The motor repertoire in 3- to 5-month old infants with Down syndrome.

This was an exploratory convenience sample, not a randomised or representative study of all infants with Down syndrome. The infants were assessed only at 3 to 5 months post-term, so the paper cannot show how these movements relate to later motor, cognitive or language outcomes. Muscle tone was not measured, although the authors discuss low muscle tone as a possible explanation for several movement and posture findings. Neurological examination data were unavailable for 44 of 47 infants, and cranial ultrasound data were available for only 8 infants. The study used several centres and ethnic backgrounds, although the authors argue that spontaneous general movements are not expected to differ by ethnicity. The comparison infants came from an existing data bank and were matched on gestational age and recording age, but the study did not use randomised allocation or blinding of all raters to clinical history.

Do not conclude that abnormal fidgety movements or a low motor score diagnose cerebral palsy or predict later disability. The study was cross-sectional, and the motor score was higher than that of infants later diagnosed with cerebral palsy.