Alberta Infant Motor Scale Research Articles

Investigation of the Relationship Between Sensory Processing and Motor Development in Preterm Infants.

The aim of this study was to analyze the correlation between sensory processing and motor development in preterm infants. We included 30 preterm and 30 term infants with corrected and chronological ages between 10 and 12 mo. We used the Test of Sensory Functions in Infants to evaluate sensory processing and the Alberta Infant Motor Scale to evaluate motor development. The Spearman correlation test indicated a strong positive relationship between sensory processing and motor development in preterm infants (r = .63, p < .001). Given the relationship between sensory processing and motor development in the preterm group, the evaluation of sensory processing and motor development in preterm infants was considered necessary for the effective implementation of physiotherapy assessment and interventions.

Web-Based Intervention to Teach Developmentally Supportive Care to Parents of Preterm Infants: Feasibility and Acceptability Study.

BackgroundPreterm birth affects 8% to 11% of the population and conveys a significant risk of developmental delays. Intervention programs that support child development have been shown to have a positive impact on early motor and cognitive development and on parental well-being. However, these programs are often difficult to implement in a real-life setting due to lack of resources. Hence, our multidisciplinary team developed Mieux Agir au Quotidien (MAQ) to teach developmentally supportive care to parents of preterm infants with the goal of improving child development and parental outcomes. Our intervention included 3 in-person workshops that occurred prior to hospital discharge and a Web-based platform with written and videotaped materials that addressed 5 main themes: (1) infant behavioral cues, (2) flexion positioning; (3) oral feeding support, (4) parent-infant interactions, and (5) anticipation of developmental milestones.ObjectiveThis study aimed to test the feasibility and acceptability of the intervention by parents of preterm infants and assess clinical benefits on child neurodevelopment and parental outcomes during the first year of life.MethodsA total of 107 infants born at <30 weeks and admitted to Sainte-Justine Hospital neonatal intensive care unit and their parents were enrolled in a nonrandomized controlled before-and-after interventional study (intervention n=55, comparison n=52). Acceptability of the program was assessed with a user satisfaction questionnaire. When the infants were at 4 months’ corrected age, all parents completed questionnaires on infant temperament, parenting stress, sense of competence, and parenting satisfaction. At 12 months’ corrected age, neurodevelopmental testing was performed on infants using the Alberta Infant Motor Scale and the Bayley Scales of Infant and Toddler Development, Third Edition. Comparisons between the 2 groups were done using independent t tests, Wilcoxon rank-sum tests, and Fisher exact tests.ResultsThe majority of parents (43/45) were satisfied with the intervention program and all would recommend MAQ to others. MAQ met their need for evidence-based information that proved useful to support their child development. No difference in parental or child neurodevelopmental outcomes was detected in this pilot study for most outcomes except for higher median scores for parental coercive behaviors in the intervention group, although proportions scoring in the coercive range did not differ.ConclusionsAcceptability of the program was high among parents thus supporting the relevance of such intervention. A larger study using a randomized controlled trial design is needed to better document impact on parent and children and investigate how Web-based technologies can efficiently complement individualized intervention to alleviate the burden on health care resources.

Feasibility of Using the General Movements Assessment of Infants in the United States

ABSTRACTAims: To pilot the practicality of administering the Prechtl General Movements Assessment of infants (GMA) in the Neonatal Intensive Care Unit (NICU) setting and at home to infants at risk for developing cerebral palsy (CP). Additional aims included assessing inter-rater reliability and comparing GMA predictions to AIMS motor assessment at 12 months. Methods: 12 “at risk” infants were recruited by convenience sample. Video recordings were obtained in the NICU and provided by parents after discharge. These recordings were analyzed by two trained examiners to assess infants in the writhing and fidgety movement periods (birth to 16 weeks). Infants were assessed at 12 months corrected age using the Alberta Infant Motor Scale (AIMS) with scores lower than 5th centile considered a motor delay. Results: 33 of 42 videos (79%) were of sufficient quality to permit interpretation and there was 97% inter-examiner subcategory agreement and 100% overall developmental trajectory (abnormal/normal) agreement. The GMA demonstrated a sensitivity of 60% and a specificity of 100% in predicting AIMS score (age appropriate or delayed). Conclusions: Clinical feasibility of GMA obtained in the NICU was demonstrated however feasibility of parents providing video samples after discharge was not demonstrated, indicating a need for a parent-friendly method.

