Tests & Measures: A Resource for Pediatric Physical Therapy Practitioners

Use of the TIMP in Assessment of Motor Development of Infants With Down Syndrome

Kloze A, Brzuszkiewicz-Kuzmicka G, Czyzewski P. Use of the TIMP in Assessment of Motor Development of Infants With Down Syndrome. Pediatr Phys Ther. 2016 Spring;28(1):40-5. doi: 10.1097/PEP.0000000000000216. PMID: 27088684.

 

Purpose:

The Test of Infant Motor Performance (TIMP) is an outcome measure utilized in pediatric physical therapy to assess posture and movement patterns in infants under 4 months of age.  It is considered the gold standard for infant motor performance and has been shown to predict outcomes for 12 months of age.  This study assessed the utilization of the TIMP to examine motor performance in infants diagnosed with down syndrome.

Study Population:

Subjects were 64 infants with down syndrome with a mean adjusted age of 9.4 weeks old who had no comorbidities that could place the child at an increased risk for surgery or long-term hospitalization.  The study included a control group of 77 infants with a mean age of 10 weeks old and who have not been diagnosed with a motor development disorder.

Methods:

This was an observational cross-sectional study in which the infants were assessed only once.  A physical therapist well trained in pediatrics performed the TIMP assessment during the visit with the infant.  Parents were present during the assessment for each subject in the test and control groups for data collection.  The TIMP consists of 42 items and is used to identify delayed motor performance in infants and can assist therapists in goal setting that actively involves caregivers in the therapeutic process.

Outcome Measure:

The Test of Infant Motor Performance (TIMP) was performed by a physical therapist.

Intervention:

The purpose of the study was to determine the validity of the TIMP with infants diagnosed with down syndrome.  There was no intervention applied to the infants with down syndrome or the control subjects.

Results:

A t-test was used to identify differences between the means of the two groups, and a Chi-square test analyzed the significance of the difference in distribution of the variables.  A significance figure was identified as p<0.05.  There were statistically significant differences in the assessed items of head in midline, fingers object/surfaces on right, fingers object/surfaces on left, bilateral hip and knee flexion, reciprocal kicking, fidgety movements, ballistic movements of the arms or legs, oscillation of arm or leg during movement.  The largest differences were noted for items measuring head control, quality of movement in response to a visual or auditory stimulus, behavioral response to a cloth placed over the face and items measuring trunk control in space.

Strengths/Limitations:

The sample size was strong with 141 infants with similar age ranges of the infants with down syndrome and those identifies as controls.  A notable limitation is that all the children in the study were of the white race and lacked inclusivity.  The control group infants were all born at term while 30 of the 64 infants with down syndrome were born before the 38th week of pregnancy.

Conclusion:

When assessing motor performance in infants diagnosed with down syndrome, the TIMP can be utilized to measure delayed motor performance and determine the need for physical therapy.  This may improve functional outcomes within this population.