Timing, duration, and severity of iron deficiency in early development and motor outcomes at 9 months.

BACKGROUND/OBJECTIVES: Poorer motor development is reported in infants with iron deficiency (ID). The role of timing, duration and severity is unclear. We assessed relations between ID timing, duration, and severity and gross motor scores, neurological integrity, and motor behavior quality at 9 months. SUBJECTS/METHODS: Iron status was determined at birth and 9 months in otherwise healthy term Chinese infants. The 9-month motor evaluation included the Peabody Developmental Motor Scale (PDMS-2), Infant Neurological International Battery (INFANIB), and motor quality factor. Motor outcomes were analyzed by ID timing (fetal-neonatal, infancy), duration, and severity. For severity, we also considered maternal iron status. RESULTS: The data were available for 1194 infants. Iron status was classified as fetal-neonatal and infancy ID (n = 253), fetal-neonatal ID (n = 256), infancy ID (n = 288), and not ID (n = 397). Compared with not ID, infants with fetal-neonatal or infancy ID had lower locomotion scores (effect size ds = 0.19, 0.18) and those with ID in both periods (longer duration) had lower locomotion and overall PDMS-2 gross motor scores (ds = 0.20, 0.18); ID groups did not differ. More severe ID in late pregnancy was associated with lower INFANIB Vestibular function (p = 0.01), and total score (p = 0.03). More severe ID in infancy was associated with lower scores for locomotion (p = 0.03), overall gross motor (p = 0.05). CONCLUSIONS: Fetal-neonatal and/or infancy ID was associated with lower overall gross motor development and locomotion test scores at 9 months. Associations with ID severity varied by ID timing: more severe ID in late pregnancy, poorer neurological integrity; more severe ID in infancy, poorer gross motor development.

Iron Supplementation in Pregnancy or Infancy and Motor Development: A Randomized Controlled Trial.

BACKGROUND AND OBJECTIVE: Insufficient iron levels for optimal fetal and infant development is a concern during pregnancy and infancy. The goal of this study was to assess the effects of iron supplementation in pregnancy and/or infancy on motor development at 9 months. METHODS: The study was a randomized controlled trial (RCT) of infancy iron supplementation linked to an RCT of pregnancy iron supplementation, conducted in Hebei, China. A total of 1482 infants were randomly assigned to receive placebo (n = 730) or supplemental iron (n = 752) from 6 weeks to 9 months. Gross motor development (assessed by using the Peabody Developmental Motor Scale, Second Edition, instrument) was the primary outcome. Neurologic integrity and motor quality were secondary outcomes. RESULTS: Motor outcome was available for 1196 infants, divided into 4 supplementation period groups: (1) placebo in pregnancy/placebo in infancy (n = 288); (2) placebo in pregnancy/iron in infancy (n = 305); (3) iron in pregnancy/placebo in infancy (n = 298); and (4) iron in pregnancy/iron in infancy (n = 305). Using the Peabody Developmental Motor Scale, instrument, iron supplementation in infancy but not pregnancy improved gross motor scores: overall, P < .001; reflexes, P = .03; stationary, P < .001; and locomotion, P < .001. Iron supplementation in infancy improved motor scores by 0.3 SD compared with no supplementation or supplementation during pregnancy alone. Effects of iron supplementation in infancy alone were similar to effects with iron in both pregnancy and infancy. CONCLUSIONS: The RCT design supports the causal inference that iron supplementation in infancy, with or without iron supplementation in pregnancy, improved gross motor test scores at 9 months.

The new affordances in the home environment for motor development - infant scale (AHEMD-IS): Versions in English and Portuguese languages.