Desenvolvimento motor, cognição e linguagem em lactentes que frequentam creches

***Motor development, cognition and language in infants who attend day care centers*** AIMS: To evaluate the acquisition of motor milestones in the first two years of life and the relationship between gross motor function and manipulation, cognition and language in infants who attend day care centers. METHODS: Cross-sectional study with a non-probabilistic sample of infants attending public and private day care centers in a city in southern Brazil. The Alberta Infant Motor Scale and the Bayley Scales of Infant and Toddler Development were used to assess the motor performance of each child. Descriptive statistics were used for the characterization of the sample and simple linear regression in three different age groups (group 1: between six and nine months; group 2: between 10 and 12 months; group 3: between 13 and 16 months) for the analysis of relationships between the variables gross and fine motor skills, cognition and language. RESULTS: We studied 63 infants between six and 16 months of age who did not present statistically significant differences in their biological and sociodemographic characteristics when the three stratified groups were compared. Most children did not acquire the developmental milestones in the period expected for their age group. There was correlation between the developmental scores, and the gross motor function was able to explain a large part of the variability in the fine motor function, cognition and language scores (R2ajust&gt;0.5) over the first two years of life. CONCLUSIONS: The evaluated motor skills occurred generally late in the sample. The delay in the acquisition of gross motor milestones had an impact on the overall developmental skills, corroborating the influence of gross motor function in the other domains of development.

Predicting the effectiveness of Test of Infant Motor Performance as an early marker of motor development delay in preterm infants

Objectives: The purpose of this study was to determine the effectiveness of Test of Infant Motor Performance (TIMP) in detecting motor developmental delay in preterm infants. Material and methods: The present study was conducted on 30 infants born preterm with corrected age of 2 months and follow up of TIMP at 4 months corrected age and Alberta Infant Motor Scale (AIMS) at 2, 4 and 6 months corrected age. Study period was January 2012 to December 2015. Results: Pearson product moment correlation coefficient used to assess the relationship between the raw scores of TIMP and AIMS percentilerank at corrected age of 2 and 4 months, was 0.757 (p<0.0001) and 0.874 (p<0.0001) respectively. An analysis of the sensitivity, specificity, positive predictive value and negative predictive value of various TIMP cutoff scores for comparison with AIMS scores above and below the 10th percentile revealed the best TIMP score with a cutoff of -1 standard deviation below the mean. The results for comparison of 2, 4, 6 months corrected age AIMS data using Pearson chi square test was highly significant with p 0.001 at 2months CA AIMS data with 4 months CA AIMS data. Conclusion and Interpretation: TIMP and AIMS are equally useful in the assessment of infant motor performance at 4 months of corrected age. A cutoff score of -1 SD from the mean on TIMP was a better predictor of developmental outcome in this study.

“The effects of family-centered physiotherapy on the cognitive and motor performance in premature infants”

ObjectiveThe aim of this study is to investigate the effects of family centered physiotherapy according to the neurodevelopmental treatment (NDT) principles on mental and motor performance in premature infants. MethodsA total of 156 infant, ≥24/36 week+6days gestational age included in the study. All the infants were diagnosed by a child neurologist and referred to psychology and physiotherapy department for their neurodevelopmental assessment and treatment. Bayley Scale of Infant II (BSI-II) was used for neurodevelopmental assessment and Alberta Infant Motor Scale (AIMS) was used for assessing their motor performance. Seventy-eight of the infants were in the study group and 76 were recruited as age matched controls according to the classification of their gestational age. Family centered physiotherapy according to the neurodevelopmental treatment principles was used as an intervention and all the mothers are trained accordingly. ResultsCognitive Development Scores and Motor Development Scores of Bayley II were recorded for the 3., 6., 9., and 12 months respectively. Between the 3. and 12. month of gestational age, within-groups measurements in both Cognitive Development Scores (p<0.001) and Motor Development Scores (p<0.001) were significantly increased. However, the improvements in both Cognitive Development Scores (p=0.059) and Motor Development Scores (p=0.334) between the groups was not different. ConclusionFamily centered physiotherapy with NDT principles may not be enough to improve motor and cognitive performance in preterm infants at the first year of age. For supporting the motor and cognitive development of the preterm infants other intervention modalities also should be considered. Keywords: infants; premature; early intervention

Preterm and term-equivalent age general movements and 1-year neurodevelopmental outcomes for infants born before 30weeks' gestation.

