Perceptuo-motor competence in prematurely born children at school age: neurological and psychological aspects.

This thesis focuses on perceptuo—motor competence in children born prematurely.\ud The cohort, now 6 years of age, was highly selected and consisted of 183 children whose\ud early cranial ultrasound appearance was well documented. In the literature review issues\ud regarding the detection and classification of brain lesions, the outcome of follow up\ud studies, and the description, identification and sub—grouping of children with perceptuo—\ud motor problems are discussed. This is followed by an outline of the study undertaken and\ud the results obtained.\ud Overall differences in the performance on the neurological, perceptuo—motor,\ud cognitive, behaviour and self—concept measures between the premature and reference\ud groups are described. Prematurely born children showed more minor neurological signs\ud and were less competent in age—appropriate perceptuo—motor tasks. Cognitive ability was\ud generally lower in this group, but no differences with respect to the behaviour and self—\ud concept measures were found.\ud The relationship between early brain lesion and later perceptuo—motor competence\ud was explored. Major haemorrhagic and/or ischaemic lesions were related to poor outcome.\ud The prognosis of children with minor haemorrhagic and/or ischaemic lesions was more\ud favourable although these children are clearly at an increased risk for more subtle\ud perceptuo—motor problems as they grow up.\ud The analyses suggested that among the group of children with perceptuo—motor\ud problems six separate sub—groups existed. In addition to two sub—groups whose profile\ud showed either average or below average performance across tasks, there were four sub—\ud groups who showed specific problems with dynamic or static balance, ball skills or\ud constructional tasks, respectively.\ud Finally, the characteristics of children with poor constructional ability were\ud examined in more detail. Using performance on a specially for this study designed form\ud board task as an example, it was shown that in addition to quantitative profiles, qualitative\ud descriptions of performance are important to gain a better understanding of subtle\ud perceptuo—motor impairment in individual children