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– In what is believed to be a landmark finding, researchers have shown than modifiable risk factors, such as parent-infant relationships, may play a role in preventing children from developing high motor problems during early life.

“Our findings suggest that early health and clinical problems, such as neonatal complications and abnormal neonatal neurological status, are useful indicators to help identify children at risk of poor motor development,” lead study author Nicole Baumann said in an interview in advance of the Pediatric Academic Societies meeting. “Additionally, as a possible implication, children may benefit in motor development from early interventions that incorporate and focus on improving parent-infant relationships.”

Nicole Baumann
According to Ms. Baumann, a PhD candidate in the department of psychology at the University of Warwick in Coventry, England, previous research has established perinatal risk factors, such as low birth weight, prematurity, and smallness for gestational age, as prominent predictors of poor motor development (Clin Orthop Relat Res. 2005 May;[434]:33-9). However, aspects of children’s early social environment, such as family adversity or parent-child relationships, have seldom been considered. “Most cross-sectional studies have focused on testing differences between groups, often defined by child age or degree of prematurity,” she said. “In contrast, longitudinal studies, with the advancement of being able to measure change of motor functioning, often test whether normative motor milestones have been reached or use group means. As far as we are aware, only two recent longitudinal studies have used a person-centred statistical approach (i.e., Latent Class Growth Analysis, LCGA) to measure motor functioning over time (Front Psychol. 2018 Jan 09. doi: 10.3389/fpsyg.2017.02314 and Phys Ther. 2017;97[3]:365-73). In contrast to other statistical techniques, LCGA is able to identify groups of children who ‘grow’ similarly or show similar patterns of change.”

For the current study, she and her associates investigated motor development using data from two different cohorts: the Bavarian Longitudinal Study in Germany (BLS) and the Arvo Ylppö Longitudinal Study in Finland (AYLS). A total of 4,741 and 1,423 children, respectively, underwent assessment from birth to age 56 months. Motor functioning was evaluated via standard physical and neurological assessments at birth and at 5, 20, and 56 months. Perinatal, neonatal, and early environmental information was collected at birth and at 5 months via medical records and reports from parents and research nurses.

The researchers identified two distinct trajectories of motor development problems from birth to 56 months: low (94.3% of BLS and 97.3% of AYLS) and high (5.7% of BLS and 2.7% of AYLS) motor problems.

In the BLS cohort, high motor problem trajectory was predicted by poor parent-infant relationship, such as the mother feeling insecure when taking care of the infant at home (OR 1.52); abnormal neonatal neurological status (odds ratio, 1.16); neonatal complications (OR, 1.12); and duration of initial hospitalization (OR, 1.02).

 

 

In the AYLS cohort, high motor problem trajectory was also predicted by abnormal neonatal neurological status (OR, 1.69) and duration of hospitalization (OR, 1.02). Although neonatal complications (OR, 1.08) and poor parent-infant relationship (OR, 1.09) did not significantly predict high motor problem trajectory in the AYLS cohort, trends identified were comparable with those obtained from the BLS cohort.

“Most surprising was that one of the four risk factors that remained as independent predictors of high motor problem trajectory was poor parent-infant relationship,” Ms. Baumann said. “As far as we are aware, parent-infant relationship has not been previously reported as a predictor of poor motor development.”

She acknowledged certain limitations of the study, including the fact that nearly 33% of children could not be assessed throughout the study period because of dropout. “Families with children who had poor health and were socially disadvantaged were less likely to continue participation, and may even suggest that our findings have an even larger effect than reported,” Ms. Baumann said. “This is a problem that affects many longitudinal studies, and it may affect group comparisons. However, simulations have shown that even when dropout is selective or correlated with the outcome that predictions only marginally change (Br J Psychiatry. 2009;195[3]:249-56).”

She reported having no financial disclosures.
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– In what is believed to be a landmark finding, researchers have shown than modifiable risk factors, such as parent-infant relationships, may play a role in preventing children from developing high motor problems during early life.

