This page is an introduction to postnatal neural development. Neurological development continues postnatally with both growth and reorganization of the central nervous system. The amount of simple physical growth is shown by the skeletal flexibility designed around the brain and spinal cord, which allows continued postnatal growth of these structures.
WHO Motor Development Milestones
The World Health Organization (WHO) recently identified early postnatal motor skill development in terms of "milestones"(More Motor Milestones). Postnatal changes have also been quantified in the development of the cortex: "...the relationship between cortex thickness and IQ varied with age, particularly in the prefrontal cortex, seat of abstract reasoning, planning, and other "executive" functions" (More? Cortex Development). It is also useful to see what has gone before in the prenatal development of the nervous system which may result in postnatal abnormalities (More? Neural Notes). The ongoing flexibility of postnatal neural development can be demonstrated also by the impact of sensory abnormalities (vision, hearing) on achieving developmental milestones (More? Hearing Notes | Eye Notes). In other cases, an obvious macroscopic structural abnormality may not be easily identified, the change may be a subtle change in the neural network established in areas of association and IQ (More? Fetal Alcohol Syndrome). Finally it is worth considering how you can assess neurological development at this stage (More? Pediatric Neurological Exam)
Page Links: Introduction | Motor Development Milestones | Cortex Development | Neurological Assessment | Abnormal Neural Development | References | WWW Links | Glossary
Most embryology textbooks (by definition) do not cover postnatal developmenty in any detail.
The links below are to useful external online resources on general postnatal growth.
The World Health Organization (WHO) in a recent publication documented early postnatal motor skill development in terms of "milestones". This was released along with new international growth charts (More? Growth Charts). See also the external linkpage for the original data on which the study and graph are based.
Reference: WHO Multicentre Growth Reference Study Group. WHO Motor Development Study: Windows of achievement for six gross motor development milestones. Acta Paediatrica Supplement 2006;450:86-95.
Links: WHO Motor Development Milestones |
Recent NIH research has looked at the postnatal development of the cortex in children (Cortex Matures Faster in Youth with Highest IQ) "The researchers found that the relationship between cortex thickness and IQ varied with age, particularly in the prefrontal cortex, seat of abstract reasoning, planning, and other "executive" functions. .... While the cortex was thinning in all groups by the teen years, the superior group showed the highest rates of change."
The developmental trajectory in cortex thickness differs as the brain matures in different IQ groups. Thickness of the area at the top/front/center, highlighted in MRI brain maps at left, peaks relatively late, at age 12 (blue arrow), in youth with superior intelligence, perhaps reflecting an extended critical period for development of high-level cognitive circuits. (Image and text source: NIMH Child Psychiatry Branch)
There are many different neurological assessment tests that have been designed over the years using a number of motor and intelligence (comprehension) skill tests. Some of these assessment tests are applicable to specific early neurological development ages.
PD Larsen and SS Stensaas from the Utah School of Medicine have also made a series of movies demonstrating normal postnatal neurological development assessment (More? PediNeuroLogic Exam)
Neonatal
Test of Infant Motor Performance (TIMP) can be used in very early development (from 32 weeks post-conceptional age to 4 months post-term). Involves observation of 28 items and elicitation of 31 items measures behaviours of functional relevance.
Einstein Neonatal Neurobehavioral Assessment Scale
Neurobehavioral Assessment of the Preterm Infant
Bayley Scales of Infant Development (BSID) a postnatal (from 1 to 42 months) neurological assessment scale used in screening and diagnosis of development using 178 item mental scale and the 111 item motor scale, the original BSID was revised in 1993 to version 2 (BSID-II).
Peabody Developmental Motor Scale II (PDMS-2) tests a child’s motor competence relative to his or her peers. Involves a series of evaluations: reflexes (8 items), stationary/nonlocomotor (30 items), locomotion (89 items), object manipulation (24 items), grasping (26 items) and visual-motor integration (72 items).
Infant
Alberta Infant Motor Scale (AIMS) birth to 18 months. Identify infants with motor delay (discrimination) and evaluates motor development over time.
Battelle Developmental Inventory Screening Test (BDIST) for children 6 months to 8 years old.
Brief Assessment of Motor Function (BAMF) is a series of 10-point ordinal scales developed for rapid description of gross motor, fine motor, and oral motor performance.
Fagan Test of Infant Intelligence (FTII)
Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) a developmental test designed in Taiwan.
Denver-II (CDIIT) a historic test redesigned as a version 2, for 3 and 72 months of age. It has been suggested that the test may require additional revision for better accuracy.
