Cultural translation and adaptation of the Alberta Infant Motor Scale Thai version

Effects of 4 weeks of play in standing and walking on gross motor ability and segmental trunk control in preterm infants using a playpen: A randomized control trial

OBJECTIVE

To investigate the effect of computer-based early intervention with a playpen to enhance standing and walking, and to examine the relationship between changes in gross motor percentile and segmental trunk control in preterm infants nine months corrected age.

METHODS

Forty infants born before 37 weeks of gestation were randomly assigned to either the experimental or control group. The Alberta Infant Motor Scale (AIMS) and the Segmental Assessment of Trunk Control (SATCo) were administered before and after the intervention. The experimental group, consisting of twenty preterm infants, participated in a computer-based early intervention involving 45 min of play in standing and walking positions, five times a week for 4 weeks.

RESULTS

There were significant between-group differences in the gross motor percentiles of the AIMS (p-value <0.001). In addition, there was a significant difference in all conditions of the SATCo scores (p-value <0.05) compared with baseline score. The change in percentiles of gross motor development was significantly correlated (rs = 0.643; p-value <0.001) with reactive SATCo during walking in infants in the experimental group.

CONCLUSION

Early intervention with a playpen in a standing and walking position can be applied to improve changes in gross motor percentiles and segmental trunk control in preterm infants.

Psychometric properties of the Alberta Infant Motor Scale and culturally adapted or translated versions when used for infant populations internationally: A systematic review

AIM

To systematically review the psychometric properties of the Alberta Infant Motor Scale (AIMS) when used for infant populations internationally, defined as infants not living in Canada, where the normative sample was established.

METHOD

Seven databases were searched for studies that informed the psychometric properties of the AIMS and culturally adapted or translated versions in non-Canadian infant cohorts.

RESULTS

Forty-nine studies reported results from 11 663 infants representing 22 countries. Country-specific versions of the AIMS are available for Brazilian, Polish, Serbian, Spanish, and Thai infant cohorts. Country-specific norms were introduced for Brazilian, Dutch, Polish, and Thai cohorts. The original Canadian norms were appropriate for Brazilian, Greek, and Turkish cohorts. Across countries, the validity, reliability, and responsiveness of the AIMS was generally sufficient, except for predictive validity. Sufficient structural validity was found in one study, responsiveness in one study, discriminant validity in four of four studies, concurrent validity in 14 of 16 studies, reliability in 26 of 26 studies, and predictive validity in only eight of 13 studies.

INTERPRETATION

The use of the AIMS with validated versions and norms is recommended. The AIMS or country-specific versions should be used with caution if norms have not been validated within the specific cultural context.

Factors influencing on gross motor skills in infants: Implications for walking development

BACKGROUND

This longitudinal study aimed to explore the impact of containers on gross motor percentile from 8 to 13 months corrected age during the walking development in moderate to late preterm infants.

METHODS

Sixty preterm infants were enrolled in this study, and their monthly assessment the gross motor percentile using the Alberta Infant Motor Scale. Monthly parent interviews focused on collecting information about container characteristics.

RESULTS

Infants exhibited fluctuating percentiles in gross motor development, averaging 37.81 (SD = 21.9; SEM = 1.4). The gross motor skills percentiles varied between 2 and 86 points across the six assessments. Factors significantly associated with gross motor development percentiles were a large container size (Coef. = 15.29; p < 0.001*) and a container with a soft floor surface (Coef. = 3.64; p = 0.042*).

CONCLUSION

Healthy preterm infants exhibited minimal instability in gross motor development and attained walking independently by 13 months. Placing preterm infants in a baby container during their first year should prioritize a wide space and a soft floor surface to enhance gross motor development.

