Purpose: To examine whether the Canadian normative values of the Alberta Infant Motor Scale (AIMS) are appropriate for Dutch infants. Method: In a cross-sectional study, 499 infants developing typically (0.5-19 months) were assessed using the AIMS home video method. The scaling method was used for calculating item locations of the Dutch sample, and Welch test to compare Canadian and Dutch raw scores. Results: The AIMS items (45 of 58) met the criterion for stable regression to calculate item locations of the Dutch data set and compare these with the Canadian data set. Dutch infants passed 42 of 45 items at an older age. Most monthly age groups of Dutch infants had lower mean AIMS scores. Conclusion: The Canadian norms are not appropriate for the Dutch study sample. Dutch infants appear to develop in a similar sequence but at a slower rate. This has implications regarding the clinical use of the AIMS in the Netherlands.
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OBJECTIVE: Coordinating sucking, swallowing and breathing to achieve effective sucking is a complex process and even though sucking is essential for nutrition, little is known about sucking patterns after birth. Our objective was to study sucking patterns in healthy fullterm infants and to describe the age-specific variations.METHOD: We studied the sucking patterns of 30 healthy, fullterm infants longitudinally from 2 or 3 days after birth to 10 weeks of age. During this time we recorded five to seven feeding episodes that we assessed off-line with the Neonatal Oral-Motor Assessment Scale (NOMAS).RESULTS: We found a normal sucking pattern on the second or third day after birth in 27 out of 30 infants. During the following weeks we found abnormal sucking patterns in 23 out of 171 feeding episodes (14%) and normal patterns in 148 episodes (86%). Altogether, between 38 and 50 weeks' postmenstrual age (10 weeks after birth), 10 infants displayed a deviating, arrhythmical sucking pattern. Dysfunctional sucking patterns and problems of coordinating sucking, swallowing and breathing did not occur. Birth weight, gestational age, type of labour and gender did not influence sucking patterns. Arrhythmical sucking was seen more often in bottle-fed infants.CONCLUSION: Our study demonstrated that practically all healthy fullterm infants started off with a normal sucking pattern soon after birth. One-third of the infants displayed one or more deviating episodes up to the age of 10 weeks. Apart from bottle-feeding, no other factors were found that influenced sucking patterns.
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This study examined the effect of meals varying in amount, size, and hardness of food pieces on the development of the chewing capabilities of 8-month-old infants. The study also examined changes in shivering, gagging, coughing, choking, and their ability to eat from a spoon. In an in-home setting two groups were given commercially available infant meals and fruits, purees with either less, smaller and softer or more, larger and harder pieces. Both groups were given these foods for 4 weeks and were monitored several times during this period. After the 4-week exposure period infants in both groups were given the same five test foods. Structured questionnaires with questions on eating behavior and the child's development were conducted 6 times in the 4 to 12-month period and video analyses of feedings were conducted 4 times between 8 and 9 months. After the 4-week exposure period, the group that had been exposed to the foods with more, larger and harder pieces showed a significantly higher rating for chewing a piece of carrot and potato for the first time, but not for a piece of banana nor for mashed foods. Shivering, gagging, coughing, choking, and ability to eat from a spoon were not different between the two groups. These results contribute to the insight that exposure to texture is important for young children to learn how to handle texture. PRACTICAL APPLICATIONS: (a) The study shows the feasibility of testing the effects of texture interventions on chewing capability and oral responses such as gagging, coughing, and choking in infants. (b) The study contributes to the insight that exposure to food texture to learn how to handle texture is important for infants and showed that exposing children to a higher amount of larger pieces improves their chewing capability for a piece of carrot and potato, at least immediately after the intervention.
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Are sucking skills in a specific period (in weeks post menstrual age, PMA) associated with an abnormal development at age 2?Do preterm infants with abnormal sucking patterns in the early post term period differ in motor skills at age 5 from preterm infants with normal sucking patterns in the same early post term period?
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From the perspective of caregivers, social interaction is a dynamic process in which many aspects are involved. Caregivers reported about eight main themes across child factors, parental factors and environmental factors that influence real-time as well as long term processes of social interaction. Our proposed model of social interaction in preterm infants visualizes the interrelatedness of these themes. Recommendation: Development of social skills and social power could be strengthenend by paying more attention to the relatedness between real-time social interaction experiences and long-term outcome, with regard to possible cascading effects.
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The studies reported on in this thesis addressed the development of suckingpatterns in preterm newborns. Preterm infants often have problems learningto suckle at the breast or to drink from a bottle. It is unclear whether this isdue to their preterm birth or whether it is the consequence of neurologicaldamage. From the literature, as well as from daily practice, we know thatthere is much variation in the time and in the way children start suckingnormally. Factors such as birth weight and gestational age may indeed berisk factors but they do not explain the differences in development. A smallspot-check proved that most hospitals in the Netherlands start infants onoral feeding by 34 weeks’ post-menstrual age (pma). By and large the policyis aimed at getting the infant to rely on oral feeding entirely as soon aspossible. The underlying rationale is to reduce the stay in hospital, and theidea that prolonged tube-feeding delays or even hampers the development ofsucking.
