Concurrent and predictive validity of the infant motor profile in infants at risk of neurodevelopmental disorders

Riccardo Rizzi, Valentina Menici, Maria Luce Cioni, Alessandra Cecchi, Veronica Barzacchi, Elena Beani, Matteo Giampietri, Giovanni Cioni, Giuseppina Sgandurra, Clinical CareToy-R Consortium, Claudia Artese, Marta Cervo, Carlo Dani, Patrizio Fiorini, Viola Fortini, Simona Giustini, Clara Lunardi, Giada Martini, Martina Orlando, Letizia Padrini, Filomena Paternoster, Riccardo Rizzi, Valentina Menici, Maria Luce Cioni, Alessandra Cecchi, Veronica Barzacchi, Elena Beani, Matteo Giampietri, Giovanni Cioni, Giuseppina Sgandurra, Clinical CareToy-R Consortium, Claudia Artese, Marta Cervo, Carlo Dani, Patrizio Fiorini, Viola Fortini, Simona Giustini, Clara Lunardi, Giada Martini, Martina Orlando, Letizia Padrini, Filomena Paternoster

Abstract

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).

Keywords: Alberta infant motor scale; Infant motor profile; Neurodevelopmental disorder, general movement assessment.

Conflict of interest statement

The authors report no competing interests.

Figures

Fig. 1
Fig. 1
Association between Prechtl’s General Movement Assessment at 3 months and the Infant Motor Profile Total and the Alberta Infant Motor Scale at 5 months corrected age. * p < .001
Fig. 2
Fig. 2
Infant Motor Profile (IMP) scores, Alberta Infant Motor Scale (AIMS) scores at the corrected age of 5 months in children with typical development and neurodevelopmental disorders (NDD). Mann-Whitney U test: *p < .001
Fig. 3
Fig. 3
Scatterplot of predicted probability of neurodevelopmental disorders (NDD) from the regression model derived from the Infant Motor Profile (IMP). Total scores at the corrected age of 5 months. Values ≤70 determine a major increase of the probability to develop NDD. Empty markers represent actual typical development, full markers represent actual NDD
Fig. 4
Fig. 4
Receiver operating characteristic (ROC) curve of the Infant Motor Profile (IMP) Total score and the Alberta Infant Motor Scale (AIMS) score as predictors of neurodevelopmental disorders (NDD) at the corrected age of 5 months

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Source: PubMed

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