3). The purpose of this study was to examine the multivariate associations among health-related fitness, physical activity, and motor skills assessed using the TGMD-3. Participants included 1460 school-aged children (730 boys, 730 girls; M age = 8.4 years, SD = 1.8 years) recruited from the K to sixth grades from three low-income schools. Health-related fitness was assessed using the FITNESSGRAM battery, physical activity was assessed using accelerometers and pedometers, and motor skills were assessed using the TGMD-3. Canonical correlations revealed statistically significant correlations between the Ball Skills and health-related fitness variates (Rc = 0.43, Rc2 = 17%, p < 0.001). Significant canonical coefficients in the Ball Skills variate included two-handed striking, dribbling, and catching, and significant canonical coefficients in the health-related fitness variate included body mass index and the progressive aerobic cardiovascular endurance run ( p < 0.01). Locomotor skills did not significantly correlate with health-related fitness or physical activity. Ball skills are related to health-related fitness in disadvantaged children from low-income families.

Effect of a 12-Week Physical Activity Program on Gross Motor Skills in Children.

This study examined the effects of a 12-week Comprehensive School Physical Activity Program (CSPAP) on gross motor skill development in children from low-income families. Participants were 1,460 school-aged children (mean age = 8.4 ± 1.8 years; 730 girls, 730 boys) recruited from three schools receiving U.S. governmental financial assistance. Students were recruited from grades K-6. CSPAP was implemented over one semester during the 2014-2015 school year. Select gross motor skill items were assessed during each student's physical education class at baseline and at a 12-week follow-up using the Test for Gross Motor Development-2nd Edition (TGMD-2). Each student's TGMD-2 score was converted to a percentage of the total possible score. A 7 × 2 × 2 analysis of variance test with repeated measures was employed to examine the effects of age, sex, and time on TGMD-2 percent scores, adjusting for clustering within the data structure. There were greater TGMD-2 percent scores at follow-up compared with baseline (82.4% vs. 72.6%, mean difference = 9.8%, p < .001, Cohen's d = 0.67), and greater improvements were seen in younger children compared with older children (mean difference of change = 4.0%-7.5%, p < .01, Cohen's d = 0.30-0.55).

Attention Deficit Hyperactivity Disorder and Motor Impairment.

Attention deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder during childhood, affecting approximately 3-6% of school-aged children; its cardinal symptoms of high activity, impulsivity, and behavioral distractibility might be assumed to have close relationships to interferences with motor skills. A separate body of literature attests to ways that motor problems can severely impact children's daily lives, as motor problems may occur in 30-50% of children with ADHD. This article critically reviews research on motor impairment in children with ADHD, notable differences in motor performance of individuals with ADHD compared with age-matched controls, and possible neural underpinnings of this impairment. We discuss the highly prevalent link between ADHD and developmental coordination disorder (DCD) and the lack of a clear research consensus about motor difficulties in ADHD. Despite increasing evidence and diagnostic classifications that define DCD by motor impairment, the role of ADHD symptoms in DCD has not been delineated. Similarly, while ADHD may predispose children to motor problems, it is unclear whether any such motor difficulties observed in this population are inherent to ADHD or are mediated by comorbid DCD. Future research should address the exact nature and long-term consequences of motor impairment in children with ADHD and elucidate effective treatment strategies for these disorders together and apart.

Teachers' Perceptions of Preschool Children's Psychomotor Development in Spain.

This study analyzed the psychomotor profiles of preschool stage students and to determine how these data agreed with the students' teachers' subjective assessment. We also correlated these data with other variables such as age, gender, and family influence. A total of 211 children aged 3 to 6 years, in the second cycle of preschool from 30 classes of 10 schools in Spain participated. Additionally, 30 preschool teachers from these classes participated. Study results revealed serious teacher misperceptions regarding their students' psychomotor development, with low agreement rates between students and teachers in the motor dimension and slight agreement rates in communicative, cognitive, and social areas. The reasons for and implications of these misperceptions are discussed.

Intervenção motora e desenvolvimento infantil: uma revisão narrativa envolvendo programas sem abordagens motivacionais e com o clima de motivação para a maestria / Motor intervention and child development: a narrative review involving programs without motivational approaches and mastery motivational climate programs / Intervención motora y desarrollo infantil: una revisión narrativa que involucra programas sin enfoques motivacionales y con clima de motivación para la maestría

O objetivo deste artigo foi revisar na literatura as pesquisas que implementaram programas interventivos sem abordagens motivacionais, e aquelas que utilizaram o clima de motivação para a maestria. Foram consultadas as bases Scientific Electronic Library Online, Sportdiscus, Literatura Latino-Americana e do Caribe, Pubmed, Google acadêmico e Periódicos Capes, além de busca manual nas referências dos estudos publicados. Os programas interventivos mostraram impacto positivo sobre aspectos do desenvolvimento de crianças. O clima de motivação para a maestria apresentou maior impacto em comparação a outras estratégias interventivas.

The aim of this article was to review the researches in literature that implemented motor intervention programs with motivational approaches and those that included the mastery motivational climate. Scientific Electronic Library Online, Sportdiscus, Caribbean Latin American Literature, Pubmed, Academic Google and Capes Periodicals were consulted. In addition, the references of published studies were also conducted. Intervention programs have shown positive impact in important aspects of child development. The mastery motivational climate has shown a greater impact than other intervention.

El objetivo fue revisar el referencial teórico de las investigaciones que desarrollaron programas de intervención motora, principalmente aquellos que sirven de motivación para la maestría. Fueron consultadas las bases Scientific Eletronic Library Online, Sportdiscus, Literatura Latinoamericana y del Caribe, Pubmed, Google académico y Periódicos Capes, además de búsqueda manual en las referencias de los estudios publicados. Los programas de intervención mostraron un impacto positivo con relación a aspectos del desarrollo de los niños. El clima de motivación para la maestría tuvo un gran impacto en comparación con otras estrategias de intervención.