Wow, thank you so much for your kind words. As an educator, I'm truly touched that my video could explain something your professor could not do in an entire class. It's a great honor to know that my video helped you understand the subject better. Being able to share my knowledge and help others understand topics is the primary reason I create videos. I put a lot of effort into making my videos, so it's very rewarding to hear that it was able to make a difference for you. I hope you keep learning and growing in your field, and I will keep doing my best to create more valuable content for you. Thanks again for the kind words and support!
You know man , I am so glad I came across this explanation right before my Peds final in PT school. She didn't do a good job explaining it but made sure to make us score it on final lol / Hopefully I will remember it till tomorrow, Thank you!
your videos are super helpful, especially as a PT that has made the transition to paedatrics from the adult ortho world, I very much appreciate your concise but informative content!
It’s funny that you point out what other clinicians do wrong in your videos… I learned the things wrong from my mentor when I first started and have kept those errors for years so I’ve been finding your videos incredibly helpful. Apparently I’ve been scoring the AIMS wrong this whole time.
I'm glad to help. I found myself in a similar predicament when I started to re-evaluate earlier learned content from my mentors as well so you're not alone!
seus vídeos são muito bons e de qualidade, obrigada por compartilhar seus conhecimentos! (Your videos are very good and of high quality, thank you for sharing your knowledge!)
What if the score falls on completely blank space on the graph. How do I interpret it? How do I come up with the percentile rank and standard deviation
Thanks a lot for your detailed explanation. What confuses me is whether I should use the chronological age or corrected ones when using these scales? It seems to me in some scales we don't have to correct the age. Is there a reason or just the way it was designed?
Huaide, that is an excellent observation and, unfortunately, this is a shared experience among many PT and OT providers for many standardized outcome measures. However, as a rule of thumb, standardized outcome measures tend to adjust for prematurity until 2 years of age (when the general effects of prematurity are expected to resolve). However, that's not to say that all delays of a premature child will resolve by the time they turn 2... there may be lingering delays still present due to concomitant conditions or comorbidities, maybe even environmental factors or lack of exposure to activities conducive to development. So, as the AIMS is an assessment we perform before a child turns 2 years old, we adjust for prematurity. Considering a measure like the PDMS-2, (assesses children 0-6 years), we adjust until the 2 year marker as well.
What if the child has developmental delays and scores below the 5th percentile and therefore don't land on any curve. How do you document? Do you just say scores below 5th percentile or do you say scores below 5th percentile most closely matching abilities of a child who is X months old? Thank you!
Oscar, your first assumption is correct. If I were performing the AIMS on a child who scores below the 5th percentile (below the thin solid line, I would document the interpretation as, "This child scores below the 5th percentile based on their AIMS score following appropriate age adjustments" (assuming you needed to adjust for age).
would you ever reverse calculate score? ie if they are well below 5% would you move across to 50% and go down to determine the average age they are performing at?
Question regarding AIMS: If an infant changes testing position (rolls) during the allotted observation time, do you just place the infant back in that position? Also if an infant requires consoling by a caregiver do you pause the observation time? Thanks!
Lisa, An infant in distress may alter their typical movement patterns and be less willing to interact with their surroundings. For example, an infant who is calm and curious may be more inclined to explore their visual environment thus is likely further engaged in attempting to lift their head while prone. In contrast, an upset infant may bear down, close their eyes, and cry, thus limiting the accuracy of your assessment findings. Because of this, I pause the assessment time if the infant cannot immediately self-soothe/self-regulate and allow the caregiver to comfort the child. With this in mind, if you induce frustration by limiting a child's desire to roll/sit/stand etc., the aforementioned complications may impact your assessment's accuracy. As such, despite the standard practice of repositioning the child in the original testing position, I only attempt this once or twice. If they continue to demonstrate a desire to change positions, I respect that and move on to their positional preference and may return to the prior position at a later time. Short Answers: 1) The standard is to reposition them until the allotted observation time expires. However, I have leniency with this (see above). 2) If an infant requires consoling, pause the observation time and allow the caregiver to comfort the child. Excellent questions. I love it! -Warren
Could you elaborate on why you wouldn't recommend this test for cerebral pasley? What would the drawback be for using it? I know a few PT who are using it on babies with mild CP
Great questions! 1) Why wouldn't I recommend this test for infants with Cerebral Palsy (CP)? While the AIMS is a valuable tool for assessing infant motor development, it may not be the most appropriate test for infants with CP because it may not provide a complete picture of their motor development, as it does not account for the presence of spasticity, abnormal reflexes, or muscle tone that can be associated with CP. Exceptions: However, infants with mild CP may still perform well on the AIMS, which was why I mentioned that I had used this assessment in cases when the clinical manifestations of one's CP were so minor (they weren't functionally impacted). 2) What would the drawback be? Most notably, your results/findings may not accurately reflect the infant's motor abilities and impairments associated with CP. As such, using an outcome measure that is validated for use in infants/children with CP would be ideal.
