Alberta Infant Motor Scale

Instrument Name: Alberta Infant Motor Scale

Abbreviation: AIMS

Points for Consideration:

May be limited in what it assesses. Easy to administer, especially for children with stranger anxiety as compared to some other available measures. Concerns with sensitivity to change over time (does Not account for regression; Not appropriate for neurological challenge). Appropriate for clinical use, but Not necessarily for trials. With premature infants, can identify qualitative issues; early indicator of neuromuscular problems. Used in Pompeii (early trial).

Description of Tool:

The Alberta Infant Motor Scale (AIMS), an ObsRO, was constructed to measure gross motor maturation in infants from birth through independent walking. Based upon the literature, 58 items were generated and organized into four positions: prone, supine, sitting and standing. Each item describes three aspects of motor performance--weight-bearing, posture and antigravity movements.

Minimum Qualification Required by COA Administrator: MA or BA

Year: 1992

Objective of Development:

To measure gross motor maturation in infants from birth through independent walking

Population of Development: Age range (therapeutic indication):

0-18 months (Normal infants - Generic for Musculoskeletal Diseases)

Pediatric Population(s) in which COA has been used:

Nervous system diseases; Wounds and injuries; Female Urogenital Diseases and Pregnancy Complications; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Nutritional and Metabolic Diseases; Cardiovascular Diseases; Musculoskeletal Diseases; Virus Diseases; Pathological Conditions, Signs and Symptoms; Hemic and Lymphatic Diseases; Immune System Diseases; Respiratory Tract Diseases; Digestive System Diseases; Male Urogenital Diseases; Endocrine System Diseases; OtorhiNolaryngologic Diseases; Mental disorders

COA type:

Number of Items 58

Mode of Administration:

Data Collection Mode:

Time for Completion: 20 to 30 minutes

Response Scales: Dichotomous: Yes or No

Summary of Scoring:

Available scores: Global score: The sum of the 4 Motor Area composite standard scores is converted to a Total Motor Composite standard score (mean (M) =50; standard deviation (SD) =10), which is compared to reported scores of the norm group (a representative sample of 1,520 children and youth from across the USA). Confidence intervals, Percentile ranks, and Descriptive Categories (ranging from "Well-Below Average" to "Well-Above Average") are used to interpret the Total Motor Composite standard score. On the Record Form, the Total Motor Composite standard score with its corresponding confidence interval can be plotted on a Score Profile, relating it to the normal curve.

Scores by domains: Item raw scores are converted to point scores which are summed within each subtest to generate total point scores. Each subtest total point score is converted to a scale score (M=15; SD=5) and the sum of all scale scores within a Motor Area composite is converted to a Standard Score (M=50; SD=10). Confidence intervals, Percentile ranks, Age equivalents, and Descriptive Categories (ranging from "Well-Below Average" to "Well-Above Average") are used to interpret scale and standard scores. On the Record Form, scale and standard scores with their corresponding confidence intervals can be plotted on a Score Profile, relating the scores to the normal curve. Pairwise comparisons between Motor Area composites and between subtests can also be examined for statistical significance and frequency of difference, to identify a personal strength or weakness

Weighting: No

Score Interpretation: Higher score = Better motor skills

Evidence of Literature Review: Yes

Evidence of Instrument Review: None identified

Evidence of Clinical or Expert Input: Yes

Evidence of concept elicitation in target patient population: None identified

Evidence of a Saturation Grid: None identified

Evidence for Selection of Data Collection Method: None identified

Recall/Observation Period:

Evidence for Selection of Reponse Options: None identified

Evidence of cognitive interviewing of draft instrument in target patient population: None identified

Evidence of Preliminary Scoring of Items and Domains: Yes

Evidence related to respondent and administrator burden: Yes

Evidence of a Conceptual Framework: None identified

Evidence of an item-tracking matrix: None identified

Evidence related to item selection: Yes

Evidence of re-testing the final version: None identified

Internal consistency (Cronbach's alpha): None identified

Test-retest Reliability (ICC):

Piper (1992)
- Correlation Coefficient used: Not stated. Adjusted reliability ranged from 0.987 to 0.996; p Not stated for all results
- Was a definition of stability applied to identify stable patients: No
- Time frame or interval between the two administrations: Within 7 days
- Population/Disease: Normal infants (age range 0-18 months); n= 233

Inter-rater/ inter-interviewer reliability (kappa):

Piper (1992)
Inter-rater reliability
- Correlation Coefficient used: Not stated. Adjusted reliability ranged from 0.996 to 0.998; p Not stated for all results
- Population/Disease: Normal infants (age range 0-18 months); n= 221