The home environment has been established as a crucial factor for motor development, especially in infants. Exploring the home environment can have significant implications for intervention, as it is common practice in physical therapy to have professionals advise patients on home activities. Since 2010, our group has been working on the development of the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS), a parental self-reporting instrument designed to assess the quality and quantity of factors (affordances) in the home environment. In Brazil, the instrument has been translated as "Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê", and it has been extensively used in several studies that address infant development. These studies in Brazil and other parts of the world highly recommended the need for a normative sample and standardized scoring system. A description of the study that addressed that need, along with the English version of the questionnaire and score sheets, was recently published in the well-known and respected journal Physical Therapy. Our intent with the present short communication is to notify Brazilian investigators and clinicians of this latest update so they can download the new instrument, as well as present the Brazilian (Portuguese) version of the AHEMD-IS along with its scoring system.

Comparações entre o desempenho motor e oportunidades de estimulação motora no ambiente domiciliar de lactentes residentes nas regiões Sudeste e Norte do Brasil / Comparaciones del desempeño motor y oportunidades de estimulación motora en el entorno del hogar de lactantes moradores en las regiones Sureste y Norte de Brasil / Comparisons between motor performance and opportunities for motor stimulation in the home environment of infants from the North and Southwest regions in Brazil

A proposta deste estudo foi comparar as relações entre o desempenho motor e as características do ambiente familiar (espaço físico, atividades diárias, brinquedos) de lactentes residentes em duas regiões do Brasil, Norte (Marabá, PA) e Sudeste (Piracicaba, SP). Foram utilizados a Alberta Infant Motor Scale (AIMS) para a análise do desempenho motor e o Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS) para a análise do ambiente familiar em oitenta lactentes de 3 a 18 meses de idade. Os grupos dos dois municípios não diferiram quanto ao desempenho motor (p>0,05), porém, foram encontradas diferenças significativas entre os grupos no que se refere à frequência em creches, à escolaridade paterna e ao número de quartos nas residências. Os resultados também indicaram diferenças significativas para as oportunidades no lar, com o grupo de Marabá obtendo pontuações significativamente menores na maior parte do AHEMD-IS: espaço externo (p=0,021), brinquedos para motricidade fina (p<0,001) e grossa (p<0,001), e o escore total do AHEMD-IS (p=0,002). Não foram encontradas diferenças entre os grupos nas atividades diárias e no espaço interno da residência. O desempenho motor e as oportunidades no ambiente domiciliar (total do AHEMD-IS) demonstraram uma correlação fraca tanto para o grupo de Marabá (r=0,33; p=0,03) quanto para o grupo de Piracicaba (r=0,45; p<0,001). Em conclusão, apesar dos grupos apresentarem níveis de desenvolvimento motor similares, o grupo de lactentes em Marabá apresentou menos affordances (oportunidades de ação) comparados aos residentes de Piracicaba, o que, no futuro, pode resultar em diferenças no desempenho motor dos grupos.

En este estudio tuvo el propósito de comparar las relaciones entre el desempeño motor y las características del entorno del hogar (el espacio físico, las actividades diarias, los juguetes) de lactantes moradores en dos regiones de Brasil, el Norte (Marabá, PA) y el Sureste (Piracicaba, SP). Se utilizaron el Alberta Infant Motor Scale (AIMS) para el desempeño motor y el Affordances in the Home Environment for Motor Development Infant Scale (AHEMD-IS) para el análisis del entorno del hogar en ochenta lactantes de 3 hasta 18 meses de edad. Los grupos de los dos municipios no presentaron diferencias significativas en relación al desempeño motor (p>0,05), sin embargo, se encontraron diferencias significativas en lo que se refiere a la asistencia a guardería, al nivel de educación del padre y al número de habitaciones en sus casas. Los resultados también mostraron diferencias significativas en las oportunidades en los hogares, el grupo de Marabá obtuvo puntuaciones significativamente menores en la mayor parte del AHEMD-IS: espacio externo (p=0,021), juguetes para habilidades motoras finas (p<0,001) y gruesas (p<0,001), y el escore total del AHEMD-IS (p=0,002). En cuanto a las actividades diarias y al espacio interno de las casas no se encontraron diferencias. El desempeño motor y las oportunidades en el entorno del hogar (total del AHEMD-IS) mostraron una correlación baja tanto para el grupo del Marabá (r=0,33; p=0,03) como para el de Piracicaba (r=0,45; p<0,001). Aunque los grupos presentaron niveles semejantes de desarrollo motor, se concluyó que el grupo de lactantes de Marabá presentó menos affordances (oportunidades de acción) que el de Piracicaba, lo que puede resultar en diferencias para su futuro en relación al desempeño motor de los grupos.

