Summary:
Background: The Alberta Infant Motor Scale (AIMS) is a norm-referenced test
that assesses, via observation, the spontaneous motor performance of infants
from birth through independent walking (0-19 months). The AIMS was created by
Piper M and Darrah J and was based on the evaluation of a full term infant
population derived from Alberta, Canada. The basic pre-condition of the
application of a motor performance scale in the population of a country, is its
previous standardization in that country’s population.
Aim: The objectives of this study were 1) to standardize the Alberta Infant
Motor Scale (AIMS) for Greek full term and preterm infants from 1 to 19 months
of age, 2) to explore the association between socioeconomic/demographic
parameters and AIMS scores, and 3) to assess the effect of preterm neonatal
morbidity factors on AIMS scores and thus on the development of infant motor
performance.
Material-Methods: For this research a sample of 1068 Greek full term infants
(602 boys and 466 girls) aged 7 days to 19 months, as well as a sample of 403
Greek preterm infants (251 boys and 152 girls) with a corrected age of 1 to 19
months, were evaluated using the AIMS scale. The sample was derived from
maternity clinics, pediatric clinics, neonatal intensive care units (NICU) and
follow-up clinics, public and private day care centers, and private
pediatricians’ practices from various prefectures of Attica, Greece and from
all socio-economic backgrounds, in order to ensure a random sample of
representative nature. The sample was stratified according to the infants’ age
at the date of the evaluation. For each age group the mean AIMS scores were
calculated and compared with the original sample of Piper and Darrah using
(t-test). Comparisons between preterm and full-term infants were implemented
for each age group, from 1 to 19 months (t-test). Linear regression was used to
explore the impact of socioeconomic parameters on AIMS scores for the full term
infants, using the total AIMS score as dependent variable, while hierarchical
regression analysis was used to identify possible factors influencing the total
AIMS scores in preterm infants.
Results: With regard to reliability control checks, a satisfactory number of
test-retest reliability [ICC: 0.998, (95% CI: 0.997-0.999)] and inter-rater
reliability [ICC: 0.996, (95% CI: 0.995-0.997)] indicators were observed. No
statistically significant differences in the mean AIMS scores were detected
between the Greek and Canadian full term infants, for any monthly age level.
Maternal educational level and person responsible for the infants’ care had a
significant impact on infants motor development (p=0.02 and p<0.0001,
respectively). The differences between AIMS scores of the premature versus the
full term Greek infant population yielded a statistically significant result
(p<0.0001) favoring the latter. Hierarchical regression analysis showed that
neonatal morbidity factors such as RDS, IVH and ROP, as well small for
gestational age, had a significant influence on AIMS scores in preterm infants.
Conclusions: Gross motor development of healthy Greek full-term infants,
assessed by AIMS during the first 19 months of age, follows a similar course to
that of the original Canadian sample. Specific socioeconomic factors are
associated with the infants' motor development. Gross motor development is
inferior in preterm than in full term infants and is negatively correlated with
neonatal morbidity factors including RDS, IVH and ROP and low birth weight.
According to the results of this study, the AIMS scale appears to constitute a
reliable tool for the evaluation of gross motor development of Greek preterm
and full term infants.
Keywords:
Alberta Infant Motor Scale, Gross motor development, Reference values full term infants , Reference values preterm infants
