Hemgren E, Persson K
Department of Women's and Children's Health, Uppsala University Children's Hospital, Uppsala 751 85, Sweden.
Child Care Health Dev. 2009 Jan;35(1):120-9. doi: 10.1111/j.1365-2214.2008.00896.x. Epub 2008 Oct 20.
A total of 189 children without major impairments who needed neonatal intensive care (NIC) were followed up at ages 3 and 6.5 years.
To determine the prevalence of different motor deviations at age 6.5 years and the co-occurrence of attention deficits; also, to analyse the predictive ability of motor co-ordination and attention assessments at age 3 years for motor deviations at 6.5 years.
A combined assessment of motor performance and behaviour (CAMPB) was used at the 3-year examination. The Test of Motor Impairment (TOMI) and the Motor-Perceptual Development (MPU) were used together with the criteria of the diagnostic and statistical manual of mental disorders (DSM-IV-TR) to define motor deviations.
At 6.5 years 64% of the children showed a motor deviation either as a delay according to MPU, a problem according to TOMI or Developmental Coordination Disorder (DCD) according to DSM-IV-TR. Higher proportions of children with attention deficit (50%) were found in the DCD group. The predictive ability of CAMPB was analysed in two ways: when all children with either a co-ordination or attention deficit, or both, at 3 years were considered to be at risk for motor deviations at 6.5 years, the sensitivity reached 78% and the specificity was 42%. But when only the 3 year olds with a combined deficit were considered to be at risk, the sensitivity was 37% and the specificity 89%; however, a positive predictive value of 86% was reached.
At 6.5 years of age a majority of NIC children with no major impairments showed motor deviations. To fulfil the DCD criteria in DSM-IV-TR, a strict definition of motor deviations is recommended. Attention deficits are more prevalent among children with DCD. Deficits in motor co-ordination and/or attention in 3-year-old children are strong predictors of motor deviations and, especially, of DCD at 6.5 years of age.
对189名无需重症监护但需要新生儿重症护理（NIC）的儿童在3岁和6.5岁时进行了随访。
确定6.5岁时不同运动偏差的患病率以及注意力缺陷的共现情况；此外，分析3岁时运动协调和注意力评估对6.5岁时运动偏差的预测能力。
在3岁检查时采用运动表现与行为综合评估（CAMPB）。运动障碍测试（TOMI）和运动感知发育测试（MPU）与精神障碍诊断与统计手册（DSM-IV-TR）的标准一起用于定义运动偏差。
在6.5岁时，64%的儿童表现出运动偏差，表现为根据MPU的发育迟缓、根据TOMI的问题或根据DSM-IV-TR的发育性协调障碍（DCD）。在DCD组中发现注意力缺陷儿童的比例更高（占50%）。CAMPB的预测能力通过两种方式进行分析：当将3岁时存在协调或注意力缺陷或两者皆有的所有儿童视为6.5岁时运动偏差的风险人群时，敏感性达到78%，特异性为42%。但当仅将3岁时存在综合缺陷的儿童视为有风险时，敏感性为37%，特异性为89%；然而，阳性预测值达到了86%。
在6.5岁时，大多数无重大损伤的NIC儿童表现出运动偏差。为符合DSM-IV-TR中的DCD标准，建议对运动偏差进行严格定义。注意力缺陷在患有DCD的儿童中更为普遍。3岁儿童的运动协调和/或注意力缺陷是运动偏差尤其是6.5岁时DCD的有力预测指标。
