Hand function and its prognostic factors of very low birth weight preterm children up to a corrected age of 24 months.
Half of very-low-birth-weight toddlers have hand-use delays; neonatal illness history and lower maternal education flag the kids who need the earliest help.
01Research in Context
What this study did
Wang et al. (2014) followed very-low-birth-weight preterm babies until they reached two years old. The team tested how well each child could use their hands at 12 and 24 months corrected age.
They also collected neonatal medical charts and family details. They wanted to see which early medical problems and which family factors predicted later hand-use trouble.
What they found
About half of the children showed clear hand-function delays at both check-ups. The delays showed up even though the babies looked healthy otherwise.
Kids who had more medical complications right after birth scored lower. Children whose mothers had fewer years of school also scored lower.
How this fits with other research
de Campos et al. (2010) and Hausmann-Stabile et al. (2011) watched infants with Down syndrome grasp toys. They also found object size and stiffness change grasp success, adding toy-choice tips to Tien-Ni’s medical-risk picture.
Mailleux et al. (2021) reviewed trials on infants with unilateral cerebral palsy. Modified constraint and bimanual training improved hand use. Their results give Tien-Ni’s ‘at-risk’ group two low-cost therapy options to test early.
Crotti et al. (2024) showed poor visual perception predicts poor two-hand skills in older kids with unilateral CP. This extends Tien-Ni’s work by adding vision screening to the predictor list for preterm toddlers too.
McKenzie et al. (2012) argue for sleep screening in early-intervention intakes. Sleep loss can hide or mimic motor delay, so pairing their sleep check with Tien-Ni’s hand test gives a fuller picture.
Why it matters
If you serve toddlers born very early, plan to check hand skills at one and two years. Add a quick visual-perception game and a sleep screener. When medical history is heavy or parent education is limited, start brief daily grasp play with sticky mittens or tiny toys. These small moves can narrow the gap before preschool.
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02At a glance
03Original abstract
A delay in functional hand performance broadly affects a child's successful participation in daily activities as well as later academic performance. Despite its high prevalence, hand function has received much less attention than other developmental domains, especially for young children. The aims of this study, therefore, were to examine hand function in preterm children up to a corrected age of 24 months; to establish predictive models for estimating preterm children's hand function; and to identify the contribution of early neuromotor assessments. This study included 230 preterm children (69, 76, and 85 children at corrected ages of 6-, 12-, and 24-months, respectively) who were recruited from the database of the preemie follow-up clinic at the National Cheng Kung University Hospital in Tainan, Taiwan. Hand function was evaluated using the Peabody Developmental Motor Scales II. Demographic information, birth history, and developmental documents were obtained from the medical records of routine preemie clinic follow-ups. Approximately half of healthy preterm children demonstrate hand function deficits at 12 and 24 months of corrected age. The Neonatal Medical Index, representing an infant's history of medical complication, was the best predictor of hand function at 12 and 24 months of corrected age. The social factor, represented by maternal educational year, was found to have influence on hand function only in preterm children at corrected age of 24 months old. Finally, early neuromotor performance demonstrated significant predictability of later hand function that supports the importance of continuous follow-up examinations in children with a history of prematurity. An understanding of a preterm child's early hand function as well as how its risk factors evolve helps clinicians both target children who might benefit from early intervention and ensure that children reach their full developmental potential.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2013.11.023