Research Article  |   December 2015
Head Lag in Infancy: What Is It Telling Us?
Author Affiliations
  • Roberta G. Pineda, PhD, OTR/L, is Assistant Professor, Program in Occupational Therapy and Department of Pediatrics, Washington University School of Medicine, St. Louis, MO; pineda_r@kids.wustl.edu
  • Lauren C. Reynolds, OTD, OTR/L, is Research Coordinator, Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO
  • Kristin Seefeldt, OTR/L, is Occupational Therapist, The Lighthouse Neurological Rehabilitation Center, Kingsley, MI
  • Claudia L. Hilton, PhD, OTR, is Assistant Professor, Department of Occupational Therapy and Department of Rehabilitation Sciences, University of Texas Medical Branch, Galveston
  • Cynthia E. Rogers, MD, is Assistant Professor, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
  • Terrie E. Inder, MD, PhD, is Chair, Department of Pediatric Newborn Medicine, Brigham and Women’s Infant Hospital, Boston, MA
Article Information
Pediatric Evaluation and Intervention / Children and Youth
Research Article   |   December 2015
Head Lag in Infancy: What Is It Telling Us?
American Journal of Occupational Therapy, December 2015, Vol. 70, 7001220010p1-7001220010p8. doi:10.5014/ajot.2016.017558
American Journal of Occupational Therapy, December 2015, Vol. 70, 7001220010p1-7001220010p8. doi:10.5014/ajot.2016.017558
Abstract

OBJECTIVE. To investigate changes in head lag across postmenstrual age and define associations between head lag and (1) perinatal exposures and (2) neurodevelopment.

METHOD. Sixty-four infants born ≤30 wk gestation had head lag assessed before and at term-equivalent age. Neurobehavior was assessed at term age. At 2 yr, neurodevelopmental testing was conducted.

RESULTS. Head lag decreased with advancing postmenstrual age, but 58% (n = 37) of infants continued to demonstrate head lag at term. Head lag was associated with longer stay in the neonatal intensive care unit (p = .009), inotrope use (p = .04), sepsis (p = .02), longer endotracheal intubation (p = .01), and cerebral injury (p = .006). Head lag was related to alterations in early neurobehavior (p < .03), but no associations with neurodevelopment were found at 2 yr.

CONCLUSION. Head lag was related to medical factors and early neurobehavior, but it may not be a good predictor of outcome when used in isolation.