To examine the associations between Prechtl's General Movements Assessment (GMA), conducted from birth to term-equivalent age, and neurodevelopmental outcomes at 12months corrected age, in infants born very preterm. One hundred and thirty-seven infants born before 30weeks' gestation had serial GMA (categorized as 'normal' or 'abnormal') before term and at term-equivalent age. At 12months corrected age, neurodevelopment was assessed using the Alberta Infant Motor Scale (AIMS); Neurological, Sensory, Motor, Developmental Assessment (NSMDA); and Touwen Infant Neurological Examination (TINE). The relationships between GMA at four time points and 12-month neurodevelopmental assessments were examined using regression models. Abnormal GMA at all time points were associated with worse continuous scores on the AIMS, NSMDA, and TINE (p<0.05). Abnormal GMA before term and at term-equivalent age were associated with increased odds of mild-severe dysfunction on the NSMDA (odds ratio [OR] 4.26, 95% confidence interval [CI] 1.55-11.71, p<0.01; and OR 4.16, 95% CI 1.55-11.17, p<0.01 respectively) and abnormal GMA before term with increased odds of suboptimal-abnormal motor function on the TINE (OR 2.75, 95% CI 1.10-6.85, p=0.03). Abnormal GMA before term and at term-equivalent age were associated with worse neurodevelopment at 12months corrected age in children born very preterm. Abnormal general movements before term predict developmental deficits at 1year in infants born very preterm. General Movements Assessment before term identifies at-risk infants born very preterm.

Using the Alberta Infant Motor Scale (AIMS) to Screen for Motor Delay in Former Preterm Infants: A Validation Study

Using the Alberta Infant Motor Scale (AIMS) to Screen for Motor Delay in Former Preterm Infants: A Validation Study

Desenvolvimento motor no primeiro ano de vida de crianças prematuras conforme o peso de nascimento

***Motor development in the first year of life of premature infants according to birth weight***AIMS: To assess motor development in the first year of life of children born at 36 weeks' gestational age, comparing two groups, one with birth weight below 2500g and the other with 2500g or more.METHODS: A cross-sectional study evaluated the motor development of children enrolled in the Basic Health Units of Caxias do Sul and Porto Alegre, by the Alberta Infant Motor Scale. The sample consisted of infants born at 36 weeks' gestation, evaluated with a corrected chronological age of 0 to 12 months, divided into two groups: Low Birth Weight group (LBW group: birth weight below 2,500 g) and Adequate Birth Weight group (ABW group: birth weight of 2,500 g or more). The independent t-test, the chi-square test of Pearson and the Eta2 test (strong association&gt; 0.60) were used to analyze the data. P &lt;0.05 was considered significant.RESULTS: We evaluated 42 children, 21 in each group. Fifteen (71.42%) children with low birth weight were classified as small for gestational age. The mean motor development score percentile was 17.90±17.74 for the LBW group and 34.57±25.80 for the ABW group, indicating a better motor development of the second group (p=0.02) . There was a greater number of children with developmental delay in the LBW group (52.4%), whereas in the ABW group most were within the normal range (47.6%). The association was statistically significant between performance categories and birth weight groups, using the chi-square test (p=0.001), with Eta2=0.64 (strong association).CONCLUSIONS: In preterm infants with matched gestational age at 36 weeks, the low birth weight group had worse motor performance in the first year of life compared to the group with adequate birth weight.

Concurrent validity of the Alberta Infant Motor Scale to detect delayed gross motor development in preterm infants: A comparative study with the Bayley III

ABSTRACTObjective: To investigate the concurrent validity of AIMS in relation to the gross motor subtest of the Bayley Scale III/GM in preterm infants. Methods: A total of 159 gross motor development assessments were performed with the AIMS and Bayley-III/GM. Linear regression was used to assess the correlation between AIMS and Bayley-III/GM scores. The intra-class correlation coefficient (ICC) and the Bland-Altman plot were used to analyze intra- and inter-rater reliability. Results: There was a prevalence of delayed gross motor development of 20.8% according to the Bayley-III/GM, and 11.9% for the 5th percentile and 21.4% for the 10th percentile of AIMS. A good correlation of AIMS with Bayley-III/GM scores and intra- and inter-rater reliability was encountered in this study. Conclusion: AIMS proved very capable of detecting delayed gross motor development in preterm infants when compared with the Bayley-III/GM. The 10th percentile of AIMS provided the best combination of indicators, with greater specificity.

