T.I.M.E. The Toddler and Infant Motor Evaluation
Title, Edition, Dates of Publication and Revision –
The Toddler and Infant Motor Evaluation (T.I.M.E.) 1st Edition, Published 1994
*Could not find any revisions
Author (s) –
Lucy Jane Miller, PhD, OTR and Gale H. Roid, PhD
Source (publisher or distributor, address) –
Distributor – Pearson Clinical Assessment Group
Locations in Bloomington, MN and San Antonio, TX, in United States
Costs (booklets, forms, kit)* –
T.I.M.E. Complete Kit $485.00
Includes Examiner’s Manual, 10 Record Booklets, Timer, Rattle, 2 Balls, Squeak Toy, Toy Car, 3 Containers, Toy Telephone, 2 Shoelaces, 6 Blocks, and nylon tote bag.
Manual – $206.00
Administration Materials – $55.00
Replacement Parts for Kit – $5.55-35.00
*Costs as stated from Pearson Clinical Assessment Group
Purpose* –
To measure gross and fine motor skills. Author purpose stated to have three primary goals:
1) Diagnostic tool for evaluating children who are suspected to have motor delays or deviations.
2) To develop appropriate remediation programs for children with motor delays or deviations.
3) To determine efficacy of treatment.
Type of Test (eg, screening, evaluative; interview, observation,checklist or inventory)* –
Primarily – Discriminative and Evaluative
Secondarily – Social/emotional abilities, functional performance
Target Population and Ages* –
Children with developmental delays (particularly children with Downs Syndrome and Prader-Willi Syndrome); ages 4-42 months
*Website that sells kits claims birth to 42 months, but all research is rated for 4-42 months.
Time Requirements – Administration and Scoring* –
15-55 minutes, dependent on how many variables are assessed.
5 primary subtests: mobility, motor organization, stability, functional performance, and social/emotional abilities
3 optional clinical subtests: component analysis, quality rating, and atypical movements
Administration –
Two methods of administration are combined for examination within subtests:
1) Therapist observes child and parent is used to provide interaction as needed for encouragement of movement (play-based approach).
2) Parent/Caregiver Questionnaire
Scoring –
Variable within each subtest and is complex.
- Mobility subtest is scored by recording child’s sequence of movement within and between five positions (supine, prone, sitting, quadruped, and standing).
- Motor Organization subtest is scored during observations of the parent playing with the child. Items are grouped into four developmental levels and scoring is dichotomous (pass/fail) and follow a developmental sequence.
- Stability subtest is scored based on observations during previous subtests and records highest-level item (representing four elements related to stability) that child can achieve in each of the five above positions.
- The functional performance subtest is administered by interview with parents/caregivers with open-ended questions if possible. There are four subdomains – self-care, self-management and mastery, relationships and interactions, and functioning in the community. This subtest has two levels depending on functional level of the child and each item is scored using a three point scale representing consistency of child performing functional tasks.
- Social/emotional abilities subtest is scored on Liker-type scale and includes state/activity level (sleepiness/alertness), attention (concentration and impulsiveness), and emotions/reactions sections (reaction to external stimuli and adaptability).
*Optional subtests scored during mobility subtest and result in raw scores.
Type of information, resulting from testing (e.g. standard scores, percentile ranks) –
Primary subtests result in raw scores that are converted to standard scores and percentile ranks and are norm-referenced.
*Optional clinical subtests do not have standard scores, however, a clinical deviation score may be obtained for atypical positions subtest.
Equipment and Materials Needed –
Full test kit and/or manual
Examiner Qualifications –
No stated qualifications for main 5 subtests, but the three optional clinical subtests are “intended for clinicians with advanced training and comprehensive knowledge about the motor development of children.”
Standardization/normative data –
Standardization sample derived from 731 children from across the U.S. who did not have motor delays or deviations and 144 children who did have motor delays
Evidence of Reliability –
Interrater Reliability – r = 0.90-0.99 (Pearson Product Moment Correlation)
Intrarater Reliability – r = 0.96-0.99
Test-Retest Reliability with same examiner – r = 0.97-0.99
Internal Consistency (Cronbach’s α) –
•0-6 months α = 0.79-0.93
•7-12 months α = 0.88-0.97
Evidence of Validity –
Construct Validity:
•Factor Analysis
•Sensitive to age-related change
•Rasch Analysis
•Discriminated between children with and without developmental delays
Concurrent Validity:
•Mobility Scale – Sens=94, Spec=86
•Stability Scale – Sens=91, Spec=90
•Atypical Scale – Sens=97, Spec=99
Discriminative –
This tool helps discriminate between those with and those without motor delays.
Standardized mean difference between groups with and without delays averaged 1.5 standard deviations. (standard error ranged 0.52-1.59)
*Analyzed by dividing data into four age groups representing levels of motor organization subtests.
Strengths –
The T.I.M.E. can show transitional periods in movement as well as definitive (milestone) movement periods, parent participation (family-friendly), scoring can be done during testing or session can be taped for later scoring, and is responsive to clinical change.
