Minor neurological signs and perceptual-motor diYculties in prematurely born children

Aim—To examine the spectrum of neurological dysfunction and perceptualmotor diYculties at school age in a cohort of prematurely born children, and the relation of these measures to neonatal brain lesions, intelligence quotient, and behavioural adjustment. Method—One hundred and eighty three children were tested at the age of 6 years using Touwen’s Examination of the Child with Minor Neurological Dysfunction, the Movement Assessment Battery for Children (Movement ABC), the Developmental Test of Visual-Motor Integration (VMI), British Ability Scales, and Rutter Scales. Results—Twenty six children had definite cerebral palsy and one was blind. Of the remaining 156, the proportions falling below the 15th centile point were 31% on Touwen’s Examination, 44% on the Movement ABC, and 17% on the VMI. Forty two passed all three tests. No child with a normal ultrasound scan developed cerebral palsy, whereas nearly all those with major lesions did. Minor lesions, however, were not generally predictive of later outcome. Correlations between the tests were generally low. Conclusions—These findings stress the need to assess neurological and perceptual motor functioning separately at school age and to monitor relationships with other aspects of development. (Arch Dis Child 1997;76:F9–F14)