To investigate motor and cognitive developmental profiles and to evaluate the correlation between two developmental areas and assess the influencing factors of the developmental process in children with Down syndrome (DS).
Seventy-eight children with DS participated in this study. The medical history was taken and motoric milestone achievements recorded. The Korean Wechsler Preschool and Primary Scale of Intelligence (K-WPPSI) and Bayley Scales of Infant Development-II (BSID-II) were administered. Subjects were divided into severe motor delay group (severe group) and typical motor delay group (typical group).
Children with DS follow the same sequence of motor development and generally displayed double times of acquisition of developmental milestones compared with healthy children. Furthermore, having surgery for associated complications showed negative influence to the motor development. Almost of all children with DS showed moderate degree of intellectual disability and motor and cognitive development do not seem to correlate one another.
Surgery of associated complications can be negatively related to motor development. However, early motor development did not have any significant effects on the achievement of later cognitive functioning.
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Method: We performed the BSID-II for children with delayed development who were diagnosed as CP or global developmental delay (GDD). The characteristics of mental developmental index (MDI) and psychomotor developmental index (PDI) of BSID-II were evaluated and sensitivity and specificity of BSID-II in the diagnosis of CP were studied.
Results: While both MDI and PDI were decreased similarly in the GDD, PDI were significantly more decreased than MDI in the CP. The CP with hemiplegic pattern showed high MDI and PDI compared to those with the other patterns. When abnormal PDI defined as lower than 85 was used as a diagnostic criteria of CP, sensitivity and specificity were 0.88 and 0.41. When abnormal PDI defined as 13 and higher than MDI was used, sensitivity and specificity for the diagnosis of CP were 0.50 and 0.84.
Conclusion: The characteristic findings of BSID-II in the CP could be used as a supportive diagnostic measurement. We should interpret carefully in the children with hemiplegic pattern because they had a near normal MDI and higher PDI than functional status of hemiplegic limbs. (J Korean Acad Rehab Med 2003; 27: 210-214)
Objective: To clarify the relationship of primitive reflexes and motor development during second six months of age.
Method: All infants were referred to Inha University Hospital Cerebral Palsy Clinic from January 1, 1996 to March 30, 1997. Identical evaluations were performed on 49 risk infants at eight months of age. Their primitive reflexes were graded on a 0∼2 scale; 0 being inability to elicit the reponses passively, 1 being intermediate degree, 2 being obligatory. The following primitive reflexes were studied; asymmetric tonic neck reflex (ATNR), tonic labyrinthine reflex on supine (TLS), Moro reflex (Moro). The presence of some voluntary activities (rolling prone to supine, rolling supine to prone, and sitting unsupported) were observed. The Mantal-Haenszel chi-square for trend test was used in order to study the association of primitive reflex and motor development in infants with delayed development.
Results: Inability of rolling prone to supine was most significantly associated with presence of ATNR and TLS but not with that of Moro reflex. Inability of rolling supine to prone was significantly associated with presence of TLS and then Moro reflex, ATNR. Inability to Sit independently without support was associated with the presence of TLS, but not with that of ATNR and Moro reflexes.
Conclusion: This study suggests that the presence of primitive reflexes at second half of age are negatively influenced on motor development of infants.
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