Test of Infant Motor Performance

Original Editor - Rucha Gadgil Top Contributors - Rucha Gadgil
Original Editor - Rucha Gadgil Top Contributors - Rucha Gadgil

Objective

The Test of Infant Motor Performance (TIMP) is a motor outcome measure of 25-35 mins carried out usually to assess the posture and selective control of movement needed by infants under four months of age for functional performance in daily life. The TIMP was developed to 1) identify infants with delayed motor development, 2) discriminate among infants with varying degrees of risk for poor motor outcome, and 3) measure change resulting from intervention[1].

It is used by physical and occupational therapists to identify infants with motor delay between 34 weeks post-conceptional age to 5 months post-term and 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.

How it is done?

TIMP is carried out every week until approximately 4 months of corrected age. It consists of reviewing a total of 42 items. 13 items are observed during a period of spontaneous activity. 5 items on the test are all related to head control in supported sitting. There is a series of items to examine postural control in the supine position. There is also a series of prone items that can be evaluated together. The remaining items to be evaluated focus on righting reactions during tilting and side-lying as well as postural control in standing.

Scoring: Correct scoring is explained during workshops.

Environment for Testing: The TIMP can be used both in special care nursery settings and in early intervention programs. It can be carried out on a Out patient basis and in the NICU but a regular follow up and documentation needs to be maintained.

Equipment and Materials Needed: Testing forms and pen.

Examiner Qualifications: The test must be administered by those with experience in the TIMP attained by workshops.

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[2] but it was too lengthy and time consuming to be followed regularly. As a result the short concise version was made by Suzann Campbell.

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[3].

The test-retest reliability for 116 pairs of tests of r = .89 over 3 days; no significant difference between testers.

Standardization data: Diagnose motor developmental delay from 34 weeks postconceptional 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[4].

Resources

For more information about the courses and the test

http://www.thetimp.com/

References

  1. 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
  2. Girolami and Campbell, 1994)
  3. 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>
  4. 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.