Bruininks-Oseretsky Test of Motor Proficiency (1978) ages 4.5 to 14.5 years.
Early Language Milestone Scale-2, Early Intervention Developmental Profile (EIDP), Gross Motor Function Measure (GMFM)
There are also a range of task based tests: Means-End Problem-Solving Task, Operant Discrimination Learning, Mobile/Train Conjugate Reinforcement Tasks, The Transparent Barrier Detour Task, The A-not-B Task
References:
van Hartingsveldt MJ, Cup EH, Oostendorp RA. Reliability and validity of the fine motor scale of the Peabody Developmental Motor Scales-2. Occup Ther Int. 2005;12(1):1-13.
Cintas HL, Siegel KL, Furst GP, Gerber LH. Brief assessment of motor function: reliability and concurrent validity of the Gross Motor Scale. Am J Phys Med Rehabil. 2003 Jan;82(1):33-41.
Bartlett DJ, Fanning JE. Use of the Alberta Infant Motor Scale to characterize the motor development of infants born preterm at eight months corrected age. Phys Occup Ther Pediatr. 2003;23(4):31-45.
Provost B, Crowe TK, McClain C. Concurrent validity of the Bayley Scales of Infant Development II Motor Scale and the Peabody Developmental Motor Scales in two-year-old children. Phys Occup Ther Pediatr. 2000;20(1):5-18.
Wilkinson AR, Jiang ZD. Brainstem auditory evoked response in neonatal neurology. Semin Fetal Neonatal Med. 2006 Dec;11(6):444-51. Epub 2006 Oct 2. Review.
There are several developmental neurological abnormalities that are diagnosed postnatally as learning disorders. (More? Autism | Fragile X | Neural Notes - Autism | Neural Notes - Fragile X)
Journals
Reviews
Tieman BL, Palisano RJ, Sutlive AC. Assessment of motor development and function in preschool children. Ment Retard Dev Disabil Res Rev. 2005;11(3):189-96.
Gale CR, O'Callaghan FJ, Godfrey KM, Law CM, Martyn CN. Critical periods of brain growth and cognitive function in children. Brain. 2004 Feb;127(Pt 2):321-9. Epub 2003 Nov 25.
Gale CR, Walton S, Martyn CN. Foetal and postnatal head growth and risk of cognitive decline in old age. Brain. 2003 Oct;126(Pt 10):2273-8.
Lidsky TI, Schneider JS. Lead neurotoxicity in children: basic mechanisms and clinical correlates. Brain. 2003 Jan;126(Pt 1):5-19.
Frisk V, Amsel R, Whyte HE. The importance of head growth patterns in predicting the cognitive abilities and literacy skills of small-for-gestational-age children. Dev Neuropsychol. 2002;22(3):565-93.
Rice D, Barone S Jr. Critical periods of vulnerability for the developing nervous system: evidence from humans and animal models. Environ Health Perspect. 2000 Jun;108 Suppl 3:511-33. Review. (Pubmed Central)
Articles
Cintas HL, Siegel KL, Furst GP, Gerber LH. Brief assessment of motor function: reliability and concurrent validity of the Gross Motor Scale. Am J Phys Med Rehabil. 2003 Jan;82(1):33-41.
van Hartingsveldt MJ, Cup EH, Oostendorp RA. Reliability and validity of the fine motor scale of the Peabody Developmental Motor Scales-2. Occup Ther Int. 2005;12(1):1-13.
Utah School of Medicine PD Larsen and SS Stensaas series of movies demonstrating normal postnatal neurological development assessment PediNeuroLogic Exam
National Library of Medicine (USA) neurologic diseases
Baylor College of Medicine Cain Foundation
University of California Irvine School of Medicine Pediatric Neurology Research
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It would seem obvious to say that neural development does not stop at birth. Related information can be found on pages: Neural Notes, Hearing Notes, Eye Notes, Fetal Alcohol Syndrome.
In fact many systems (cardiovascular, respiratory, gastrointestinal, homeostasis) undergo significant changes at birth, and many others (neural) have not yet completed their development.
Note this current project focuses on prenatal development, so postnatal content is not as detailed.
This section of notes covers issues related to early childhood and development. It is sometimes easy to forget the many health issues that affect childhood development around the world. There are many links to external resources that relate to the many issues of this period of development.
Following childhood we have the early teenager, where hormonal changes trigger changes that lead to growth and reproductive maturation.
Please email Dr Mark Hill if you wish to make a comment about this current project.