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Aim The aim of this cross-sectional study was to provide normative data (ordinal scores and timed performances) for gross and fine motor tasks in typically developing children between 3 and 5 years of age using the Zurich Neuromotor Assessment (ZNA). Method Typically developing children ( n=101; 48 males, 53 females) between 3 and 5 years of age were enrolled from day-care centres in the greater Zurich area and tested using a modified version of the ZNA; the tests were recorded digitally on video. Intraobserver reliability was assessed on the videos of 20 children by one examiner. Interobserver reliability was assessed by two examiners. Test-retest reliability was performed on an additional 20 children. The modelling approach summarized the data with a linear age effect and an additive term for sex, while incorporating informative missing data in the normative values. Normative data for adaptive motor tasks, pure motor tasks, and static and dynamic balance were calculated with centile curves (for timed performance) and expected ordinal scores (for ordinal scales). Results Interobserver, intraobserver, and test-retest reliability of tasks were moderate to good. Nearly all tasks showed significant age effects, whereas sex was significant only for stringing beads and hopping on one leg. Interpretation These results indicate that timed performance and ordinal scales of neuromotor tasks can be reliably measured in preschool children and are characterized by developmental change and high interindividual variability. [ABSTRACT FROM AUTHOR]

Intensity of contralateral associated movements (AMs) is a measure of movement quality assessed using frequency and degree of AMs. A sample of 593 right-handed participants without disability (286 males, 307 females; aged 5y-18y 6mo) was studied with the Zurich Neuromotor Assessment (ZNA). The ZNA is a standardized testing procedure which assesses performance on standardized motor tasks according to timed performance and frequency and degree of AMs. In contrast to frequency and degree, intensity of AMs allowed the calculation of centiles which were quasi-continuous. Centile curves of contralateral AMs for the ZNA and data on inter- and intraobserver reliability are presented. The significance of age, sex, and side differences are discussed. Intensity of AMs offers clinical and scientific advantages for measurement of movement quality. There is a decrease of AMs with age depending on the complexity of tasks. Females showed consistently fewer AMs than males, whereas only minor side differences were shown. [ABSTRACT FROM AUTHOR]

Motor performance and movement quality were quantitatively examined (Zurich Neuromotor Assessment: timed motor performances and associated movements) in 87 prospectively enrolled very-low-birthweight (VLBW; <1250g) children (38 males, 49 females; mean birthweight 1016.2g [SD 141.5andrsqb:, range 720-1240g; mean gestational age 28.7wks [SD 2], range 25.7-33.4wks) at 6 years of age. All motor tasks were below the reference population: pure motor (median z-score) -0.46; adaptive fine motor (pegboard) -0.99; adaptive gross motor -0.88; static balance -0.48; and associated movements -1.90. All tasks correlated with the degree of neurological abnormalities (p

Motor performance and movement quality were quantitatively examined (Zurich Neuromotor Assessment: timed motor performances and associated movements) in 87 prospectively enrolled very-low-birthweight (VLBW; <1250g) children (38 males, 49 females; mean birthweight 1016.2g [SD 141.5], range 720–1240g; mean gestational age 28.7wks [SD 2], range 25.7–33.4wks) at 6 years of age. All motor tasks were below the reference population: pure motor (median z-score) –0.46; adaptive fine motor (pegboard) –0.99; adaptive gross motor –0.88; static balance –0.48; and associated movements –1.90. All tasks correlated with the degree of neurological abnormalities (p0.004). VLBW children with no neurological abnormality also performed below the 10th centile and associated movements occurred more frequently than in the reference population (odds ratio 18, 95% confidence interval 6.7–47.9). Severity of periventricular leukomalacia and intraventricular haemorrhage assessed by ultrasound was associated with adaptive fine and gross motor tasks. We conclude that speed of motor performance and movement quality in particular were substantially impaired in VLBW children and are related to the degree of neurological abnormalities and neonatal cerebral injury. [ABSTRACT FROM AUTHOR]

AIM Longitudinal studies that have examined cognitive performance in children with intellectual disability more than twice over the course of their development are scarce. We assessed population and individual stability of cognitive performance in a clinical sample of children with borderline to mild non-syndromic intellectual disability. METHOD Thirty-six children (28 males, eight females; age range 3-19y) with borderline to mild intellectual disability (Full-scale IQ [FSIQ] 50-85) of unknown origin were examined in a retrospective clinical case series using linear mixed models including at least three assessments with standardized intelligence tests. RESULTS Average cognitive performance remained remarkably stable over time (high population stability, drop of only 0.38 IQ points per year, standard error=0.39, p=0.325) whereas individual stability was at best moderate (intraclass correlation of 0.58), indicating that about 60% of the residual variation in FSIQ scores can be attributed to between-child variability. Neither sex nor socio-economic status had a statistically significant impact on FSIQ. INTERPRETATION Although intellectual disability during childhood is a relatively stable phenomenon, individual stability of IQ is only moderate, likely to be caused by test-to-test reliability (e.g. level of child's cooperation, motivation, and attention). Therefore, clinical decisions and predictions should not rely on single IQ assessments, but should also consider adaptive functioning and previous developmental history. [ABSTRACT FROM AUTHOR]