“Our findings suggest that early health and clinical problems, such as neonatal complications and abnormal neonatal neurological status, are useful indicators to help identify children at risk of poor motor development,” lead study author Nicole Baumann said in an interview in advance of the Pediatric Academic Societies meeting. “Additionally, as a possible implication, children may benefit in motor development from early interventions that incorporate and focus on improving parent-infant relationships.”

Nicole Baumann
According to Ms. Baumann, a PhD candidate in the department of psychology at the University of Warwick in Coventry, England, previous research has established perinatal risk factors, such as low birth weight, prematurity, and smallness for gestational age, as prominent predictors of poor motor development (Clin Orthop Relat Res. 2005 May;[434]:33-9). However, aspects of children’s early social environment, such as family adversity or parent-child relationships, have seldom been considered. “Most cross-sectional studies have focused on testing differences between groups, often defined by child age or degree of prematurity,” she said. “In contrast, longitudinal studies, with the advancement of being able to measure change of motor functioning, often test whether normative motor milestones have been reached or use group means. As far as we are aware, only two recent longitudinal studies have used a person-centred statistical approach (i.e., Latent Class Growth Analysis, LCGA) to measure motor functioning over time (Front Psychol. 2018 Jan 09. doi: 10.3389/fpsyg.2017.02314 and Phys Ther. 2017;97[3]:365-73). In contrast to other statistical techniques, LCGA is able to identify groups of children who ‘grow’ similarly or show similar patterns of change.”

For the current study, she and her associates investigated motor development using data from two different cohorts: the Bavarian Longitudinal Study in Germany (BLS) and the Arvo Ylppö Longitudinal Study in Finland (AYLS). A total of 4,741 and 1,423 children, respectively, underwent assessment from birth to age 56 months. Motor functioning was evaluated via standard physical and neurological assessments at birth and at 5, 20, and 56 months. Perinatal, neonatal, and early environmental information was collected at birth and at 5 months via medical records and reports from parents and research nurses.

The researchers identified two distinct trajectories of motor development problems from birth to 56 months: low (94.3% of BLS and 97.3% of AYLS) and high (5.7% of BLS and 2.7% of AYLS) motor problems.

In the BLS cohort, high motor problem trajectory was predicted by poor parent-infant relationship, such as the mother feeling insecure when taking care of the infant at home (OR 1.52); abnormal neonatal neurological status (odds ratio, 1.16); neonatal complications (OR, 1.12); and duration of initial hospitalization (OR, 1.02).

 

 

In the AYLS cohort, high motor problem trajectory was also predicted by abnormal neonatal neurological status (OR, 1.69) and duration of hospitalization (OR, 1.02). Although neonatal complications (OR, 1.08) and poor parent-infant relationship (OR, 1.09) did not significantly predict high motor problem trajectory in the AYLS cohort, trends identified were comparable with those obtained from the BLS cohort.

“Most surprising was that one of the four risk factors that remained as independent predictors of high motor problem trajectory was poor parent-infant relationship,” Ms. Baumann said. “As far as we are aware, parent-infant relationship has not been previously reported as a predictor of poor motor development.”

She acknowledged certain limitations of the study, including the fact that nearly 33% of children could not be assessed throughout the study period because of dropout. “Families with children who had poor health and were socially disadvantaged were less likely to continue participation, and may even suggest that our findings have an even larger effect than reported,” Ms. Baumann said. “This is a problem that affects many longitudinal studies, and it may affect group comparisons. However, simulations have shown that even when dropout is selective or correlated with the outcome that predictions only marginally change (Br J Psychiatry. 2009;195[3]:249-56).”

She reported having no financial disclosures.

– In what is believed to be a landmark finding, researchers have shown than modifiable risk factors, such as parent-infant relationships, may play a role in preventing children from developing high motor problems during early life.

“Our findings suggest that early health and clinical problems, such as neonatal complications and abnormal neonatal neurological status, are useful indicators to help identify children at risk of poor motor development,” lead study author Nicole Baumann said in an interview in advance of the Pediatric Academic Societies meeting. “Additionally, as a possible implication, children may benefit in motor development from early interventions that incorporate and focus on improving parent-infant relationships.”

