Test of Infant Motor Performance (TIMP)
Article Review
Peyton C, Schreiber MD, Msall ME. The test of infant motor performance at 3 months predicts language, cognitive, and motor outcomes in infants born preterm at 2 years of age. Developmental Medicine & Child Neurology. 2018;60:1239-1243. : 10.1111/dmcn.13736
Purpose: To examine if motor performance scores on the TIMP measured at 3 months of age could predict cognitive and language scores on the Bayley Scales of Infant and Toddler Development 3rd edition (Bayley-III) at 2 years of age in high-risk pre-term infants.
Study Population: Infants born less than 31 weeks gestational age, a birth weight no more than 1500 g, and who required oxygen at birth. Infants were excluded if they had congenital malformations, genetic syndromes, or who had severe respiratory distress.
Methods: The TIMP was used to assess posture and motor control of infants at 10-15 weeks after term age. Infants were categorized as low average, below average or far below average. The Bayley-III was used to assess cognition, language, and motor performance of infants at 18-24 months corrected age. Linear regression was used for statistical analysis of TIMP z-scores and each Bayley-III subscale.
Results: TIMP scores at 10-15 weeks of age were significantly associated with all 3 subscales (cognition, language, motor) on the Bayley-III at 2 years of age. Specificity for the TIMP was high for all 3 subscales, however sensitivity was low. At all time points, sensitivity was highest for the motor subscale. Each 1 point decrease in the TIMP score results in increased odds of having a poor outcome on the Bayley-III.
Strengths: Even though the TIMP assesses motor performance, it can also be used to predict cognition and language performance in addition to motor skills. Therefore early infant motor behavior can be used to determine if other professionals should be included in the plan of care early on in the case of infants who perform lower.
Limitations: Follow up of the infants was limited to 2-3 years of age, therefore long-term follow up of these infants range might be necessary to see the association of the TIMP in children of school age.
Conclusion: The TIMP scores at 3 months of age can predict Bayley-III outcomes at 2 years of age, and that it can discriminate between children who will and will not have typical development, as measured by motor, cognitive and language performance.
Test of Infant Motor Performance (TIMP)
Descriptive Information
It is a norm-referenced 42-item assessment of posture and motor control (13 items assess spontaneous movement and 29 items assess postural control and movement in supported sitting, supine, prone, sidelying and supported standing).
Publisher: Infant Motor Performance Scale
Costs: Test forms are $68.00, test manuals are $38.00, the e-Learning course is $500.00 and the self-instructional DVD is $85.00.
Purpose: To identify infants with delayed motor development, plan an intervention program, or measure change as a result of an intervention. However, it is mainly used to target infants most in-need of early intervention.
Type of Test: Evaluative, observation
Target Population: Infants between 34 weeks post-conceptual age to 4 months post-term.
Test Administration
Scoring: Three categories, low average (0.5-1 SD below the mean), below average (-1 to -2 SD) and far below average (>2 SD below the mean). TIMP scores were calculated from published normative data.
Environment: Outpatient and inpatient settings
Equipment and Materials: Testing forms, pen, a rattle with a soft sound, a squeaky object, a shiny red bad 2 inches in diameter, and an age calculation wheel for automatic calculation of corrected age.
Examiner Qualifications: It was developed for use by physical therapists and occupational therapists with experience working with young infants, however other health professionals who have experience with assessing young infants and have appropriate education on safe handling can use the TIMP. Online workshops and self-instruction DVDs are available to be trained in administration and scoring of the TIMP.
Normative data: Age standards were developed from a sample of 990 U.S. infants of all races/ethnicities.
Evidence of reliability: It has excellent test-retest and rater reliability when administered by trained users.
Evidence of validity: The TIMP has been validated for use to diagnose delayed development of infants prior to 5 months corrected age.
Discriminative: The TIMP can discriminate infants who are at a varying degrees of risk for poor motor outcomes.
Predictive: The TIMP has been shown to predict 12-month motor performance with sensitivity 92% and specificity 76%. It has also been shown to predict outcomes on the Bayley-III outcome measure at 2 years of age.
MCID: No MCID values have been found for the TIMP
Summary
Strengths: It has strong predictive value to identify infants most at risk for developmental delays and promote early intervention
Weaknesses: It takes up to 35 minutes to administer, and requires special training through workshops.
Clinical Applications: Pre-term infants or infants with a complicated perinatal history who are under four months of age would benefit from taking this motor performance assessment to identify if early physical therapy is warranted.
REFERENCES
Infant Motor Performance Scale. TIMPS. https://thetimp.com/. Accessed February 21, 2019.
Peyton C, Schreiber MD, Msall ME. The test of infant motor performance at 3 months predicts language, cognitive, and motor outcomes in infants born preterm at 2 years of age. Developmental Medicine & Child Neurology. 2018;60:1239-1243. : 10.1111/dmcn.13736
Physiopedia. Test of Infant Motor Performance. https://www.physio-pedia.com/Test_of_Infant_Motor_Performance. Accessed February 21, 2019.
2 responses to “Test of Infant Motor Performance (TIMP)”
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Great review, Trishia. I think this is very helpful for future use of this outcome measure. Parents are always asking about the future of their child and it would be nice to be able to show research to support your thoughts on how to progress them in physical therapy and what is most appropriate to work on and set goals for. I would be interested to see how this would relate to their motor development after 2-3 years of age.
Yes the TIMP can be a great tool to identify the areas of improvement a child needs (especially those who are pre-term). The TIMP has been shown to be a good predictor of motor development at 2 years of age!