Category: 02 Alberta Infant Motor Scale (AIMS)


Archive for the ‘02 Alberta Infant Motor Scale (AIMS)’ Category

Mar 13 2015

Alberta Infant Motor Scale (AIMS)

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1. Descriptive Information.

Title, Edition, Dates of Publication and Revision: Piper MC, Darrah J. Motor Assessment of the Developing Infant. Philadelphia , PA: Saunders; 1994.

Authors: Martha C Piper and Johanna Darrah

Costs: Pack for 50 score sheets is $48.95. Elsevier; http://store.elsevier.com/

Purpose: To measure the motor development for infants at risk for motor delay, focusing on attaining motor milestones and components necessary to attain the milestones. The AIMS takes into consideration three criteria related to quality of movement: weight distribution, posture and movement against the force of gravity.

Type of Test: performance based, norm-referenced observational measure

Target Population and Ages: Infants 0-18 months or until child is able to independently walk

2. Test Administration.

Administration: observation of spontaneous activity

Scoring: The AIMS consists of 58 items, including 4 positions: prone (21 items), supine (9 items), sitting (12 items) & standing(16 standing). Each item is scored as ‘observed’ or ‘not observed’. The scorer identifies the least and most mature item observed. The items between these items represent the ‘motor window.’ Each item within the ‘motor window’ is scored as ‘observed’ or ‘not observed.’ 1 point is given for each item prior to the least mature item and 1 point within the motor window. Add up all the points for each subscale, sum the 4 subscales for a total score and plot on the percentile graph.

Type of information, resulting from testing: percentile ranking

Equipment and Materials Needed: scoring sheets

Examiner Qualifications: Should be administered by professionals in child healthcare who have knowledge of normal infant motor development and experience with administering the instrument.

Psychometric Characteristics: Interobserver reliability found intraclass correlation coefficients of 0.76 to 0.99 of infants 0-18 months (Almeida et al.)

Standardization/normative data: Data was collected between1990-1992 in which 2,202 infants were assessed to represent the largest normative data set for a pediatric measure.

Evidence of Validity & Reliability: Piper and Darrah found the AIMS to be a valid and reliable tool for evaluating the gross motor development of Canadian infants (1992).

Predictive: The predictive capacity of the AIMS varies based on the age that the child was evaluated. Infants below the 10th percentile at 4 months and below the 5th percentile at 8 months can be considered valid and reliable indicators of motor developmental delay or abnormality.

 

Summary.

The article by van Wijk et al., Response to Pediatric Physical Therapy in Infants With Positional Preference and Skull Deformation, investigates infant and parent characteristics related to pediatric physical therapy in infants 2-4 months with positional preference, skull deformation, or both. The primary outcome was a good or poor response to therapy of infants at 4.5 to 6.5 months of age. Questionnaires, plagiocephalometry and the Alberta Infant Motor Scale assessed predictors for responses. Physical therapy consisted of positioning and activities that facilitated position of movements opposite of the infant’s positional preference. The study consisted of 657 infants. These infants were split into 2 groups based on their outcome of physical therapy. 364 infants demonstrated a good response to therapy and 293 infants responded poorly. The article found that parents with a lower level of education and male infants were more likely to respond poorly to physical therapy. The significant independent predictors for a poor response to therapy were: starting therapy after 3 months, plagiocephaly, and a low parental satisfaction score regarding the shape of the infant’s head. No association was established between motor development and skull deformation in infants 4.5 to 6.5 month of age. The strength of this study was the large cohort available to assess the relationship between multiple characteristics and outcomes. A weakness of the study was that only general information was collected about therapy.

Overall, the characteristics found in this study can be used in daily practice wand provide insight when working with this population.Children over the age of 3 months should be referred to a pediatric physical therapist in order to achieve the most positive outcomes from therapy.

 

References:

1. Alberta Infant Motor Scale: A Clinical Refresher and Update on Re-Evaluation of Normative Data. http://www.physiotherapy.ca/getattachment/practice-resources/professional-development/pd-storage/pd-handouts/oct-8-alberta-infant-motor-scale-a-clinical-refres/slides-3-up-bw.pdf.aspx Published October 8, 2014. Accessed March 12, 2015.

