Test of Infant Motor Performance: Difference between revisions

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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div><div class="editorbox">'''Original Editor '''- [[User:Rucha Gadgil|Rucha Gadgil]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div><div class="editorbox">'''Original Editor '''- [[User:Rucha Gadgil|Rucha Gadgil]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
==Objective==
==Objective==
The Test of Infant Motor Performance (TIMP) is a motor outcome measure to assess posture and selective control of movement in infants for functional performance in daily life. The TIMP was developed to  
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:<ref name=":1">Campbell SK, Wright BD, Linacre JM. Development of a functional movement scale for infants. J Appl Meas. 2002;3(2):190-204. PMID: 12011500.</ref><ref name=":0">Kvestad I, Silpakar JS, Hysing M, Ranjitkar S, Strand TA, Schwinger C, Shrestha M, Chandyo RK, Ulak M. T[https://www.sciencedirect.com/science/article/pii/S0163638323000012?via%3Dihub he 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.</ref>


# identify infants with delayed motor development  
# identify infants with delayed motor development  
# precisely track typically developing infants
# precisely track typically developing infants
# evaluate and develop intervention goals for infants with delays
# develop and then evaluate intervention goals for infants who have delays in their development
# educate parents on infant motor development<ref>JOURNAL OF APPLIED MEASUREMENT, 3(2), 190-204 Development of a Functional Movement Scale for Infants Suzann K. Campbell University of Illinois at Chicago Benjamin D. Wright J. Michael Linacre University of Chicago</ref><ref name=":0">Kvestad I, Silpakar JS, Hysing M, Ranjitkar S, Strand TA, Schwinger C, Shrestha M, Chandyo RK, Ulak M. T[https://www.sciencedirect.com/science/article/pii/S0163638323000012?via%3Dihub he 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.</ref>
# educate parents / caregivers on infant motor development<br />
It is used by physiotherapists and occupational therapists to identify infants with motor delay between 34 weeks post-conception to 4 months post-term.<ref name=":0" /><ref name=":2" /> It helps therapists plan interventions and document any changes in motor performance over time.<ref name=":0" /> The TIMP was developed for use in neonatal intensive care units (NICU) and in early intervention programmes.<ref name=":1" /><ref>Campbell SK, Zawacki L, Rankin KM, Yoder JC, Shapiro N, Li Z, White-Traut R. [https://journals.lww.com/pedpt/FullText/2013/25040/Concurrent_Validity_of_the_TIMP_and_the_Bayley_III.3.aspx Concurrent validity of the TIMP and the Bayley III scales at 6 weeks corrected age]. Pediatr Phys Ther. 2013 Winter;25(4):395-401. </ref>


==Components and Scoring==
The TIMP includes 42 items:<ref name=":0" /><ref>Fan J, Wang J, Zhang X, He R, He S, Yang M, Shen Y, Tao X, Zhou M, Gao X, Hu L. [https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-021-02627-x 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.</ref>


It is used by physical and occupational therapists to identify infants with motor delay between 34 weeks post-conceptional to 4 months post-term.  In addition the TIMP is used to plan an intervention program and document change in motor performance over time. The TIMP can be used both in special care nursery settings and in early intervention programs, thus facilitating communication among caregivers in different settings.
* 13 items are observed during a period of spontaneous activity, such as:
 
** head orientation in the midline
==Components/Scoring==
TIMP consists of reviewing a total of 42 items:
 
* 13 items are observed during a period of spontaneous activity
** head orientation in the midline,
** ballistic movements of the limb
** ballistic movements of the limb
* 29 items are elicited   
* 29 items are elicited   
** antigravity control and postural
** antigravity control
** auditory and visual response to stimuli<ref>Fan J, Wang J, Zhang X, He R, He S, Yang M, Shen Y, Tao X, Zhou M, Gao X, Hu L. [https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-021-02627-x 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.</ref><ref name=":0" />
** postural, auditory and visual response to stimuli


'''Scoring:'''
'''Scoring:'''<ref name=":0" />


* Observed items:
* Observed items:
** 1 if found
** 1 if found
** 0 if absent
** 0 if absent
* Elicited Items:
* Elicited items:
** 0-6 based on the infants performance<ref name=":0" />
** 0-6 based on the infants performance


 * Detailed scoring is explained during workshops.
 * Detailed scoring is explained in [https://www.thetimp.com/ TIMP workshops / courses].


