Bcl. Touwen, PRENATAL AND EARLY POSTNATAL-DEVELOPMENT AND ITS IMPORTANCE IN EARLY RECOGNITION OF DEVELOPMENTAL DISTURBANCES, Monatsschrift fur Kinderheilkunde, 141(8), 1993, pp. 638-642
The normal central nervous system is characterized by both activity an
d reactivity. Under normal circumstances the former leads the latter.
In abnormal conditions reactivity may predominate, usually in the form
of reflexes and abnormal postural reactions. Ultrasound registration
shows that the first spontaneous motor movements can be seen in the se
venth to eighth gestational week. Movement patterns develop fast, and
in mid-pregnancy all patterns are observed that can be found in the te
rm newborn baby. During the second half of pregnancy movement patterns
are refined: the first differentiation leading to variable and fluent
movements. The intrauterine movements are qualitatively more or less
similar to those seen in normal preterm babies, the main difference be
ing that the latter as to counteract gravity forces to a greater exten
t. Qualitative changes of the movement patterns signal deteriorating i
ntrauterine conditions. Stereotyped quality of movement can be a sign
of abnormal development. During infancy normal development is characte
rized by great variability in performance, developmental sequences and
relationships. Stereotype performance and strong relationship between
the various motor functions, reactions and reflexes should arouse the
suspicion that there may be a disturbance in development.