Developmental motor outcomes of children aged nine to twenty-four months with hypoxic ischaemic encephalopathy based on the Thompson score

Nicolson, Tasha
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Hypoxic ischaemic encephalopathy (HIE) is the occurrence of impaired neurological function in a new-born, associated with asphyxia at birth. It may be considered mild, moderate or severe depending on the presence or absence of various clinical signs. The incidence of HIE in South Africa ranges from 0.4 – 3.7 per 1000 live births. In the moderate and severe form, HIE is known to cause functional motor deficits, cognitive deficits, intellectual impairment, language, learning and executive skills limitations and/or social impairments. This study was a quantitative cross-sectional study investigating the motor outcomes, as measured by the Peabody Developmental Motor Scales: second edition (PDMS-2), of 28 children with various severities of HIE. The severity of the HIE was measured by the Thompson HIE score. Participants were between the ages of nine and twenty-four months and attended the Mowbray Maternity Hospital Neurodevelopmental High-Risk Clinic. There were thirteen participants with mild HIE, seven participants with moderate HIE and eight participants with severe HIE. Demographic and perinatal factors were comparable across groups. Results of the study showed that all participants functioned within the normal range for all subtests of the PDMS-2. The mild and moderate HIE groups were comparable in all areas and therefore were combined and compared to the severe group. This comparison showed that the severe HIE group performed worse in all subtests with small to large effect sizes. It is therefore important for occupational therapists to ensure that children with severe HIE, according to the Thompson HIE score receive comprehensive assessment and follow up treatment. This assessment and treatment should focus on fine motor development, particularly VMI.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Occupational Therapy Johannesburg, 2019