Tests & Measures: A Resource for Pediatric Physical Therapy Practitioners

Harris Infant Neuromotor Test Edition 2- Update

Harris SR, Megens AM, Backman CI, Hayes V. (2003) Development and standardization of the Harris Infant Neuromotor Test. Infants Young Children 16: 143-151.

• Screen to identify early motor deficits, cognitive delays, or behavioral difficulties in infants ages 3-12 months.
• Administer by: reserachers, OT, PT, family physicians, community health nurses
• Cost: $60.00
• Validity: assessed by comparison with Mental and Motor Scales of BSID-II. Calculated by using Pearson product moment correlation coefficient (r).
  • Concurrent: Strong relationship between HINT and Bayley Scales of Infant Development (BSID-II)
    • r= -0.73 (p<.01) BSID-II Mental
    • r= -0.89 (p<.01) BSID-II Motor
  • Predictive:
    • r=-0.11 (p<.01) BSID-II Mental
      • Poor predictive validity for mental scale
    • r=-0.49 (p<.01) BSID-II Motor
      • Modest predictive validity for motor scale
  • Stronger correlation with motor scale of BSID-II than the mental scale of BSID-II
  • HINT shown to be stronger predictor than initial BSID-II score for the final BSID-II score.
  • Valid screen when time constraint
• Weakness: age limit, poor predictor for mental score on BSID-II
• Overall, the HINT is a reliable screen with strong concurrent and predictive validity. Experts involved in this study rate the HINT as an appropriate screen for early developmental delays based on content validity particularly for motor skills.

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Harris SR, Backman CL, Mayson TA. Comparative predictive validity of the Harris Infant Neuromotor Test and the Alberta Infant Motor Scale. Dev Med Child Neurol. 2010;52(5):462-7.

• Predictive Validity of HINT with Bayley-II motor scale for mild delay (1 standard deviation cutoff)
  • 4-6.5 mo HINT
    • Sensitvity: 21.1%
    • Specificity: 92%
    • Positive Predictive Value: 63.2%
    • Negative Predictive Value: 64%
  • 10-12.5mo HINT
    • Sensitvity: 19.3%
    • Specificity: 93.1%
    • Positive Predictive Value: 64.7%
    • Negative Predictive Value: 63.8%
• Predictive Validity of HINT with Bayley-II motor scale for significant delay
  • 4-6.5 mo HINT
    • Sensitvity: 100%
    • Specificity: 88%
    • Positive Predictive Value: 10.5%
    • Negative Predictive Value: 100%
  • 10-12.5 mo HINT
    • Sensitvity: 100%
    • Specificity: 89.4%
    • Positive Predictive Value: 11.8%
    • Negative Predictive Value: 100%

 

Article Summary

In the 2010 prospective study by Harris et al, researchers compared the predictive ability of the Alberta Infant Motor Scale (AIMS) and Harris Infant Neuromotor Test (HINT) performad during infancy to predict Bayley Scales of Infant Development (BSID) at 2 and 3 years old. Of 144 infants assessed, 86 were rated to be “at risk” based on criteria such as maternal age, low birth weight, less than 38 weeks gestation, along with other factors that can impact an infant’s development. AIMS and HINT were performed for all infants at 4.5-6 months of age and 10-12.5 months and the BSID was performed when the infants were 2 and 3 years old. Based on the results of this study, researchers discovered that the early HINT was better for predicting BSID-motor at 2 years old and BSID-gross motor skills at 3 years old. There was an identical correlation between later HINT and AIMS and the BSID-III gross and fine motor subscales. The HINT was found to have stronger predictive correlations for the infants deemed to be “at risk.” Overall, HINT was determined to have comparable predictive validity to AIMS and should be considered for use as a screen in research and in the clinic.