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The Performance of Infants Born Preterm and Full-term in the Mobile Paradigm: Learning and Memory

JC Heathcock, PT, MPT, is Physical Therapist, Department of Physical Therapy, and a doctoral student in the Biomechanics and Movement Science Program, Department of Biomechanics and Movement Science, University of Delaware, Newark, Del. This study was conducted in partial fulfillment of the requirements for Ms Heathcock's master's degree at the University of Delaware
AN Bhat, PT, MSc, is Physical Therapist, Department of Physical Therapy, and a doctoral student in the Biomechanics and Movement Science Program, Department of Biomechanics and Movement Science, University of Delaware
MA Lobo, PT, MPT, is Physical Therapist, Department of Physical Therapy, and a doctoral student in the Biomechanics and Movement Science Program, Department of Biomechanics and Movement Science, University of Delaware
JC Galloway, PT, PhD, is Physical Therapist and Assistant Professor, Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware, 301 McKinly Lab, Newark, DE 19716 (USA) (jacgallo{at}udel.edu)

Address all correspondence to Dr Galloway

Background and Purpose. By 3 to 4 months of age, infants born full-term and without known disease display associative learning and memory abilities in the mobile paradigm, where an infant's leg is tethered to a mobile such that leg kicks result in proportional mobile movement. The first purpose of this study was to examine the learning and memory abilities of a group of infants born full-term compared with those of a comparison group. Little is known about the learning and memory abilities in infants born preterm, a group at known risk for future impairments in learning and movement. The second purpose of this study was to determine if and when an age-adjusted group of infants born prematurely display associative learning and memory abilities over a 6-week period. Subjects. Ten infants born full-term (38–42 weeks gestational age [GA]) and 10 infants born preterm (<33 weeks GA and <2,500 g) who were tethered and had control over the mobile movement were independently compared with a comparison group of 10 infants born full-term who were tethered and viewed a moving mobile but did not have control over the mobile movement. Infants in all 3 groups were seen at 3 to 4 months of age and were excluded from participation for any known visual or orthopedic diagnoses. Methods. Infants were tested using the mobile conjugate reinforcement paradigm, where one leg is tethered to an overhead mobile such that kicking with that leg results in proportional mobile movement. The kicking rates of the full-term group and the preterm group were compared with their own initial (baseline) kicking rates and with those of the comparison group. Results. After exposure to the conjugate relationship between kicking and mobile movement, the full-term group kicked more frequently compared with their own baseline levels and compared with the comparison group, fulfilling both criteria for learning and memory. In contrast, the preterm group did not increase their kicking rate according to both criteria. Discussion and Conclusion. These results suggest that infants born prematurely differ in their performance in the mobile paradigm as compared with age-matched infants born full-term. The mobile paradigm may provide clinicians with an important early assessment of infants' associative learning and memory abilities. Follow-up studies are needed, however, to further validate this paradigm as a clinical assessment tool.

Key Words: Kicking • Motor control • Motor learning • Pediatric assessment • Premature infant

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