Background: Current use of smartphone cameras by parents create opportunities for longitudinal home-video-assessments to monitor infant development. We developed and validated a home-video method for parents, enabling Pediatric Physical Therapists to assess infants’ gross motor development with the Alberta Infant Motor Scale (AIMS). The objective of the present study was to investigate the feasibility of this home-video method from the parents’ perspective. Methods: Parents of 59 typically developing infants (0–19 months) were recruited, 45 parents participated in the study. Information about dropout was collected. A sequential mixed methods design was used to examine feasibility, including questionnaires and semi-structured interviews. While the questionnaires inquired after the practical feasibility of the home-video method, the interviews also allowed parents to comment on their feelings and thoughts using the home-video method. Results: Of 45 participating parents, 34 parents returned both questionnaires and eight parents agreed to an interview. Parent reported effort by the infants was very low: the home-video method is perceived as similar to the normal routine of playing. The parental effort level was acceptable. The main constraint parents reported was time planning. Parents noted it was sometimes difficult to find the right moment to record the infant’s motor behavior, that is, when parents were both at home and their baby was in the appropriate state. Technical problems with the web portal, reported by 28% of the parents were also experienced as a constraint. Positive factors mentioned by parents were: the belief that the home videos are valuable for family use, receiving feedback from a professional, the moments of one-on-one attention and interaction with their babies. Moreover, the process of recording the home videos resulted in an increased parental awareness of, and insight into, the gross motor development of their infant. Conclusion: The AIMS home-video method is feasible for parents of typically developing children. Most constraints are of a practical nature that can be addressed in future applications. Future research is needed to show whether the home-video method is also applicable for parents with an infant at risk of motor development problems.
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The purpose of this study was a serial assessment of gross motor development of infants at risk is an established procedure in neonatal follow-up clinics. Assessments based on home video recordings could be a relevant addition. In 48 infants (1.5-19 months), the concurrent validity of 2 applications was examined using the Alberta Infant Motor Scale: (1) a home video made by parents and (2) simultaneous observation on-site by a pediatric physical therapist. Parents’ experiences were explored using a questionnaire.
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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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This thesis focuses on topics such as preterm birth, variation in gross motor development, factors that influence (premature) infant gross motor development, and parental beliefs and practices. By gaining insight into these topics, this thesis aims to contribute to clinical decision-making of paediatric physiotherapists together with parents, and with that shape early intervention.
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Background: The aim of this study is to investigate whether age of infant motor milestone achievement is related to levels of physical activity (PA), weight status and blood pressure at age 4–7years of age. Methods: In the Dutch GECKO (Groningen Expert Center of Kids with Obesity) Drenthe cohort, the age of achieving the motor milestone ‘walking without support’ was reported by parents. Weight status and blood pressure were assessed by trained health nurses and PA was measured using the Actigraph GT3X between age 4 and 7years. Results: Adjusted for children’s age, sex and the mother’s education level, infants who achieved walking without support at a later age, spent more time in sedentary behaviour during childhood and less time in moderate-tovigorous PA. Later motor milestones achievement was not related to higher BMI Z-score, waist circumference Zscore, diastolic or systolic blood pressure. Conclusion: The results of this study indicate that a later age of achieving motor milestone within the normal range have a weak relation to lower PA levels at later age. It is not likely that this will have consequences for weight status or blood pressure at 4–7years of age.
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Aim The aim of this study is to gain more insight into child and environmental factors that influence gross motor development (GMD) of healthy infants from birth until reaching the milestone of independent walking, based on longitudinal research. Background A systematic search was conducted using Scopus, PsycINFO, MEDLINE and CINAHL to identify studies from inception to February 2020. Studies that investigated the association between child or environmental factors and infant GMD using longitudinal measurements of infant GMD were eligible. Two independent reviewers extracted key information and assessed risk of bias of the selected studies, using the Quality in Prognostic Studies tool (QUIPS). Strength of evidence (strong, moderate, limited, conflicting and no evidence) for the factors identified was described according to a previously established classification. Results In 36 studies, six children and 11 environmental factors were identified. Five studies were categorized as having low risk of bias. Strong evidence was found for the association between birthweight and GMD in healthy full-term and preterm infants. Moderate evidence was found for associations between gestational age and GMD, and sleeping position and GMD. There was conflicting evidence for associations between twinning and GMD, and breastfeeding and GMD. No evidence was found for an association between maternal postpartum depression and GMD. Evidence for the association of other factors with GMD was classified as ‘limited’ because each of these factors was examined in only one longitudinal study. Conclusion Infant GMD appears associated with two child factors (birthweight and gestational age) and one environmental factor (sleeping position). For the other factors identified in this review, insufficient evidence for an association with GMD was found. For those factors that were examined in only one longitudinal study, and are therefore classified as having limited evidence, more research would be needed to reach a conclusion.