Psychometric properties of clinician-reported and performance-based outcomes cited in a scoping review on spinal manipulation and mobilization for pediatric populations with diverse medical conditions: a systematic review

INTRODUCTION

Risks and benefits of spinal manipulations and mobilization in pediatric populations are a concern to the public, policymakers, and international physiotherapy governing organizations. Clinical Outcome Assessments (COA) used in the literature on these topics are contentious. The aim of this systematic review was to establish the quality of clinician-reported and performance-based COAs identified by a scoping review on spinal manipulation and mobilization for pediatric populations across diverse medical conditions.

METHOD AND ANALYSIS

Electronic databases, clinicaltrials.gov and Ebsco Open Dissertations were searched up to 21 October 2022. Qualitative synthesis was performed using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines to select studies, perform data extraction, and assess risk of bias. Data synthesis used Grading of Recommendations, Assessment, Development and Evaluations (GRADE) to determine the certainty of the evidence and overall rating: sufficient (+), insufficient (-), inconsistent (±), or indeterminate (?).

RESULTS

Four of 17 identified COAs (77 studies, 9653 participants) with supporting psychometric research were classified as:Performance-based outcome measures: AIMS - Alberta Infant Motor Scale (n = 51); or:Clinician-reported outcome measures: LATCH - Latch, Audible swallowing, Type of nipple, Comfort, Hold (n = 10),Cobb Angle (n = 15),Postural Assessment (n = 1).AIMS had an overall sufficient (+) rating with high certainty evidence, and LATCH had an overall sufficient (+) rating with moderate certainty of evidence. For the Cobb Angle and Postural Assessment, the overall rating was indeterminate (?) with low or very low certainty of evidence, respectively.

CONCLUSION

The AIMS and LATCH had sufficient evidence to evaluate the efficacy of spinal manipulation and mobilization for certain pediatric medical conditions. Further validation studies are needed for other COAs.

Predicting Age of Independent Walking in Preterm Infants: A Longitudinal Study Using Neonatal Characteristics and Motor Development Variables

OBJECTIVE

To formulate an equation estimating months to independent walking in moderate to late preterm infants based on neonatal characteristics and gross motor development from 7 months to independent walking.

METHODS

Sixty infants born between 32 to 36 weeks were assessed using Alberta Infant Motor Scale (AIMS) for gross motor development. Neonatal characteristics were recorded at 7 months, and caregiver-reported independent walking onset. Pearson correlation analyzed age, AIMS scores, and neonatal factors. Multiple regression developed the prediction equation.

RESULTS

The equation for independent walking onset, which included gestational age (GA) at birth, total AIMS score at 10 months of age (10th AIMS), and birth head circumference (BHC), exhibited a strong correlation (r=0.707) and had a predictive power of 50.0%. The equation is as follows: age onset of independent walking (months)=33.157, -0.296 (GA), -0.132 (10th AIMS), -0.196 (BHC), with an estimation error of 0.631 months.

CONCLUSION

Neonatal characteristics, such as GA, 10th AIMS, and BHC, are key determinants in estimating the onset of independent walking in moderate to late preterm infants.

Inter-Rater Reliability of the Polish Version of the Alberta Infant Motor Scale in Children with Heart Disease

There is an urgent need for the systematic monitoring of motor and cognitive neurodevelopment and the evaluation of motor skill development in infants and children with heart disease. Familiarizing students and early graduates with the developmental care needed by these patients may help in the system-wide implementation of early motor screening in this population. The purpose of this study was to investigate the agreement between a last-year physiotherapy student and an experienced pediatric physiotherapist when applying the Polish version of the Alberta Infant Motor Scale (AIMS) to a heterogenous group of children with congenital heart defects. Agreement between raters was verified based on the observation of 80 (38 females) patients with heart disease aged 1-18 months using a Bland-Altman plot with limits of agreement and an intraclass correlation coefficient. The bias between raters for the total score for four age groups (0-3 months, 4-7 months, 8-11 months and 12-18 months) was between -0.17 and 0.22 (range: -0.54-0.78), and the ICC was between 0.875 and 1.000. Thus, a reliable assessment of motor development or motor skills using the Polish version of the AIMS can be performed in pediatric patients with heart defects by clinically inexperienced last-year physiotherapy students who are familiarized with the AIMS manual.

