General movements: a window for early identification of children at high risk for developmental disorders
Section snippets
Child's brain: a continuously changing system
The development of the human brain is a long-lasting process. It is at approximately 30 years of age that the nervous system obtains its adult configuration (Fig 1).1., 2. Development starts during the early phases of gestation with the proliferation of neurons in the germinal layers near the ventricles. Next, neurons migrate in an orderly fashion to their final places of destination, and they start to differentiate. Neuronal differentiation includes the formation of dendrites and axons, the
Normal development of general movements
Heinz Prechtl, a pioneer in the field of early neurological development, recognized the significance of spontaneous motor behavior in early life. Prechtl and others7., 8. realized that self-generated motility during early development plays an important role in survival and adaptation. In addition, Prechtl discovered that the quality of spontaneous motility, especially the quality of general movements (GMs), accurately reflects the condition of the nervous system of the fetus and young infant.9
Conclusions
The assessment of the quality of GMs is a sensitive tool to evaluate brain function in young infants. It has a function complementary to the traditional neurological examination. Prediction of developmental outcome on the basis of longitudinal series of GM assessment is best. Second best is prediction on the basis of an assessment at fidgety age. European experience indicates that a single GM assessment at fidgety age can be implemented relatively easily into clinical practice.
The presence of
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