Melbourne School of Psychological Sciences - Theses

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    Neurodevelopment in children with single-suture craniosynostosis: the early years
    KNIGHT, SARAH ( 2010)
    Craniosynostosis is a common developmental disorder characterised by premature, pathological fusion of one or more of the fibrous connections, or sutures, that normally separate the bony plates of the skull during early development. Premature sutural fusion, typically occurring in utero, results in anomalous skull growth, and may have consequences for the developing brain. Most cases of single-suture craniosynostosis (SSC) require surgery, preferentially performed within the first year of life, to release the fused suture and reshape the deformed skull and improve brain growth potential. The exact mechanisms by which brain development is disrupted in SSC are uncertain. Research suggests that children with all forms of SSC are at heightened risk for neuropsychological problems; however, the nature, extent and risk factors (e.g., genetic, environmental, severity of skull deformity) for these disturbances, are yet to be established. The aim of this study was to examine the impact that SSC may have on neurodevelopmental skills during infancy and to use a theory-driven approach to explore the possible contributory factors to developmental progression during infancy. Participants included 30 infants with SSC (16 metopic, 14 sagittal). Participants were assessed on the Bayley Scales of Infant and Toddler Development – Third Edition (BSID-III) during early infancy when they were between 5 and 15 months of age. Fifty-three percent (n=16) of these infants were also assessed in late infancy when they were between 17 and 33 months of age and at least six months post-surgical intervention. During both early and late infancy, children with craniosynostosis demonstrated significantly poorer gross motor skills compared to the normative sample, but other skills were in line with normal population expectations. Factors including subtype of craniosynostosis, severity of deformity, social risk and age at surgery, were not shown to be significantly associated with developmental level during early or late infancy. The impact of genetic variables on early development was unclear in the current sample. This study has provided important insights into the functional significance of disruption to typical brain growth in infants with SSC. Findings indicate that SSC is a condition associated with developmental delay during early infancy prior to surgical intervention, with developmental concerns remaining evident post-surgically in late infancy. Findings support recommendations for the close monitoring of the development of these children during early life.