Test of Infant Motor Performance

Original Editor - Rucha Gadgil Top Contributors - Rucha Gadgil, Jess Bell, Robin Tacchetti and Kim Jackson
Original Editor - Rucha Gadgil Top Contributors - Rucha Gadgil, Jess Bell, Robin Tacchetti and Kim Jackson

Objective[edit | edit source]

The Test of Infant Motor Performance (TIMP) is a motor outcome measure designed to assess posture and selective control of movement in infants for functional performance in daily life. The TIMP was developed to:[1][2]

  1. identify infants with delayed motor development
  2. precisely track typically developing infants
  3. develop and then evaluate intervention goals for infants who have delays in their development
  4. educate parents / caregivers on infant motor development

It is used by physiotherapists and occupational therapists to identify infants with motor delay between 34 weeks post-conception to 4 months post-term.[2][3] It helps therapists plan interventions and document any changes in motor performance over time.[2] The TIMP was developed for use in neonatal intensive care units (NICU) and in early intervention programmes.[1][4]

Components and Scoring[edit | edit source]

The TIMP includes 42 items:[2][5]

  • 13 items are observed during a period of spontaneous activity, such as:
    • head orientation in the midline
    • ballistic movements of the limb
  • 29 items are elicited
    • antigravity control
    • postural, auditory and visual response to stimuli


  • Observed items:
    • 1 if found
    • 0 if absent
  • Elicited items:
    • 0-6 based on the infants performance

 * Detailed scoring is explained in TIMP workshops / courses.

Environment for testing: The TIMP is used in NICU and early intervention programmes. Regular follow up and documentation must be maintained.

Equipment and materials needed: Testing forms and pen, ball, cloth and rattle[3]

Examiner qualifications: The test must be administered by assessors with experience in the TIMP (gained through TIMP workshops/online modules).

Relevant Information[edit | edit source]

The increasing survival rate of infants with complicated birth and perinatal histories meant there was a need for a test that assessed functional motor performance and identified infants aged under four months with delayed development.[1] The first version of the test was developed by Girolami.[1] A shorter version was developed by Suzann Campbell.

Reliability and Validity[edit | edit source]

  • The TIMP has been found to have sufficient test-retest reliability for clinical use[6]
  • Test–retest reliability of the TIMP has an intra-class correlation coefficient of 0.99[7]
  • The TIMP is able to predict 12-month motor performance with a sensitivity of 92% and a specificity of 76%[8]
  • It can predict preschool motor performance in infants aged 3 months with a sensitivity of 72% and a specificity of 91%[8]
  • The validity of the TIMP was determined by comparing it with the Alberta Infant Motor scale (AIMS)[8][9]
    • It was found that TIMP scores are able to significantly predict AIMS percentile ranks 6 to 12 months later
    • A TIMP score at 3 months of age "has the greatest degree of validity for predicting motor performance on the AIMS at 12 months"[9] - it can, therefore, be used to identify infants who may benefit from intervention

Resources[edit | edit source]

For more information about the TIMP, see http://www.thetimp.com/

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 Campbell SK, Wright BD, Linacre JM. Development of a functional movement scale for infants. J Appl Meas. 2002;3(2):190-204. PMID: 12011500.
  2. 2.0 2.1 2.2 2.3 2.4 Kvestad I, Silpakar JS, Hysing M, Ranjitkar S, Strand TA, Schwinger C, Shrestha M, Chandyo RK, Ulak M. The reliability and predictive ability of the Test of Infant Motor Performance (TIMP) in a community-based study in Bhaktapur, Nepal. Infant Behavior and Development. 2023 Feb 1;70:101809.
  3. 3.0 3.1 Shirley Ryan Ability Lab. Test of Infant Motor Performance. 2023. Available from: https://www.sralab.org/rehabilitation-measures/test-infant-motor-performance
  4. Campbell SK, Zawacki L, Rankin KM, Yoder JC, Shapiro N, Li Z, White-Traut R. Concurrent validity of the TIMP and the Bayley III scales at 6 weeks corrected age. Pediatr Phys Ther. 2013 Winter;25(4):395-401.
  5. Fan J, Wang J, Zhang X, He R, He S, Yang M, Shen Y, Tao X, Zhou M, Gao X, Hu L. A home-based, post-discharge early intervention program promotes motor development and physical growth in the early preterm infants: a prospective, randomized controlled trial. BMC pediatrics. 2021 Dec;21(1):1-8.
  6. Campbell SK. Test-retest reliability of the Test of Infant Motor Performance. Pediatric Physical Therapy: Summer 1999;11(2):60-6.
  7. Ustad T, Helbostad JL, Campbell SK, Girolami GL, Jørgensen L, Øberg GK, Evensen KA. Test-retest reliability of the Test of Infant Motor Performance Screening Items in infants at risk for impaired functional motor performance. Early Hum Dev. 2016 Feb;93:43-6.
  8. 8.0 8.1 8.2 De Vries N, Atkins D, Grupp O, Austin N, Practice recommendations for 2 year follow-up of infants, at high risk of developmental disability. New Zealand Newborn Clinical Network Clinical Reference Group; 2022. Available from: https://media.starship.org.nz/follow-up-recommendations-neurodevelopmental/Follow-up_recommendations_neurodevlpt.pdf [Accessed 15 May 2023].
  9. 9.0 9.1 Campbell SK, Kolobe TH, Wright BD, Linacre JM. Validity of the Test of Infant Motor Performance for prediction of 6-, 9- and 12-month scores on the Alberta Infant Motor Scale. Dev Med Child Neurol. 2002 Apr;44(4):263-72.