Thank you for your video, it was very helpful. One additional question about scoring. I know you stated babies cannot be placed into position outside of the placing them in prone, supine, standing but for sitting on propped arms are you able to help position there hands for assessing this item? Thanks for taking the time to address this question in advance!
Nikia, you present a fantastic question, and I apologize for not replying sooner. For the sitting section, to ensure that the results accurately reflect the child's abilities versus ability following a situational aid provided by the clinician, it should not be acceptable to assist with a child's hand placement for the "Sitting with Propped Arms" item. I hold around the trunk as shown in "Sitting with Support" and wait to see if they place or attempt to place hands (if they do not attempt, I try providing the same manual support, but while I'm seated behind the child so that they can look at the parents or a favorite toy instead as that can sometimes be better motivation for them). But, since learning to place a child's own hands for support is a part of that child's seated development process, if we place hands into position for them, they may be able to hold said position, but it's a false sense of ability. To add to this, assume a child is still in prominent physiological flexion, we could place their hands into position "support weight briefly," and their head may not be as ideally extended, but it might be "maintained in midline," thus giving credit for the item, but the child might not have been able to assume that position from "Sitting with Support" even if we waited an hour had we not positioned their hands for them. If we could do that, then I would argue that we should be able to give them credit for maintaining a "Four-Point Kneeling" (in the Prone section) even if they couldn't independently mount into that position (as some children do develop the hip, trunk, head, and scapular stabilization required to maintain that position before the appropriate developmental window). I hope this clarifies things for you. Please let me know if you receive any conflicting information from the AIMS developers. And if you have any other questions, don't hesitate to reach out.
Hi, thank you for the video, very informative, however I have another question. Besides the percentile do we need to calculate the standard deviation? I observe it on some evals of my colleagues, and if yes, how is it calculated?
What happens if a child’s scores between the lines on the graph? I.e between the fifth and 10th percentile. Is the appendix II, or the graph on the back a more reliable way for percentile?
That's a great question Anais. The AIMS possesses components of function, activity, and participation concerning an infant's level of capability. However, if I had to relegate it to a singular category, I think most people would agree that this assessment tool primarily focuses on ACTIVITIES as its locus pertains to the acquisition of developmental milestones for an infant's own movement (rather than interacting with others/their expanded environment)
I'm hoping you have since advanced in your knowledge of infant movement, but in case you didn't know, the way infants/children organize movement is vastly different from an adult. Most important to note, muscles do not create movement, rather, muscles respond to movement that is created by the skeletal system in response to forces of gravity, buoyancy etc. The development of our body and brain organizes around and in reaction to the force of gravity. (this is why age adjusting should only be used for organ functions, not motor) The ability to oppose gravity is intrinsic to all living organisms, and there are two foundational movements that directly oppose gravity, on which all other, more complex movements are built. These are rotation and counterbalance. I could go on, but at least now you've been introduced to the concept. Up to you, but I highly recommend looking further into this and the Newborn/Child Movement Assessment produced by MIchelle Turner (not me 😉) With this assessment method you won't have to exlude the kids who really need assessing for early intervention -- CP, SMA...Good luck! never stop learning.
@@WarrenMcAdamsPT thanks a lot for this very useful video..Does that mean, during interpretation using the graph we have to use corrected age instead of chronological age??
What percentage would a 15th month old infant be if they scored 44 points? Confused on how to score when point is to the right of the 5th percentile line on graph.
Liz, this is a great question. Despite being so skewed to the right of the 5th percentile line, I would refrain from estimating something like "the ranks roughly at the margin of 2.5%." It's tempting to do but is not entirely accurate. Instead, I would state that "per the child's adjusted age of 15 months and a corresponding score of 44 on the AIMS, the child has a resultant norm referenced percentile rank in the
You managed to explain to me in 11 minutes what my professor doctor at the university couldn't do in an entire class.🙄 Thanks 🙏🏽😜
Wow, thank you so much for your kind words. As an educator, I'm truly touched that my video could explain something your professor could not do in an entire class. It's a great honor to know that my video helped you understand the subject better.
Being able to share my knowledge and help others understand topics is the primary reason I create videos. I put a lot of effort into making my videos, so it's very rewarding to hear that it was able to make a difference for you.
I hope you keep learning and growing in your field, and I will keep doing my best to create more valuable content for you. Thanks again for the kind words and support!
You know man , I am so glad I came across this explanation right before my Peds final in PT school. She didn't do a good job explaining it but made sure to make us score it on final lol / Hopefully I will remember it till tomorrow, Thank you!
