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Motor skill delay in Dravet’s children increases with age, study finds

Motor development is delayed in most children with Dravet syndrome over the age of 2, and this delay increases with age, research shows.

The research article, “Motor Development in Children with Dravet Syndrome,” was published in Childhood developmental medicine and neurology.

Early motor development is important for autonomy and performance in the daily activities of any individual. However, children with Dravet syndrome exhibit delays in early gross motor skills such as sitting and walking independently, and the course of motor development in these children throughout childhood remains uncertain.

“Mapping the motor development in these children can provide information to improve therapy planning, thereby improving their independence and thus may reduce the burden on parents and caregivers,” the researchers wrote. “Due to a lack of knowledge regarding motor development in Dravet syndrome, no adequate treatment can be offered.”

Therefore, researchers at the University of Antwerp examined a large cohort of children with Dravet syndrome, obtaining retrospective information from the medical records of patients treated between February 1985 and March 2018. They investigated the clinical records of 43 children (21 men and 22 women, with a mean age of 4.5 years at the last assessment) who met the diagnostic criteria for Dravet syndrome.

Overall motor age equivalents (age based on motor skills versus chronological age) were available for 22 children. Multiple results from the same child were included, yielding 38 overall motor age equivalents (19 male results and 19 female results). Twenty-nine of 38 results were found to be below age equivalent, indicating motor delays.

The most frequently observed delay was in sitting independently in 7 of 14 children with Dravet syndrome. In typically developing children, independent sitting occurs between 3.8 and 9.2 months. However, 50% of children with Dravet (7 of 14) reported sitting up independently later, between 6 and 12 months old.

Likewise, about half of children with Dravet (11 out of 25) began to walk independently beyond the age range where unaffected children start – developing children typically ages 8.2 to 17.6 months, compared to 11 to 37 months for children with Dravet. In addition, the age at which they began to walk independently was very varied.

Data were available for the development of fine motor skills in 18 children and the development of gross motor skills in 13 children. Fine motor skills are those that require a high degree of control and precision in the small muscles of the hand (such as the use of a knife or fork). Gross motor skills use large muscles and include larger movements, such as walking or jumping.

Gross motor delay was present in all 7 assessments and fine motor delay in 10 of 13 assessments of children with Dravet.

A delay in motor development occurred in all five domains – balance, visual motor integration, strength, coordination and locomotion – according to the results of a total of 16 children.

Motor retardation was already evident before the age of 2 when taking gross motor results into consideration. Overall motor development is delayed in most children with Dravet syndrome over 2 years of age, and this delay increases with age.

The researchers recommend future large-group studies to define the course of motor development in each child with Dravet syndrome and carefully map the course of motor development for each individual. This information is essential for developing adequate treatments for motor impairments, they said.

“Encouraging children with Dravet syndrome who show early signs of motor retardation to gain more movement experience could be valuable for their motor development later in life,” the researchers wrote. “By gaining confidence in their movements, more stability will be created.”

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