Visual-manual development in low risk preterm born infants

Abstract : The extent of and reasons for visual-manual coordination deficits in moderate and late low risk preterm born infants are not well known. The aim of the thesis presented here was to investigate the development of visual-manual coordination in twelve low risk preterm infants born after 33-36 weeks of gestation and examined from 5 to 23 months of age. We conducted a series of studies with specific goals. The goal of study 1 was to investigate the development of visual-manual and bimanual coordination as well as handedness in the preterm infants between the postnatal ages of 6 and 12 months, after having evaluated their visual functions at 5 months. Gross motor development was also evaluated every month. Preterm infants were compared to a control group of ten full-term infants according to corrected age. Results show that preterm infants had a visual perception close to normal, with only visual fixation being lower than in full-terms. Preterm infants had delayed development of visual-manual integration, grasping, bimanual coordination and handedness. Tonicity and gestational age at birth were the main variables associated to the delays. There was no delay for gross motor development. The goal of study 2 was to investigate at what age preterm infants integrate the notion of object cohesiveness into their action plan. The same preterm and full-term infants as in first study were presented with a composite object task at 6, 8, and 10 months in two conditions, "composite object" condition, in which a bright ball was attached to the end of a neutral handle, and "invisible disconnection" condition in which the ball seemed to be connected to the handle but was not. Only the handle was within reach. Corrected age comparisons between preterm infants and full-terms showed no significant difference between the two groups. However, the hypotonic preterm infants had a significantly lower performance than the hypertonic infants. Based on the results from studies 1 and 2 it seems that preterm infants, in particular the hypotonic infants, have a delayed development in their first year of life, and one can wonder if this delay remains at later stages. To answer this question, in study 3 we compared the development of tool use in the preterm infants, aged 15 to 23 months, with that of full-terms according to corrected age. Understanding the affordance of a tool is an important milestone in early sensorimotor period. Using a tool to bring within reach an out-of-reach object, for instance, has been shown to develop during the second year in full-term infants. Here we presented preterm infants with an attractive toy out of reach and with a rake-like tool within reach in five conditions of spatial relationships between the toy and the tool. As a group, preterm infants showed a normal development of tool use. However not all preterm infants developped tool use without delay. Hypotonic and moderate preterm infants were significantly delayed in their acquisition of tool use. These results, show that some low risk preterm infants can still be impaired for the development of new manual skills beyond the first year. By following these low risk preterm children, it should be possible to evaluate which of the delays observed in our studies are the best predictors of later neuropsychological deficits in childhood. These results should also be confirmed with a larger sample of preterm infants.
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Maja Petkovic. Visual-manual development in low risk preterm born infants. Psychology. Université Sorbonne Paris Cité, 2016. English. ⟨NNT : 2016USPCB179⟩. ⟨tel-01997527⟩

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