THE DUTCH GO SLOW?

CANADIAN NORM VALUES OF THE

ALBERTA INFANT MOTOR SCALE

EVALUATED FOR DUTCH INFANTS

November 22nd 2019Imke Suir, MSc

Marike Boonzaaijer, MSc

Jacqueline Nuysink, PhD

Research Group Lifestyle and Health, Research Center Healthy and

Sustainable living

Institute of Human Movement Sciences

Impact your future

AIMS-NL study

Canada (Alberta)

The Netherlands

Mendonca et al. (2016)Piper M and Darrah J (1994)

Research question

Are the Canadian norm values appropriate for Dutch infants?

Are we the same ???

Design study

Film II

For children who do notcrawl yet

Instruction video for parents

GODIVA

study

Step 1: Parental instruction Step 2: Filming + Uploading Step 3: Scoring Step 4: Feedback

Min. 450 infants

Typical developing

Age range 14 days-19 months

7.6 % premature born

12% non-Western origin

Boonzaaijer M. et al. (2017)

A father at work

Hypotheses

0

10

20

30

40

50

60

70

0 10 20 30 40 50 60 70

Ag

e (

wks)

a

tta

inin

me

nt

AIM

S it

em

s D

utc

h in

fan

ts

Age (wks) attainment AIMS items Canadian infants

Gemiddelde leeftijd behalen item AIMS Canada

vs Nederland

CAN slower

than NL

NL slower than

CAN

CAN = NL

1. Canadian infants = Dutch infants

2. Canadian infants < Dutch infants

3. Canadian infant > Dutch infants

Results

0

10

20

30

40

50

60

70

0 10 20 30 40 50 60 70

Ag

e (

wks)

a

tta

inin

me

nt

AIM

S ite

ms

Du

tch

in

fan

ts

Age (wks) attainment AIMS items Canadian infants

Mean age of attainment AIMS itemsCanada vs The Netherlands

Prone

Supine

Sitting

Standing

N= 499

45/58 items could be analyzed

41 items: later mean age of attainment NL infants

(range 0.4 -14.4 wks)

3 items: slightly earlier mean age of attainment item NL infants

(range 0.5 - 2 wks)

1 item showed exactly the same mean age

Results: Subscales

0

100

200

300

400

500

st3 st4 st5 st6 st7 st8 st9 st10 st11 st12 st13

Standing

0

100

200

300

400

500

sup5 sup6 sup7 sup8 sup9

Supine

0

100

200

300

400

500

Prone

0

100

200

300

400

500

sit2 sit3 sit4 sit5 sit6 sit7 sit8 sit9 sit10 sit11 sit12

Sitting

Me

an

ag

eo

f a

tta

inm

en

t

Me

an

ag

eo

f a

tta

inm

en

t

Me

an

ag

eo

f a

tta

inm

en

t

Me

an

ag

eo

f a

tta

inm

en

t

CAN

NL

CAN

NL

CAN

NL

CAN

NL

Results: z-scores

74% scores below 50th percentile

23% at risk for developmental delay

16% having a developmental delay

0

20

40

60

80

100

120

140

160

180

200

>-2SD -SD1<-SD2 0<-1SD 0>+1SD +1SD>+2SD >+2SD

z-score CAN vs NL

CAN NL

0

20

40

60

80

100

120

140

160

180

>-2SD -SD1<-SD2 0<-1SD 0>+1SD +1SD>+2SD >+2SD

z-score CAN vs NL

CAN

Discussion

Limitations:

Sample is not perfectly representative

7.6% premature

5.8% infants of non-Western origin

Mostly high educated mothers and fathers

Small sample-sizes in monthly age-groups 0-3 mo and 17-19 mo

Discussion

Fleuren (2007): almost 75% score below 50th percentile

Steenis (2016): BSID III Dutch norms are different from the US norms for gross

motor development

Saccani (2013): Culture influences the speed at which motor milestones are attained

adjustment needed for the Brazilian population

Conclusion

Canadian norm values of the AIMS seem NOT appropriate for our sample of

Dutch infants.

Dutch infants seem to develop their gross motor skills in the same order, but at

a slower pace than Canadian infants.

ImplicationsConsequences:

• Risk of over-referral

• Unnecessary parental concern

• Unnecessary treatment

Recommendations:

• Research: larger & representative sample Dutch infants to set new norm values

• Take the results of the AIMS-NL study into account next to other available diagnostics as family concerns, medical history

and clinical tests to support your clinical view.

• Cross-cultural validation in other (European) countries……………..?!?!?!?! Networksession Saturday 23rd

Explanation ?!?!?!?

Does it matter ?!?!?!?

Childin

Motion