The standardization of the Polish version of the Alberta Infant Motor Scale

BACKGROUND

The Alberta Infant Motor Scale (AIMS) is a standardized tool for assessing gross motor development from birth through independent walking (0-18 months). The AIMS was developed, validated and standardized in the Canadian population. Results of previous studies on the standardization of the AIMS have discerned differences in some samples in comparison with Canadian norms. This study aimed to establish reference values of the AIMS for the Polish population and compare them to Canadian norms.

METHODS

The research involved 431 infants (219 girls, 212 boys, aged 0-<19 months), divided into nineteen age groups. The translated into Polish and validated version of the AIMS was used. The mean AIMS total scores and percentiles for every age group were calculated and compared with the Canadian reference values. Raw total AIMS scores were converted to 5th, 10th, 25th, 50th, 75th, and 90th percentiles. A one sample t-test was used to compare the AIMS total scores between Polish and Canadian infants (p-value < 0.05). A binomial test was performed to compare percentiles (p-value < 0.05).

RESULTS

The mean AIMS total scores in the Polish population were significantly lower in the seven age groups: 0-<1, 1-<2, 4-<5, 5-<6, 6-<7, 13-<14, and 15-<16 months of age (with small to large effect size). A few significant differences were found in the comparison of percentile ranks, mostly in the 75th percentile.

CONCLUSION

Our study provides the norms for the Polish AIMS version. According to differences in the mean AIMS total scores and percentiles, the original Canadian reference values are not congruent for Polish infants.

TRIAL REGISTRATION

ClinicalTrials.gov ID NCT05264064. URL https://clinicaltrials.gov/ct2/show/NCT05264064 . Date of registration: 03/03/2022.

Enhancing motor screening efficiency: Toward an empirically derived abridged version of the Alberta Infant Motor Scale

Use of machine learning (ML) in the early detection of developmental delay is possible through the analysis of infant motor skills, though the large number of potential indicators limits the speed at which the system can be trained. Body joint obstructions, the inability to infer aspects of movement such as muscle tone and volition, and the complexities of the home environment - confound machine learning's ability to distinguish between some motor items. To train the system efficiently requires using an excerpted list of validated items, a salient set, which uses only those motor items that are the 'easiest' to see and identify, while being the most highly correlated to a low/qualifying score. This work describes the examination of motor items, selection of 15 items that comprise the salient set, and the ability of the set to reliably screen for motor delay in the first-year infant.

Effects of Play in an Upright Position on Intra-Individual Variability of Gross Motor and Language Development in Institutionalized Infants

(1) Objective: To investigate the effects of play in an upright position on intra-individual variability and to examine the relationship between the variability of gross motor and language development in institutionalized infants aged six to ten months. (2) Methods: Thirty infants were conveniently enrolled in either the experimental or control groups. The Alberta Infant Motor Scale (AIMS) and the Communication and Symbolic Behavior Scales Developmental Profile (CSBS-DP) Infant/Toddler Checklist were tested pre and post each monthly intervention for three months. Sixteen infants in the experimental group received an additional program of 45 min play in an upright position three times a week for a 3-month period. (3) Results: There were significant between-group differences in intra-individual variability of the AIMS percentiles (p-value = 0.042). In addition, there was a significant difference in the intra-individual variability of the language percentile between groups (p-value = 0.009). The intra-individual variability of gross motor development was significantly correlated (r_s = 0.541; p = 0.03) with language development. (4) Conclusions: Play in an upright position could be applied to improve intra-individual variability in gross motor and language development percentiles in institutionalized infants.

