Category: Predictive

Archive for the ‘Predictive’ Category

Mar 06 2016

Test of Infant Motor Performance (TIMP)

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Barbosa VM, Campbell SK, Smith E, Berbaum M. Comparison of Test of Infant Motor Performance (TIMP) item responses among children with cerebral palsy, developmental delay, and typical development. Am J Occup Ther. 2005;59:446-56.

The purpose of the above study was to analyze collected data from an individual Infant Motor Performance test (TIMP) in a sample of infants to determine which individual items were the best indicators for cerebral palsy. The TIMP has 28 observed items such as head centering and individual finger movements, while 31 items examine motor responses in various positions & visual/auditory stimulation. Each infant was assessed using the TIMP repeatedly from birth to approximately 4 months corrected age. Follow-up information was later collected after the study to see if any of the infants were diagnosed with Cerebral palsy at 1 to 11/2 years of age.

The study originally included 96 infants that were born from 1996-1998 that were at risk for poor developmental outcomes in Chicago. Once the study was complete, the 96 infants were then put into one of three groups at the 1.5 year old mark as: 1) typically developing (TD) 2) motor delayed (MD) and 3) having cerebral palsy (CP). The diagnosis was made based on a pediatrician’s clinical judgment and independent assessment of AIMS at 12 months of age for each infant. Scores below the 16th percentile rank on AIMS without diagnosis of CP was used to define DD. Since 11 infants were unavailable for a follow-up diagnosis, there were excluded from the study. During the study, eleven testers participated in the weekly TIMP assessment of the infants.

To analyze the data, a graphical and Rasch analysis were used. In the graphical exploratory analysis, the CP group compared to the TD and MD group had a better performance than average in items involving neck extension (E23) and lateral head righting in vertical suspension (E30/31). However, staring at 2 weeks post term, children with CP showed decreased ability to hold head in line with midline (E9) of the body in supine and continued to remain delayed compared to typical developing and those with delays and without CP despite improvements. Arm movements against gravity were also poor in the CP from 2-10 weeks (E14), but only reached average performance level of delayed infants at 12 weeks. The CP group also were less likely to inhibit trunk rotation to the side when head is passively rotated (E7/8), have poor anterior-posterior head control (E4/5) in supported sitting, and lateral hip abduction reactions (E22) and unable to mature. The CP group showed signs of difficulty at the 90-day mark with postural control compared to the TD and DD. The CP group also regressed in developmental skills such as antigravity hip flexion and kicking during the study, which was not present in the TD and DD groups.

The Rasch Analysis grouped infants by age of each development group and compared line items. The Rasch analysis showed the CP group having overall difficulty of 11 observed and 19 elicited items. Some key items include: head in midline, hand to mouth & trunk control in supported sitting. TD children compared to CP group had difficulty with head turning to the side in prone/supine, turning to sound in prone and arm movement in prone. Overall, the Rasch analysis identified the same 17 of the 30 items the CP group behaved differently in compared to the TD group in the graphical analysis group. The WINSTEPS statistical program used to analyze the DIF data.

Overall the study revealed that the TIMP did well in quantifying improvements in movement patters but there is still no proof of neurological impairments presenting the same at every age. However, most early atypical motor behaviors of children with CP presented the most at 90 days of age. One item of the TIMP that was highly significant in determining children with CP compared to DD without CP was decreased neck flexion when pulled to sit at 90 days. CP group also had consistent difficulty with movements against gravity compared to the other groups and supported other literature for preterm infants and infants who were later diagnosed with CP.

Feb 27 2017

The Pediatric Stroke Outcome Measure: A Validation and Reliability Study

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Introduction/Background: The Pediatric Stroke Outcome Measure (PSOM) is appropriate for newborn to adult age for determining stroke-specific outcomes through 115 test items in 5 functional and neurological deficit subscales including: right sensorimotor, left sensorimotor, language production, language comprehension and cognitive/behavior. The PSOM is chronologically organized across the development spectrum. For instance, primitive reflexes are included for children <2 years. Scores for each item range from 0 (no deficit) to 10 (maximum deficit), and are summed to infer the total score. Administration time for this measure is approximately 20 minutes.