This study aimed at comparing the relationships between motor development and the characteristics in the home environment (physical space, daily activities, toys) of infants in two Brazilian regions, North (Marabá, PA) and Southeast (Piracicaba, SP). Alberta Infant Motor Scale (AIMS) was used to analyze motor development, and Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS) was used in order to analyze the family environments of eight breastfeed babies of 3 to 18 months of age. The groups in the two municipalities were not different in regards to motor development (p<0.05); however, significant differences were found among groups concerning day care frequency, fatherly schooling, and number of rooms in households. The results also indicated significant differences for opportunities at home, with the group from Marabá receiving significantly lower scores for the most part of the AHEMD-IS: external space (p=0.021), toys for fine motor skills (p<0.001), and total AHEMD-IS score (p=0.002). No differences were found among groups in daily activities and the internal space of homes. Motor development and opportunities in the home environment (total AHEMD-IS) were found to have weaker correlations for both the group from Marabá (r=0.33; p=0.03) and the group from Piracicaba (r=0.45; p<0.001). In summary, although both groups had similar motor development levels, the group of infants from Marabá was found to have fewer affordances (opportunities for action) as compared to the ones living in Piracicaba, which may result in differences in the motor development of the groups in the future.

Further Development and Validation of the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS).

BACKGROUND: Affordances in the home environment may play a significant role in infant motor development. OBJECTIVE: The purpose of this study was to further develop and validate the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS), an inventory that measures the quantity and quality of motor affordances in the home. DESIGN: A cross-sectional study was conducted to evaluate criteria for content validity, reliability, internal consistency, floor and ceiling effects, and interpretability of the instrument. METHODS: A pilot version of the inventory with 5 dimensions was used for expert panel analysis and administered to parents of infants (N=419). Data were analyzed with Cronbach alpha, intraclass correlation coefficients (ICCs), ceiling and floor effects, and item and dimension interpretability analyses for creation of a scoring system with descriptive categories for each dimension and total score. RESULTS: Average agreement among the expert panel was 95% across all evaluation criteria. Cronbach alpha values with the 41-item scale ranged between .639 and .824 for the separate dimensions, with a total value of .824 (95% confidence interval [95% CI]=.781, .862). The ICC values were .990 for interrater reliability and .949 for intrarater reliability. There was a ceiling effect on 3 questions for the Inside Space dimension and on 3 questions for the Variety of Stimulation dimension. These results demonstrated the need for reduction in total items (from 41 to 35) and the combination of space dimensions. After removal of questions, internal consistency was .766 (95% CI=.729, .800) for total score. Overall assessment categories were created as: less than adequate, moderately adequate, adequate, and excellent. LIMITATIONS: The inventory does not determine specific use (time, frequency) of affordances in the home, and it does not account for infants' out-of-home activities. CONCLUSIONS: The AHEMD-IS is a reliable and valid instrument to assess affordances in the home environment that promote infant motor development.

Family socioeconomic status and the provision of motor affordances in the home.

