Denver Development Screening Test II article summary
“Position of pelvis in the 3rd month of life predicts further motor development” by Gajewska et al (2018)
Summary
In this study, authors investigated whether certain predictors from a 3-month observation- based, therapeutic evaluation could predict development in infants at the 9-month age mark. The purpose of the article was to describe how the authors intended to define elements of postural control and developmental motor skills measured at 3 months to best project defining characteristics for motor function at 9 months old. The study population included 422 children, of those 292 infants born full-term and 130 born pre-term. The researchers used previously-established therapeutic evaluation techniques to examine 3-month-old children, both in the supine and prone positions (Gajewski et al 2013). At 9 months, a neurological examination using the Denver Development Screening Test II (DDST II) was conducted by a neurologist who was unaware of the previous 3-month evaluation findings. The study found that correct pelvis positioning at 3 months is the most influential factor linked to proper spine curvature development, which ultimately influences the ability of a child to attain erect posture by the 9th month of life. This can indicate a child’s future performance in other motor skills, such sitting independently and as advanced as ambulation.
Strengths
The suggested assessment sheet described by the authors in the article (and previously written article) uses observation to both detect abnormalities but also can be used to define a plan for further intervention and therapy. The assessment sheet’s intra and inter-observer reliability had been previously confirmed (Gajewski 2013).
Weaknesses
The delayed group of children displayed a diverse range of motor impairments and did not reflect a specific population of children. The authors suggest that future research be focused on children at risk for cerebral palsy to affirm the results of this study and its ability to predict developmental delays. In addition, the suggested evaluation sheet lacks a predicted sensitivity and specificity due to a lack of a recognized gold standard to refer to.
Clinical application
Early identification of developmental delays and abnormalities can help health care providers design early intervention plans and prevent further delay that may have a multi-dimensional effect on a child’s development. This study contains the earliest documented finding that proper pelvis alignment at the 3-month mark may be observed and correlated to proper motor development in the future. This article also gives in-depth suggestions on observation and evaluation of infants in both the prone and supine positions with typical signs to look, for such as an intermediate position of the pelvis (in both positions), medially observed scapulae in prone, spine extended appropriately in both supine and prone. The early identification of deviations from these typical identifiers can help promote better outcomes for children who are at risk or who may be displaying signs of motor developmental delay.
Reference:
Gajewska, E., Sobieska, M., Kaczmarek, E., Suwalska, A., & Steinborn, B. (2013). Achieving motor development milestones at the age of three months may determine, but does not guarantee, proper further development. The Scientific World Journal.
4 responses to “Denver Development Screening Test II article summary”
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Did they mention what interventions might be beneficial for those children that have deficits in pelvis position? Also, did any of the children in the study receive therapy during that 6-month time-frame? Great article Kelsey! If there is a possibility for this to become a “gold-standard” assessment, it could be very beneficial to our pediatric patients with motor development delays.
Josh, great questions. I did not find any suggested interventions within the article to correct for incorrect position of the pelvis. Great question to give further research to!
The children were not receiving therapy during that time frame.
Great summary, Kelsey! Very interesting and informative study. I think this data is very beneficial when looking at the possibility of early intervention. I noticed they included both infants born full-term and infants born pre-term. Was there any mention of the differences in findings between the 2 groups? Again, very interesting article that is great for education and pre-screening purposes.
Great question! There were no mention of differences in findings, and the corrected age of the pre-term infants included in the study was considered. The study states that each child was studied at 3 month’s age, which I assumed to be chronological age. No differentiation was made as to if any of the 72 children classified as “delayed” were born full-term or preterm.