2. Almeida KM, Dutra MVP, Reis de Mello R et al. Concurrent validity and reliability of the Alberta Infant Motor Scale in premature infants. J Pediatr. 2008; 84(5): 442-448.

3. Blanchard Y, Neilan E, Busanich J, et al. Interrater reliability of early intervention providers scoring the Alberta Infant Motor Scale. Pediatr Phys Ther. 2004; 16:13-18.

4. Darrah J, Piper MC, Watt MJ. Assessment of gross motor skills of at risk infants: predictive validity of the Alberta Infant Motor Scale. Dev Med Child Neurol. 1998;40: 485-491.

5. Piper MC, Pinnell LE, Darrah J, Maguire T, Byrne PJ. Construction and validation of the Alberta Infant Motor Scale (AIMS). Can J Public Health. 1992; 83: 46-50.

6. Piper MC, Darrah J. Motor Assessment of the Developing Infant. Philadelphia , PA: Saunders; 1994.

7. Van Wijk RM, Pelsma M, Croothuis-Oudshoorn C et al. Response to Pediatric Physical Therapy in Infants With Positional Preference and Skull Deformation. Phys Ther. 2014;94(9):1262-1271.

Mar 06 2017

AIMS Update and Article Review 2017

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Updated Information:

Time Requirements: A trained evaluator should be able to complete the AIMS assessment within 20-25 minutes.

Strengths: The AIMS takes into account 4 different functional positions to assess infant motor skills. AIMS includes percentiles for raw scores so that infants can be assessed comparatively and atypical development can be identified.

Weaknesses: The data for the AIMS was collected almost 30 years ago and are reflective of Canadian infants. It has been shown that when determining if infants are at risk or developing atypically, these norms may not be reflective for all geographical, socioeconomic or cultural groups.

Clinical Applications: AIMS is a tool used to identify motor development delays in infants.

Article Summary:

New Brazilian developmental curves and reference values for the Alberta infant motor scale

The Alberta Infant Motor Scale (AIMS) was originally validated in Canada and thus the established norms are reflective of Canadian infants. This study was intended to determine appropriate norms using the Alberta Infant Motor Scale for infants in Brazil. In order to account for any geographical disparities, infants from the five main geographic areas of Brazil were assessed. The sample size was 1455 infants total with 1231 full term infants and 224 premature infants. Premature infants were age corrected for the study. Infants were assessed by 3 different examiners each having 3 years of experience using the AIMS. The results indicated that Canadian infants scored higher than Brazilian infants for several age groups. There were significant differences in motor scores in infants up to 15 months of age. With these differences in mind, it was also determined that the AIMS was not sensitive enough to the typical motor development of Brazilian infants and therefore could not be used as an accurate assessment tool to determine typical, at risk and atypical results.

Strengths: The article clearly states the need for this study, highlighting specific cases in which the established Canadian norms were not appropriate for different geographical or cultural groups. The study uses an appropriate sample size to represent the Brazilian population so that new norms could be established with a confidence interval of 95%. The examiners that performed the AIMS testing with infants had more than 3 years of training and were thus experienced with the tool. Inter-rater reliability between examiners included values from .86 to .99 indicating good agreement.

Weaknesses: The study recruited infants/families through both newspaper and internet advertisements. This could have led to bias within the representative sample, as it only takes into account those with access to these media sources. The study does not state the specifics of infant behavior during administration of the test and the possibility for differences in performance based on emotional state.

Overall the study makes a strong case for establishment of new norms for Brazilian infants, reiterating the concern that different cultural, socioeconomic, and geographic groups may develop at different rates. This is important clinically as the identification of at risk or atypical development can be based on the outcome of this test.

Saccani R, Valentini NC, Pereira KR. New Brazilian developmental curves and reference values for the Alberta infant motor scale. Infant Behav Dev. 2016 Nov;45(Pt A):38-46. doi: 10.1016/j.infbeh.2016.09.002. PubMed PMID: 27636655.