Concurrent and predictive validity of the infant motor profile in infants at risk of neurodevelopmental disorders

Abstract

Background Preterm infants and infants with perinatal brain injury show a higher incidence of neurodevelopmental disorders (NDD). The Infant Motor Profile (IMP) is a clinical assessment which evaluates the complexity of early motor behaviour. More data are needed to confirm its predictive ability and concurrent validity with other common and valid assessments such as the Alberta Infant Motor Scale (AIMS) and Prechtl’s General Movement Assessment (GMA). The present study aims to evaluate the concurrent validity of the IMP with the AIMS, to assess its association with the GMA, to evaluate how the IMP reflects the severity of the brain injury and to compare the ability of the IMP and the AIMS to predict an abnormal outcome in 5-month-old infants at risk of NDD. Methods 86 infants at risk of NDD were retrospectively recruited among the participants of two clinical trials. Preterm infants with or without perinatal brain injury and term infants with brain injury were assessed at 3 months corrected age (CA) using the GMA and at 5 months CA using the IMP and the AIMS. The neurodevelopmental outcome was established at 18 months. Results Results confirm a solid concurrent validity between the IMP Total Score and the AIMS (Spearman’s ρ 0.76; p < .001) and a significant association between IMP Total Score and the GMA. Unlike the AIMS, the IMP Total score accurately reflects the severity of neonatal brain injury (p < .001) and proves to be the strongest predictor of NDD (p < .001). The comparison of areas under receiver operating characteristic curves (AUC) confirms that the IMP Total score has the highest diagnostic accuracy at 5 months (AUC 0.92). For an optimal IMP Total Score cut-off value of 70, the assessment shows high sensitivity (93%) and specificity (81%) (PPV 84%; NPV 90%). Conclusions Early motor behaviour assessed with the IMP is strongly associated with middle-term neurodevelopmental outcome. The present study confirms the concurrent validity of the IMP with the AIMS, its association with the GMA and its ability to reflect brain lesion load, hence contributing to the construct validity of the assessment. Trial registration NCT01990183 and NCT03234959 (clinicaltrials.gov).

Active head lifting from supine in infancy in the general population: Red flag or not?

“…Yet, AHLS with stereotyped leg movements, i.e., the pattern that van Haastert et al described, was associated with a doubling of the risk of low IMP-variation scores. From other studies we know that lower scores on movement variation in infancy are associated with atypical neurodevelopmental outcome, including lower cognitive scores at later age [17][18][19][20]. Thus, our data support the notion that AHLS with stereotyped leg movements may be associated with lower cognitive scores at later age.…”

Early Diagnostics and Early Intervention in Neurodevelopmental Disorders—Age-Dependent Challenges and Opportunities

“…Two retrospective clinical studies addressed IMPs prediction of CP. They showed that low IMP scores predicted CP well, one study reported areas under the receiver-operating characteristic curves: 0.89-0.99 [109], the other a sensitivity of 93% and a specificity of 81% [110]. Low IMP scores also have been associated with lower IQ scores at preschool and school age [111,112].…”

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