BACKGROUND: Socioeconomic status (SES) and stimulation provided in the home environment are influential factors in aspects of child well-being including motor development. Little is known regarding the influence of SES on specific aspects of the home environment. OBJECTIVE: To evaluate the availability of affordances in the home to promote infant motor development and family SES. METHOD: The sample consisted of 300 families with infants aged 3 to 18 months. SES was assessed according to family socioeconomic class, income and parental level of education. To evaluate motor affordances found at home, the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) was used. The AHEMD-IS was designed to assess dimensions of the home environment including Physical Space (outside and inside space), Daily Activities and Play Materials (fine-motor and gross-motor toys). RESULTS: SES indicators significantly influenced the availability of Physical Space and Play Materials. The Physical Space dimension was influenced by family economic class and income. The Play Materials dimension was influenced by all SES indicators. Daily Activities were not influenced by any of the SES indicators. Daily activities and play material were influenced by the infant's age. CONCLUSIONS: This study suggests that SES indicators are influential with regard to the provision of motor affordances in the home environment for infants. However, daily activities, which represent an aspect of the environment that is highly dependent on parental generation of situations that are conducive to motor skill development, are independent of family SES.

Family socioeconomic status and the provision of motor affordances in the home

BACKGROUND: Socioeconomic status (SES) and stimulation provided in the home environment are influential factors in aspects of child well-being including motor development. Little is known regarding the influence of SES on specific aspects of the home environment. OBJECTIVE: To evaluate the availability of affordances in the home to promote infant motor development and family SES. METHOD : The sample consisted of 300 families with infants aged 3 to 18 months. SES was assessed according to family socioeconomic class, income and parental level of education. To evaluate motor affordances found at home, the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) was used. The AHEMD-IS was designed to assess dimensions of the home environment including Physical Space (outside and inside space), Daily Activities and Play Materials (fine-motor and gross-motor toys). RESULTS: SES indicators significantly influenced the availability of Physical Space and Play Materials. The Physical Space dimension was influenced by family economic class and income. The Play Materials dimension was influenced by all SES indicators. Daily Activities were not influenced by any of the SES indicators. Daily activities and play material were influenced by the infant's age. CONCLUSIONS: This study suggests that SES indicators are influential with regard to the provision of motor affordances in the home environment for infants. However, daily activities, which represent an aspect of the environment that is highly dependent on parental generation of situations that are conducive to motor skill development, are independent of family SES. .

Effect of the home environment on motor and cognitive behavior of infants.

Although information is sparse, research suggests that affordances in the home provide essential resources that promote motor and cognitive skills in young children. The present study assessed over time, the association between motor affordances in the home and infant motor and cognitive behavior. Thirty-two (32) infants were assessed for characteristics of their home using the Affordances in the Home Environment for Motor Development--Infant Scale and motor and cognitive behavior with the Bayley Scales of Infant and Toddler Development--III. Infant's home and motor behavior were assessed at age 9 months and 6 months later with the inclusion of cognitive ability. Results for motor ability indicated that there was an overall improvement in performance from the 1st to the 2nd assessment. We found significant positive correlations between the dimensions of the home (daily activities and play materials) and global motor performance (1st assessment) and fine-motor performance on the 2nd assessment. In regard to cognitive performance (2nd assessment), results indicated a positive association with fine-motor performance. Our results suggest that motor affordances can have a positive impact on future motor ability and speculatively, later cognitive behavior in infants.

Development of the Affordances in the Home Environment for Motor Development-Infant Scale.

BACKGROUND: The present study reports the development and application of the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS), a parental self-report designed to assess the quantity and quality of affordances in the home environment that are conducive to motor development for infants aged 3-18 months. METHODS: Steps in its development included use of expert feedback, establishment of construct validity, interrater and intrarater reliability, and predictive validity. With all phases of the project, 113 homes were involved. RESULTS: Intraclass correlation coefficients for interrater and intrarater reliability for the total score were 1 and 0.94, respectively. In addition, results indicate that the test has the characteristic of differentiating a wide range of scores. Regression analysis for the AHEMD-IS and motor development using the Alberta Infant Motor Scale supports preliminary evidence for predictive validity. CONCLUSION: Our findings suggest that the AHEMD-IS has sufficient reliability and validity as an instrument for assessing affordances in the home environment, with clinical and research applications.