'''Environment for Testing:''' The TIMP can be used both in special care nursery settings and in early intervention programs. It can be carried out at an outpatient basis and in the NICU but a regular follow up and documentation needs to be maintained.
'''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<ref>Shirley Ryan Ability Lab. Test of Infant Motor Performance. 2023. Available from: https://www.sralab.org/rehabilitation-measures/test-infant-motor-performance</ref>
'''Equipment and materials needed:''' Testing forms and pen, ball, cloth and rattle<ref name=":2">Shirley Ryan Ability Lab. Test of Infant Motor Performance. 2023. Available from: https://www.sralab.org/rehabilitation-measures/test-infant-motor-performance</ref>


'''Examiner Qualifications''': The test must be administered by those with experience in the TIMP attained by workshops.
'''Examiner qualifications''': The test must be administered by assessors with experience in the TIMP (gained through TIMP workshops/online modules).
==Relevant Information==
==Relevant Information==
The increasing survival rate of infants with a complicated birth and perinatal history generated the need for a test of functional motor performance with the capability identifying children under four months of age with delayed development which could addressed with physical therapy. The first version of the test was developed by Girolami,<ref>Girolami and Campbell, 1994)</ref> however it was too lengthy and time consuming to be followed regularly. As a result the short concise version was made by Suzann Campbell.
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.<ref name=":1" /> The first version of the test was developed by Girolami.<ref name=":1" /> A shorter version was developed by Suzann Campbell.
 
==Reliability and Validity==
The Test of Infant Motor Performance (TIMP) is the current gold standard infant motor assessment, but rarely used by pediatricians during well-child visits due to lack of time and special training required.  A short, standardized screening test administered to infants in the first months of life would target early intervention to those most at risk hence proving the importance of the test.
 
This test has been conducted more widely and regularly in the US but has started gaining momentum with the NDT trained therapists all over the world thanks to its positive results.
==Reliability/ Validity==
The usefulness of a tool in a clinical setting depends on how much the clinician can rely on the data and how stable the data is over time. A good tool will have strong reliability, validity, and will be responsive to change.
 
'''Reliability''' refers to how consistent the tool is at measuring your outcome of interest, and is it free of error.
 
Test–retest reliability of the TIMPSI was excellent with the intra-class  coefficient of 0.99<ref>Test-Retest Reliability of the Test of Infant Motor Performance, Campbell Suzann K. PhD PT;Pediatric Physical Therapy: Summer 1999 ;Volume 11 - Issue 2<article><header> </header> </article></ref>.


The test-retest reliability for 116 pairs of tests of r = .89 over 3 days; no significant difference between testers.
* The TIMP has been found to have sufficient test-retest reliability for clinical use<ref>Campbell SK. Test-retest reliability of the Test of Infant Motor Performance. Pediatric Physical Therapy: Summer 1999;11(2):60-6.</ref>
* Test–retest reliability of the TIMP has an intra-class correlation coefficient of 0.99<ref>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. </ref>
* The TIMP is able to predict 12-month motor performance with a sensitivity of 92% and a specificity of 76%<ref name=":3">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].</ref>
* It can predict preschool motor performance in infants aged 3 months with a sensitivity of 72% and a specificity of 91%<ref name=":3" />
* The validity of the TIMP was determined by comparing it with the [[Alberta Infant Motor Scale (AIMS)|Alberta Infant Motor scale (AIMS)]]<ref name=":3" /><ref name=":4">Campbell SK, Kolobe TH, Wright BD, Linacre JM. [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1469-8749.2002.tb00802.x?sid=nlm%3Apubmed 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.</ref>
** 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"<ref name=":4" /> - it can, therefore, be used to identify infants who may benefit from intervention


'''Standardization data:''' Diagnose motor developmental delay from 34 weeks post-conception age through 4 months post term based on age standards developed from a sample of 990 U.S. infants of all races/ethnicities.
'''Predictive/Discriminative:''' Predicts 12-month motor performance with sensitivity 92% and specificity 76% and preschool motor performance with sensitivity 72% and specificity 91% at 3 months of age.
'''Validity''' of an assessment is the degree to which it '''measures''' what it is supposed to '''measure.'''
In case of TIMP, its validity was measured by comparing it with Alberta Infant Motor scale (AIMS) and correlation between scores on the TIMP and the AIMS was highest for TIMP tests at 90 days and AIMS testing at 6 months (r=0.67, p=0.0001) concluding that TIMP can be used clinically to identify infants likely to benefit from intervention<ref>Dev Med Child Neurol. 2002 Apr;44(4):263-72. Validity of the Test of Infant Motor Performance for prediction of 6-, 9- and 12-month scores on the Alberta Infant Motor Scale. Campbell SK1, Kolobe TH, Wright BD, Linacre JM.</ref>.
==Resources==
==Resources==
For more information about the courses and the test
For more information about the TIMP, see http://www.thetimp.com/
 
http://www.thetimp.com/


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[[Category:Outcome Measures]]
[[Category:Outcome Measures]]
[[Category:Paediatrics - Outcome Measures]]
[[Category:Paediatrics - Outcome Measures]]
[[Category:Course Pages]]

Latest revision as of 02:20, 16 May 2023

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

Scoring:[2]

  • 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.


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