Commentary on "Concurrent Validity Between Live and Home Video Observations Using the Alberta Infant Motor Scale".

Commentary on "Concurrent Validity Between Live and Home Video Observations Using the Alberta Infant Motor Scale".

Concurrent Validity Between Live and Home Video Observations Using the Alberta Infant Motor Scale.

Serial assessment of gross motor development of infants at risk is an established procedure in neonatal follow-up clinics. Assessments based on home video recordings could be a relevant addition. In 48 infants (1.5-19 months), the concurrent validity of 2 applications was examined using the Alberta Infant Motor Scale: (1) a home video made by parents and (2) simultaneous observation on-site by a pediatric physical therapist. Parents' experiences were explored using a questionnaire. The intraclass correlation coefficient agreement between live and home video assessment was 0.99, with a standard error of measurement of 1.41 items. Intra- and interrater reliability: intraclass correlation coefficients were more than 0.99. According to 94% of the parents, recording their infant's movement repertoire was easy to perform. Assessing the Alberta Infant Motor Scale based on home video recordings is comparable to assessment by live observation. The video method is a promising application that can be used with low burden for parents and infants.

Infant Motor Skills After a Cardiac Operation: The Need for Developmental Monitoring and Care

Neurodevelopmental dysfunction is increasingly recognized as a common outcome of congenital heart defects and their treatment in infancy. The effects of the intensive care unit (ICU) experience and environment on these infants are unknown and potentially modifiable, but no validated metric is available for objective evaluation of early motor impairments in the ICU/hospital setting. The purpose of this study was to characterize the motor status of hospitalized infants after cardiac operations, including the development and field-testing of the Congenital Heart Assessment of Sensory and Motor Status (CHASMS) metric. CHASMS item generation was based on review of the literature, focused interviews with parents, and expert consensus. A nurse administered CHASMS to 100 infants aged younger than 10 months old undergoing cardiac operations. Preoperative and postoperative CHASMS scores were compared, and associations between CHASMS scores and patient characteristics were examined. Physical therapists assessed neuromotor skills by using the Test of Infant Motor Performance or the Alberta Infant Motor Scales for correlation with CHASMS scores. CHASMS gross motor scores declined postoperatively in 64% (25 of 39). Lower CHASMS scores, after adjusting for age, were associated with longer duration of mechanical ventilation (p < 0.001) and ICU length of stay (p= 0.001). Gross motor CHASMS scores were significantly correlated with Test of Infant Motor Performance (r= 0.70, p < 0.001) and Alberta Infant Motor Scales scores (r= 0.88, p < 0.001). Motor impairments in infants after cardiac operations are common and may be exacerbated by longer intubation and prolonged exposure to the ICU environment. The feasibility, reliability, and validity of CHASMS were supported for the evaluation of motor skills in this at-risk population.

A randomized clinical trial in preterm infants on the effects of a home-based early intervention with the 'CareToy System'.

CareToy system is an innovative tele-rehabilitative tool, useful in providing intensive, individualized, home-based, family-centred Early Intervention (EI) in infants. Our aim was to evaluate, through a Randomized Clinical Trial (RCT) study, the effects of CareToy intervention on early motor and visual development in preterm infants. 41 preterm infants (range age: 3.0–5.9 months of corrected age) were enrolled and randomized into two groups, CareToy and Standard Care. 19 infants randomized in CareToy group performed a 4-week CareToy program, while 22 allocated to control group completed 4 weeks of Standard Care. Infant Motor Profile (IMP) was primary outcome measure, Alberta Infant Motor Scale (AIMS) and Teller Acuity Cards were secondary ones. Assessments were carried out at baseline (T0) and at the end of CareToy training or Standard Care period (T1). T1 was the primary endpoint. After RCT phase, 17 infants from control group carried out a 4-week CareToy program, while 18 infants from the CareToy group continued with Standard Care. At the end of this phase, infants were re-assessed at T2. In RCT phase, delta IMP total score and variation and performance sub-domains were significantly higher (P<0.050) in CareToy group if compared to Standard Care group. Similar results were found for Teller Acuity Cards, while no differences between groups were found for AIMS. No differences were found in any outcome measure results (T2-T0), between infants who started CareToy training before or after one month of standard care. This RCT study confirms the results of a previous pilot study, indicating that CareToy system can provide effective home-based EI.Trial Registration: This trial has been registered at www.clinicaltrials.gov (Identifier NCT01990183).

