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Baril R, Joffe AR, Andersen JC, Khademioureh S, Dinu IA, Robertson CMT. The Alberta Infant Motor Scale as an Outcomes Measure of Gross Motor Abilities after Early Complex Cardiac Surgery. Pediatr Cardiol 2024; 45:1079-1088. [PMID: 38512487 DOI: 10.1007/s00246-024-03458-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/20/2024] [Indexed: 03/23/2024]
Abstract
To address the research hypothesis that the Alberta Infant Motor Scale (AIMS) completed following complex cardiac surgery (CCS) is a useful outcomes measure this study determined: (1) AIMS scores at age 8 months after CCS; (2) predictive validity of AIMS at 8 months for Bayley Scales of Infant and Toddler Development-III Gross Motor-scaled scores (GMSS) and diagnosis of cerebral palsy (CP) at 21 months; and (3) predictive demographic and surgical variables of AIMS scores. A prospective cohort study of 250/271 (92.3%) surviving children from Northern Alberta (born 2009-2020) who had CCS at age < 6 months determined AIMS scores at age mean (SD) 8.6 (2.4) and the GMSS at 21.9 (3.8) months. Gross motor delay was defined as AIMS < 5th percentile and GMSS as < 4 (-2SD). Predictions using multiple logistic regressions were expressed as Odds Ratios (OR) and 95% Confidence Interval (CI). Of children, 100/250 (40%) had AIMS < 5th predicting GMSS < 4 (n = 43); sensitivity, specificity, positive, and negative predictive values were 88%, 71%, 40%, and 97%. Hospitalization days were independently associated with AIMS < 5th, OR 1.02 (95% CI 1.007, 1.032; p = 0.005). Excluding hospital days, ventilation days independently predicted AIMS < 5th, OR 1.08 (95% CI 1.038, 1.125, p < 0.001. Gross motor delay determine by AIMS scores of < 5th percentile occurred in 40% of survivors with good prediction of continued delay. Delay determined by AIMS was predicted by longer hospitalization and ventilation; further investigations about the causes are required. AIMS results provide opportunity for early motor intervention.
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Affiliation(s)
- Rebecca Baril
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Department of Pediatrics, Glenrose Rehabilitation Hospital, Room 242A Glen East, 10230-111 Avenue, Edmonton, AB, T5G 0B7, Canada
| | - Ari R Joffe
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - John C Andersen
- Department of Pediatrics, University of Alberta, Edmonton, Canada
- Department of Pediatrics, Glenrose Rehabilitation Hospital, Room 242A Glen East, 10230-111 Avenue, Edmonton, AB, T5G 0B7, Canada
| | | | - Irina A Dinu
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Charlene M T Robertson
- Department of Pediatrics, University of Alberta, Edmonton, Canada.
- Department of Pediatrics, Glenrose Rehabilitation Hospital, Room 242A Glen East, 10230-111 Avenue, Edmonton, AB, T5G 0B7, Canada.
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Reynolds K, Urbanowicz A, Mayston M, Foley S. Kids+ Parent Infant Program (PIP): a community model for supporting partnerships in early developmental follow-up and support. Front Pediatr 2024; 12:1354971. [PMID: 38756970 PMCID: PMC11096506 DOI: 10.3389/fped.2024.1354971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/19/2024] [Indexed: 05/18/2024] Open
Abstract
High-risk infants are discharged home from hospital with increased care needs and the potential for the emergence of developmental disabilities, contributing to high levels of parental stress and anxiety. To enable optimal outcomes for high-risk infants and their families, developmental follow-up programs need to continue following hospital discharge. However, current follow-up care for high-risk infants is variable in terms of type, access and equity, and there seems to be a gap in existing services such as supporting the transition home, parental support, and inclusion of all at-risk infants regardless of causality. Routine follow-up that identifies developmental delays or neuromotor concerns can facilitate timely referral and access to targeted intervention during critical periods of development. The Kids+ Parent Infant Program (PIP) is a unique model of developmental follow-up that shares some characteristics with established programs, but also includes additional key elements for a seamless, wrap-around service for all high-risk infants and their families living in a regional area of Australia. This community-based program provides integrated assessment and intervention of infants, alongside parent support and education, embracing a holistic model that accounts for the complexity and interrelatedness of infant, parent, medical and developmental factors. By prioritising the well-being of high-risk infants and their families, the Kids+ PIP paves the way for improved developmental outcomes and provides an innovative model for developmental follow-up, with the potential for reproduction in other healthcare settings.
