Concurrent Validity and Reliability of the Alberta Infant Motor Scale in Infants at Dual Risk for Motor Delays

Concurrent validity of scores for the Alberta Infant Motor Scale (AIMS) and the Peabody Developmental Gross Motor Scale-2 (PDGMS-2) was examined with a sample of 35 infants at dual risk for motor delays or disabilities. Dual risk was defined as low birthweight (≤ 1,500 g at birth) and environmental risk (children from low-income families). Measures were administered to participants during one visit to a high-risk, follow-up program. Pearson product-moment correlation coefficients were high (r = .90 to .97), with the highest correlation between PDGMS-2 locomotion subscale and AIMS total score. Correlation coefficients were lower for infants > 9 months of age. Novice examiners' scores on both measures closely approximated those of experienced examiners (ICC range = .98 to .99). The results support concurrent validity of the AIMS and PDGMS-2 for infants at dual risk and have implications for using the AIMS in high-risk follow-up programs, particularly in relation to evaluating functional components of motor performance and ease of administration.     

Concurrent Validity of Two Standardized Measures of Gross Motor Function in Young Children with Autism Spectrum Disorder

Aims: This study provides information on how two standardized measures based on different theoretical frameworks can be used in collecting information on motor development and performance in 4- and 5-year-olds with autism spectrum disorder (ASD). The purpose of the study was to determine the concurrent validity of the Miller Function and Participation Scales (M-FUN) with the Peabody Developmental Motor Scales, Second Edition (PDMS-2) in young children with ASD. Methods: The gross motor sections of the PDMS-2 and the M-FUN were administered to 22 children with ASD between the ages of 48 and 71 months. Concurrent validity between overall motor scores and agreement in identification of motor delay were assessed. Results: A very strong correlation (Pearson's r =.851) was found between the M-FUN scale scores and the PDMS-2 gross motor quotients (GMQs). Strong agreement in identification of children with average motor skills and delayed motor skills at 1.5 standard deviations below the mean was also found. Conclusions: This study supports the concurrent validity of the M-FUN with the PDMS-2 for young children with ASD. While both tests provide information regarding motor delay, the M-FUN may provide additional information regarding the neurological profile of the child.     

Effects of Modified Instructions on Peabody Developmental Motor Scales,Second Edition,Gross Motor Scores in Children with Typical Development

Aims: The current study assessed whether modifying instructions on the Peabody Developmental Motor Scales, Second Edition (PDMS-2) affected scores in children with typical development. Methods: The gross motor portion of the PDMS-2 was administered twice, 2–10?days apart, to 38 children. Age- and gender-matched groups received instructions in both standard and modified formats, with order depending on group assignment. Results: Gross Motor Quotient results showed an effect for instruction type (p?=?.03) and an interaction between instruction type and order (p?=?.02). Improved scores for those given modified instructions during the second session indicated the interaction favored modifications. Stationary scores showed an effect for instruction type (p?=?.01) and an interaction between instruction type and age (p?=?.02). Object Manipulation scores showed an interaction between instruction type and order only (p =.002); Locomotion scores showed no significant changes (p?=?.25). Percentile rank changes ranged from 9% to 22% across subtests. Conclusions: Findings suggested instruction modifications may change PDMS-2 gross motor scores, even in children with typical development. Findings also suggested normative scores should not be reported if modifications were used during testing. Research is needed to determine optimal cues for the best representation of true motor ability during standardized assessment.     

Concurrent validity of the Bayley Scales of Infant Development II Motor Scale and the Peabody Developmental Motor Scales in two-year-old children

Concurrent validity of the Bayley Scales of Infant Development, Second Edition (BSID II) Motor Scale and the Peabody Developmental Motor Scales (PDMS) was examined by administering both tests to 38 two-year-old Native American children. A correlation analysis of age equivalent scores indicated very good to high correlation for the BSID II Motor Scale with the PDMS Fine Motor Scale (PDFMS) (r = .87) and the PDMS Gross Motor Scale (PDGMS) (r = .83). A correlation analysis of standard scores showed poor to unacceptable correlation between the BSID II Motor Scale with the PDFMS (r = .64) and the PDGMS (r = .49); further, there was poor agreement between the classifications of significantly delayed, mildly delayed, and within normal limits performance on each test. The PDFMS tended to classify children lower than the BSID II Motor Scale. The scores of the relatively younger children within each of the PDMS 6-month age categories agreed less between the tests than did the scores of the relatively older children. In conclusion, this study provides evidence for the concurrent validity of the BSID II Motor Scale and the PDMS for age equivalent scores, but not for standard scores of 2-year-old children. Professionals must be aware of the strengths and limitations of the BSID II and the PDMS, and choose appropriately to avoid denial of or over-referral for services for young children.     