Mechanism of neurodevelopment of children with hearing deprivation

100 children with sensorineural hearing loss, who had confirmed hearing impairment, were examined by routine somatoneurological and surdological survey, as well as standard psychomotor development scales (Alberta Infant Motor Scale (AIMS), Denver Developmental Screening Test (DDST), Griffiths Mental Development Scales (GMDS, GMDS-ER) in the city rehabilitation center for children with hearing and speech pathology. Criterion for inclusion in the study were the following: post-conceptual age of the child had to be not more than 36 months at the time of observation; bilateral or unilateral chronic sensorineural hearing loss or deafness and/or the presence of auditory neuropathy, confirmed by objective methods with modern audiological examinations for the core group; the absence of hearing loss, set by the modern objective methods of audiological examination for the comparison group; assessment of psychomotor and speech development of a child with at least two scales from the selection below. The survey results were analyzed using nonparametric statistical methods. Next Bayesian networks were used as efficient, compact, and intuitive way to represent knowledge related to uncertainty. Patterns of mental development, motor skills, speech and social functions in children with hearing impairment were obtained. The technique, which, depending on the factors affecting the trait under study, can help to predict with certainty the likelihood of various normal and deviant development of the child.

Intervenção parental melhora o desenvolvimento motor de lactentes de risco: série de casos

RESUMO A intervenção precoce no desenvolvimento, por meio de atividades parentais, favorece ganhos cognitivos, físicos, sociais e emocionais da criança, que são determinantes da saúde infantil. Contudo, estudos com intervenção precoce com atividades parentais são escassos. Assim, o objetivo deste estudo foi analisar o efeito da intervenção parental precoce no desenvolvimento motor de lactentes em seguimento em ambulatório de risco. Este é um estudo de série de casos, longitudinal e intervencionista, em 100 lactentes, com idade entre 0-18 meses, provenientes de um ambulatório de risco. O desenvolvimento motor dos lactentes foi avaliado pela escala motora infantil de Alberta. Foram transmitidas orientações aos pais, a depender do atraso motor observado. Não houve relação dos fatores de risco com o desenvolvimento motor. Porém, esses fatores apresentaram relação com a idade gestacional, que teve, por sua vez, relação com o desenvolvimento motor. Após intervenção precoce parental, a frequência amostral aumentou de 45% para 69% no grupo de crianças com desenvolvimento motor normal. No grupo com atraso no desenvolvimento, a frequência amostral reduziu de 55% para 31%. Fatores de risco pré-natal e/ou perinatal podem acarretar prematuridade e consequentemente atraso no desenvolvimento motor infantil. Para esses lactentes, protocolos de intervenção precoce com atividades parentais são efetivos para promover um desenvolvimento motor normal de crianças em seguimento em ambulatório de risco.

Gross Motor Trajectories During the First Year of Life for Preterm Infants With Very Low Birth Weight.