Nicole Baumann
According to Ms. Baumann, a PhD candidate in the department of psychology at the University of Warwick in Coventry, England, previous research has established perinatal risk factors, such as low birth weight, prematurity, and smallness for gestational age, as prominent predictors of poor motor development (Clin Orthop Relat Res. 2005 May;[434]:33-9). However, aspects of children’s early social environment, such as family adversity or parent-child relationships, have seldom been considered. “Most cross-sectional studies have focused on testing differences between groups, often defined by child age or degree of prematurity,” she said. “In contrast, longitudinal studies, with the advancement of being able to measure change of motor functioning, often test whether normative motor milestones have been reached or use group means. As far as we are aware, only two recent longitudinal studies have used a person-centred statistical approach (i.e., Latent Class Growth Analysis, LCGA) to measure motor functioning over time (Front Psychol. 2018 Jan 09. doi: 10.3389/fpsyg.2017.02314 and Phys Ther. 2017;97[3]:365-73). In contrast to other statistical techniques, LCGA is able to identify groups of children who ‘grow’ similarly or show similar patterns of change.”

For the current study, she and her associates investigated motor development using data from two different cohorts: the Bavarian Longitudinal Study in Germany (BLS) and the Arvo Ylppö Longitudinal Study in Finland (AYLS). A total of 4,741 and 1,423 children, respectively, underwent assessment from birth to age 56 months. Motor functioning was evaluated via standard physical and neurological assessments at birth and at 5, 20, and 56 months. Perinatal, neonatal, and early environmental information was collected at birth and at 5 months via medical records and reports from parents and research nurses.

The researchers identified two distinct trajectories of motor development problems from birth to 56 months: low (94.3% of BLS and 97.3% of AYLS) and high (5.7% of BLS and 2.7% of AYLS) motor problems.

In the BLS cohort, high motor problem trajectory was predicted by poor parent-infant relationship, such as the mother feeling insecure when taking care of the infant at home (OR 1.52); abnormal neonatal neurological status (odds ratio, 1.16); neonatal complications (OR, 1.12); and duration of initial hospitalization (OR, 1.02).

 

 

In the AYLS cohort, high motor problem trajectory was also predicted by abnormal neonatal neurological status (OR, 1.69) and duration of hospitalization (OR, 1.02). Although neonatal complications (OR, 1.08) and poor parent-infant relationship (OR, 1.09) did not significantly predict high motor problem trajectory in the AYLS cohort, trends identified were comparable with those obtained from the BLS cohort.

“Most surprising was that one of the four risk factors that remained as independent predictors of high motor problem trajectory was poor parent-infant relationship,” Ms. Baumann said. “As far as we are aware, parent-infant relationship has not been previously reported as a predictor of poor motor development.”

She acknowledged certain limitations of the study, including the fact that nearly 33% of children could not be assessed throughout the study period because of dropout. “Families with children who had poor health and were socially disadvantaged were less likely to continue participation, and may even suggest that our findings have an even larger effect than reported,” Ms. Baumann said. “This is a problem that affects many longitudinal studies, and it may affect group comparisons. However, simulations have shown that even when dropout is selective or correlated with the outcome that predictions only marginally change (Br J Psychiatry. 2009;195[3]:249-56).”

She reported having no financial disclosures.
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Key clinical point: Four risk factors are independent predictors of high motor problem trajectory in young children.

Major finding: In the Bavarian Longitudinal Study cohort, high motor problem trajectory was predicted by abnormal neonatal neurological status (odds ratio, 1.16), duration of initial hospitalization (OR 1.02), neonatal complications (OR 1.12), and poor parent-infant relationship (OR 1.52).

Study details: A longitudinal analysis of 4,741 children from the Bavarian Longitudinal Study in Germany and 1,423 children from the Arvo Ylppö Longitudinal Study in Finland.

Disclosures: Ms. Baumann reported having no financial disclosures.


 

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