File
van Maren-Suir I.1, Boonzaaijer M.1, Volman M.2, Jongmans M.2, Nuysink J.1
1HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Institute of Human Movement Studies, Utrecht, Netherlands, 2Utrecht University of Applied Sciences, Faculty of Social and Behavioral Sciences, Department of Pedagogical and Educational Sciences, Utrecht, Netherlands
Background: The way and speed in which infants reach the motor milestone of independent walking is characterized by inter- and intra-individual variability. Timely recognition of atypical or deviant motor development is important. With a better understanding of the variability in gross motor developmental pathways of typically developing infants, atypical developing infants are probably better recognized. Longitudinal designs are preferred to study the variety of developmental pathways in individual infants. However, commitment of parents and infants to participate in such studies is challenging. Therefore, an e-health method was developed and validated in which parents record a home video of their child at the most suitable time for parents and child. This method allows a pediatric physiotherapist to easily, and repeatedly, assess gross motor development with the Alberta Infant Motor Scale (AIMS).
Purpose: To explore the variability in gross motor developmental pathways of full-term born, typically developing infants measured longitudinally using the AIMS home video protocol.
Methods: In this longitudinal pilot study 57 infants were divided in two parallel cohorts covering the total age-range of the AIMS. The first cohort started at the age of six weeks and the second cohort started at 8.5 months.
Parents were asked to record their infant every two months according to an instruction film and checklist (the AIMS home video method). Parents uploaded their video-recordings in a secured environment, a web portal. Two pediatric physiotherapists/researchers assessed the video-observations with the AIMS. Parents received feedback on the gross motor development of their infant after every observation. Only infants with at least 3 measurements available were included in the analysis.
Results: Of thirty-five infants at least 3 measurements were available. The data show a wide variability within the individual percentile ranks on the AIMS every two months in both cohorts. Twelve out of 14 infants demonstrated a decline in percentile score at the age of 5.5 months. At 7.5 months of age 10 out of 12 infants demonstrated an increase in percentile score. At all ages the mean percentile scores appeared to be below the 50th percentile.
Conclusion(s): The results of this study show a large variety in gross motor development in typically developing Dutch infants from the age of 6 weeks to 18.5 months measured longitudinally with the AIMS home video protocol. Although this pilot is a small sample, apparent findings are the decline and increase in percentile scores at 5.5 and 7.5 months. The finding that mean scores were below the 50th percentile raises the question whether Dutch infants are comparable to Canadian infants (on which the AIMS was standardized) in the speed of gross motor development. These findings need further investigation.
Implications: A large individual variety in gross motor development has implications for infant screening and shows that longitudinal measurements are needed to identify atypical developing children. Future research will involve studying individual gross motor pathways and potential systematic patterns in a larger sample and with infants at risk. Furthermore, comparative research has to verify if the Canadian norm references of the AIMS are comparable with the Dutch population.
Funding acknowledgements: SIA-RAAK-public (GODIVA 2013-2016). Taskforce for applied research-SIA is part of The Netherlands organization for scientific research (NWO).
Topic: Paediatrics
Ethics approval: The study was approved by the Medical Ethical Board METC/ UMCU Utrecht, The Netherlands nr.14-399/C and included informed consent procedure.
All authors, affiliations and abstracts have been published as submitted.