The Alberta Infant Motor Scale: A tool for the assessment of motor aspects of neurodevelopment in infancy and early childhood

According to the recommendations of the American Academy of Pediatrics, the surveillance of motor development should accompany systematic appointments with medical professionals in infancy and early childhood. One of the standardized tools for evaluating motor development is the Alberta Infant Motor Scale (AIMS). This paper aims to present assumptions and psychometric properties of the AIMS, the methodology of assessment of an infant's performance with the AIMS, and research on the validation and standardization of the AIMS as well as the use of the scale as an outcome measure. We conducted a non-systematic literature review using three electronic databases: PubMed, Scopus, and Embase (from June 1992 to February 2022). We included original research with a full-text manuscript in English. No geographical restrictions were applied. The search terms “alberta infant motor scale” AND “reliability” OR “validity” and “alberta infant motor scale” AND “norms” OR “reference” OR “standardization” were used for literature review on the validation and standardization of the AIMS in other non-Canadian populations. This narrative review also focuses on how the AIMS is applied as an outcome measure in research by presenting studies on the AIMS conducted over the last decade. Our review found that the AIMS is widely used for both research and clinical purposes. The AIMS has been used as an outcome measure in both interventional and observational studies conducted on both neurotypical infants and those with conditions affecting motor development. The advantages of the scale are its infant-friendliness, time duration of the examination, and relative ease of application for an examiner. The scale has been validated and standardized in many countries.

The Polish Version of the Alberta Infant Motor Scale: Cultural Adaptation and Validation

The Alberta Infant Motor Scale (AIMS) is a diagnostic tool for the assessment of the motor performance of infants from the time of birth, to the period of independent walking (0-18 months). This study aims to derive a Polish version of the AIMS through its cultural adaptation and validation. The study included 145 infants aged 0-18 months, who were divided into four further age groups: 0-3 months, 4-7 months, 8-11 months, and older than 12 months. The validation was based on an analysis of intrarater and interrater reliability values, as well as concurrent validity, using the gross motor scale of Peabody Developmental Motor Scales-2 (PDMS-2). The total Intraclass Correlation Coefficient (ICC) for intrarater reliability was 0.99 (ICC range in positions was 0.87-0.99, in subgroups was 0.91-0.99), while in particular positions, the ICC ranges were as follows: prone 0.97-0.99, supine 0.94-0.99, sitting 0.95-0.99, and standing: 0.63-0.99. The total ICC for interrater reliability was 0.99 (ICC range in positions was 0.98-0.99, in subgroups was 0.91-0.99), while in particular positions, the ICC ranges were as follows: prone 0.95-0.99, supine 0.93-0.96, sitting 0.93-0.98, standing 0.91-0.98. Only the standing position was analyzed for the subgroup of participants over 12 months old. The Spearman correlation between the Polish version of the AIMS and the gross motor scale of PDMS-2 was significant in the total population (r = 0.97, p < 0.0001) and in subgroups (r = 0.79-0.85, p < 0.0001). The results of our study confirm that the Polish version of the AIMS is reliable for infants aged 0-18 months and can be applied to this population for clinical and scientific purposes.

Trial Registry

ClinicalTrials.gov ID NCT05264064, URL https://clinicaltrials.gov/ ct2/show/NCT05264064.

The association between smartphone and tablet usage and children development

Smartphone and tablet usage duration may relate to problems with early development in children. It is imperative to determine the appropriate duration of its usage by children. The purpose of the study was 1) to investigate the correlation between child development and smartphone and tablet usage duration, 2) to study the correlation of smartphone and tablet usage duration between children and their caregivers, and 3) to correlate child development and other factors. A cross-sectional study was conducted. Eighty-five community children with a mean age of 4.05 ± 0.91 years were recruited as study subjects. Development was assessed using the Denver Developmental Screening Test II, which includes gross motor, language, fine motor-adaptive and personal-social developments. Subsequently, details of smartphone and tablet usage for the next seven days were recorded. The average duration of smartphone and tablet usage was 82.78 ± 62.82 min/day. In addition, 32.94%, 11.76%, 9.42%, and 2.35%, of children were classified as suspected fine motor-adaptive, personal-social, language, and gross motor development, respectively. The main findings revealed a highly significant correlation between a child's smartphone and tablet usage duration and their gross motor development. Children's smartphone and tablet usage duration showed a positive significant correlation with the duration spent on smartphones and tablets by mothers and relatives. Father's medical history and family income showed a significant correlation with child development. Thus, caregivers must pay attention to the smartphone and tablet usage time of children, mothers and relatives to prevent abnormal development in children.

