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Can the Griffiths scales predict neuromotor and perceptual-motor impairment in term infants with neonatal encephalopathy?
  1. A L Barnett1,
  2. A Guzzetta3,
  3. E Mercuri2,
  4. S E Henderson4,
  5. L Haataja5,
  6. F Cowan1,
  7. L Dubowitz1
  1. 1Department of Paediatrics, Imperial College School of Medicine, Hammersmith Campus, London, UK
  2. 2Department of Child Neurology, Catholic University, Rome, Italy
  3. 3Department of Child Neurology and Psychiatry, Stella Maris Institute, University of Pisa, Italy
  4. 4School of Psychology and Human Development, Institute of Education, University of London, UK
  5. 5Department of Paediatrics and Child Neurology, Turku University Central Hospital, Turky, Finland
  1. Correspondence to:
    Dr E Mercuri
    Department of Paediatrics, Hammersmith Hospital, Du Cane Road, London W12 OHN, UK; e.mercuriic.ac.uk

Abstract

Aims: To examine the predictive value of early developmental testing for identifying neuromotor and perceptual-motor impairment at school age in children with neonatal encephalopathy (NE).

Methods: Eighty full term infants with NE were followed longitudinally. Where possible, children were tested on the Griffiths scales at 1 and 2 years and at 5–6 years, on the Touwen Examination, Movement ABC, and WPPSI. The relation between the Griffiths scores and later outcome measures was examined using correlation coefficients and sensitivity and specificity values.

Results: By 2 years, 25 children with cerebral palsy were too severely impaired to be formally assessed and remained so at 5–6 years. Abnormal Griffiths scores were obtained by 12% and 7% of the children at 1 and 2 years respectively. At 5–6 years, 33% had poor Movement ABC scores and 15% poor WPPSI scores. The highest correlation between Griffiths scores and the outcome measures was for the Movement ABC (0.72), although this accounted for only 50% of the variance. Sensitivity scores for the Movement ABC were below 70% but specificity was 100%.

Conclusions: A poor score on the Griffiths scales at 1 and/or 2 years is a good predictor of impairment at school age. However, a normal score in the early years cannot preclude later neurological, perceptual-motor, or cognitive abnormalities.

  • neonatal encephalopathy
  • developmental testing
  • perceptual-motor
  • cognitive

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Footnotes

  • This study was supported by grants from Action Research and SCOPE