Assessment of global motor performance and gross and fine motor skills of infants attending day care centers.

OBJECTIVE: To analyze the global motor performance and the gross and fine motor skills of infants attending two public child care centers full-time. METHODS: This was a longitudinal study that included 30 infants assessed at 12 and 17 months of age with the Motor Scale of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). This scale allows the analysis of global motor performance, fine and gross motor performance, and the discrepancy between them. The Wilcoxon test and Spearman's correlation coefficient were used. RESULTS: Most of the participants showed global motor performance within the normal range, but below the reference mean at 12 and 17 months, with 30% classified as having "suspected delays" in at least one of the assessments. Gross motor development was poorer than fine motor development at 12 and at 17 months of age, with great discrepancy between these two subtests in the second assessment. A clear individual variability was observed in fine motor skills, with weak linear correlation between the first and the second assessment of this subtest. A lower individual variability was found in the gross motor skills and global motor performance with positive moderate correlation between assessments. Considering both performance measurements obtained at 12 and 17 months of age, four infants were identified as having a "possible delay in motor development". CONCLUSIONS: The study showed the need for closer attention to the motor development of children who attend day care centers during the first 17 months of life, with special attention to gross motor skills (which are considered an integral part of the child's overall development) and to children with suspected delays in two consecutive assessments.

Avaliação do desempenho motor global e em habilidades motoras axiais e apendiculares de lactentes frequentadores de creche / Assessment of global motor performance and gross and fine motor skills of infants attending day care centers

OBJETIVO: Analisar o desempenho motor global em habilidades motoras axiais e apendiculares de lactentes que frequentavam, em tempo integral, duas Escolas Municipais de Educação Infantil. MÉTODOS: Estudo longitudinal do qual participaram 30 lactentes avaliados aos 12 e 17 meses de vida com a escala motora das Bayley Scales of Infant and Toddler Development-III, que possibilita a análise do desempenho motor global, apendicular e axial e a discrepância entre eles. Utilizaram-se o teste de Wilcoxon e o Coeficiente de Correlação de Spearman. RESULTADOS: A maioria dos participantes apresentou desempenho motor global dentro dos limites de normalidade, porém abaixo da média de referência aos 12 e 17 meses, com 30 por cento classificados como suspeitos de atraso em pelo menos uma das avaliações. O desempenho motor axial foi inferior ao apendicular aos 12 e aos 17 meses, com grande discrepância entre eles especialmente na 2ª avaliação. Observou-se marcada variabilidade individual nas habilidades motoras apendiculares, com fraca correlação linear no desempenho entre a 1ª e a 2ª avaliações nesse domínio. Nas habilidades axiais e no desempenho motor global, encontrou-se menor variabilidade individual, com correlações moderadas e positivas entre a 1ª e a 2ª avaliações. Identificaram-se quatro lactentes com suspeita de atraso no desenvolvimento motor em ambas as avaliações. CONCLUSÕES: O estudo aponta necessidade de maior atenção ao desenvolvimento motor durante os primeiros 17 meses de crianças que frequentam creches, com especial vigilância à motricidade axial (considerando que ela é parte integrante do desenvolvimento global da criança) e às crianças com desempenho suspeito de atraso em duas avaliações consecutivas.

OBJECTIVE: To analyze the global motor performance and the gross and fine motor skills of infants attending two public child care centers full-time. METHODS: This was a longitudinal study that included 30 infants assessed at 12 and 17 months of age with the Motor Scale of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). This scale allows the analysis of global motor performance, fine and gross motor performance, and the discrepancy between them. The Wilcoxon test and Spearman's correlation coefficient were used. RESULTS: Most of the participants showed global motor performance within the normal range, but below the reference mean at 12 and 17 months, with 30 percent classified as having "suspected delays" in at least one of the assessments. Gross motor development was poorer than fine motor development at 12 and at 17 months of age, with great discrepancy between these two subtests in the second assessment. A clear individual variability was observed in fine motor skills, with weak linear correlation between the first and the second assessment of this subtest. A lower individual variability was found in the gross motor skills and global motor performance with positive moderate correlation between assessments. Considering both performance measurements obtained at 12 and 17 months of age, four infants were identified as having a "possible delay in motor development". CONCLUSIONS: The study showed the need for closer attention to the motor development of children who attend day care centers during the first 17 months of life, with special attention to gross motor skills (which are considered an integral part of the child's overall development) and to children with suspected delays in two consecutive assessments.

