Agreement between scales for screening and diagnosis of motor development at 6 months

Abstract

Objective: To ascertain the degree of agreement between a score for screening and another for diagnosis of motor development in 6-month old infants and to define the most appropriate cutoff point for screening.Methods: A sectional study, enrolling asymptomatic full term newborns with gestational ages from 37 to 41 weeks, who were discharged from the maternity unit 2 days after birth and are resident in the Campinas area. Infants were excluded if they presented genetic syndromes, malformations, congenital infections, intensive care admission or low birth weight. The assessment instruments investigated were the Alberta Infant Motor Scale (AIMS) and the Bayley Scales of Infant Development II (BSID-II). Two cutoff points were evaluated for the AIMS, the 5th and 10th percentiles, and for the BSID-II infants were classified according to its motor index score (IS) as having inadequate (IS < 85, at least 1 standard deviation below the mean) or adequate performance (IS ≥ 85, above the mean minus 1 standard deviation).Results: The study sample comprised 43 infants. Six infants (14.00%) exhibited inadequate motor performance. Using the BSID-II motor classification and the 5th percentile AIMS cutoff, sensitivity was 100%, specificity 78.37%, accuracy 81.39%, kappa index 0.50 and p < 0.001; whereas, using the BSID-II motor classification and the 10th percentile AIMS cutoff, sensitivity was 100%, specificity 48.64%, accuracy 55.81%, kappa index 0.20 and p 0.025. Conclusions:The results suggest that concordance between the two 6-month assessment scales is good. The parameters employed are best combined using the 5th percentile AIMS cutoff point. ResumoObjetivo: Verificar o grau de concordância entre uma escala de triagem e uma de diagnóstico do desenvolvimento motor de lactentes no sexto mês de vida, estabelecendo o ponto de corte mais apropriado para triagem.Métodos: Estudo seccional, incluindo recém-nascidos a termo, com idade gestacional entre 37 e 41 semanas, assintomáticos, que receberam alta da maternidade 2 dias após o nascimento, residentes na região de Campinas. Foram excluídas síndromes genéticas, malformações, infecções congênitas, internações em unidade de terapia intensiva e baixo peso ao nascimento. Os instrumentos de avaliação foram: Alberta Infant Motor Scale (AIMS) e Bayley Scales of Infant Development II (BSID-II). Para a AIMS, foram utilizados dois pontos de corte, percentil 5 ou 10 e, para as BSID-II, foi utilizada a classificação dos lactentes na escala motora conforme a pontuação do index score (IS): desempenho inadequado (IS < 85, abaixo de menos 1 desvio padrão da média) ou desempenho adequado (IS ≥ 85, maior ou igual a menos 1 desvio padrão da média).Resultados: A amostra foi constituída por 43 lactentes. Seis lactentes (14,00%) apresentaram desempenho motor inadequado. Considerando a classificação motora das BSID-II e o percentil 5 da AIMS, obteve-se sensibilidade = 100%, especificidade = 78,37%, acurácia = 81,39%, índice kappa = 0,50 e p < 0,001; considerando a classificação motora das BSID-...

Relationship Between Postural Control and Fine Motor Skills in Preterm Infants at 6 and 12 Months Adjusted Age

“…Finally, we investigated the relationship between postural control and fine motor skills for two groups of preterm infants, those with and without motor delays at 6 and 12 mo adjusted age. In this study, we identified preterm infants as being delayed in postural control if their AIMS score was lower than the fifth percentile ranking of the norm in their respective age group (Campos et al, 2006;Piper & Darrah, 1994).…”

Avaliação do desempenho motor de prematuros nos primeiros meses de vida na Escala Motora Infantil de Alberta (AIMS)

“…5 This scale, despite not having been validated for use with the Brazilian population, has been widely used by services that monitor premature newborn, due to its practicality. 10 This study followed a selected population of premature infants with minimal intercurrent conditions, free from acute clinical or neurological disease and meeting rigid inclusion/ exclusion criteria and did not observe any influence from birth weight on the motor abilities assessed by AIMS. One possible limitation may be the choice of cutoff point for stratifying the groups, at less than 1,750 g, rather than 1,500 g, as is habitually employed.…”

Diagnóstico precoce de anormalidades no desenvolvimento em prematuros: instrumentos de avaliação

“…The studies have demonstrated that the common profile found was below the normative sample proposed by the authors of the test, which means that there is need for further studies that can identify the causes of these differences. 56,57,[63][64][65] The AIMS is considered to be a quick test that is easy to administer, having a guidance manual available. The authors state that there is no need of training for physical and occupational therapists who work with children, but they recommend that other health professionals are trained by skilled professionals, which requires a longer period of training so that safe administration of the test is achieved.…”