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Affiliation(s)
- K. Reynolds
- Kids Plus Foundation (Kids+), Geelong, VIC, Australia
- Childrens Therapy Services, Geelong, VIC, Australia
| | - A. Urbanowicz
- Kids Plus Foundation (Kids+), Geelong, VIC, Australia
- Australian Institute for Health Transformation, Determinants of Health, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - M. Mayston
- Division of Biosciences, Neurosciences, Physiology & Pharmacology, University College London, London, United Kingdom
| | - S. Foley
- Kids Plus Foundation (Kids+), Geelong, VIC, Australia
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Passamani RS, Shigihara CK, Gomes PG, Dos Santos AN. Agreement of synchronous remote and in-person application of the Alberta Infant Motor Scale: Cohort study. J Telemed Telecare 2024:1357633X241245160. [PMID: 38659374 DOI: 10.1177/1357633x241245160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Using standardized scales to assess motor development via telemedicine can increase access for low-income populations. Our aim was to verify the agreement and feasibility between remotely and synchronously applying the Alberta Infant Motor Scale (AIMS) and the in-person format. METHODS This was a concordance study, with 77 typical infants aged 4-18 months (mean = 13 months). The AIMS was applied remote via video calls and face-to-face. We applied a questionnaire to caregivers to verify feasibility. RESULTS There was a high level of agreement between the remote and in-person assessments, with intraclass correlation coefficients above 0.98 and low standard error measure values (<1 item for each posture, <2 items for the total raw score, and =5% for the normative score). The smallest detectable change was between 1.67 and 2.45 for each posture, 3 for the total raw score, and 6% for the normative score. The Bland-Altman analysis showed low bias with the mean difference close to zero (<0.80) and low error with little dispersion of the difference points around the mean. Caregivers' perspectives on the synchronous remote assessment were positive, with good quality, clear information during the assessment, and comfort with the method. DISCUSSION The synchronous remote application of the AIMS may be an alternative for families without access to in-person services that assess motor development.
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Affiliation(s)
- Rafaela S Passamani
- Department of Health Science, Universidade Federal de Santa Catarina, Santa Catarina, Brazil
| | - Carolina K Shigihara
- Department of Health Science, Universidade Federal de Santa Catarina, Santa Catarina, Brazil
| | - Paula G Gomes
- Department of Health Science, Universidade Federal de Santa Catarina, Santa Catarina, Brazil
| | - Adriana N Dos Santos
- Department of Health Science, Universidade Federal de Santa Catarina, Santa Catarina, Brazil
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Montedori KT, Lima MCMP. Early childhood development monitoring during the first thousand days: Investigating the relationship between the developmental surveillance instrument and standardized scales. Early Hum Dev 2024; 190:105965. [PMID: 38354455 DOI: 10.1016/j.earlhumdev.2024.105965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/13/2024] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE This study aims to investigate the relationship between the Developmental Surveillance Instrument -Instrumento de Vigilância do Desenvolvimento (IVD), found in the Child's Booklet Caderneta da Crianca (CC), and standardized scales: Alberta Infant Motor Scale (AIMS) and Denver Developmental Screening Test (Denver-II). METHODS Employing an exploratory observational approach, we adopted a prospective longitudinal design with a quantitative approach. The convenience sample included 83 Brazilian children born between May and August 2019 in a public hospital. Of the total, 45 (54.22 %) were male, and 38 (45.78 %) were female. Developmental screening utilized the IVD, AIMS and Denver-II tests. Comparative analysis between groups employed Mann-Whitney or Kruskal-Wallis tests for numerical variables and chi-square/Fisher tests for categorical variables, with a significance level of 5 % (p < 0.05). RESULTS A significant correlation was observed between the IVD and the AIMS and Denver-II tests (p < 0.001) at months 1, 4, and 8. CONCLUSION The presence of a robust correlation between the IVD and the AIMS and Denver-II tests at months 1, 4, and 8 implies that the IVD in the Child's Booklet serves as a reliable and effective indicator for screening infant development during this critical period. Detecting issues early through these methods is crucial to ensure the well-being of children, allowing for appropriate interventions as needed.
