Hemgren E, Persson K
Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala, Sweden.
Child Care Health Dev. 2007 Jan;33(1):11-21. doi: 10.1111/j.1365-2214.2006.00625.x.
Children who have needed neonatal intensive care (NIC) are considered to be at risk for deficits such as developmental co-ordination disorder and attention-deficit/hyperactivity disorder. By assessing motor-perceptual development, motor co-ordination and attention already at 3 years of age, it might be possible to identify such deficits earlier than they are today.
To investigate the motor-perceptual development in a group of 202 NIC children but had no major impairments, to describe associations of deficits in co-ordination and attention with motor-perceptual delays, and to estimate the prevalence of NIC children with combined deficits together with a motor-perceptual delay.
Co-ordination and attention in children born very preterm (n = 57), moderately preterm (n = 75) and full-term (n = 70) were observed according to a model for Combined Assessment of Motor Performance and Behaviour while they were assessed using a developmental scale, Motor-Perceptual Development, 0-7 years, MPU.
In two out of 14 MPU areas, a larger proportion of very preterm than of moderately preterm and full-term children had marked developmental delay. Overall, the proportion of NIC children having a motor-perceptual delay increased with increasing incoordination and especially increasing lack of attention. Twenty-one (11%) of the NIC children had different motor-perceptual delays combined with pronounced incoordination and pronounced lack of attention.
Deficits in co-ordination and attention were associated with motor-perceptual delays in areas important for daily living and development of academic skills. Therefore, to find children at risk for developmental co-ordination disorder and attention-deficit/hyperactivity disorder, assessments of co-ordination and attention should be added to assessments of motor-perceptual development in 3-year-old NIC children.
曾需要新生儿重症监护(NIC)的儿童被认为有发育协调障碍和注意力缺陷/多动障碍等缺陷风险。通过在3岁时评估运动感知发育、运动协调性和注意力,可能比目前更早发现此类缺陷。
调查一组202名无重大损伤的NIC儿童的运动感知发育情况,描述协调性和注意力缺陷与运动感知延迟之间的关联,并估计合并缺陷及运动感知延迟的NIC儿童的患病率。
根据运动表现和行为综合评估模型,观察极早产(n = 57)、中度早产(n = 75)和足月出生(n = 70)儿童的协调性和注意力,同时使用0 - 7岁运动感知发育量表(MPU)进行评估。
在MPU的14个领域中的2个领域,极早产儿童中发育明显延迟的比例高于中度早产和足月出生的儿童。总体而言,运动感知延迟的NIC儿童比例随着不协调程度增加,尤其是注意力缺乏程度增加而上升。21名(11%)NIC儿童存在不同的运动感知延迟,并伴有明显的不协调和明显的注意力缺乏。
协调性和注意力缺陷与对日常生活和学术技能发展重要的领域中的运动感知延迟相关。因此,为了发现有发育协调障碍和注意力缺陷/多动障碍风险的儿童,应在对3岁NIC儿童的运动感知发育评估中增加协调性和注意力评估。