2 years later and still help me alot with your explanation, thank you!
your videos are super helpful, especially as a PT that has made the transition to paedatrics from the adult ortho world, I very much appreciate your concise but informative content!
It’s funny that you point out what other clinicians do wrong in your videos… I learned the things wrong from my mentor when I first started and have kept those errors for years so I’ve been finding your videos incredibly helpful. Apparently I’ve been scoring the AIMS wrong this whole time.
I'm glad to help. I found myself in a similar predicament when I started to re-evaluate earlier learned content from my mentors as well so you're not alone!
This video has been very helpful
JusTee, I'm thrilled that you found this video helpful! It is affirming to hear. Thank you very much.
Great stuff! Big fan of what you do!
Thank you Luis, I appreciate the kind remark! It's very motivating to hear.
seus vídeos são muito bons e de qualidade, obrigada por compartilhar seus conhecimentos! (Your videos are very good and of high quality, thank you for sharing your knowledge!)
Thank you! It was very helpful, you explained it clearly!
I'm very happy that you found this helpful. Thank you for the feedback Aija!
Really great video!!
It's affirming to hear. Thank you Teysseire!
What if the score falls on completely blank space on the graph. How do I interpret it? How do I come up with the percentile rank and standard deviation
wondering the same thing. I have a very delayed child that i'm trying to score
Thanks a lot for your detailed explanation. What confuses me is whether I should use the chronological age or corrected ones when using these scales? It seems to me in some scales we don't have to correct the age. Is there a reason or just the way it was designed?
Huaide, that is an excellent observation and, unfortunately, this is a shared experience among many PT and OT providers for many standardized outcome measures.
However, as a rule of thumb, standardized outcome measures tend to adjust for prematurity until 2 years of age (when the general effects of prematurity are expected to resolve). However, that's not to say that all delays of a premature child will resolve by the time they turn 2... there may be lingering delays still present due to concomitant conditions or comorbidities, maybe even environmental factors or lack of exposure to activities conducive to development.
So, as the AIMS is an assessment we perform before a child turns 2 years old, we adjust for prematurity.
Considering a measure like the PDMS-2, (assesses children 0-6 years), we adjust until the 2 year marker as well.
Can you explain your thought process on the use of the AIMS vs the PDMS-II in children 0-12 months?
What if the child has developmental delays and scores below the 5th percentile and therefore don't land on any curve. How do you document? Do you just say scores below 5th percentile or do you say scores below 5th percentile most closely matching abilities of a child who is X months old? Thank you!
Oscar, your first assumption is correct. If I were performing the AIMS on a child who scores below the 5th percentile (below the thin solid line, I would document the interpretation as, "This child scores below the 5th percentile based on their AIMS score following appropriate age adjustments" (assuming you needed to adjust for age).
would you ever reverse calculate score? ie if they are well below 5% would you move across to 50% and go down to determine the average age they are performing at?
Question regarding AIMS: If an infant changes testing position (rolls) during the allotted observation time, do you just place the infant back in that position? Also if an infant requires consoling by a caregiver do you pause the observation time? Thanks!
Lisa,
An infant in distress may alter their typical movement patterns and be less willing to interact with their surroundings. For example, an infant who is calm and curious may be more inclined to explore their visual environment thus is likely further engaged in attempting to lift their head while prone. In contrast, an upset infant may bear down, close their eyes, and cry, thus limiting the accuracy of your assessment findings. Because of this, I pause the assessment time if the infant cannot immediately self-soothe/self-regulate and allow the caregiver to comfort the child.
With this in mind, if you induce frustration by limiting a child's desire to roll/sit/stand etc., the aforementioned complications may impact your assessment's accuracy. As such, despite the standard practice of repositioning the child in the original testing position, I only attempt this once or twice. If they continue to demonstrate a desire to change positions, I respect that and move on to their positional preference and may return to the prior position at a later time.
Short Answers:
1) The standard is to reposition them until the allotted observation time expires. However, I have leniency with this (see above).
2) If an infant requires consoling, pause the observation time and allow the caregiver to comfort the child.
Excellent questions. I love it!
-Warren
Could you elaborate on why you wouldn't recommend this test for cerebral pasley? What would the drawback be for using it? I know a few PT who are using it on babies with mild CP
Great questions!
1) Why wouldn't I recommend this test for infants with Cerebral Palsy (CP)? While the AIMS is a valuable tool for assessing infant motor development, it may not be the most appropriate test for infants with CP because it may not provide a complete picture of their motor development, as it does not account for the presence of spasticity, abnormal reflexes, or muscle tone that can be associated with CP.
Exceptions: However, infants with mild CP may still perform well on the AIMS, which was why I mentioned that I had used this assessment in cases when the clinical manifestations of one's CP were so minor (they weren't functionally impacted).