Evidence of test-retest or inter-rater reliability: Yes

Concurrent validity (convergent, divergent):

Piper (1992)
- Correlation coefficient used: Pearson's correlation coefficient
- Measure: Bayley Psychomotor Developmental Scale; Peabody Developmental Motor Scale
- Results: p Not stated for all results
- Correlation between the AIMS and the Bayley Scale was r= 0.98
- Correlation between the AIMS and the Peabody Scale was r= 0.97
- Population/Disease: Normal infants (age range 0-13 months); n= 120

Known-group validity:

None identified

Evidence of Translatability Assessment: None identified

Evidence related to missing data: None identified

Evidence for Selection of Recall Period: Yes

Evidence of Administration Instructions and Training Provided: Yes

Evidence of concurrent validity: Yes

Evidence of known-groups validity: None identified

Evidence of ability to detect change over time: None identified

Ability to detect change (Responsiveness):

None identified

Evidence of responder thresholds: None identified

Piper MC, Pinnell LE, Darrah J, Maguire T, Byrne PJ. Construction and validation of the Alberta Infant Motor Scale (AIMS). Can J Public Health. 1992 Jul-Aug;83 Suppl 2:S46-50 (PubMed Abstract: http://www.ncbi.nlm.nih.gov/pubmed/1468050)

See (PubMed results: https://pubmed.ncbi.nlm.nih.gov/?term=%22Alberta%20Infant%20Motor%20Scale%22&sort=pubdate)

Yes

Myozyme, Alglucosidase Alfa (FDA, 2006)
Results:
Published in the label/SPC: 29-Mar-2006
AIMS-assessed gains in motor function occurred in 13 patients. In the majority of patients, motor function was substantially delayed compared to Normal infants of comparable age. The continued effect of MYOZYME treatment over time on motor function is unkNown. Two of 9 patients who had demonstrated gains in motor function after 12 months of MYOZYME treatment and continued to be followed regressed despite treatment.

Myozyme, Alglucosidase Alfa (EMA, 2006)
Results:
Study 1: Published in the label/SPC: 28-Apr-2006
Infantile-onset Pompe disease; clinical trial in patients aged 6 months or less (AGLU01602):
As measured by motor performance age-equivalent scores of the Alberta Infant Motor Scale (AIMS), seven of the 18 patients made motor development gains during the study and were walking independently by the last study assessment (with individual patient treatment durations ranging from 52 to 130 weeks; mean follow-up period of 94 weeks). An additional 4 patients made motor development gains during the study and were sitting independently by the last study assessment (with individual patient treatment durations ranging from 78 to 130 weeks; mean follow-up period of 110 weeks), although they did Not have functional use of the legs. The remaining 7 patients made No clinically significant motor gains or were unable to sustain the motor gains made and had very limited motor movement by the last study assessment (with individual patient treatment durations ranging from 52 to 142 weeks; mean follow-up period of 103 weeks). Analyses of efficacy did Not reveal meaningful differences between the 2 dose groups with respect to survival, invasive ventilator-free survival, any ventilator-free survival, decrease in LVM, gains in growth parameters and acquisition of motor milestones. Based on these results the 20 mg/kg qow dose is recommended.

Infantile-onset Pompe disease; clinical trial in patients aged 6 months to 3.5 years (AGLU01702):
After 52 weeks of treatment, 3 out of 8 patients with available data made gains in motor function over baseline as measured by raw scores and age-equivalent scores from baseline in the AIMS. Six of the 11 patients with available data continued to make motor development gains beyond Week 52 (with individual patient treatment durations ranging from 58 to 168 weeks; mean follow-up period of 121 weeks), including 3 patients ambulatory and 3 patients with only functional sitting skills by the last study visit. The remaining 5 patients showed No significant change in motor development beyond Week 52 (with individual patient treatment durations ranging from 104 to 168 weeks; mean follow-up period of 140 weeks), including 4 patients with No significant motor skills in any of the positions evaluated and 1 patient with only functional sitting skills by the last study visit. However, motor and respiratory responses to treatment have been more variable. Patients with infantile-onset Pompe disease who demonstrated motor gains, had greater preservation of motor function and lower glycogen content in the quadriceps muscle at baseline. It is Noteworthy that a higher proportion of patients with better motor outcomes show stability or improvement in growth parameters (weight), while the large majority of patients, regardless of their motor outcomes or baseline features, show reversal of cardiomyopathy as measured by changes in LVM Z-score. The totality of the data suggests that early diagNosis and treatment at an early stage of disease may be critical to achieve the best outcomes in these infantile onset patients.

