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Concurrent and predictive validity of the infant motor profile in infants at risk of neurodevelopmental disorders
Riccardo Rizzi1,2, Valentina Menici2, Maria Luce Cioni3
1Tuscan PhD Programme of Neuroscience, University of Florence, Pisa and Siena, Florence, Italy.
Insights
The Infant Motor Profile (IMP) accurately predicts neurodevelopmental disorders in infants at risk. This assessment shows strong validity and is a better predictor than the Alberta Infant Motor Scale (AIMS).
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Clinical assessment validation
Background:
- Infants born preterm or with perinatal brain injury have increased neurodevelopmental disorder (NDD) risk.
- The Infant Motor Profile (IMP) assesses early motor behavior complexity.
- Further validation of IMP against established tools like AIMS and GMA is needed.
Purpose of the Study:
- Evaluate IMP's concurrent validity with AIMS.
- Assess IMP's association with General Movement Assessment (GMA).
- Determine IMP's ability to reflect brain injury severity and predict NDD.
- Compare IMP and AIMS in predicting abnormal outcomes at 5 months.
Main Methods:
- Retrospective analysis of 86 infants at risk for NDD from two clinical trials.
- Infants assessed at 3 months corrected age (CA) with GMA, and at 5 months CA with IMP and AIMS.
- Neurodevelopmental outcome determined at 18 months.
Main Results:
- Strong concurrent validity between IMP and AIMS (ρ=0.76, p<.001).
- IMP Total Score significantly associated with GMA and accurately reflects brain injury severity (p<.001).
- IMP demonstrated higher diagnostic accuracy (AUC=0.92) and predictive ability for NDD than AIMS.
Conclusions:
- IMP assessment of early motor behavior strongly correlates with neurodevelopmental outcomes.
- Study confirms IMP's concurrent validity, association with GMA, and ability to reflect brain lesion load.
- IMP is a valid and accurate tool for predicting NDD in at-risk infants.
Background:
Preterm infants and infants with perinatal brain injury show a higher incidence of neurodevelopmental disorders (NDD). The Infant Motor Profile (IMP) is a clinical assessment which evaluates the complexity of early motor behaviour. More data are needed to confirm its predictive ability and concurrent validity with other common and valid assessments such as the Alberta Infant Motor Scale (AIMS) and Prechtl's General Movement Assessment (GMA). The present study aims to evaluate the concurrent validity of the IMP with the AIMS, to assess its association with the GMA, to evaluate how the IMP reflects the severity of the brain injury and to compare the ability of the IMP and the AIMS to predict an abnormal outcome in 5-month-old infants at risk of NDD.
Methods:
86 infants at risk of NDD were retrospectively recruited among the participants of two clinical trials. Preterm infants with or without perinatal brain injury and term infants with brain injury were assessed at 3 months corrected age (CA) using the GMA and at 5 months CA using the IMP and the AIMS. The neurodevelopmental outcome was established at 18 months.
Results:
Results confirm a solid concurrent validity between the IMP Total Score and the AIMS (Spearman's ρ 0.76; p < .001) and a significant association between IMP Total Score and the GMA. Unlike the AIMS, the IMP Total score accurately reflects the severity of neonatal brain injury (p < .001) and proves to be the strongest predictor of NDD (p < .001). The comparison of areas under receiver operating characteristic curves (AUC) confirms that the IMP Total score has the highest diagnostic accuracy at 5 months (AUC 0.92). For an optimal IMP Total Score cut-off value of 70, the assessment shows high sensitivity (93%) and specificity (81%) (PPV 84%; NPV 90%).
Conclusions:
Early motor behaviour assessed with the IMP is strongly associated with middle-term neurodevelopmental outcome. The present study confirms the concurrent validity of the IMP with the AIMS, its association with the GMA and its ability to reflect brain lesion load, hence contributing to the construct validity of the assessment.
Trial Registration:
NCT01990183 and NCT03234959 (clinicaltrials.gov).