 Purpose: The purpose of this study was to examine the PSOM’s construct validity in measuring neurological outcomes in pediatric stroke survivors and interrater reliability for both prospective and retrospective scoring. When using this objective measure in a prospective study, one would evaluate a like group of individuals to determine how differing factors affect rates of certain outcomes. Whereas a retrospective study would compare those with a specific impairment following pediatric stroke to those who’ve not been exposed. The study verified the PSOM is valid and reliable for pediatric stroke in both types of studies, but is especially useful in scoring prospective clinical trials.

 Methods: Children, newborn to 18 years, diagnosed with arterial ischemic stroke (AIS) or cerebral sinovenous thrombosis (CSVT), at the Hospital for Sick Children (Toronto, CA), from 1994 to 2010 were included in this study. 203 Participants were serially examined with PSOM at 3, 6 and 12 months poststroke and at 2-5 year intervals until the age of 18. QoL and standardized neuropsychological outcomes were assessed in addition to the PSOM. Construct validity (for prospective study) was evaluated against the standardized neurophysiological measures and statistically analyzed through Spearman correlation, linear regression (95% CI), and an alternative chance-corrected statistical test. PSOM scores from medical records were scored by 3 raters and compared with “live” in-clinic PSOM exams completed by those same raters. This information was statistically analyzed to determine both retrospective validity and inter-rater reliability. The range for inter-rater agreement ranged from 0.0-0.2= poor to >0.8= almost perfect.

 Results/Limitations/Conclusion: The results indicate PSOM is both valid and reliable for use in children poststroke. These findings are relevant because the PSOM is the only measure of neurological outcomes for this population and is currently being or has been used in many research studies. Construct validity proved to highlight relevant impairments in all 5 subcategories including significant correlation between the cognitive-behavioral subscale and standardized neuropsychological measures of overall intellect, verbal/perceptual reasoning and parental/behavior questionnaires. Additionally, both in-clinic and health record-based scoring was found to have excellent reliability. Some limitations of this study were not all children consented to neuropsychological testing and normally distributed statistics potentially downplayed concerns regarding referral bias. Another shortcoming is that the PSOM is likely to be biased toward motor and sensory deficits over cognitive, language and behavioral impairments. Despite these limitations, the PSOM has proven to be a strong outcome measure, both valid and reliable for prospective and retrospective studies geared towards improving pediatric poststroke outcomes.


Kitchen L, Westmacott R, Friefeld S, et al. The Pediatric Stroke Outcome Measure. Stroke. 2012;43(6):1602-1608.

Feb 27 2017

Test of Infant Motor Performance (TIMP)

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Test of Infant Motor Performance (TIMP): discriminatory, predictive (according to

  • Newly launched online learning program for the TIMP
    • 9 learning modules, which includes lectures by the TIMP designers and other workshop instructors, videos of the TIMP in action, and comprehension assessments of the material and score test item video clips
    • $500 for individual course enrollment (discount for 4 or more enrollees)
  • Materials required for testing:
    • Rattle with a soft, not sharp or harsh sound. Maracha toys are suitable as are plastic eggs or boxes filled with popcorn or rice.
    • Squeaky object with a soft, not whispery nor harsh sound; many 4-5” dog toys from pet stores are useful but latex items must be avoided.
    • Shiny red ball approximately 55 mm or 2 inches in diameter.
    • An age calculation wheel that allows automatic calculation of corrected age or chronologic age up to 18 weeks post-term based on expected date of birth is required to accurately evaluate performance against age expectations from the TIMP and TIMPSI normative studies; specially designed wheels for this purpose are available for sale on the TIMP products page
  • Otherwise, all other information up to date.
  • Review of article utilizing TIMP:

Cardoso, Aline Christine das Neves, Ana Carolina de Campos, Mariana Martins dos Santos, Denise Castilho Cabrera Santos, and Nelci Adriana Cicuto Ferreira Rocha. “Motor Performance of Children With Down Syndrome and Typical Development at 2 to 4 and 26 Months:” Pediatric Physical Therapy 27, no. 2 (2015): 135–41. doi:10.1097/PEP.0000000000000120.

