Validity of the TIMPSI for estimating concurrent performance on the test of infant motor performance.

PURPOSE: The TIMPSI, a short version of the Test of Infant Motor Performance (TIMP), is used for screening. The project was designed to compare concurrent TIMPSI scores with those on the TIMP and recommend cutscores for clinical decision making. METHODS: Infants (n = 990) were recruited reflecting the race/ethnicity of US infants with low birth weight. From 67 to 97 infants were tested in 2-week age groups ranging from 34 to 35 weeks postmenstrual age through 16 to 17 weeks post-term. Rasch analysis of raw scores was used. TIMPSI cutscores ranging from the mean to -1.00 standard deviation (SD) were compared with performance above/below -0.5 SD on the TIMP to assess accuracy of classification. RESULTS: The TIMPSI was a valid screening instrument when compared with concurrent performance on the TIMP. CONCLUSION: A cutscore of -0.25 SD appears useful in predicting the best combination of false negatives (5.8%) and false positives (12.5%) with overall accuracy of classification of 81.7%.

Population-based age standards for interpreting results on the test of motor infant performance.

PURPOSE: The goals of this study were establishment of age standards for the Test of Infant Motor Performance (TIMP) and evaluation of possible group differences based on sex, medical risk for poor developmental outcome, and race/ethnicity. SUBJECTS: Subjects were 990 infants with a range of risk for poor outcome from 11 geographic locations across the United States that were recruited to reflect the distribution of race/ethnicity in the US population of low birth weight infants. METHODS: Between 67 and 97 infants were tested in each two-week age range from 34-35 weeks' postconceptional age through 16-17 weeks after term. Boys made up 52% of the subjects. Fifty-eight percent of the sample was white, 25% black, and the remainder were of other ethnicities. Scores for all infants in each age group were averaged to form age expectations for each two-week period. Multiple regression was used to explore the effect on TIMP scores of sex, risk, and race/ethnicity. RESULTS: Means ranged from 49 (standard deviation = 15) at 34-35 weeks' postconceptional age through 120 (standard deviation = 16) at 16-17 weeks after term. High-risk infants scored significantly lower than other infants (beta = -0.133, P < 0.0001). Latino infants scored lower than infants of all other ethnicities (beta = -0.052, p < 0.006). Performance did not differ by sex. CONCLUSIONS/CLINICAL IMPLICATIONS: These standards for performance on the TIMP can be used to identify infants with delayed motor development.

Annotated bibliography: effects of sleep position and play position on motor development in early infancy.

The prevalence of prone sleeping has decreased dramatically since the American Academy of Pediatrics (AAP) published sleep position guidelines and launched the Back to Sleep Campaign in 1992. One aspect of the guidelines, which suggests placing infants in the prone position for supervised play time, is often overlooked. This review summarizes published articles related to the effects of sleep/play position on motor development and provides considerations for physical and occupational therapy practice in early infancy. The study results suggested that delays in the attainment of gross motor milestones in the prone position could be observed in infants whose predominant sleep position was supine, but the delays in motor development disappeared later in life. Some studies also found a reverse order of the rolling development. Therapists should educate parents about the less known advised rules of supervised play time in the prone position by the AAP, and include activities in the prone position as part of the home program in early infancy.

Examination of the item structure of the Alberta infant motor scale.

PURPOSE: The Alberta Infant Motor Scale (AIMS) is a screening tool for identifying delayed motor development from birth to 18 months of age. The purpose of this study was to examine the psychometric structure of the AIMS, including the hierarchical scale of items and the precision for measuring infant ability at different ages. METHODS: Ninety-seven infants with varying degrees of risk of developmental disability were recruited from three hospitals or from the community in the Chicago metropolitan area. Infants were tested on the AIMS at three, six, nine, and 12 months of age. The hierarchical structure and the range and distribution of item difficulty on the AIMS were analyzed using Rasch psychometric analysis. RESULTS: The Rasch analysis confirmed that items for each of the four testing positions (supine, prone, sitting, and standing) were arranged in increasing order of difficulty, but a ceiling effect was present. Gaps exist at six ability levels, indicating low precision of measurement for differentiating among infants after about nine months of age. CONCLUSIONS: The AIMS shows a ceiling effect, measures infant ability best from three to nine months of age, and has few items available for discriminating among infants after they pass the controlled lowering through standing item. Clinical impressions should be drawn with caution at ages when the precision of measurement is low.

Comparison of two methods for teaching therapists to score the test of infant motor performance.

PURPOSE: This study compared the effectiveness of a CD-ROM self-study program with a workshop and scoring videotapes as methods for learning to score the Test of Infant Motor Performance. METHODS: Twenty-three therapists participated. Subjects in the videotape group (N = 11) were trained by attending a four-hour workshop and scoring 14 training videotapes, whereas subjects in the CD-ROM group (N = 12) used a CD-ROM self-study program. All subjects scored four videotapes for rater reliability analysis after completing the training procedures. Student t tests were used to compare the means of the two groups on three reliability variables (percentage of aberrant ratings, rater consistency, and rater severity) obtained from Rasch analysis and to compare average time spent on learning. RESULTS: Seven therapists (58.3%) in the CD-ROM group and six (54.5%) in the videotape group met the preestablished criteria for achieving satisfactory rater reliability. No statistically significant difference between learning methods was found in percentage of aberrant ratings or rater consistency, but raters in the videotape group were more lenient in scoring than those in the CD-ROM group. The CD-ROM group spent significantly less time learning than the videotape group. CONCLUSIONS: Therapists can learn how to score the Test of Infant Motor Performance by using the CD-ROM self-study program in about half the time and with similar reliability when compared with a workshop and videotape practice training procedure. About 40% of therapists will need more training to attain acceptable rater reliability.