Test of Infant Motor Performance in the developmental assessment of preterm infants / 中华实用儿科临床杂志

Objective:To assess the characteristics and correlation of motor development in preterm infants of different gestational weeks by using the Test of Infant Motor Performance (TIMP) method, and to develop better individualized early interventions based on TIMP test results.Methods:A prospective study involving 43 full-term healthy infants and 77 preterm followed up in 3201 Hospital from June 2019 to July 2021 was conducted.Preterm infants were divided into the early preterm group (39 cases) and late preterm group (38 cases) according to their gestational age at birth.TIMP assessment was performed at the gestational age of 40 weeks and the corrected age of 16 weeks after birth.Similarly, the full-term healthy infants were assessed by TIMP at the postnatal age of 16 weeks.The differences between groups were investigated using ANOVA or Mann- Whitney rank sum test.Correlations were analyzed by the Pearson correlation method. Results:There were no significant difference in TIMP scores between early and late preterm infants at the gestational age of 40 weeks [(65.74±6.52) scores vs.(66.96±8.51) scores] and the corrected age of 16 weeks [(101±10) scores vs.(104±8) scores] (all P>0.05). TIMP scores in the full-term healthy group at the corrected age of 16 weeks [(108±10) scores] differed significantly from those of early and late preterm infants ( P<0.05). Compared with full-term infants, early and late preterm infants had lower TIMP scores in observation, supine position, and supine turning (all P<0.05), but a higher TIMP score in standing position ( P<0.05). For both early and late preterm infants, TIMP scores at the gestational age of 40 weeks were significantly positively correlated with those at the corrected age of 16 weeks ( r=0.565, 0.302, all P<0.01). Conclusions:There were significant differences in motor development between preterm infants of different gestational ages and term infants, which had guiding significance for early intervention.English version TIMP could play a positive role in promoting individualized follow-up and early intervention of preterm infants in China.

Predictive Value of Test of Infant Motor Performance for Infants based on Correlation between TIMP and Bayley Scales of Infant Development

OBJECTIVE: To assess the relationship of scores on the test of infant motor performance (TIMP), with those on the Bayley scales of infant development (BSID), and to investigate the sensitivity and specificity of TIMP and the optimal cut-off value of TIMP scores using ROC analysis. METHOD: Seventy-six preterm and term infants were recruited from neonatal intensive care units. Subjects were tested with the TIMP at their initial visit and after 6 months, they were tested by using BSID. RESULTS: In the reliability study, TIMP scores showed highly significant correlation with the Bayley physical developmental index (BPDI) (p=0.001) and Bayley mental developmental index (BMDI) (p=0.017). Receiver operator characteristics (ROC) curve analysis was performed to evaluate the TIMP test for screening infant motor development. ROC analysis showed an area under the curve (AUC) of 0.825 (p=0.005) in BPDI and 0.992 (p=0.014) in BMDI, indicating an excellent classification performance of the model. The optimal cut-off value where a sensitivity of 86%, and specificity of 68% were achieved with the TIMP was 1.50 (between average and below average) in BPDI and where a sensitivity of 100%, and specificity of 66% were achieved with the TIMP was 1.50 in BMDI. CONCLUSION: Our results indicate that the TIMP provides a reliable and valid measurement that can be used for the evaluation of motor function in preterm and term infants. TIMP was highly sensitive and specific with the follow-up examination of BSID. Therefore it can be used as a reliable screening tool for neonates and infants aged <4 months.

The Test of Infant Motor Performance (TIMP) in Preterm and Term Infants

OBJECTIVE: To assess motor development of preterm and term infants using the test of infant motor performance (TIMP) and to compare the reliability of the TIMP measuring by different raters. METHOD: 55 preterm and term infants were tested with the TIMP at ages ranging from 35 weeks postconceptional age to 14 weeks corrected age. A linear correlation analysis was used to assess the contributions of age, risk, and radiologic findings to the variance in TIMP scores. In the reliability study, the TIMP was administered to the infants by an occupational therapist, and infant performances were videotaped. The performance was then rescored by another tester to examine the interrater reliability. RESULTS: No significant correlations between infant variables and TIMP score changes were revealed. In the reliability study, statistically significant correlation between two raters was found (Cohen's kappa: 0.959, p<0.001). CONCLUSION: TIMP has a good interrater test reliability for use in clinical practice to assess infant motor performance. But the TIMP could not discriminate among infants with differing risks for motor developmental delay. Further evaluation and follow up survey is necessary to find correlation between the development process and medical risk factor among the participated subjects in this study.