The purpose of this article was to compare the gross motor performance of typically developing (TD) children and children with Down Syndrome (DS) and see if there was a relation between their early motor development (2 to 4 months old) and outcome at an older age (2 years old). Data was collected in two phases: Phase 1 was performed when both groups (TD & DS) were 2-4 months old and used the TIMP to look at gross motor movement; Phase 2 was performed when the children were 2 years old and used the Bayley Scales of Infant and Toddler Development (Bayley-III) to assess gross motor movement. In Phase 1, 10 TD infants were compared to 7 infants with DS. Ten of these original 17 participants returned for Phase 2 so therefore, 15 more children were recruited to participate in Phase 2, totaling 25 children: 13 TD, 12 DS. Depending on the Phase, the respective test was administered, scores recorded, and a two-way ANOVA for the TIMP to compare the effect of group and age on the scores, whereas an independent samples t-test was performed for the Bayley-III scores to compare the TD & DS groups in Phase 2. The researchers found that TD infants scored significantly higher on the TIMP and the Bayley-III than DS infants. The regression analysis that was performed to compare the two tests, generated results that supported the TIMP’s predictive abilities of motor performance later in life compared to the results found during the child’s early months. This study’s strengths are: well organized, thought-out topic, good analytical testing performed to assess results found during the phases, and good interpretation of the data. The limitations of this study are: small sample size, high dropout rate between phase 1 and phase 2 making it hard to compare results found in phase 1 to phase 2. Overall, this article did a great job of utilizing the TIMP for children with potential delays in motor development (in this instance Down Syndrome), and was able to support it’s discriminatory and predictive qualities.

Feb 28 2017

Neonatal Behavioral Assessment Scale

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All previous information has been reviewed and is up to date. There continues to be limited research on the psychometric characteristics of this outcome measure, including validity, reliability, and standardized norms.

Summary of article utilizing the NBAS:

Canals, J. et al. Neonatal behavioral assessment scale as a predictor of cognitive development and IQ in full-term infants: a 6-year longitudinal study. Acta Paediatrica. 2011; 100(10): 1331-1337.

The purpose of this study was to determine whether neonatal behavior could predict mental and psychomotor development of infants at 4 and 12 months as well as intelligence at 6 years. The study population included 80 full term newborns (39 boys and 41 girls) and were followed from 3 days to 6 years of age. The mean weight at birth was 3277.7 grams and mean gestational age was 39.7 weeks. The NBAS is used to assess the behavior of newborns and included areas such as habituation, range of state, motor performance, ANS stability, attention, irritability, and tone, among others. The NBAS was utilized at 3 days after birth by a trained examiner in a room with appropriate conditions. The assessment took 25-35 min and was completed midway between feedings. The Bayley Scales for Infant Development (BSID) was administered at 4 and 12 months and Wechsler Preschool and Primary Scale of Intelligence was administered at 6 years of age. The Child Behavior Checklist was administered at 6 years to look at emotional and behavioral problems.

The results of this study showed that the mean scores of all of the outcome measures used were in the normal range. Some of the characteristics measured in the NBAS could predict future development. For short term, better state regulation assessed in the NBAS and longer gestation predicted psychomotor development at 4 months. This was predicted at 12 months by clusters such as ranges of state, ANS stability, muscle tone, and regulation capability. Better self-regulation at birth was a good indicator of mental and psychomotor development at 4 and 12 months and better IQ at 6 years. Limitations of this study include small sample size as well as the inclusion of only healthy infants. In order to generalize to a greater population, it would be beneficial to perform more studies using infants that may have certain health issues at birth. Major strengths of this study include the predictive ability of the NBAS for future development and IQ, as well as the use of a variety of outcome measures. The overall conclusion of this study showed that the NBAS is an appropriate tool use for both healthy infants, as well as those at risk for developing problems.


Feb 28 2017

Pediatric Functional Status Scale, Update 2

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The previous information was reviewed. No further updates were found available at this time.

