ABSTRACT
The Alberta Infant Motor Scale (AIMS), an observational assessment scale, was constructed to measure gross motor maturation in infants from birth through independent walking. Based upon the literature, 58 items were generated and organized into four positions: prone, supine, sitting and standing. Each item describes three aspects of motor performance--weight-bearing, posture and antigravity movements. Content validation of the instrument was accomplished through a mail survey of Canadian pediatric physical therapists and consultation with an international panel of experts. Five hundred and six infants, age-stratified from birth through 18 months, participated in the reliability and validity testing of the AIMS. In addition, 20 infants who were experiencing abnormal motor development and 50 infants at risk for motor disorders were assessed and compared with the results of the full-term sample. Results to be presented include: 1) test-retest and inter-rater reliability estimates; 2) correlations between the AIMS and the Bayley and Peabody motor scores; and 3) scaling of the items along the age continuum for normal motor development.
Subject(s)
Child Development , Motor Activity , Motor Skills , Child, Preschool , Humans , Infant , Infant, Newborn , Movement/physiology , Movement Disorders/physiopathology , Observer Variation , Posture/physiology , Reproducibility of Results , Weight-Bearing/physiologyABSTRACT
The motor development of 75 preterm infants was assessed at 4 months chronological and 4 months adjusted ages using the Movement Assessment of Infants (MAI). Infants were followed until 18 months old when neurological and motor outcomes were assessed by a developmental pediatrician, and outcomes were classified as normal, suspicious, or abnormal. Sensitivity, specificity, and positive and negative predictive values were calculated at the two points in time using a variety of cutoff MAI scores. At 4 months, the practice of adjusting for prematurity resulted in the better combination of screening rates for the detection of both neurologically abnormal and neurologically abnormal/suspicious children. To obtain comparable rates, different cutoff MAI scores were used to identify the neurologically abnormal versus the neurologically abnormal/suspicious children. The optimal combination of sensitivity, specificity, positive and negative predictive values varies according to the age of assessment, the disorders being identified, and the cutoff scores employed.
Subject(s)
Brain Damage, Chronic/prevention & control , Infant, Premature, Diseases/prevention & control , Neonatal Screening , Neurologic Examination/statistics & numerical data , Age Factors , Brain Damage, Chronic/diagnosis , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , Infant, Premature, Diseases/diagnosis , Male , Motor Skills , Psychometrics , Psychomotor Disorders/diagnosis , Psychomotor Disorders/prevention & control , Risk FactorsABSTRACT
The impact of the extrauterine environment on the early neuromotor development of a cohort of 73 normally developing preterm infants was assessed prospectively by comparing the neurologic maturation from birth to term of two groups of infants born at different gestational ages (less than 32 weeks; 32 to 36 weeks). Assessments were performed at 32, 35, and 40 weeks postconceptional age. Detailed analyses revealed that the neuromotor performance at the three points in time of the two gestational age groups of preterm infants did not differ. These findings suggest that the early neuromotor development from birth to term of the normally developing preterm infant is essentially unaffected by the gestational age at birth.
Subject(s)
Central Nervous System/growth & development , Child Development , Gestational Age , Infant, Premature/growth & development , Motor Skills , Birth Weight , Cohort Studies , Female , Humans , Infant, Newborn , Intelligence Tests , Male , Pregnancy , Prospective StudiesABSTRACT
Ninety-five infants of 37 weeks' gestation or greater with evidence of hypoxic-ischemic encephalopathy following perinatal asphyxia were prospectively identified in the neonatal period. The degree of encephalopathy was graded the staging system of Sarnat and Sarnat. Six infants died, 78 infants were sequentially followed in the Neonatal Follow-up Clinic, and in five additional infants, follow-up information was available. The mean duration of follow-up was 19.3 months. Fifty-eight (65%) of the 89 infants followed were normal or mildly handicapped, six (7%) died, and the remainder had significant handicap. There was no significant relationship between any of over 100 obstetrical antepartum or intrapartum variables and outcome. Infants with five-minute Apgar scores of 0 to 3, seizures within the first day of life, Stage II or III encephalopathy, or a suppressed electroencephalogram had a significantly greater incidence of severe handicap or death. In addition, although there were fewer females, they had a significantly greater incidence of handicap. There appeared to be an improved outcome in the last two years (1977-1978) compared to the first two years (1975-1976), suggesting that improved recognition and neonatal management may lead to a decrease in significant sequelae.