Aim To study the development of motor speed and associated movements in participants aged 5 to 18 years for age, sex, and laterality. Method Ten motor tasks of the Zurich Neuromotor Assessment (repetitive and alternating movements of hands and feet, repetitive and sequential finger movements, the pegboard, static and dynamic balance, diadochokinesis) were administered to 593 right-handed participants (286 males, 307 females). Results A strong improvement with age was observed in motor speed from age 5 to 10, followed by a levelling-off between 12 and 18 years. Simple tasks and the pegboard matured early and complex tasks later. Simple tasks showed no associated movements beyond early childhood; in complex tasks associated movements persisted until early adulthood. The two sexes differed only marginally in speed, but markedly in associated movements. A significant laterality ( p<0.001) in speed was found for all tasks except for static balance; the pegboard was most lateralized, and sequential finger movements least. Associated movements were lateralized only for a few complex tasks. We also noted a substantial interindividual variability. Interpretation Motor speed and associated movements improve strongly in childhood, weakly in adolescence, and are both of developmental relevance. Because they correlate weakly, they provide complementary information. [ABSTRACT FROM AUTHOR]

Aim: The aim of this cross-sectional study was to provide normative data for motor proficiency (motor performance and contralateral associated movements [CAMs]) in typically developing children between 3 years and 18 years of age using an updated version of the Zurich Neuromotor Assessment (ZNA-2).Method: Six-hundred and sixteen typically developing children between 3 years and 18 years of age were enrolled from day-care centres, kindergartens, and schools, and were tested using the ZNA-2 with improved items of the original battery. Motor proficiency was assessed on five components (fine motor tasks, pure motor tasks, static balance, dynamic balance, and CAMs) as a function of age and sex to determine centile curves for each task. Intraobserver, interobserver, and test-retest reliabilities were evaluated.Results: Most ZNA-2 tasks featured a marked developmental trend and substantial interindividual variability. Test-retest reliability was generally high (e.g. static balance 0.67; CAMs 0.81; and total scores 0.84).Interpretation: The ZNA-2 is a reliable and updated test instrument to measure motor proficiency in children from 3 to 18 years with improved properties for assessing motor performance. It allows continuous measurement without changing items for the entire age range; this feature of the ZNA-2 is unique and makes the instrument suitable for clinical purposes. The reduction of CAMs scoring simplifies the clinical procedure and increases its reliability.What This Paper Adds: The Zurich Neuromotor Assessment, Second Edition (ZNA-2) provides new norms for motor proficiency in children between 3 years and 18 years. High reliabilities suggest that the revised test battery is a useful tool for assessing neuromotor development. Integration of a 'not able to perform' category makes the ZNA-2 suitable for clinical purposes. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to examine neurodevelopment, psychological adjustment, and health-related quality of life ( HRQoL) in adolescents after bypass surgery for congenital heart disease ( CHD) during early childhood. Method Fifty-nine adolescents (34 females, 25 males) with CHD were examined at a median age of 13 years 8 months (range 11y 5mo-16y 11mo). Outcome was assessed with the Wechsler Intelligence Scale for Children, (fourth edition); the Beery Test of Visual- Motor Integration; the Rey- Osterrieth Complex Figure Test; the Zurich Neuromotor Assessment; the Strengths and Difficulties Questionnaire; and the KIDSCREEN questionnaires. Results were compared with those of 40 age- and sex-matched healthy comparison individuals. Results Outcome with regard to full-scale IQ, perceptual reasoning, and the working memory scale was poorer in patients with CHD than in the comparison group (all p≤0.001). Visual perception, visuomotor integration ( p≤0.001), and executive functions (Rey figure copy: p=0.05) were also affected. Patients with CHD also had lower scores on all motor domains ( p<0.02) except static balance. Psychological adjustment was affected only in the 'peer relationship' domain ( p=0.05). Quality of life was similar to that of typically developing peers. Interpretation Adolescents with CHD may manifest persistent cognitive and motor impairments, while psychological adjustment and self-reported HRQoL are mostly typical. Thus, long-term neurodevelopmental evaluations are necessary to provide early educational and therapeutic support. [ABSTRACT FROM AUTHOR]