Article Summary:

Bennett TD, Dixon RR, Kartchner C, et al. Functional Status Scale in Children with Traumatic Brain Injury: A Prospective Cohort Study. Pediatr Crit Care Med. 2016; 17(12):1147-1156

The objective of this study was twofold. First off, the researchers wanted to describe and assess changes in children with traumatic brain injuries (TBI) in the intensive care unit (ICU) using the functional status scale (FSS). This change was to be assessed from baseline function which was attained on admission at one of the two, level 1 pediatric trauma centers participating in the study. Secondly, to examine correlations between the FSS and age, mechanism of injury, exam/imaging, and known outcomes for children 0-18 years old who had sustained a TBI. Inclusion in the study was limited to individuals admitted to the ICU with a diagnosis of acute TBI and a Glasgow Coma Scale (GCS) score <12 or a neurosurgic procedure. All 196 individuals who participated in the study were under the age of 18 and must have met the criteria within 24 hours of admission. This was a prospective cohort study and data was collected through review of documentation and provider discussions as appropriate. No interventions were performed and the child’s discharge FSS was either obtained when discharged from the hospital or on the day they were transferred to inpatient rehab in order to maintain consistency between the two participating sites.

The results indicated that a third of all individuals assessed from baseline developed new morbidity at discharge. The mean change in FSS for all survivors was 3.9, and 5.2 in those with severe TBI. Functional impairments were present in all 6 domains (mental status, sensory, communication, motor function, feeding, and respiratory function) with the respiratory domain demonstrating the least amount of change. The FSS score change was highest in the motor, feeding, and communication domains. No correlation was found between patient age and discharge FSS. An inverse relationship was found between admission GCS for total/motor scores and the FSS at discharge. Imaging (CT scan) showed that individuals who presented with an epidural hematoma had good functional status at discharge where as individuals with a subdural hematoma, intraventricular hemorrhage, subarachnoid hemorrhage, or intraparenchymal hemorrhage had worse outcomes. New gastrostomy tube placement was associated with moderately impaired functional status when replaced during their acute hospitalization.

Overall strengths of this article included its reproducibility as the FSS has good construct validity, is consistent with activities of daily living, tracks adaptive behaviors, has a wide age range (0-18 years), has good interrater reliability, and pertinent information can be easily and quickly obtained. Limitations included the use of only two hospitals and the fact that the FSS is not sensitive to family functioning or quality of life. It also does not account for pre/post morbidities and is not as specific in detail as other neurological outcome measures. Long-term effects of the study are difficult to generalize as data was not collected post discharge, and CT scans were read by the facilities radiologists rather than standardized. Overall, it was determined that the FSS is appropriate for use with children who have sustained a TBI. It appropriately measures change in preinjury functional status and can be used for hospital improvement initiatives and interventional studies.



Mar 01 2017

3 and 6 minute walk test update

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There have not been any new updates regarding the 6-minute walk test norms since last year. However, there have been new studies published that indicate it is a valid test for the pediatric population. Also, I was not able to find any normative values for the 3 minute walk test in the pediatric or adult population.

Citation of Article:

Den boer SL, Flipse DH, Van der meulen MH, et al. Six-Minute Walk Test as a Predictor for Outcome in Children with Dilated Cardiomyopathy and Chronic Stable Heart Failure. Pediatr Cardiol. 2016

Article Summary:

The purpose of the article was to see if the 6 minute walk test could be a predictive outcome in children with dilated cardiomyopathy. There were 49 participants with dilated cardiomyopathy who were 6 years and older who performed the 6 minute walk test. The patients were instructed to walk back and forth on an 8 m track at a self-chosen speed. The objective was to walk as far as possible with no running during a 6 minute time period. The researched converted the 6 minute walk distance to a percentage using the age and gender specific normal values. By using a univariable Cox regression analysis, the researchers determined a higher 6MWD% resulted in a lower risk of death or transplantation. They determined patients with a 6MWD% less than 63% had a 2 year transplant free survival of 73%. If the patient had a percentage greater than or equal to 63%, their transplant free survival rate was 92%.