Lumizyme, Alglucosidase Alfa (FDA, 2010)
Results:
Published in the label/SPC: 24-May-2010
Other outcome measures in this study included unblinded assessments of motor function by the Alberta Infant Motor Scale (AIMS), a measure of infant motor performance that assesses motor maturation of the infant through age 18 months. Although gains in motor function were Noted in 13 patients, the motor function was substantially delayed compared to Normal infants of comparable age in the majority of patients. Two of 9 patients who had initially demonstrated gains in motor function after 12 months of alglucosidase alfa treatment regressed despite continued treatment.

Original: English for Canada

Translations:
None identified

Chinese for China
Wang H, Li H, Wang J, Jin H. Reliability and Concurrent Validity of a Chinese Version of the Alberta Infant Motor Scale Administered to High-Risk Infants in China. Biomed Res Int. 2018 Jun 13;2018:2197163 (Full text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020663/pdf/BMRI2018-2197163.pdf)

Portuguese for Brazil
Saccani R, Valentini NC. Reference curves for the Brazilian Alberta Infant Motor Scale: percentiles for clinical description and follow-up over time. J Pediatr (Rio J). 2012 Jan-Feb;88(1):40-7 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/22057554/)

Valentini NC, Saccani R. Brazilian validation of the Alberta Infant Motor Scale. Phys Ther. 2012 Mar;92(3):440-7 (Full text article: https://watermark.silverchair.com/ptj0440.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAaMwggGfBgkqhkiG9w0BBwagggGQMIIBjAIBADCCAYUGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMXw3LdnEizOnuczuOAgEQgIIBVhmnCJm4T-_udjjKFg1qiOagfB8JzDVKEqlcPEPXvtfoGNPzCWA7IGhJvZpTpcWQIjz9iDlf7ElN2KuSjZ331qzFieR0BwzfjG3LgFWYuewmAqp5D8Gj57OSjRIB8GcbpstxsHHRSjU9LlPY7ELr1U7oFvBgzqI3PPZXd0rit76v8_KyjI7UNSSTUHd6Lsx8XryAZfMwwLsOmhATfn0oXjp9wkaWSLGSnr9FU2o_uvdl5t3D3Oxo-xXgN9frEp6-TrWt5cFXXgyI3K3nmpjQa9R13T-HCljCZYEgou9nTp1i944OmxFJFzjjpTP6y_4HWqmWmqHsoQAYNtF71TdtGO5RDNHyqfDi2kYRsMvaovq4pTaVpHtlj0g0mBJ759Mrq43IUTqhCpHhnjwZLRfKheM8UTgkWpH98wwOD86mzXvrRpD5rB6yNU3P_D02X025O7goVc6Llw)

Saccani R, Valentini NC. Cross-cultural analysis of the motor development of Brazilian, Greek and Canadian infants assessed with the Alberta Infant Motor Scale. Rev Paul Pediatr. 2013 Sep;31(3):350-8 (Full text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182973/pdf/0103-0582-rpp-31-03-00350.pdf)

Saccani R, Valentini NC, Pereira KR. New Brazilian developmental curves and reference values for the Alberta infant motor scale. Infant Behav Dev. 2016 Nov;45(Pt A):38-46 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/27636655/)

Chiquetti EMDS, Valentini NC, Saccani R. Validation and Reliability of the Test of Infant Motor Performance for Brazilian Infants. Phys Occup Ther Pediatr. 2020;40(4):470-485 (Full text article: https://pubmed.ncbi.nlm.nih.gov/31928290/)

Serbian for Serbia
Lackovic M, Nikolic D, FilimoNovic D, Petronic I, Mihajlovic S, Golubovic Z, Pavicevic P, Cirovic D. Reliability, Consistency and Temporal Stability of Alberta Infant Motor Scale in Serbian Infants. Children (Basel). 2020 Mar 2;7(3):16 (Full text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7140807/pdf/children-07-00016.pdf)

Spanish for Spain
Morales-Monforte E, Bagur-Calafat C, Suc-Lerin N, Fornaguera-Martí M, Cazorla-Sánchez E, Girabent-Farrés M. The Spanish version of the Alberta Infant Motor Scale: Validity and reliability analysis. Dev Neurorehabil. 2017 Feb;20(2):76-82 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/28125359/)

Thai for Thailand
Aimsamrarn P, Janyachareon T, Rattanathanthong K, Emasithi A, Siritaratiwat W. Cultural translation and adaptation of the Alberta Infant Motor Scale Thai version. Early Hum Dev. 2019 Mar;130:65-70 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/30703619/)