Motor performance of infants born small or appropriate for gestational age: a comparative study.

PURPOSE: To compare the motor performance of infants born small for gestational age (SGA) with those appropriate for gestational age (AGA) at 1, 2, 3, and 6 months. METHODS: A prospective cross-sectional study was conducted including infants born full-term, with birth weight under the 10th percentile for the SGA group and between the 10th and 90th percentiles for the AGA group. The Motor Scale of Bayley Scales of Infant Development-II was used to document motor performance. RESULTS: The SGA group presented a mean motor index score lower than the AGA group at 2 and 6 months, with the SGA group presenting fewer infants that successfully accomplished "makes crawling movements," "turns from side to back," "balances head," "sits alone momentarily," and "sits alone for 30 seconds." CONCLUSIONS: Data analysis suggested that infants who are SGA present greater risk of adverse outcomes that are detectable in motor performance measures at 2 months.

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

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 >or= 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.

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

OBJETIVO: 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 por cento) apresentaram desempenho motor inadequado. Considerando a classificação motora das BSID-II e o percentil 5 da AIMS, obteve-se sensibilidade = 100 por cento, especificidade = 78,37 por cento, acurácia = 81,39 por cento, índice kappa = 0,50 e p < 0,001; considerando a classificação motora das BSID-II e o percentil 10 da AIMS, obteve-se sensibilidade = 100 por cento, especificidade = 48,64 por cento, acurácia = 55,81 por cento, índice kappa = 0,20 e p = 0,025. CONCLUSÕES: Os resultados sugerem boa concordância entre os instrumentos de avaliação no sexto mês. A melhor combinação para os parâmetros analisados é a utilização do percentil 5 da AIMS.

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 percent) exhibited inadequate motor performance. Using the BSID-II motor classification and the 5th percentile AIMS cutoff, sensitivity was 100 percent, specificity 78.37 percent, accuracy 81.39 percent, kappa index 0.50 and p < 0.001; whereas, using the BSID-II motor classification and the 10th percentile AIMS cutoff, sensitivity was 100 percent, specificity 48.64 percent, accuracy 55.81 percent, 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.

Escalas padronizadas de avaliação do desenvolvimento neuromotor de lactentes / Standardized scales for the assessment of infants neuromotor development

O objetivo deste trabalho é apresentar as principais escalas de avaliação atuais que observam as aquisições neuromotoras, identificando as semelhanças e diferenças quanto a sua metodologia. Foram revisados artigos de 1980 a 2003, sendo observadas escalas de triagem de desenvolvimento como a Milani-Camparetti Development Screening Test e o Teste Seletivo de Desenvolvimento de Denver II. Outras escalas avaliaram a função neuromotora: Movement Assessment of Infant (MAI), Test of Infant Motor Performance (TIMP), Alberta Infant Motor Scale (AIMS), Gross Motor Function Measure (GMFM) e Gross Motor Performance Measure (GMPM), Harris Infant Neuromotor Test (HINT), Peabody Development Motor Scales. A literatura refere ainda escalas voltadas para o diagnóstico do desenvolvimento, mais abrangentes, que avaliam, além das funções neuromotoras, as funções mentais e o comportamento, como o Programa de Desenvolvimento de Gesell, as Bayley Scales of Infant Development II, a Escala de Desenvolvimento do Comportamento da Criança: o primeiro ano de vida e a Postural and Fine Movement Assessment of Infant. Existem, portanto, várias escalas para analisar a função neuromotora em diferentes idades, e cabe ao pesquisador selecionar e conhecer de forma cuidadosa a que melhor interage com a proposta metodológica de sua pesquisa.(AU)

