To address the need for a standardized system to classify the gross motor function of children with cerebral palsy, the authors developed a five-level classification system analogous to the staging and grading systems used in medicine. Nominal group process and Delphi survey consensus methods were used to examine content validity and revise the classification system until consensus among 48 experts (physical therapists, occupational therapists, and developmental pediatricians with expertise in cerebral palsy) was achieved. Interrater reliability (kappa) was 0.55 for children less than 2 years of age and 0.75 for children 2 to 12 years of age. The classification system has application for clinical practice, research, teaching, and administration.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1469-8749.1997.tb07414.x

Development and reliability of a system to classify gross motor function in children with cerebral palsy

How we raise young children is one of today's most highly personalized and sharply politicized issues, in part because each of us can claim some level of "expertise." The debate has intensified as discoveries about our development-in the womb and in the first months and years-have reached the popular media. How can we use our burgeoning knowledge to assure the well-being of all young children, for their own sake as well as for the sake of our nation? Drawing from new findings, this book presents important conclusions about nature-versus-nurture, the impact of being born into a working family, the effect of politics on programs for children, the costs and benefits of intervention, and other issues. The committee issues a series of challenges to decision makers regarding the quality of child care, issues of racial and ethnic diversity, the integration of children's cognitive and emotional development, and more. Authoritative yet accessible, From Neurons to Neighborhoods presents the evidence about "brain wiring" and how kids learn to speak, think, and regulate their behavior. It examines the effect of the climate-family, child care, community-within which the child grows.

/pdf/from-neurons-to-neighborhoods-the-science-of-early-childhood-3bfl5g72ow.pdf

From Neurons to Neighborhoods: The Science of Early Childhood Development

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Modern Applied Statistics With S

ContextThe cognitive and behavioral outcomes of school-aged children who were
born preterm have been reported extensively. Many of these studies have methodological
flaws that preclude an accurate estimate of the long-term outcomes of prematurity.ObjectiveTo estimate the effect of preterm birth on cognition and behavior in
school-aged children.Data SourcesMEDLINE search (1980 to November 2001) for English-language articles,
supplemented by a manual search of personal files maintained by 2 of the authors.Study SelectionWe included case-control studies reporting cognitive and/or behavioral
data of children who were born preterm and who were evaluated after their
fifth birthday if the attrition rate was less than 30%. From the 227 reviewed
studies, cognitive data from 15 studies and behavioral data from 16 studies
were selected.Data ExtractionData on population demographics, study characteristics, and cognitive
and behavioral outcomes were extracted from each study, entered in a customized
database, and reviewed twice to minimize error. Differences between the mean
cognitive scores of cases and controls were pooled. Homogeneity across studies
was formally tested using a general variance-based method and graphically
using Galbraith plots. Linear meta-analysis regression models were fitted
to explore the impact of birth weight and gestational age on cognitive outcomes.
Study-specific relative risks (RRs) were calculated for the incidence of attention-deficit/hyperactivity
disorder (ADHD) and pooled. Quality assessment of the studies was performed
based on a 10-point scale. Publication bias was examined using Begg modified
funnel plots and formally tested using the Egger weighted-linear regression
method.Data SynthesisAmong 1556 cases and 1720 controls, controls had significantly higher
cognitive scores compared with children who were born preterm (weighted mean
difference, 10.9; 95% confidence interval [CI], 9.2-12.5). The mean cognitive
scores of preterm-born cases and term-born controls were directly proportional
to their birth weight (R2 = 0.51; P<.001) and gestational age (R2 = 0.49; P<.001). Age at evaluation had
no significant correlation with mean difference in cognitive scores (R2 = 0.12; P = .20).
Preterm-born children showed increases in externalizing and internalizing
behaviors in 81% of studies and had more than twice the RR for developing
ADHD (pooled RR, 2.64; 95% CI, 1.85-3.78). No differences were noted in cognition
and behaviors based on the quality of the study.ConclusionsChildren who were born preterm are at risk for reduced cognitive test
scores and their immaturity at birth is directly proportional to the mean
cognitive scores at school age. Preterm-born children also show an increased
incidence of ADHD and other behaviors.

https://jamanetwork.com/journals/jama/articlepdf/195181/JMA10039.pdf

Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis.

New Ballard Score, expanded to include extremely premature infants.

Eficacia de una intervención precoz en niños minusválidos y en situación de riesgo

Early delay in motor development

With the advent in the early 1960s of neonatal intensive care technology for low birthweight, premature, and other biologically vulnerable and medically fragile infants, there has been an associated professional, parental, and general public interest in the health and developmental outcomes of the survivors of this highly specialized care. Concerns about the short- and long-term neurodevelopmental prognoses for graduates of neonatal intensive care have increased as the accepted medical intervention strategies—such as mechanical ventilation, continuous positive airway pressure (CPAP), parenteral nutrition, central nervous system shunting, and drainage procedures—have become continually more complex and more aggressively utilized.

Promoting Development and Integration of Infants Experiencing Neonatal Intensive Care

Early Intervention for low birthweight infants: What can we achieve?"

I was distressed to see the understanding and management of children with behavior and/or learning problems set back 20 years by Dr James S. Miller9s article (Pediatrics 61:217, 1978). The unifying concept of minimal brain dysfunction arose in the 1950s for three main reasons: (1) many children seen clinically for family, school, and/or peer problems showed a mixture of both hyperactivity and learning disability in a wide range from mild to severe1-3; (2) most of these children, as Dr Miller states, had no history even suggestive of brain damage4; and (3) most of these children were treated as though their hyperactivity and cognitive deficits were caused entirely by interpersonal, family relationships, thus reinforcing parental guilt and making psychotherapy for the parents and child the usual treatment of choice without consideration of other causes and treatments.5

Forrest C. Bennett

Papers

Eficacia de una intervención precoz en niños minusválidos y en situación de riesgo

Early delay in motor development

Promoting Development and Integration of Infants Experiencing Neonatal Intensive Care

Early Intervention for low birthweight infants: What can we achieve?"

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