Some strengths of this article were that the participants were of various ages between 7 and 15 so it represented almost half of the pediatric age range. All participants with a cardiomyopathy could be included and no single diagnosis was excluded except for if they had a structural heart defect or neuromuscular disease. Some weaknesses of this article were that it was a small samples size but given the population in the Netherlands with this diagnosis, it was a good percentage (88%). The researchers used an 8 m track instead of a 30 m track, which is recommended by the American Thoracic Society guidelines. Therefore due to the small track size, the participants had to make more turns during the walk, which may have skewed the results. The study was conducted at seven different centers so the consistency of the way the tests was administered may have been different per participant. In conclusion, children with a dilated cardiomyopathy, the 6 minute walk test is a good predictor to identify children with a higher risk of death or heart transplantation.

Mar 05 2017

Physical Activity Questionnaire for Older Children and Adolescents

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The information listed previously is accurate and still the current information. No information found for MDIC.

Article Summary: The association between healthy lifestyle behaviors and health-related quality of life among adolescents

The purpose of this research was to study the relationships between body mass index, physical activity, adherence to Mediterranean diet, with the health related quality of life in Spanish adolescents.  The sample population of 480 adolescents between the ages of 11 and 14, 235 girls and 221 boys from 5 of the 55 public schools in the Spanish city of Granada.  Twenty-four of the students were excluded from the study for failure to fill out all of the required questionnaires.

The study compared health related quality of life utilizing the KIDSCREEN 27 questionnaire, 27 items in five categories (physical well-being, psychological well-being, autonomy and parent’s relation, social support and peers and school environment) and compared the results with physical activity, adherence to a Mediterranean diet, and body mass index (BMI).  To determine physical activity, participants completed the Physical Activity Questionnaire for Older Children (PAQ-C), maximal oxygen uptake (VO2max) was estimated utilizing a maximal effort shuttle run, and sedentary screen time (self-report).  Adherence to a Mediterranean Diet (MD) was measured using the Evaluation of the Mediterranean Diet Quality Index (KIDMED) 16 yes-no questions 12 about behaviors consistent with MD diet for example “Do you use olive oil at home?”  and 4 inconsistent questions “Do you eat candy or sweets multiple times a day?”

Statistical analysis was applied to all of the data starting with calculation of the means and standard deviations of all of the variables.  Normality of the data was assessed and finding it was not normally distributed a Mann-Whitney U test was used for two-group comparison and Kruskal-Wallis test was employed for three-group comparison.  Hierarchical linear regression were used to determine whether quality of life could be predicted utilizing Mediterranean diet, BMI and physical activity utilizing a stepwise manner.

Results of the hierarchical analysis indicated that Mediterranean diet accounted for 4.6% of the variance in quality of life with higher adherence to the diet correlating with higher quality of life, BMI accounted for a further 4.1% of the variance with higher BMI correlating with lower quality of life, and 11.3% of the variance accounted for by physical activity with higher levels of physical activity correlating to higher quality of life. When combined these three variables accounted for 20% of the variance in quality of life in the study adolescents.

Strengths of this study were that it is one of the first studies in adolescents to use the Mediterranean diet as a correlate in addition to BMI and physical activity to health related quality of life as well as the relatively large cross sectional sample size.  The major weakness with the study was the results showed a correlation but not a causal relationship between physical activity and quality of life. Also, because all of the questionnaires were self-report they are highly variable in measurement error. In addition, socioeconomic status was not reported, children from lower socioeconomic families may not have access to fresh fruit and vegetables, staples of the Mediterranean diet.

This study suggest that physical activity, BMI and adhering to a Mediterranean diet all correlated to high health related quality of life scores, with physical activity having the greatest impact.  Further research in this area is warranted especially in terms of longitudinal studies with physical activity intervention.

Muros JJ, Salvador Pérez F, Zurita Ortega F, Gámez Sánchez VM, Knox E. The association between healthy lifestyle behaviors and health-related quality of life among adolescents. Jornal de Pediatria. January 2017. doi:10.1016/j.jped.2016.10.005.