Developmental Progression of Motor Skills in Children Prenatally Exposed to Cocaine

This study tested the motor development of 73 infants who were prenatally exposed to cocaine using the Peabody Developmental Motor Scales at 6, 12, 18, and 24 months of age. Repeated measures MANOVA found a main effect for age with scores decreasing as children increased in age. The significant interactive effect between age and skill type indicated that fine motor quotient scores decreased more than the comparable gross motor scores. T-tests showed significant differences between the two skill types: fine motor skills were higher at the first two testing periods and lower at the last two periods. This article discusses the nature of the delays at specified age periods and the implications for future assessment and programming.     

Concurrent Validity of the School Outcomes Measure (SOM) and Pediatric Evaluation of Disability Inventory (PEDI) in Preschool-Age Children

ABSTRACT

Aims: The purpose of this study was to examine the concurrent validity of the School Outcomes Measure (SOM) compared with the Pediatric Evaluation of Disability Inventory (PEDI) in preschool-age children. This study also examined the consistency of children's motor performance across the home and school settings. Methods: Five school-based physical therapists collected data on 44 preschool-age children with physical or combined physical and cognitive disability. Correlation coefficients analyzed the strength of association between SOM and PEDI subscale scores, while participant group mean scores analyzed agreement between measures regarding level of motor performance. Results: Correlations between homologous PEDI and SOM subscale scores varied from r_s = .53 to r_s = .92 supporting concurrent validity. With some exceptions, group mean SOM scores showed agreement with group mean PEDI scores when children were categorized by age, gross motor function level, or PEDI cutoff score (1 or 2 SD below the mean). Conclusions: The results partially support concurrent validity between the SOM and PEDI, and suggest that the children's motor performance was similar across home and school settings. The findings also suggest that as a minimal database the SOM can reliably assess motor performance in the school setting; the disadvantage is difficulty interpreting SOM scores.     

Longitudinal motor development of "apparently normal" high-risk infants at 18 months, 3 and 5 years

Background: Motor development appears to be more affected by premature birth than other developmental domains, however few studies have specifically investigated the development of gross and fine motor skills in this population. Aim: To examine longitudinal motor development in a group of “apparently normal” high-risk infants. Setting: Developmental follow-up clinic in a perinatal centre. Study design: Longitudinal observational cohort study. Subjects: Fifty-eight infants born less than 29 weeks gestation and/or 1000 g and without disabilities detected at 12 months. Outcome measures: Longitudinal gross and fine motor skills at 18 months, 3 and 5 years using the Peabody Developmental Motor Scales. The HOME scale provided information of the home environment as a stimulus for development. Results: A large proportion (54% at 18 months, 47% at 3 years and 64% at 5 years) of children continued to have fine motor deficits from 18 months to 5 years. The proportion of infants with gross motor deficits significantly increased over this period (14%, 33% and 81%, p<0.001), particularly for the ‘micropreemies’ (born <750 g). In multivariate analyses, gross motor development was positively influenced by the quality of the home environment. Conclusions: A large proportion of high-risk infants continued to have fine motor deficits, reflecting an underlying problem with fine motor skills. The proportion of infants with gross motor deficits significantly increased, as test demands became more challenging. In addition, the development of gross and fine motor skills appears to be influenced differently by the home environment.     

Interaction between mothers and infants born at risk during the first six months of corrected age

Abstract The effects of preterm birth and the perinatal infant health condition on mother-infant interactions were analysed in 278 mother-infant pairs, divided into four groups according to infants' gestational age at birth: group 1. 23–31 weeks; group 2,32–36 weeks; group 3, 37–42 weeks; and group 4, a control group of healthy full-term infants. The methodological approach was based on observation of the pairs at 2,4 and 6 months of infants" corrected age (± 1 week) during undressing of the infant and face-to-face interaction. It was found that mother-infant pairs with preterm infants (groups 1 and 2) did not differ in interactional variables from those of the control group. On the other hand, the birth of a full-term infant in need of neonatal intensive care (group 3) affected maternal and infant interactive behaviour. Additionally, infants from group 3 did not show stability in their interactive behaviour between any ages of measurement. This result suggests that interactive behaviour of full-term infants in need of neonatal intensive care are rather unpredictable during their first 6 months of life, which might have contributed to the less optimal interactive pattern observed for their mothers compared with mothers of the control group.     

