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早产婴儿在生命的头两年中对自身身体和物体表面的探索能力受损。

Infants Born Preterm Demonstrate Impaired Exploration of Their Bodies and Surfaces Throughout the First 2 Years of Life.

作者信息

Babik Iryna, Galloway James Cole, Lobo Michele A

机构信息

Department of Physical Therapy, University of Delaware, Newark, Delaware.

Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware.

出版信息

Phys Ther. 2017 Sep 1;97(9):915-925. doi: 10.1093/ptj/pzx064.

Abstract

BACKGROUND

Non-object-oriented exploratory behaviors infants perform with their bodies and surfaces have been proposed to be key precursors of infants' object exploration, early learning, and future cognitive development. Little is known about the developmental trajectories of these behaviors, especially for infants born preterm.

OBJECTIVE

The purpose of the study was to longitudinally compare non-object-oriented exploratory behaviors performed by full-term and preterm infants.

DESIGN

The study followed 24 full-term and 30 preterm infants (6 with significant brain injury) performing non-object-oriented exploratory behaviors in prone, supine, and sitting from birth through 24 months.

METHODS

Infants were observed without objects or direct social interaction for 3 minutes in prone and supine (0 through 9 months) and in sitting (3 through 24 months). Behavioral coding produced data that were analyzed using hierarchical linear modeling. Developmental trajectories of behaviors were compared among full-term infants, preterm infants without significant brain injury, and preterm infants with significant brain injury.

RESULTS

Compared to full-term peers, preterm infants showed poorer postural control (less head lifting in prone), midline behavior (holding the head in midline, holding both hands in midline), hand-to-mouth and visual-motor behaviors against gravity, and more asymmetrical one-handed fisting. Preterm infants performed fewer bouts of non-object-oriented exploratory behaviors, and their behaviors were less variable with fewer combinations.

LIMITATIONS

There was a limited sample of infants born preterm with significant brain injury.

CONCLUSIONS

Non-object-oriented exploratory behaviors are important for early perceptual-motor development. Key differences were noted in these behaviors for infants born preterm. These differences may lead to impaired reaching, object exploration, and cognition. Early intervention programs should utilize assessments and interventions that target these very early non-object-oriented exploratory behaviors.

摘要

背景

婴儿通过身体与物体表面进行的非面向对象的探索行为被认为是婴儿物体探索、早期学习及未来认知发展的关键先兆。关于这些行为的发展轨迹,我们知之甚少,尤其是对于早产儿。

目的

本研究旨在纵向比较足月儿和早产儿的非面向对象探索行为。

设计

本研究追踪了24名足月儿和30名早产儿(6名有严重脑损伤),观察他们从出生到24个月期间在俯卧、仰卧和坐姿时的非面向对象探索行为。

方法

在无物体或直接社交互动的情况下,观察婴儿在俯卧和仰卧位(0至9个月)以及坐位(3至24个月)时的3分钟表现。行为编码产生的数据通过分层线性模型进行分析。比较了足月儿、无严重脑损伤的早产儿和有严重脑损伤的早产儿之间行为的发展轨迹。

结果

与足月儿相比,早产儿的姿势控制较差(俯卧时抬头较少)、中线行为(头部保持在中线、双手保持在中线)、手到嘴和对抗重力的视觉运动行为较差,且单手握拳更不对称。早产儿进行的非面向对象探索行为次数较少,其行为变化较少,组合也较少。

局限性

有严重脑损伤的早产儿样本有限。

结论

非面向对象的探索行为对早期感知运动发展很重要。早产儿在这些行为上存在显著差异。这些差异可能导致伸手、物体探索和认知能力受损。早期干预项目应采用针对这些早期非面向对象探索行为的评估和干预措施。

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