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Aim: The primary aim of this study was to investigate the accuracy of the Alberta Infant Motor Scale (AIMS) and Neuro-Sensory Motor Developmental Assessment (NSMDA) over the first year of life for predicting motor impairment at 4 years in preterm children. The secondary aims were to assess the predictive value of serial assessments over the first year and when using a combination of these two assessment tools in follow-up., Method: Children born <30 weeks' gestation were prospectively recruited and assessed at 4, 8 and 12 months' corrected age using the AIMS and NSMDA. At 4 years' corrected age children were assessed for cerebral palsy (CP) and motor impairment using the Movement Assessment Battery for Children 2nd-edition (MABC-2). We calculated accuracy of the AIMS and NSMDA for predicting CP and MABC-2 scores ≤15th (at-risk of motor difficulty) and ≤5th centile (significant motor difficulty) for each test (AIMS and NSMDA) at 4, 8 and 12 months, for delay on one, two or all three of the time points over the first year, and finally for delay on both tests at each time point., Results: Accuracy for predicting motor impairment was good for each test at each age, although false positives were common. Motor impairment on the MABC-2 (scores ≤5th and ≤15th) was most accurately predicted by the AIMS at 4 months, whereas CP was most accurately predicted by the NSMDA at 12 months. In regards to serial assessments, the likelihood ratio for motor impairment increased with the number of delayed assessments. When combining both the NSMDA and AIMS the best accuracy was achieved at 4 months, although results were similar at 8 and 12 months., Interpretation: Motor development during the first year of life in preterm infants assessed with the AIMS and NSMDA is predictive of later motor impairment at preschool age. However, false positives are common and therefore it is beneficial to follow-up children at high risk of motor impairment at more than one time point, or to use a combination of assessment tools., Trial Registration: ACTR.org.au ACTRN12606000252516.

Aim: To compare postural control at 4 years' corrected age in very preterm children (VPT; <30wks gestational age) with term-born (>37wks gestational age) comparison participants., Method: Ninety VPT children (45 males, 45 females; mean age at assessment 4y 1mo; mean birthweight 1022g; mean gestational age 27.3wks) and 36 term comparison participants (17 males, 19 females; mean age at assessment 4y; mean birthweight 3507g; mean gestational age 39.4wks) were assessed for postural stability with a portable force plate, the Wii Balance Board. Tasks included static two-limbed standing with eyes open, eyes closed, eyes open on a foam mat, eyes closed on a foam mat, a cognitive dual task, and single leg standing on each limb. The cognitive dual task involved showing the participants a series of pictures that appeared on screen at 2-second intervals. Impaired postural control was defined as increased postural sway measured by centre of pressure path-length velocity. Functional performance was assessed during dynamic jumping and hopping tasks using the outcome measure flight time, with shorter time indicating worse performance., Results: VPT children had impaired static and dynamic balance, with increased postural sway under all conditions, and reduced flight times compared with children born at term. When results were adjusted for body weight, the only group differences in postural control were in the cognitive dual task (cm/s; mean difference 0.6; 95% confidence interval [CI] 0.02, 1.2; p=0.04) and flight times (ms; jumping; mean difference -26.0; 95% CI -47.1, -5.0; p=0.02; left leg hopping; mean difference -30.1; 95% CI -48.5, -11.8; p=0.002)., Interpretation: VPT children demonstrated reduced postural control at 4 years of age compared with term-born children when presented with a cognitive dual task. They also performed worse during jumping and hopping tasks., (© 2014 Mac Keith Press.)

Aim: To assess the predictive validity of the Bayley Scales of Infant and Toddler Development - Third Edition (Bayley-III) for later motor outcome., Method: Ninety-six infants (49 males, 47 females) born at less than 30 weeks' gestation admitted to two tertiary hospitals in Melbourne, Australia, were assessed with the Bayley-III Motor Scale at 2 years' corrected age and were classified as suspect or definite motor impairment if they scored less than -1 or -2 standard deviations respectively, relative to the test mean. At 4 years' corrected age, children completed Movement Assessment Battery for Children - Second Edition (MABC-2); for the total motor score, cut-offs of not more than the 15th were used to classify motor development and cut-offs of not more than the 15th centile were classified as having a significant movement difficulty., Results: Of the 96 children assessed at both ages, at 2 years 9% had suspect and 4% had definite motor impairment; however, by 4 years, rates had increased to 22% and 19% respectively. The specificity of the Bayley-III for motor impairments for later motor outcome was excellent (ranging from 94 to 100% for cerebral palsy [CP] and 97 to 100% for motor impairment), although the sensitivity was low (ranging from 67 to 83% for CP and 18 to 37% for motor impairment); many children with later impairment were not identified by the Bayley-III., Interpretation: The Bayley-III Motor Scale at 2 years underestimates later rates of motor impairment, particularly in the absence of CP at 4 years on the MABC-2 total motor score in children born at less than 30 weeks' gestational age., (© The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.)