The ability of the Ages and Stages Questionnaire (ASQ) to indicate motor difficulties in infants in primary care.

INTRODUCTION: Delayed achievement of motor milestones may be an early indicator of motor difficulties. Parent-reported questionnaires may serve as an efficient, low-cost screening to identify infants in need of further clinical assessment, and thus be a helpful tool in busy health care centers. PURPOSE: To examine the ability of the Ages and Stages Questionnaire, second edition (ASQ-2) to indicate motor difficulties in infants using the Infant Motor Profile (IMP) as the reference standard. METHODS: A cross-sectional design was applied to examine the correlation between parent-reported data of the ASQ-2 and data from physiotherapist assessment using IMP. Included were 432 mainly low-risk infants aged 3-12 months from primary care. RESULTS: Overall, ASQ-2 gross and fine motor scores did not correlate well with the IMP total or domain scores. The ASQ-2 gross motor cut point (> 2SD below the mean), showed 34.3% sensitivity and 96.7% specificity using the 15th percentile from IMP performance domain as reference standard. The positive predictive value to indicate motor difficulties was 48%. CONCLUSION: The motor domains of ASQ-2 have poor ability to identify infants with motor difficulties as indicated by their IMP scores in low-risk infants.

Intra- and Inter-Rater Reliability of the Infant Motor Profile in Infants in Primary Health Care.

AIM: To explore intra-rater and inter-rater reliability of the Infant Motor Profile (IMP). The IMP is a video-based method assessing movement quality (movement variation, adaptability, symmetry and fluency) and motor skills in infants aged 3 to 18 months. METHOD: The IMP assessment was performed on 50 infants aged 3 to 12 months recruited in connection with health control in primary health care, mean gestational age at birth 39.4 weeks, mean birthweight 3462 g. Seven infants had a moderately increased risk of developmental disorders. Three pediatric physiotherapists performed independent rating of the video recordings. One rater assessed the video recordings twice with a four-week interval. RESULTS: Intraclass correlation coefficient (ICC) for intra-rater reliability was found satisfactory for the total IMP score (ICC = 0.95), and the domains: performance (ICC = 0.98), variation (ICC = 0.74), adaptability (ICC = 0.93) and fluency (ICC = 0.86). The ICC value for symmetry was 0.65. For inter-rater reliability, ICC values were satisfactory for the total IMP score (ICC = 0.86-0.91), and the domains: performance (ICC = 0.98), variation (ICC = 0.71-0.82), adaptability (ICC = 0.99) and fluency (ICC = 0.82-0.81). The ICC values for symmetry varied between 0.13-0.35. CONCLUSION: In this sample, including mostly low-risk infants, satisfactory intra- and inter-rater reliability for all domains were demonstrated, except for symmetry.