2) What would the drawback be? Most notably, your results/findings may not accurately reflect the infant's motor abilities and impairments associated with CP. As such, using an outcome measure that is validated for use in infants/children with CP would be ideal.
@@WarrenMcAdamsPT thank you so much
Thank you for your video, it was very helpful. One additional question about scoring. I know you stated babies cannot be placed into position outside of the placing them in prone, supine, standing but for sitting on propped arms are you able to help position there hands for assessing this item? Thanks for taking the time to address this question in advance!
Nikia, you present a fantastic question, and I apologize for not replying sooner.
For the sitting section, to ensure that the results accurately reflect the child's abilities versus ability following a situational aid provided by the clinician, it should not be acceptable to assist with a child's hand placement for the "Sitting with Propped Arms" item. I hold around the trunk as shown in "Sitting with Support" and wait to see if they place or attempt to place hands (if they do not attempt, I try providing the same manual support, but while I'm seated behind the child so that they can look at the parents or a favorite toy instead as that can sometimes be better motivation for them). But, since learning to place a child's own hands for support is a part of that child's seated development process, if we place hands into position for them, they may be able to hold said position, but it's a false sense of ability. To add to this, assume a child is still in prominent physiological flexion, we could place their hands into position "support weight briefly," and their head may not be as ideally extended, but it might be "maintained in midline," thus giving credit for the item, but the child might not have been able to assume that position from "Sitting with Support" even if we waited an hour had we not positioned their hands for them. If we could do that, then I would argue that we should be able to give them credit for maintaining a "Four-Point Kneeling" (in the Prone section) even if they couldn't independently mount into that position (as some children do develop the hip, trunk, head, and scapular stabilization required to maintain that position before the appropriate developmental window).
I hope this clarifies things for you. Please let me know if you receive any conflicting information from the AIMS developers. And if you have any other questions, don't hesitate to reach out.
Thank you for great explanation. Is there a cut off score where it determines if the baby has developmental delay or not?
Very informative! thank you .. how can I get the manual for this scale?
Hi, thank you for the video, very informative, however I have another question. Besides the percentile do we need to calculate the standard deviation? I observe it on some evals of my colleagues, and if yes, how is it calculated?
What happens if a child’s scores between the lines on the graph? I.e between the fifth and 10th percentile.
Is the appendix II, or the graph on the back a more reliable way for percentile?
Hello ! If we refer to ICF, what does this tool measure? Rather function, activity or participation?
That's a great question Anais.
The AIMS possesses components of function, activity, and participation concerning an infant's level of capability. However, if I had to relegate it to a singular category, I think most people would agree that this assessment tool primarily focuses on ACTIVITIES as its locus pertains to the acquisition of developmental milestones for an infant's own movement (rather than interacting with others/their expanded environment)
Hi!
Where can I find the pdf version of the evaluation form?
I'm hoping you have since advanced in your knowledge of infant movement, but in case you didn't know, the way infants/children organize movement is vastly different from an adult. Most important to note, muscles do not create movement, rather, muscles respond to movement that is created by the skeletal system in response to forces of gravity, buoyancy etc. The development of our body and brain organizes around and in reaction to the force of gravity. (this is why age adjusting should only be used for organ functions, not motor) The ability to oppose gravity is intrinsic to all living organisms, and there are two foundational movements that directly oppose gravity, on which all other, more complex movements are built. These are rotation and counterbalance. I could go on, but at least now you've been introduced to the concept. Up to you, but I highly recommend looking further into this and the Newborn/Child Movement Assessment produced by MIchelle Turner (not me 😉) With this assessment method you won't have to exlude the kids who really need assessing for early intervention -- CP, SMA...Good luck! never stop learning.
Do you only score on the month or do you score on the weeks/days also?
Great question, Jessica. You should score with the inclusion of weeks/days accounted for and any age adjustments for prematurity (
@@WarrenMcAdamsPT thanks a lot for this very useful video..Does that mean, during interpretation using the graph we have to use corrected age instead of chronological age??
What percentage would a 15th month old infant be if they scored 44 points? Confused on how to score when point is to the right of the 5th percentile line on graph.
Liz, this is a great question. Despite being so skewed to the right of the 5th percentile line, I would refrain from estimating something like "the ranks roughly at the margin of 2.5%." It's tempting to do but is not entirely accurate.
Instead, I would state that "per the child's adjusted age of 15 months and a corresponding score of 44 on the AIMS, the child has a resultant norm referenced percentile rank in the
Hello sir.. What if baby is 14 month old and score is 22 what's interpretation??
how you calculate the SD?
Where do we get the AIMS Record Booklet?
There are a number of places where you can get the AIMS Record Booklet. A quick google search shows that they can now be found on Amazon.