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OBJECTIVE: To examine the association between sucking patterns and the quality of fidgety movements in preterm infants.STUDY DESIGN: We studied the sucking patterns and fidgety movements of 44 preterm infants (gestational age <35 weeks) longitudinally from 34 weeks' postmenstrual age up to 14 weeks postterm. We used the Neonatal Oral-Motor Assessment Scale during feeding and scored the sucking patterns as normal or abnormal. Abnormal sucking patterns were categorized into arrhythmic sucking and uncoordinated sucking. At 14 weeks postterm, we scored the quality of fidgety movements from videotapes as normal, abnormal, or absent.RESULTS: The postmenstrual age at which sucking patterns became normal (median, 48 weeks; range, 34 to >50 weeks) was correlated with the quality of fidgety movements (Spearman ρ = -0.33; P = .035). The percentage per infant of normal and uncoordinated sucking patterns was also correlated with the quality of fidgety movements (ρ = 0.31; P = .048 and ρ = -0.33; P = .032, respectively). Infants with uncoordinated sucking patterns had a higher rate of abnormal fidgety movements (OR, 7.5; 95% CI, 1.4-40; P = .019).CONCLUSION: The development of sucking patterns in preterm infants was related to the quality of fidgety movements. Uncoordinated sucking patterns were associated with abnormal fidgety movements, indicating that uncoordinated sucking, swallowing, and breathing may represent neurologic dysfunction.
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Infants attend daycare at an early age, which raises questions about children's sensitivity to the childcare environment and the role of different temperamental traits in their development in the early years. In a two-year longitudinal study with parent- and caregiver-reported data for Dutch children at the age of 1 and 2 years (120 children from 92 groups), we explored fine-grained dimensions of negative affect and their relationship with socio-emotional functioning. Especially shyness, frustration and soothability proved robust predictors of socio-emotional development across parent- and caregiver-reported data with both concurrent (Year-1) and predictive associations (Year-2). Also, the quality of caregiver–child interactions moderated caregiver-reported child wellbeing and competence. Infants that are open to social contacts, are easy to comfort and have low levels of frustration, and have higher levels of wellbeing and less problem behaviour in early daycare than peers with higher levels of shyness and frustration and relatively low levels of soothability.
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Background and aim: Moderate preterm (MP) birth is associated with an increased risk of developmental problems. However, post-discharge support for this group is scarce. The aim of this study was to evaluate the feasibility of a post-discharge parenting program (TOP program) for MP infants. Three feasibility dimensions were evaluated (1) recruitment capability and compliance, (2) intervention acceptability, and (3) limited efficacy testing. Methods: A group of MP infants with a gestational age (GA) between 320/7‐346/7 weeks and their parents received six home visits by a TOP interventionist until 6 months corrected age (CA). A pre-posttest intervention design with quantitative and qualitative measures was used. Recruitment capability and compliance, acceptability, and satisfaction with the intervention were evaluated using a questionnaire, checklists, interviews, and a focus group. Infant socio-emotional development, parental distress, self-efficacy, and reflective functioning were measured with questionnaires. Observation measurements were used for infant motor development and parental sensitivity. Results: Thirty-two families completed the six home visits. The satisfaction rate (scale 0–10) was remarkably high (Mean 9.4, range: 8–10). Parents reported that the program was suitable, enhanced their understanding of their infants' developmental needs, and increased their self-efficacy. The infants showed age-appropriate motor and socio-emotional development post-intervention. Parental self-efficacy, reflective functioning, and sensitivity improved from pre to post intervention, with small to large effect sizes. Conclusion: The study demonstrated high compliance, acceptability, and satisfaction with the TOP program for MP infants with promising infant and parent outcomes. This study contributes to the preparatory work prior to a larger scale evaluation and dissemination.
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AIM: To determine the association between sucking in infants born preterm and developmental outcomes at 5 years.METHOD: Thirty-four infants were included (mean gestational age 30wks 4d, mean birthweight 1407g). The Neonatal Oral-Motor Assessment Scale was used longitudinally from 37 to 50 weeks postmenstrual age. At 5 years, we assessed motor skills, intelligence, language, verbal memory, and behavioural problems. Linear regression analyses were performed to test whether aspects of sucking behaviour predicted these developmental outcomes. Where linear regression was not appropriate, Spearman's correlation coefficients were calculated between sucking and developmental outcomes.RESULTS: Sucking was associated with total motor skills (B [unstandardized correlation coefficient for normally distributed data]=22.66, 95% confidence interval [CI] 6.61 to 38.71), balance (Spearman's ρ=0.64, p<0.001), total intelligence (B=-1.16, 95% CI -1.89 to -0.44, B=10.48, 95% CI 0.39 to 20.71, B=-2.22, 95% CI -3.42 to -1.02), verbal intelligence (B=-0.95; 95% CI -1.83 to -0.07, B=-2.02; 95% CI -3.55 to -0.49), performance intelligence (B=-1.34, 95% CI -2.13 to -0.54, B=12.36, 95% CI 1.13 to 23.60, B=-2.37, 95% CI -3.75 to -0.96), and language (B=-1.78, 95% CI -3.36 to -0.19). All associations were in the same direction: the better the sucking, the higher the test scores. Verbal memory and behavioural problems were not associated with sucking.INTERPRETATION: Abnormal sucking between 42 weeks and 50 weeks postmenstrual age may reflect abnormal neurological functioning in children born preterm.
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