Tupsila R, Bennett S, Mato L, Keeratisiroj O, Siritaratiwat W. Gross motor development of Thai healthy full-term infants aged from birth to 14 months using the Alberta Infant Motor Scale: Inter individual variability. Early Hum Dev. 2020 Dec;151:105169 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/32920281/)

Bibliographic references of studies outside Canada:
Belgium
De Kegel A, Peersman W, Onderbeke K, Baetens T, Dhooge I, Van Waelvelde H. New reference values must be established for the Alberta Infant Motor Scales for accurate identification of infants at risk for motor developmental delay in Flanders. Child Care Health Dev. 2013 Mar;39(2):260-7 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/22676145/)

Greece
Syrengelas D, Siahanidou T, Kourlaba G, Kleisiouni P, Bakoula C, Chrousos GP. Standardization of the Alberta infant motor scale in full-term Greek infants: Preliminary results. Early Hum Dev. 2010 Apr;86(4):245-9 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/20452736/)

Saccani R, Valentini NC. Cross-cultural analysis of the motor development of Brazilian, Greek and Canadian infants assessed with the Alberta Infant Motor Scale. Rev Paul Pediatr. 2013 Sep;31(3):350-8 (Full text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182973/pdf/0103-0582-rpp-31-03-00350.pdf)

Syrengelas D, Kalampoki V, Kleisiouni P, KonstantiNou D, Siahanidou T. Gross motor development in full-term Greek infants assessed by the Alberta Infant Motor Scale: reference values and socioecoNomic impact. Early Hum Dev. 2014 Jul;90(7):353-7 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/24796209/)

Syrengelas D, Kalampoki V, Kleisiouni P, Manta V, Mellos S, Pons R, Chrousos GP, Siahanidou T. Alberta Infant Motor Scale (AIMS) Performance of Greek Preterm Infants: Comparisons With Full-Term Infants of the Same Nationality and Impact of Prematurity-Related Morbidity Factors. Phys Ther. 2016 Jul;96(7):1102-8 (Full text article: https://academic.oup.com/ptj/article/96/7/1102/2864930)

Japan
Uesugui M, Tokuhisa K, Shimada T. The reliability and validity of the Alberta Infant Motor Scale in Japan. J Phys Ther Sci. 2008;20:169–175 (Full text article: https://www.jstage.jst.go.jp/article/jpts/20/3/20_3_169/_pdf)

The Netherlands
K.M. Fleuren, L.S. Smit, T. Stijnen, A. Hartman. New reference values for the Alberta Infant Motor Scale need to be established. Acta Paediatr. 2007. 96: 424-427

Suir I, Boonzaaijer M, Nijmolen P, Westers P, Nuysink J. Cross-Cultural Validity: Canadian Norm Values of the Alberta Infant Motor Scale Evaluated for Dutch Infants. Pediatr Phys Ther. 2019 Oct;31(4):354-358 (PubMed abstract :https://pubmed.ncbi.nlm.nih.gov/31568382/)

Gontijo APB, Mancini MC. Commentary on "Cross-Cultural Validity: Canadian Norm Values of the Alberta Infant Motor Scale Evaluated for Dutch Infants". Pediatr Phys Ther. 2019 Oct;31(4):359 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/31568383/)

van Iersel PAM, la Bastide-van Gemert S, Wu YC, Hadders-Algra M. Alberta Infant Motor Scale: Cross-cultural analysis of gross motor development in Dutch and Canadian infants and introduction of Dutch Norms. Early Hum Dev. 2020 Dec;151:105239 (Full text article: https://www.sciencedirect.com/science/article/pii/S0378378220306113?via%3Dihub)

Taiwan
Jeng SF, Yau KI, Chen LC, Hsiao SF. Alberta infant motor scale: reliability and validity when used on preterm infants in Taiwan. Phys Ther. 2000 Feb;80(2):168-78 (PubMed abstract: https://pubmed.ncbi.nlm.nih.gov/10654063/)

Author
Johanna Darrah
University of Alberta
116 St. and 85 Ave.
Edmonton
AB
T6G 2R3
Canada
E-mail: johanna.darrah@ualberta.ca

Contact:
Elsevier
Phone: (+1) 800-523-4069 x 3808
E-mail: H.Licensing@elsevier.com

Copyright:
Instrument copyrighted by Elsevier

CoU:
Please contact Elsevier directly

https://www.us.elsevierhealth.com/alberta-infant-motor-scale-score-sheets-aims-9780323798426.html

AIMS' webpage: https://www.us.elsevierhealth.com/alberta-infant-motor-scale-score-sheets-aims-9780323798426.html

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