Intra-Individual Variability in Gross Motor Development in Healthy Full-Term Infants Aged 0-13 Months and Associated Factors during Child Rearing

The gross motor development of a typically developing infant is a dynamic process, the intra-individual variability of which can be investigated through longitudinal assessments. Changes in gross motor development vary, according to the interaction of multiple sub-systems within the child, environment, task setting, and experience or practice of movement. At present, studies on environmental factors that influence gross motor development in full-term infants over time are limited. The main aim of this study was to investigate environmental factors affecting intra-individual variability from birth to 13 months. The gross motor development of 41 full-term infants was longitudinally assessed every month from the age of 15 days using the Alberta Infant Motor Scale. Parents were interviewed monthly about environmental factors during childcare. Infants showed fluctuations in the percentile of gross motor development, and no systematic pattern was detected. The total mean range of gross motor percentile was 65.95 (SD = 15.74; SEM = 2.28). The percentiles of gross motor skills over the 14 assessments ranged from 36 to 93 percentile points. Factors that were significantly associated with the gross motor development percentile were the use of a baby walker (Coef. = -8.83, p ≤ 0.0001) and a baby hammock (Coef. = 7.33, p = 0.04). The use of baby hammocks could increase the gross motor percentile by 7.33 points. Although the usage of a baby walker is common practice in childcare, it may cause a decrease in the gross motor percentile by 8.83 points according to this study. In conclusion, healthy full-term infants exhibited a natural variability in gross motor development. Placing infants in a baby walker during the first year of age should be approached with caution due to the risk of delayed gross motor development.

Reliability Study of the Items of the Alberta Infant Motor Scale (AIMS) Using Kappa Analysis

Purpose: We evaluated the interrater and intrarater reliabilities of the Korean version of the Alberta Infant Motor Scale (K-AIMS). Methods: For the interrater reliability test, six raters participated in the K-AIMS evaluation using video clips of 70 infants (aged between 0 and 18 months). One rater participated in an intrarater reliability test. Among 70 infants, 46 were born preterm and 24 were born full term. A total of 58 AIMS items were evaluated for supine, prone, sitting, and standing positions. A reliability analysis was conducted using ICC and Fleiss’ kappa. Results: The highest Fleiss’ kappa was found for the 4–7 months group for sitting (K = 0.701–1.000) and standing (K = 0.721–1.000), while the lowest K was the 3 months or under group for standing (K = 0.153–1.000). We found higher Fleiss’ kappa statistics when all infants were evaluated without grouping for the three positions (K = 0.727–1.000), except standing (K = 0.192–1.000), for the interrater analysis. Conclusion: Our results demonstrate the good reliability for the Korean version of the AIMS for Korean infants (preterm and full term).

Canadian and Brazilian Percentile Ranks for the Alberta Infant Motor Scale

Aim: To verify if there is a difference between the percentile ranks for Brazilian infants compared with norms for Canadian infants on the Alberta Infant Motor Scale (AIMS). Method: A cross-sectional study in which 322 Brazilian infants, 2 to 15 months old, were administered the AIMS. Percentile ranks were calculated using norms for Canadian infants and norms from two studies of Brazilian infants. The Friedman test compared the AIMS percentile ranks for the entire sample. For reliability analysis, the interclass correlation coefficient (ICC) was used. Bland Altman's analysis was applied to compare percentile ranks. Results: Of the 322 evaluations analyzed, there were significant differences (p<.001) between the three percentile ranks compared. The Canadian norms presented the lowest average rating. There was good reliability between the percentile ranks (ICC > 0.75) but low agreement (Bland Altman; p<.001). Conclusion: There are differences between the Brazilian and Canadian percentile ranks and between the Brazilian percentile ranks of 2014 and 2016, and these differences may influence identification of motor development.