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Affiliation(s)
- Kedma Teixeira Montedori
- Faculty of Medical Sciences of the State University of Campinas, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (UNICAMP), Brazil.
| | - Maria Cecília Marconi Pinheiro Lima
- Faculty of Medical Sciences of the State University of Campinas, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (UNICAMP), Brazil
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Passamani RS, de Vargas Ciello H, Brugnaro BH, Dos Santos AN. The psychometric properties and feasibility of the Alberta infant motor scale used in telehealth: A scoping review. Early Hum Dev 2024; 189:105941. [PMID: 38237305 DOI: 10.1016/j.earlhumdev.2024.105941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Telehealth can be a viable option for improving equitable access to early motor assessment for financially vulnerable individuals. AIM This review aimed to identify the psychometric properties of the Alberta Infant Motor Scale (AIMS) when applied via telehealth and assess its feasibility. METHODS Papers were systematically retrieved from electronic databases until October 4, 2023. We included studies that assessed the motor development of infants using the AIMS through telehealth. RESULTS Thirteen studies, encompassing 897 infants (449 male and 396 female), were included in this review. Among them, 805 were typical infants and 92 were at risk of motor delay. The age range of participants spanned from 4.9 weeks to 20 months. The studies found good concurrent validity between telehealth and in-person assessments (ICC > 0.98, SEM < 1.6, mean difference = 0.5) and good to excellent reliability (ICC > 0.80) using home videos recorded by parents or video calls with researchers. Telehealth was perceived as feasible by parents, who expressed high satisfaction, and the quality of images and assessments met commendable standards. CONCLUSION Considering the limited number of studies that have assessed infants with neuromotor disorders, this scale has the potential for telehealth application in evaluating typical infants.
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Affiliation(s)
| | - Herika de Vargas Ciello
- Department of Health Science, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Beatriz Helena Brugnaro
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Adriana Neves Dos Santos
- Department of Health Science, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil.
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Saldaris JM, Jacoby P, Marsh ED, Suter B, Leonard H, Olson HE, Rajaraman R, Pestana-Knight E, Weisenberg J, Price D, Drummond C, Benke TA, Demarest S, Downs J. Adapting a measure of gross motor skills for individuals with CDKL5 deficiency disorder: A psychometric study. Epilepsy Res 2024; 200:107287. [PMID: 38237219 DOI: 10.1016/j.eplepsyres.2024.107287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE Validated measures capable of demonstrating meaningful interventional change in the CDKL5 deficiency disorder (CDD) are lacking. The study objective was to modify the Rett Syndrome Gross Motor Scale (RSGMS) and evaluate its psychometric properties for individuals with CDD. METHODS Item and scoring categories of the RSGMS were modified. Caregivers registered with the International CDKL5 Clinical Research Network uploaded motor videos filmed at home to a protected server and completed a feedback questionnaire (n = 70). Rasch (n = 137), known groups (n = 109), and intra- and inter-rater reliability analyses (n = 50) were conducted. RESULTS The age of individuals with CDD ranged from 1.5 to 34.1 years. The modified scale, Gross Motor-Complex Disability (GM-CD), comprised 17 items. There were no floor or ceiling effects and inter- and intra-rater reliability were good. Rasch analysis demonstrated that the items encompassed a large range of performance difficulty, although there was some item redundancy and some disordered categories. One item, Prone Head Position, was a poor fit. Caregiver-reported acceptability was positive. Scores differed by age and functional abilities. SUMMARY GM-CD appears to be a suitable remotely administered measure and psychometrically sound for individuals with CDD. This study provides the foundation to propose the use of GM-CD in CDD clinical trials. Longitudinal evaluation is planned.