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ObjectiveTo obtain insights into parents' information needs during the first year at home with their very preterm (VP) born infant.MethodsWe conducted semi-structured interviews with parents of VP infants participating in a post-discharge responsive parenting intervention (TOP program). Online interviews were audiotaped and transcribed verbatim. Inductive thematic analysis was performed by two independent coders.ResultsTen participants were interviewed and had various and changing information needs during the developmental trajectory of their infant. Three main themes emerged; (1) Help me understand and cope, (2) Be fully responsible for my baby, and (3) Teach me to do it myself. Available and used sources, such as the Internet, did not meet their information needs. Participants preferred their available and knowledgeable healthcare professionals for reassurance, tailored information, and practical guidance.ConclusionThis study identified parents' information needs during the first year at home with their VP infant and uncovered underlying re-appearing needs to gain confidence in child-caring abilities and autonomy in decision-making about their infants' care.InnovationThis study provides valuable information for healthcare professionals and eHealth developers to support parental self-efficacy during the first year after preterm birth.
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OBJECTIVES: Sucking problems in preterm infants can be specified by means of visual observation. The Neonatal Oral-Motor Assessment Scale (NOMAS) is the visual observation method most commonly used to assess the non-nutritive sucking (NNS) and nutritive sucking (NS) skills of infants up to approximately 8 weeks postterm. During the first 2 min of a regular feeding the infant's sucking skill is assessed, either immediately or on video. Although NOMAS has been used since 1993, little is known about the method's reliability. The aim of our study was to determine the test-retest and inter-rater reliability of NOMAS.METHODS: The 75 infants included in this study were born at 26-36 weeks postmenstrual age (PMA). Four observers participated in the study. They were trained and certified to administer NOMAS in the Netherlands by M.M. Palmer between 2000 and 2002.RESULTS: We found the test-retest agreement of NOMAS to be 'fair' to 'almost perfect' (Cohen's kappa [kappa] between 0.33 and 0.94), whereas the inter-rater agreement with respect to the diagnosis was 'moderate' to 'substantial' (Cohen's kappa, between 0.40 and 0.65). As a diagnostic tool, however, the current version of NOMAS cannot be used for both full-term and preterm infants. For a measuring instrument such as NOMAS, one should aim at reliability coefficients for inter-rater and test-retest agreement of at least 0.8. A Cohen's kappa of 0.6 or less we find unacceptable. Nonetheless, by observing sucking and swallowing according to a protocol much useful information can be gathered about the development of an infant's sucking skills. For instance, whether the infant is able to co-ordinate sucking and swallowing, whether the infant can maintain sucking, swallowing and breathing during the continuous phase and whether the infant is able to suck rhythmically with equally long bursts. In addition, NOMAS offers useful aids for intervention.CONCLUSIONS: NOMAS should be re-adjusted in order to improve inter-rater agreement, and at the same time current insights into the development of sucking and swallowing should be incorporated in the method.
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Background: Poor motor skill competence may influence energy balance with childhood overweight as a result. Our aim was to investigate whether the age of motor milestone achievement has changed over the past decades and whether this change may contribute to the increasing trend observed in childhood overweight. Methods: Motor skill competence was assessed in children from the Young Netherlands Twin Register born between 1987 and 2007. Follow-up ranged from 4 up to 10 years. Weight and height were assessed at birth, 6 months, 14 months, and 2, 4, 7, and 10 years. Results: Babies born in later cohorts achieved their motor milestones ‘crawling’, ‘standing’, and ‘walkingunassisted’ later compared to babies born in earlier cohorts (N = 18,514, p <0.001). The prevalence of overweight at age 10 was higher in later cohorts (p = 0.033). The increase in overweight at age 10 was not explained by achieving motor milestones at a later age and this persisted after adjusting for gestational age, sex, and socioeconomic status. Conclusion: Comparing children born in 1987 to those born in 2007, we conclude that children nowadays achieve their motor milestones at a later age. This does not however, explain the increasing trend in childhood overweight.
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