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Evaluation of neuromotor function in infancy-A systematic review of available methods
Kirsten R Heineman1, Mijna Hadders-Algra
1Developmental Neurology, University Medical Center Groningen, Groningen, The Netherlands.
Insights
Assessing infant neuromotor function aids early detection of developmental disorders. Combining neurological exams, milestone observation, and motor behavior assessment offers the best predictive validity for infant development.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Infant Assessment
Background:
- Neuromotor function assessment in infancy is crucial for early detection of developmental disorders.
- Early detection allows timely intervention when the infant's nervous system plasticity is highest.
- Assessment tools also aid in monitoring intervention effectiveness.
Purpose of the Study:
- To review the psychometric properties of methods used to assess neuromotor function in infants.
- To evaluate the reliability and validity of various infant neuromotor assessment instruments.
Main Methods:
- A comprehensive literature search was conducted in PubMed, Medline, and PsycINFO databases.
- The search covered instruments for assessing infant neuromotor functioning from 1966 to 2007.
- Fifteen instruments were identified and categorized into four groups.
Main Results:
- Four groups of instruments were identified: comprehensive neurological examinations, procedures with standardized scoring, observation of milestones, and assessment of motor behavior quality.
- Neurological examinations showed good validity for major disorders but moderate for minor ones. Standardized scoring had moderate predictive validity.
- Assessment of motor behavior quality demonstrated the best predictive validity for both major and minor developmental motor disorders, particularly under four months of age.
Conclusions:
- Predicting developmental outcomes in infants remains challenging.
- A combination of complementary tools, including milestones, neurological examination, and motor behavior quality assessment, provides the most accurate predictions for high-risk infants.
Objective:
Neuromotor function in infancy can be evaluated in various ways. Assessment instruments are used for early detection of children with a high risk for developmental disorders. Early detection enables clinicians to provide intervention at a young age when plasticity of the nervous system is high. The assessments may also be used to monitor intervention. The present article will review the psychometric properties of methods to assess neuromotor function in infancy.
Method:
A literature search was performed in PubMed, Medline, and PsycINFO (1966-2007) on instruments to assess neuromotor functioning of infants.
Results:
Fifteen instruments were included and classified into 4 groups: (1) Comprehensive neurological examinations (n = 4). These techniques are widely used, though little is known about their reliability. Their validity in predicting major developmental disorders such as cerebral palsy is good; their predictive validity for minor motor disorders is moderate at best. (2) Procedures with standardized scoring (n = 7). These have good reliability, but only moderate predictive validity for major developmental disorders. No data available for prediction of minor developmental disorders. (3) Observation of milestones (n = 2). Its predictive validity for major developmental disorders is only moderate, whereas reliability is good. (4) Assessment of quality of motor behavior or motor patterns (n = 2). These instruments have the best predictive validity for major and minor developmental motor disorders, but current methods are only useful under the age of 4 months.
Conclusion:
Prediction of developmental outcome at an early age is difficult. In medical evaluations of high-risk infants, the best predictions are achieved through a combination of multiple, complementary tools, that is, achieved milestones, neurological examination and assessment of the quality of motor behavior.