Performance of 2-year-old children after early surgery for congenital heart disease on the Bayley Scales of Infant and Toddler Development, Third Edition

Background

Previous research on developmental outcomes of infants with congenital heart disease (CHD) has shown delays in both cognitive and motor skills.

Aims

To describe outcomes on the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) for infants with CHD and to compare those findings to published results for similar samples of infants assessed on the 2nd edition of the Bayley Scales (BSID-II).

Study design

Prospective cohort.

Participants and outcome measures

Of 50 infants with CHD who participated in this longitudinal study (2006–2008) at the Royal Children's Hospital in Melbourne, Australia, 47 were assessed on the Bayley-III (median age = 24.5 months), administered by a psychologist or neonatologist. Although neither assessor was blind to the CHD diagnosis, they were unaware of results of previous developmental assessments conducted in this longitudinal study.

Results

For the Bayley-III cognitive composite score, 17.0% of infants showed mild delays (1–2 SD below the mean), 2.1% had moderate delays (2–3 SD below the mean), and none had severe delays (greater than 3 SD below the mean). Motor composite scores showed mild delays in 10.9% of infants and moderate delays in 2.2%; none had severe motor delays. These findings differ from study results using the BSID-II in similar infants.

Conclusions

The Bayley-III may underestimate developmental delay in 2-year-old children with CHD when compared to results of similar children tested at 12–36 months of age on the BSID-II.     

Concurrent Validity of Two Gait Performance Measures in Children with Neuromotor Disorders

Aims: To investigate the concurrent validity of two mobility performance measures, the Functional Mobility Scale (FMS) and the Gillette Functional Assessment Questionnaire – walking scale (FAQ) in an inpatient pediatric neurorehabilitation setting. Methods: Cross-sectional data were collected on 71 children (mean age 12.7 years) with neuromotor gait impairments who participated in an inpatient rehabilitation program to evaluate aspects of concurrent validity of the FMS and FAQ. Physiotherapists independently performed ratings. Comparator instruments included the walking item of the Functional Independence Measure for children, 10-m and 6-minute walking tests, and Gross Motor Function Measure-88 dimension E. All tests were completed within 7 days. Spearman correlation coefficients were calculated to test a priori formulated hypotheses regarding the strength and direction of the measures relationships. Results: The children had a broad spectrum of mobility levels, including all levels of FMS and levels 2–10 of FAQ. Spearman correlation coefficients with comparator measures varied between 0.58–0.79 for the FMS and 0.69–0.73 for the FAQ. Hypotheses concerning correlation strengths and directions were met for FMS and FAQ. Conclusions: The findings demonstrate that the FMS and FAQ are valid to evaluate functional mobility in pediatric inpatient neurorehabilitation.     

Motor Performance of Neonatal Risk and Non-Risk Children at Early School-Age

The motor skills of 382 children with neonatal risk factors and 107 children with no risk factors, in the age group 8–9 years, were studied using the Test of Motor Impairment (Stott-Moyes-Henderson). Neonatal disturbances, such as low birthweight and neurological symptoms were associated with marked clumsiness. The test performance was found, unexpectedly, to be significantly affected by age and sex in both the study and the control group. The test items were the same for an age range of one whole year, with no allowance for continuous development of skills. The need of normative data for each country is stressed.     

Neurobehavioral and developmental profile of very low birthweight preterm infants in early infancy

AIM: To describe the neurobehavioral and developmental profile of very low birthweight (VLBW) preterm infants in early infancy. METHODS: Twenty VLBW infants and 10 term control infants were assessed at term, 3 and 6 mo of age. Neurobehavioral assessments included the Neonatal Behavioral Assessment Scale (NBAS) at term; the Infant Behavioral Assessment at term, 3 and 6 mo of age and the Behavioral Rating Scale of the Bayley Scales of Infant Development-II (BSID-II) at 3 and 6 mo of age. Development was evaluated with the Bayley Motor and Mental Scale at 3 and 6 mo. RESULTS: At term age VLBW infants differed from term infants on all the clusters and supplementary items of the NBAS. VLBW infants also showed more stress and less approach behavior at term and 6 mo of age and more problems with self-regulation in all subsystems at 6 mo of age. Moreover, VLBW infants performed lower on the Bayley Motor, Mental and Behavioral Rating Scale: 12 VLBW infants scored questionable or non-optimal on the Psychomotor Development Index and 18 questionable or non-optimal on the Behavioral Rating Scale. These results support the need for neurobehavioral intervention of VLBW infants in the first 6 mo of life. CONCLUSION: Almost all VLBW infants showed non-optimal motor quality behavior at 6 mo and encountered far more problems with self-regulation compared with term infants.     