The proposal of this study was to report current scales for the assessment of the neuromotor development, identifying similarities and differences related to their methodology Papers from 1980 to 2003 on the following scales were reviewed, and the Milani-Camparetti Development Screening Test and the Denver II Developmental Screening Test were studied. Other scales evaluated neuromotor function, such as Movement Assessment of Infants, Test of Infant Motor Performance (TIMP), Alberta Infant Motor Scale (AIMS), Gross Motor Function Measure (GMFM) e Gross Motor Performance Measure (GMPM), Harris Infant Neotomotor Test (HINT), and Peabody Development Motor Scales. Other scales evaluated the development of the behavior motor and mental functions, such as Gesell Developmental Program, Bayley Scales of Infant Development II, Escala de Desenvolvimento do Comportamento da Criança: o primeiro ano de vida, and the Postural and Fine Movement Assessment of Infant. Therefore, there are lots of scales that analyze the neoromotor function in different ages, and it is the researcher's responsibility to select and to know thoroughly the best scale that interacts with the methodological proposal of his research.(AU)

Escalas padronizadas de avaliação do desenvolvimento neuromotor de lactentes / Standardized scales for the assessment of infants neuromotor development

O objetivo deste trabalho é apresentar as principais escalas de avaliação atuais que observam as aquisições neuromotoras, identificando as semelhanças e diferenças quanto a sua metodologia. Foram revisados artigos de 1980 a 2003, sendo observadas escalas de triagem de desenvolvimento como a Milani-Camparetti Development Screening Test e o Teste Seletivo de Desenvolvimento de Denver II. Outras escalas avaliaram a função neuromotora: Movement Assessment of Infant (MAI), Test of Infant Motor Performance (TIMP), Alberta Infant Motor Scale (AIMS), Gross Motor Function Measure (GMFM) e Gross Motor Performance Measure (GMPM), Harris Infant Neuromotor Test (HINT), Peabody Development Motor Scales. A literatura refere ainda escalas voltadas para o diagnóstico do desenvolvimento, mais abrangentes, que avaliam, além das funções neuromotoras, as funções mentais e o comportamento, como o Programa de Desenvolvimento de Gesell, as Bayley Scales of Infant Development II, a Escala de Desenvolvimento do Comportamento da Criança: o primeiro ano de vida e a Postural and Fine Movement Assessment of Infant. Existem, portanto, várias escalas para analisar a função neuromotora em diferentes idades, e cabe ao pesquisador selecionar e conhecer de forma cuidadosa a que melhor interage com a proposta metodológica de sua pesquisa.

The proposal of this study was to report current scales for the assessment of the neuromotor development, identifying similarities and differences related to their methodology Papers from 1980 to 2003 on the following scales were reviewed, and the Milani-Camparetti Development Screening Test and the Denver II Developmental Screening Test were studied. Other scales evaluated neuromotor function, such as Movement Assessment of Infants, Test of Infant Motor Performance (TIMP), Alberta Infant Motor Scale (AIMS), Gross Motor Function Measure (GMFM) e Gross Motor Performance Measure (GMPM), Harris Infant Neotomotor Test (HINT), and Peabody Development Motor Scales. Other scales evaluated the development of the behavior motor and mental functions, such as Gesell Developmental Program, Bayley Scales of Infant Development II, Escala de Desenvolvimento do Comportamento da Criança: o primeiro ano de vida, and the Postural and Fine Movement Assessment of Infant. Therefore, there are lots of scales that analyze the neoromotor function in different ages, and it is the researcher's responsibility to select and to know thoroughly the best scale that interacts with the methodological proposal of his research.