Mar 05 2017

Bayley Scale of Infant Development-III

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  • The recently posted information is correct with little changes to be made. Slightly updated information includes:
    • Comprehensive kit cost: $1,391
    • Average Reliability Ranges for Subsections: 0.90-0.97
    • Weakness of Test and Measure: This is not an intuitive outcome; individuals need to be familiar with test before administration and may require training.


  • References:
    • Maccow, G. Bayley Scales of Infant and Toddler Development-Third Edition [PowerPoint]. Pearson Education, Inc., or its affiliates; 2008.


Article Summary:

Cahill-Rowley K, Rose J. Temporal-spatial gait parameters and neurodevelopment in very-low-birth-weight preterm toddlers at 18-22 months. Gait & Posture. 2016; 45: 83-89.


The purpose of this study was to assess if the use of gait and temporal-spatial components would identify neurodevelopment in very low birth weight toddlers and full term (typically developing) toddlers. Children born preterm (</= 32 weeks) with very low birth weight (VLBW) (n=79), and full term toddlers (n=43) were included in this study with ages ranging from 18-22 months. Ages were adjusted for infants that were born premature.

Gait temporal-spatial parameters were gained through use of GAITRite mat, requiring 2-3 trials with a total of 12 footfalls analyzed during fast walking. A trained individual assessed motor development of premature infants with the Bayley’s Scale of Infant and Toddler Development (BSID-III). The BSID-III scores were later compared to temporal-spatial and gait measurements to assess accuracy, since the BSID-III is already a reliable tool in assessing neurodevelopment in infants and toddlers.

The results of this study indicate that infants born prematurely and with lower BSID-III scores (<85) were born 1 week earlier than those with higher BSID-III score (>/= 85). A wider step width and step length asymmetry was found to be significant in preterm toddlers who scored <85 on BSID-III as compared to typically developing toddlers and preterm toddlers who scored >/= 85. Also gait parameters and GA correlated with BSID-III composite motor scores and gross motor sub-scores.

Weaknesses of this article include relying on parent reported age of when independent walking began, limited amount of preterm toddlers with a lower BSID-III scores (n=12 vs. n=67), and multiple reported sample sizes that conflict throughout article. Strengths of this study include large sample size with concentrated age range and the use of a reliable tool for comparison.

Overall, gait parameters including step width and step length asymmetry may be appropriate for use in the clinic to assess neurodevelopment issues; however, until further research is done BSID-III should be used in combination with gait and temporal-spatial parameters.

Mar 06 2017


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Okulöncesi, P. K. B. (2016). Prevalence and patterns of psychiatric disorders in preschool children referred to an outpatient psychiatry clinic. Anatolian Clinic. 2016 Jan; 21(1): 42-47

There has been a drastic improvement in understanding psychiatric disorders in adults especially, and even in children, but preschoolers fall into an extremely understudied population. The purpose of this research article was to determine the prevalence and patterns of psychiatric disorders in preschoolers (less than 72 months old) referred to an outpatient psychiatric clinic in Trabzon, Turkey. As stated in the article, “these early disorders are associated with impairment in multiple developmental domains, including cognitive, social and emotional functioning.” This is why it is imperative to get a better understanding of these diagnoses early in life in order to promote the best outcomes for each child. 200 preschoolers, both male and female, were evaluated using the K-SADS-P and additionally the DDST-II if development screening was indicated. Each participant was administered an intake form developed by the authors, which detailed social demographics, psychiatric diagnoses, and reasons for referral; in addition K-SADS-P, a diagnostic interview designed to assess current and past episodes of DSM-IV psychiatric disorders was given. This was not previously utilized for preschool-aged children, but has since been validated for this age group. Lastly, the children received the DDST-II, a commonly used indicator for early identification of developmental delayed in children from birth to 6 years old.

