Premium
Caregiver perception of hand function in infants with cerebral palsy: psychometric properties of the Infant Motor Activity Log
Author(s) -
Carey Helen,
Hay Krystal,
Nelin Mary Ann,
Sowers Brianna,
Lewandowski Dennis J,
MooreClingenpeel Melissa,
Maitre Nathalie L
Publication year - 2020
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14644
Subject(s) - cerebral palsy , cronbach's alpha , bayley scales of infant development , gross motor function classification system , medicine , toddler , confidence interval , construct validity , motor skill , physical therapy , physical medicine and rehabilitation , pediatrics , psychology , psychometrics , developmental psychology , cognition , clinical psychology , psychiatry , psychomotor learning
Aim To evaluate the properties of the Infant Motor Activity Log (IMAL), a caregiver‐report for frequency and quality of use of more affected upper extremity in infants with neurological and functional impairments. Method This was a prospective cohort study of 66 children (34 females, 32 males) aged 6 to 24 months (mean age [SD] 13.7mo [5.3]) with neurological and functional impairments and a confirmed cerebral palsy diagnoses after 2 years, and 51 age‐matched typically developing children. The IMAL was administered at baseline and 4 weeks later. Typically developing infants were tested with randomly assigned ‘more affected’ upper extremity. Psychometric properties were evaluated using Spearman's correlation coefficient, Cronbach's alpha, and Jonckheere‐Terpstra tests. Results In the children with impairments, the IMAL showed internal consistency (alpha≥0.88) for the How Well Scale (HWS) and How Often Scale (HOS). Test–retest reliability was 0.64 (HOS) and 0.70 (HWS), demonstrating stability over time. Correlation with Bayley Scales of Infant and Toddler Development, Third Edition more affected arm raw scores were 0.70 (HOS) and 0.72 (HWS) ( p <0.001) demonstrating construct validity. Both scale scores decreased with increasing Gross Motor Function Classification System and Mini‐Manual Ability Classification System ( p <0.001) levels, supporting discriminative validity. Discrimination between typically developing infants and infants with impairments was high (HWS: area under the receiver operating characteristic curve [AUC] 0.96, 95% confidence interval [CI] 0.94–0.99 and HOS AUC=0.95, CI 0.92–0.99). Interpretation The IMAL is a valid and reliable discriminative caregiver measure of upper limb performance and may complement measures of capacity in infants with neurological and functional impairments. What this paper adds The Infant Motor Activity Log (IMAL) is a valid and reliable measure of caregiver perception of upper limb function. The IMAL fills a measurement gap for infant motor performance in children with impairments. The IMAL discriminates among motor function levels.