Effect of lipid emulsion on IL-2 production by mononuclear cells of newborn infants and adults

The in vitro effect of a lipid emulsion (intralipid) on interleukin-2 (IL-2) production by cord blood mononuclear cells (CBMC) of preterm and term newborn infants was examined and compared to that of peripheral blood mononuclear cells (PBMC) of adults. Intralipid, added at concentrations accepted in clinical practice, caused a dose-dependent inhibition of IL-2 activity tested by bioassay. IL-2 levels, tested by radioimmunoassay (RIA), were found to be reduced only in supernatants derived from CBMC of term infants and not in those derived from MC of preterm infants or adults. The capacity of the IL-2 dependent cell line CTLL-2 to respond to IL-2 was abolished in the presence of intralipid, suggesting an interference with the binding of IL-2 to its receptor on these cells. It is conceivable that administration of intralipid to preterm infants may interfere with the binding of IL-2 to the specific receptors on their activated lymphocytes, with a possible subsequent suppression of their immune response.     

Validity of the Fine Motor Area of the 12-Month Ages and Stages Questionnaire in Infants Following Major Surgery

ABSTRACT

The Ages and Stages Questionnaires (ASQ) are parent-report screening tools to identify infants at risk of developmental difficulties. The purpose of this study was to examine validity and internal reliability of the fine motor developmental area of the ASQ, 2nd edition (ASQ2-FM) for screening 12-month-old infants following major surgery. The ASQ2-FM was completed by caregivers of 74 infants who had cardiac surgery in the first 90 days of life, 104 infants who had noncardiac surgery in the first 90 days of life, and a control group of 154 infants. The Rasch item response analysis revealed that the ASQ2-FM had poor ability to discriminate among levels of fine motor ability. Sensitivity was poor (20%) and specificity was good (98%) when compared with the scores for the fine motor subscale of the Bayley Scales of Infant and Toddler Development. The ASQ2-FM under-identified infants at risk for fine motor delay; internal reliability and construct validity do not support use as a screening tool of fine motor development of infants aged 12 months who have undergone major surgery.     

Comparison of 15-Month Motor and 18-Month Neurological Outcomes of Term Infants with and without Motor Delays at 10-Months-of-Age

Fifteen-month motor outcomes and 18-month neurological outcomes of term infants with (Group 1, n + 18) and without (Group 2, n + 18) low scores on the Alberta Infant Motor Scale (AIMS) at 10-months-of-age were compared. Their scores on the AIMS did not differ at 15-months. Infants in Group 1, however, obtained significantly lower scores on the locomotor skill area of the Peabody Developmental Motor Scales at 15 months and walked an average of 2 months later than infants in Group 2. Nevertheless, infants in both groups were functioning within the range of normal at 15 months and had neurologically normal 18-month outcomes, as assessed by a pediatrician using the Neurological Examination of the Collaborative Perinatal Project, except for one child in Group 1 who was identified as “suspicious” because he was not yet walking. The results suggest that motor delays detected at 10-months will not necessarily persist. Pediatric therapists are encouraged to consider normal variations in both rate and pattern of early motor development when making judgements about the results of norm-referenced tests. Instituting a practice of serial assessments, rather than relying on the results of one assessment, will improve the accuracy of identification of infants who exhibit persistent motor delay.     

Lipoproteins in preterm and small-for-gestational-age infants during the first week of life

Plasma lipoprotein levels and composition have been determined in preterm and small-for-gestational-age (SGA) infants, and compared to full-term infants, during the first week of life. Significantly lower levels of HDL and higher levels of VLDL were found in both preterm and SGA infants in comparison to full-term healthy infants. These results suggest a low capacity to metabolize VLDL. Preterm infants showed a behaviour similar to full-term infants with regard to the changes in lipoprotein composition. Small-for-gestational-age infants showed a higher lipoprotein lipid content than preterm infants. A low ratio of cholesteryl ester to free cholesterol (CE/FC) was found in both preterm and SGA infants suggesting a reduced lecithin: cholesterol acyl transferase (LCAT) activity. In preterm infants we observed no changes in the CE/FC ratio during the first week of life, whereas in SGA infants this ratio increased after birth.