Prediction of developmental outcome at an early age is difficult. In medical evaluations of high-risk infants, the best predictions are achieved through a combination of multiple, complementary tools, that is, achieved milestones, neurological examination and assessment of the quality of motor behavior.

A reliable and valid instrument to assess neuromotor condition in infancy is a prerequisite for early detection of developmental motor disorders. We developed a video-based assessment of motor behaviour, the Infant Motor Profile (IMP), to evaluate motor abilities, movement variability, ability to select motor strategies, movement symmetry, and fluency. The IMP consists of 80 items and is applicable in children from 3 to 18 months. The present study aimed to test intra-and interobserver reliability and concurrent validity of the IMP with the Alberta Infant Motor Scale (AIMS) and Touwen neurological examination. The study group consisted of 40 low-risk term (median gestational age [GA] 40wks, range 38-42wks) and 40 high-risk preterm infants (median GA 29.6wks, range 26-33wks) with corrected ages 4 to 18 months (31 females, 49 males). Intra-and interobserver agreement of the IMP were satisfactory (Spearman's rho=0.9). Concurrent validity of IMP and AIMS was good (Spearman's rho=0.8, p<0.005). The IMP was able to differentiate between infants with normal neurological condition, simple minor neurological dysfunction (MND), complex MND, and abnormal neurological condition (p<0.005). This means that the IMP may be a promising tool to evaluate neurological integrity during infancy, a suggestion that needs confirmation by means of assessment of larger groups of infants with heterogeneous neurological conditions.

AIM Little is known of minor neurological dysfunction (MND) in infancy. This study aimed to evaluate the inter-assessor reliability of the assessment of MND with the Touwen Infant Neurological Examination (TINE) and the construct and predictive validity of MND in infancy.METHOD Inter-assessor agreement was determined in a sample of 40 infants (24 males, 16 females) aged 3 to 12 months (25 born at term: gestational age 37-41wks, median 39; and 15 born preterm, gestational age 24-35wks, median 32). Thirty typically developing term infants (18 males, 12 females; gestational age 37-42wks, median 40) and 59 preterm infants (34 males, 25 females) born at <35 weeks' gestation (gestational age 25-34wks, median 29) participated in the validity study. They were neurologically assessed with the TINE at the corrected ages of 4, 6, 10, and 12 months and with the Hempel assessment at 18 months. RESULTSThe findings indicated that MND can be assessed reliably (inter-assessor agreement: kappa=0.83). MND during infancy was related to prenatal, perinatal, and social factors, and in particular to preterm birth. Neurological condition during infancy was prone to change, but was related to neurological condition at 18 months at all ages tested. INTERPRETATIONWe conclude that MND can be determined reliably in infancy. Important considerations in the construct of MND in infancy are its relation to prenatal and perinatal factors, its limited stability, and its moderate predictive value.Neurological assessment is one of the clinical tools used to monitor development in infants at risk for developmental disorders, such as infants born preterm. Multiple methods are available, such as the Amiel-Tison neurological examination, 1 the Touwen Infant Neurological Examination (TINE), 2 the Hammersmith Infant Neurological Examination (HINE), 3 and the neurofunctional assessment of Picciolini et al. 4 Little is known about the reliability of these widely used methods. 5 The validity of neurological assessments has been studied to some extent; marked neurological dysfunction during infancy has considerable power to predict developmental disability such as cerebral palsy (CP). [5][6][7] However, knowledge about the significance of signs of minor neurological dysfunction (MND) during infancy is scarce.Our knowledge of MND is based in particular on data of children above preschool age. Two distinct forms of MND have been distinguished: simple and complex MND.8 Before the onset of puberty the distinction is based on the number of dysfunctions present; after the onset of puberty classification is based on the type of dysfunction. Simple MND may be regarded as the expression of a normal but non-optimally functioning nervous system (minor neurological difference). In contrast, complex MND is the form of MND which is strongly related to pre-and perinatal adversities and to learning and behavioural disorders. From an aetiological point of view, this suggests that it may be considered as a borderline form of CP.8 It is uncertain whether the concept of simple ...