By the end of the study, diagnoses of ADHD, ODD, anxiety disorders, mood disorders, elimination disorders and tic disorders were finalized via the K-SADS-PL-T. Diagnosis of developmental disorders (autism, language disorders, and mental retardation) was finalized via DSM-IV criteria. If a diagnosis of developmental disorder was possible, the DDST-II was also used. In addition, parents had the ability to voice their reasons for referring their children to these services, and these reasons were placed into four categories: 1. Behavioral category (hyperactivity, impulsivity, physical or verbal aggression, rage, self-injurious behavior); 2. Developmental category (delay or abnormal development of language, social skills, and/or motor skills); 3. Emotional/adaptive category (excessive fears, tearfulness, shyness, problems with relationships with peers/siblings, problems with school adaptation); and 4. Other (issues with sleep, eating, bathroom use, nail biting, finger sucking, traumatic events, abuse). A major strength of this article is the large sample size and a limitation would be that much of the data collected was subjective, which is not always as reliable. This study is so important due to the unfortunate, wide-spread issues of behavioral and psychological impairments in young children. With studies like these, there is hope that early detection can positively impact a child’s future and create a chance for optimal functional outcomes. The DDST-II is an essential part of the screening necessary to ensure child safety and wellness.

Mar 06 2017

MABC-2 Updates and Article Summary (2017)

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Upon extensive examination, all information regarding the MABC-2 is up to date since the last blog entry, with the exception of pricing.

The update pricing information are listed on the official Pearson website as follows:

MABC-2 Record Forms (pkg of 25)- Ages 3-6: $91.70

MABC-2 Record Forms (pkg of 25)- Ages 7-10: $91.70

MABC-2 Record Forms (pkg of 25)- Ages 11-16: $91.70

MABC-2 Checklist (pkg of 50): $37.60



Article Summary

Predictive value of the Movement Assessment Battery for Children – Second Edition at 4 years, for motor impairment at 8 years in children born preterm.


The main purpose of this study was to determine the efficacy of the Movement Assessment Battery for Children – 2nd Edition (MABC-2) as a prognostic tool for motor outcomes for children born preterm (<30 weeks gestation). Specifically, the research administered the test at four years of age and followed up at eight years in order to explore any association of motor outcomes, as well as any other related outcomes.


The study originally consisted of 120 children born <30 weeks gestation who originally were recruited for a previous RCT examining developmental outcomes. The researchers included information from said RCT as there was no significant difference between groups. The participants were followed up at four and eight years old in which the MABC-2 was conducted. Between both follow ups, 24 subjects were unable to continue with the study. The remaining 96 were included with the initial data analysis while the original group were included for secondary analysis. Six children were diagnosed with CP and were found to be in the lowest 5th centile during both follow ups.


Motor impairment remained stable at 25% between four and eight years of age. The rate of motor impairment with scores in the 5th centile for males decreased from 40% at four years old to 32% at eight years old, while females increased from 7% to 16% respectively. The MABC-2 was found to have a sensitivity of 79 (58, 93), specificity of 93 (85, 98), positive predictive value of 79 (58, 93) and negative predictive value of 93 (85, 98). From the results, there was a strong correlation found from age four to eight for motor impairments. Additionally, the authors found that at motor impairment at age eight was correlated with high medical risk and cognition that was below average. Total standard score changes were found to have little evidence of correlation with sex, medical risk, social risk, or General Conceptual Ability score.


Only 19 of the 96 children were found to have motor impairments during the follow ups. Such a small number limits the predictive efficacy of the MABC-2 compared to a larger group. Another limitation mentioned by the authors included “uncooperativeness” by the participants which may have skewed data trends towards impairments in motor function.


Based on the current research, there is evidence to suggest that the MABC-2 performed at four years old provides predictive validity for impairments in motor function at eight years old in children who were born <30 weeks gestation. Specifically, the authors found that of this population, participants scoring at or below the 5th centile have a high projected likelihood for future motor impairments.



A Griffiths, P Morgan, PJ Anderson, LW Doyle, KJ Lee, AJ Spittle. Predictive value of the Movement Assessment Battery for Children – Second Edition at 4 years, for motor impairment at 8 years in children born preterm. Dev Med Child Neurol. January 9, 2017. Available at: Accessed March 5, 2017.