Early identification of motor dysfunction in preterm infants with very low birth weight (VLBW) is important in order to provide early intervention. This study was to examine the motor trajectories of preterm infants with VLBW during their first year of life and to investigate the predictive ability and influencing factors of the trajectories. A total of 342 preterm infants with VLBW were prospectively assessed for motor development by the Alberta Infant Motor Scales at 4, 6, 9, and 12 months and for developmental outcomes using the Bayley Scales of Infant and Toddler Development, second edition, at 24 months. Perinatal and socio-environmental factors were collected at baseline. Growth mixture modeling was used to explore the patterns of infants' motor trajectories during their first year of life. Logistic regression analyses were applied to examine the influencing factors associated with motor trajectories and their predictability of 24-month developmental outcomes. Preterm infants with VLBW showed 3 distinct motor trajectories: stably normal (55%), deteriorating (32%), and persistently delayed (13%). Furthermore, the motor trajectories were predictive of 24-month cognitive and motor outcomes. Perinatal factors including lower birth weight, male gender, moderate to severe bronchopulmonary dysplasia, stage III to IV retinopathy of prematurity, and major brain damage were associated with a risk of deteriorating and persistently delayed trajectories (all P < .05). Socio-environmental factors had no association with motor trajectories. The small sample size of the infants with a persistently delayed trajectory may have limited the assessment of some influencing factors. The identified early motor trajectories, predictive values, and influencing factors provide insightful implications for early detection and prevention of motor -disorders in preterm infants with VLBW.

Efeitos de um programa de intervenção motora precoce no desenvolvimento de bebês em um abrigo residencial

Objetivos: Verificar os efeitos de um programa de intervenção motora precoce no desenvolvimento motor de bebês de abrigos de Porto Alegre, entre 1 e 14 meses. Métodos: Ensaio clinico randomizado com 13 bebês no Grupo Interventivo (GI) e 12 bebês no Grupo Controle (GC). Os bebês foram avaliados pela Alberta Infant Motor Scale e o GI realizou dois meses de intervenção (perseguir objeto com os olhos, manipular brinquedos e controle postural). Resultados: Nas comparações intra grupos, o GC não apresentou diferença no seu desenvolvimento pré e pós intervenção. O GI teve aumento no percentual de normalidade e redução no atraso motor no pós intervenção. Nas comparações entre os grupos, houve significância na pré-intervenção, pois os bebês do GI eram mais atrasados. Na pós intervenção a diferença não permaneceu significativa devido à melhora acentuada no GI. Considerando as posturas, o GI obteve resultados significativos em prono, supino, sedestação, ortostase. O GC obteve significância apenas em ortostase, podendo ser justificada pela maior média de idade nesse grupo. Conclusão: Os bebês do GI melhoraram sua classificação no desenvolvimento motor.

Natural History of Aromatic L-Amino Acid Decarboxylase Deficiency in Taiwan.

Aromatic L-amino acid decarboxylase (AADC) deficiency is a rare inherited disorder of monoamine neurotransmitter synthesis; this deficiency leads to psychomotor delay, hypotonia, oculogyric crises, dystonia, and extraneurological symptoms. This study aimed to provide further insight into the clinical course of AADC deficiency in Taiwan. We present a retrospective, descriptive, single-center study of 37 children with a confirmed diagnosis of AADC deficiency. Their medical histories were reviewed for motor milestones, motor development, DDC mutation, and body weight. The termination point for each patient in this study was defined as no further follow-up, death, or enrollment in a gene therapy trial. The median age of the study patients at the end of the study was 4.39years (1.28-11.30). Of the 37 patients, 36 did not develop full head control, sitting ability, standing ability, or speech at any time point from birth to the termination points. Motor scales were administered to 22 patients. Their Alberta Infant Motor Scale scores were below the fifth percentile, and their Peabody Developmental Motor Scales, Second Edition, scores were below the first percentile. Their body weights were normal in the first few months of life, but severe growth retardation occurred at later ages. The mutation c.714+4A>T (IVS6+4A>T) accounted for 76% of all their DDC mutations. In this chapter, we report the clinical course of AADC deficiency in Taiwan. Our data will help guide the development of treatment strategies for the disease.

Changes in Motor Development During a 4-Year Follow-up on Children With Univentricular Heart Defects.

To compare changes in motor development from 1 to 5 years of age among 18 children with hypoplastic left heart syndrome and 12 with univentricular heart to 42 children without heart defect. Motor development was assessed with the Alberta Infant Motor Scale and Movement Assessment Battery for Children (Movement ABC). Children with hypoplastic left heart syndrome or univentricular heart had significantly lower scores on the Alberta Infant Motor Scale test at the age of 1 and on the Movement ABC test at the age of 5 years compared with controls. Children with clear abnormalities on brain magnetic resonance imaging had lower scores compared with those with normal images or mild changes, and their relative motor scores decreased during follow-up. Some children with univentricular heart defects may benefit from physiotherapeutic interventions to support their motor development.