Neurological condition assessed with the Hempel examination and cognition and behaviour at 4years

• Published in: Early human development Vol. 112; pp. 9 - 13
• Main Authors: Schendelaar, Pamela, Seggers, Jorien, Heineman, Maas Jan, Hadders-Algra, Mijna
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.09.2017
• Subjects: Behaviour; Child Behavior; Child, Preschool; Cognition; Complex MND; Female; Humans; Infant, Low Birth Weight - growth & development; Infant, Premature - growth & development; Male; Motor Skills; Neurological optimality score; Preschool-age; Neurological optimality score; Cognition; Behaviour; Preschool-age; Complex MND
• DOI: 10.1016/j.earlhumdev.2017.06.004
• ISSN: 0378-3782

To investigate associations between neurological condition, assessed with the Hempel examination, in terms of minor neurological dysfunction (MND) and neurological optimality, and cognition and behaviour at 4years. Cross-sectional analyses within a prospective, assessor-blinded follow-up study. Four-year-old singletons born to subfertile parents (n=235; 120 boys). Outcome parameters were complex minor neurological dysfunction (complex MND) and the neurological optimality score (NOS). Cognitive outcome was evaluated with the Kaufman Assessment Battery for Children, resulting in a total intelligence quotient (IQ). Behavioural outcome was evaluated with the Child Behavior Checklist, resulting in a total problem T-score. Fifty-seven (24.3%) children had complex MND. None of the children showed fine motor dysfunction, suggesting a ceiling effect of the Hempel assessment. Complex MND was not correlated with IQ or total problem T-score. Nevertheless, a higher NOS was correlated with a higher IQ and a lower total problem T-score (adjusted mean estimate [95% confidence interval]: cognition: 0.445 [0.026; 0.865], p=0.038; behaviour: −0.458 [−0.830; −0.087], p=0.016). At age 4, complex MND assessed with the Hempel assessment was not associated with cognition and behaviour, presumably due to a ceiling effect in the Hempel domain of fine motor function. A more optimal neurological condition was associated with higher IQ and better behaviour. •At 4years, the Hempel assessment has a ceiling effect in fine motor function.•Complex MND determined with the Hempel assessment is not associated with cognition and behaviour in 4-year-olds.•Presumably, the tool of choice to assess MND in 4-year-olds is the MND-assessment rather than the Hempel assessment.•At age 4, the neurological optimality score was associated with cognition and behaviour.