Segmental Assessment of Trunk Control in Moderate-to-Late Preterm Infants Related to Sitting Development

(1) Background: The assessment of postural segment control in premature infants seems to be critical during the onset of upright gross motor development, especially sitting. Identifying correlations between postural segment control and the development of sitting milestones could help with promoting optimal gross motor movement. However, data on this topic in home-raised premature infants via longitudinal design are still limited. The purpose of this study was to examine relationships between postural segment control and sitting development through series assessments from the corrected age of 4 months until the early onset of independent sitting attainment. (2) Methods: 33 moderate-to-late premature infants were recruited. Their trunk segment control was assessed using the Segmental Assessment of Trunk Control (SATCo), and sitting development was examined by the Alberta Infant Motor Scale (AIMS). Relationships between SATCo and sitting scores were analysed using Spearman’s rank correlation (r_s). (3) Results: significant fair-to-good correlations between segmental trunk control and sitting scales were found from 4 months (r_s = 0.370–0.420, p < 0.05) to the age of independent sitting attainment (r_s = 0.561–0.602, p < 0.01). (4) Conclusion: relationships between the trunk segment control and sitting ability of moderate-to-late preterm infants were increased in accordance with age.

Cross-country validity of the Alberta Infant Motor Scale using a Brazilian sample

BACKGROUND

Previous validity studies of the Alberta Infant Motor Scale (AIMS), using raw scores and percentile curves for group comparisons, showed that infants in Brazil achieved gross motor milestones at later ages. Validity of the AIMS norms were later reassessed using a logistic regression model that placed the AIMS items on an age scale.

OBJECTIVES

Our study examined the validity of the AIMS norms for Brazilian infants using the recommended method for calculating and comparing item locations.

METHODS

Data from 732 Brazilian infants (2009-11), 3 days to 18 months old, were compared to the AIMS normative sample (n=2202). Logistic regression placed the AIMS items of both samples on age scales representing the age at which 50% of infants passed an item and compared the two datasets. Pearson correlation coefficient tested the association across samples.

RESULTS

47 of the 58 AIMS items met the criterion for stable regression to calculate item locations of the Brazilian dataset. Based on the age when 50% of the infants passed a criterion, most of the items from the Brazilian sample (n=28) differed by two weeks or less compared to the Canadian normative sample.

CONCLUSION

The sequence and age for the emergence of AIMS items were similar between the Brazilian and Canadian samples. Canadian norms are appropriate for clinical decisions and research with Brazilian infants.

Gross motor development of Thai healthy full-term infants aged from birth to 14 months using the Alberta Infant Motor Scale: Inter individual variability

BACKGROUND

The gross motor percentiles of the Alberta Infants Motor Scale (AIMS) have been commonly referenced in research. Cross-cultural assessment of gross motor development during the first year of life is suggested as diverse child-rearing practices can cause inter-variability. The main aim of this study was to develop an AIMS percentile curve for typically developing home-raised infants in the northeastern part of Thailand. The AIMS scores of these infants were also compared with the standard Canadian norms.

METHODS

The gross motor development of 574 full-term infants aged 15 days to 14 months was assessed using the Thai version of the AIMS. Percentile curves of their gross motor ability were developed. The Thai infants' mean AIMS scores were compared with the Canadian norm using the one-sample t-test.

RESULTS

The percentile curve of gross motor development of healthy Thai infants showed that mean AIMS scores increased with age. Large inter-variability was present from the 7th to 10th months. The mean AIMS scores of Thai infants were significantly lower than the standard Canadian means during the first three months (P < 0.05), but significantly higher in three age groups: 7-<8 months, 11-<12 months, and 13-14 months.

CONCLUSION

The developed percentile curve of gross motor development is applicable for infants from the same demographic and environmental context. According to the study, infants from diverse cultures display a natural inter-variability in gross motor development between the 7th and 10th months.