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Affiliation(s)
- J M Saldaris
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - P Jacoby
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - E D Marsh
- Division of Child Neurology, Children's Hospital of Philadelphia and Departments of Neurology and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - B Suter
- Department of Pediatrics & Neurology, Baylor College of Medicine, Houston, TX, USA
| | - H Leonard
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - H E Olson
- Division of Epilepsy and Clinical Neurophysiology and Epilepsy Genetics Program, Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - R Rajaraman
- UCLA Mattel Children's Hospital, Los Angeles, CA, USA
| | | | - J Weisenberg
- St. Louis Children's Hospital and Washington University School of Medicine, St Louis, MO, USA
| | - D Price
- NYU Langone Health and Department of Neurology, New York University, New York, NY, USA
| | - C Drummond
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - T A Benke
- University of Colorado, School of Medicine, Depts Pediatrics, Neurology and Pharmacology and Children's Hospital Colorado, Aurora, CO, USA
| | - S Demarest
- University of Colorado, School of Medicine, Depts Pediatrics, Neurology and Pharmacology and Children's Hospital Colorado, Aurora, CO, USA.
| | - J Downs
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia; Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
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Kim F, Maitre N. A Call for Early Detection of Cerebral Palsy. Neoreviews 2024; 25:e1-e11. [PMID: 38161182 DOI: 10.1542/neo.25-1-e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Cerebral palsy (CP) is the most common physical disability across the lifespan, but historically, CP has not been diagnosed before the age of 2 years. Barriers to early diagnosis ranged from lack of available biomarkers, absence of curative treatments, perceived stigma associated with a lifelong diagnosis, and a desire to rule out other diagnoses first. Most importantly, the fundamental question that remained was whether children would benefit from earlier detection and intervention given the paucity of research. However, evidence-based guidelines published in 2017 demonstrated that the General Movements Assessment, the Hammersmith Infant Neurological Examination, and neuroimaging can be combined with other elements such as a clinical history and standardized motor assessments to provide the highest predictive value for diagnosing CP as early as age 3 months in high-risk newborns. Implementation of these guidelines has been successful in decreasing the age at CP diagnosis, particularly in high-risk infant follow-up clinics with expertise in performing these assessments. Early detection of CP allows for clinical and research opportunities investigating earlier interventions during a critical period of neuroplasticity, with the goal of improving developmental trajectories for children and their families. New guidelines and research are now being developed with a focus on early, targeted interventions that continue to be studied, along with global detection initiatives.
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Affiliation(s)
- Faith Kim
- Department of Pediatrics, Columbia University Irving Medical Center/NewYork-Presbyterian Children's Hospital of New York, New York, NY
| | - Nathalie Maitre
- Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA
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Ko J, Lim HK. Motor Development Comparison between Preterm and Full-Term Infants Using Alberta Infant Motor Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3819. [PMID: 36900838 PMCID: PMC10001437 DOI: 10.3390/ijerph20053819] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
The Alberta Infant Motor Scale (AIMS) was developed to evaluate the motor development of infants up to 18 months of age. We studied 252 infants in three groups (105 healthy preterm infants (HPI), 50 preterm infants with brain injury (PIBI), and 97 healthy full-term infants (HFI) under 18 months, corrected age (CoA)) using AIMS. No significant differences were found among HPI, PIBI, and HFI in infants less than 3 months old, yet significant differences were noted in positional scores (p < 0.05) and total scores for those four to six months of age and seven to nine months of age. A significant difference was also found in standing items for infants over 10 months (p < 0.05). After four months, there was a difference in motor development between preterm (with and without brain injury) and full-term infants. In particular, there was a significant difference in motor development between HPI and HFI and between PIBI and HFI at four to nine months, when motor skills developed explosively (p < 0.05). After four months, motor developmental delays (10th ≥) were observed in HPI and PIBI at rates of 26% and 45.8%, respectively. Midline supine development, a representative indicator of early motor development, was slower even in healthy preterm infants than in full-term infants. AIMS has a good resolution to discriminate preterm infants who are showing insufficient motor development from 4 months to 9 months.
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Affiliation(s)
- Jooyeon Ko
- Department of Physical Therapy, Daegu Health College, Daegu 41453, Republic of Korea
- Korean Balance Ability Data Center, Daegu 41453, Republic of Korea
| | - Hyun Kyoon Lim
- Medical Measurement Team, Korea Research Institutes of Standards and Science, Daejeon 34113, Republic of Korea
- Department of Medical Physics, University of Science and Technology, Daejeon 34113, Republic of Korea
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