Weaknesses –
There have been no revisions since 1994, a complex scoring system is used (may require training sessions or extensive self-teaching), T.I.M.E. is an expensive system only accessible with investment (paying for manual that has study information and instructions).
Clinical Applications –
The T.I.M.E. may be used by therapists for the following purposes:
1) As a diagnostic tool for evaluating children who are suspected to have motor delays or deviations.
2) To develop appropriate remediation programs for children with motor delays or deviations.
3) To determine efficacy of treatment.
The T.I.M.E. is also reported to be especially good for identifying transitional periods between movements for children with developmental delays (especially for children with Downs Syndrome and Prader-Willi Syndrome). This measure is also applicable in situations that require a family friendly administration involving parents. This measurement tool is good for use to perform detailed examination of multiple aspects of a child’s motor development to provide the family and other clinicians with a through picture of the child’s motor skills. It can also be used as a gross motor assessment tool to determine eligibility for Early Intervention services, as well as helping PT determine if recommendations to other specialists might be warranted.
References/Resources:
Long, TM., Tieman, B. “Review of Two Recently Published Measurement Tools: The AIMS and the TIME TM.” Pediatric Physical Therapy 10.2 (1998): 48-66.
Rahlin, M., Rheault, W., & Cech, D. (2003). Evaluation of the primary subtests of toddler and infant motor evaluation: implications for clinical practice in pediatric physical therapy. Pediatric Physical Therapy: The Official Publication of the Section on Pediatrics of the American Physical Therapy Association, 15(3), 176–183.
Spittle, A. J., Doyle, L. W., & Boyd, R. N. (2008). A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life. Developmental Medicine and Child Neurology, 50(4), 254–266.
Toddler and Infant Motor Evaluation: A Standardized Assessment. (n.d.). Retrieved March 15, 2015, from http://www.pearsonclinical.com/therapy/products/100000424/the-time-toddler-and-infant-motor-evaluation-a-standardized-assessment-time.html?Pid=076-1642-846&Mode=summary#tab-details
***Not able to use the book below as a reference because I did not purchase the text***
Miller LJ, Roid GH. The TIME Toddler and Infant Motor Evaluation: A Standardized Assessment. Tucson, AZ: Therapy Skill Builders, 1994.
ARTICLE SUMMARY:
Carrel, A. L., Moerchen, V., Myers, S. E., Bekx, M. T., Whitman, B. Y., & Allen, D. B. (2004). Growth hormone improves mobility and body composition in infants and toddlers with Prader-Willi syndrome. The Journal of Pediatrics, 145(6), 744–749.
The purpose of this study was to determine the effect of growth hormone (GH) on body composition and motor development in infants and toddlers with Prader-Willi syndrome (PWS). Twenty-nine subjects (13 F, 16 M) with PWS were stratified by age and gender (4-18 months and 19-37 months) and then randomized to either observation or a GH treatment for 12 months, with an age range of 4-37 months (mean age of 15 ± 9 months). Percent body fat, lean body mass, and bone mineral density were all measured using dual x-ray absorptiometry and energy expenditure was measured by deuterium dilution. The T.I.M.E. (Toddler Infant Motor Evaluation) was used to establish motor constructs of mobility and stability at baseline, 6, and 12 months. Evaluators were blinded to the treatment group of the children they treated throughout the study. Raw scores were used for comparison beyond baseline measurements in order to reflect change at very minute levels to compensate for delays associated with PWS. Being either older or younger than 18 months was set as a priori and guideline for average age of “walking” motor milestones in those with PWS. The results of this study showed that the GH treatment group versus the observation group showed decreased body fat percentage (22.6% ± 8.9% vs. 28.5% ±7.9%), increased lean body mass (9.82% ±1.9kg vs. 6.3% ±1.9kg; P<.001), and increased height velocity scores (5.0 ±1.8 vs. 1.4 ±1.0; P<.001). Subjects who received GH treatment before 18 months showed higher mobility skills development versus the controls within the same age range (mean raw score increase, 284 ± 105 vs. 206 ± 63; P<.05). The conclusion of the this study was that GH treatment of infants and toddlers with PWS for 12 months can significantly improve body composition and if begun prior to 18 months, can increase mobility skills development. The strengths of this study were the blinded, randomized design of the study and the adjustment for use of raw scores of T.I.M.E. to account for small improvements that might not show with standardized scores as a reflection of the disease process being treated in order to prevent a floor effect. The weaknesses of this study were the relative dangerous implications of long-term use of GH therapy secondary to possible association with early death in infants and toddlers with PWS, the limitations of the T.I.M.E. to show change through standardized scoring, and the variability in statistics secondary to large score ranges created by using raw scores of T.I.M.E. to show change.
2 responses to “T.I.M.E. The Toddler and Infant Motor Evaluation”
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Very informative. This is a good study as it aims to help children with Prader-Willi syndrome. Thanks for sharing!
Excellent and useful