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A Case Exploration of Early Motor Delays in an Extremely Premature Infant

This mixed-method case study explores early motor delays in an extremely premature infant and provides the mother's perspective on raising an infant whose future development is uncertain. Infant motor testing was completed at term age, 6 weeks, and 12 weeks. Magnetic resonance spectroscopy (MRS) was performed at 41 weeks corrected age after the infant scored below average on infant motor assessments. A parent interview and follow-up motor testing was completed at 10 months. The infant scored below average or low average on infant motor tests at all time periods. MRS results revealed mild abnormalities in white matter. The qualitative interview highlighted the mother's anxiety over early motor delays. Although motor delays were manifest during early motor testing, the infant received only brief early intervention (EI) but no additional therapy services. This case serves as an example of the difficulty identifying early motor delays in this high-risk population resulting in inconsistent utilization of EI services. This study's finding are supported by recent motor studies that have identified very early motor skill markers that serve as red flags for developmental disorders such as cerebral palsy or autism. These markers of atypical early head, arm, leg, or trunk movements could be used as part of more sensitive early developmental screenings that could be used by early interventionists, pediatricians, or occupational therapists to help identify those infants at highest risk for later delay. Larger studies are needed to further define standardized testing that could identify early motor deficits in extremely premature infants.