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Construction of an Infant Neurological International Battery (Infanib) for the assessment of neurological integrity in infancy.

Physical Therapy (Impact Factor: 2.78). 10/1985; 65(9):1326-31.
Source: PubMed

ABSTRACT In this article, we describe the construction of an instrument for the assessment of the neurological integrity of infants. In a follow-up program for infants from the neonatal intensive care unit, 365 evaluations of 308 infants were made by using a 32-item battery with items from four methods. Factor analyses were used for data analyses, which yielded a 20-item instrument with five factors. We named the instrument the Infant Neurological International Battery (Infanib). The Infanib has sufficient reliability for clinical and research purposes. We have formed scoring sheets, which permit clinical use of the instrument. Cut points are recommended for the separation of infants with normal, transiently abnormal, and abnormal neurologic development. The quantified scoring system enables comparison of infants on item scores, subscores (factor scores), and total scores. It also permits entry of these scores in the computer so that more complex descriptions are possible of the relationship of the neurological assessment of infants both to earlier (eg, birth) and later variables (eg, cerebral palsy, cognitive function, and school performance).

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    ABSTRACT: BACKGROUND: Chinese primary care settings have a heavy patient load, shortage of physicians, limited medical resources and low medical literacy, making it difficult to screen for developmental disorders in infants. The Infant Neurological International Battery (INFANIB) for the assessment of neuromotor developmental disorders in infants aged 0~18 months is widely applied in community health service centers because of its simplicity, time-saving advantages and short learning curve. We aimed too develop and assess a Chinese version of the INFANIB. METHODS: A Chinese version of the INFANIB was developed. Fifty-five preterm and 49 full-term infants with high risk of neurodevelopmental delays were assessed using the Chinese version of the INFANIB at 3, 7 and 10 months after birth. The Peabody Developmental Motor Scale (PDMS) was simultaneously used to assess the children with abnormalities and diagnose cerebral palsy. The sensitivity, specificity, positive predictive value and negative predictive value of the scale were calculated. RESULTS: At birth, a higher proportion of full-term infants had asphyxia (p<0.001), brain damage (p=0.003) and hyperbilirubinemia (p=0.022). The interclass correlation coefficient and intraclass correlation coefficient values for the INFANIB at 3, 7 and 10 months were >0.8, indicating excellent reliability with regard to inter- and intraobserver differences. The specificity, sensitivity, positive predictive value and negative predictive value were high for both high-risk premature infants and full-term infants at the age of 10 months. For premature infants at the age of 7 months or below, INFANIB had low validity for detecting abnormalities. CONCLUSION: The Chinese version of the INFANIB can be useful for screening infants with high-risk for neuromotor abnormality in Chinese primary care settings.
    BMC Pediatrics 06/2012; 12(1):72. · 1.98 Impact Factor
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    ABSTRACT: Despite the expanding clinical utility of antipsychotics beyond psychotic disorders to include depressive, bipolar, and anxiety disorders, reproductive safety data regarding the neurodevelopmental sequelae of fetal antipsychotic exposure are scarce. To examine whether intrauterine antipsychotic exposure is associated with deficits in neuromotor performance and habituation in 6-month-old infants. A prospective controlled study was conducted from December 1999 through June 2008 at the Infant Development Laboratory of the Emory Psychological Center examining maternal-infant dyads (N=309) at 6 months postpartum with pregnancy exposure to antipsychotics (n=22), antidepressants (n=202), or no psychotropic agents (n=85). Examiners masked to maternal-infant exposure status administered a standardized neuromotor examination (Infant Neurological International Battery [INFANIB]) that tests posture, tone, reflexes, and motor skills and a visual habituation paradigm using a neutral female face. The INFANIB composite score; number of trials required to achieve a 50% decrease in infant fixation during a visual habituation task; and mean time looking at the stimulus across 10 trials. Infants prenatally exposed to antipsychotics (mean=64.71) showed significantly lower INFANIB scores than those with antidepressant (mean=68.57) or no psychotropic (mean=71.19) exposure, after controlling for significant covariates (F(2,281)=4.51; P=.01; partial η(2)=0.033). The INFANIB scores were also significantly associated with maternal psychiatric history, including depression, psychosis, and overall severity/chronicity (P's.05) and maternal depression during pregnancy was associated with less efficient habituation (r(245)=0.16; P.02). There were no significant differences regarding habituation between medication exposure groups. Among 6-month-old infants, a history of intrauterine antipsychotic exposure, compared with antidepressant or no psychotropic exposure, was associated with significantly lower scores on a standard test of neuromotor performance, highlighting the need for further scrutiny of the reproductive safety and neurodevelopmental sequelae of fetal antipsychotic exposure. Disentangling medication effects from maternal illness effects, which also contributed, remains a critical challenge.
    Archives of general psychiatry 04/2012; 69(8):787-94. · 12.26 Impact Factor
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    ABSTRACT: OBJECTIVE: To investigate the effect of Auditory, Tactile, Visual and Vestibular stimulus (ATVV) on neuromotor development in preterm infants. METHODS: Fifty preterm infants born at 28-36 wk with a birth weight ranging from 1,000-2,000 g were recruited for the study. They were block randomized into a control group (n = 25) and study group (n = 25). New Ballard score was used for the baseline measurement of neuromaturity in both groups. In neonatal intensive care unit (NICU), the study group received multisensory stimulation for 12 min per session, 5 sessions per wk along with routine NICU care either from 33 wk corrected gestational age for infants born at 28-32 wk or from 48 h of birth for infants born at 33-36 wk until discharge from the hospital. The control group received the routine NICU care. At term age the preterm infants were assessed using Infant Neurological International Battery (INFANIB) and the groups were compared using independent t test. RESULTS: The multisensory stimulated infants showed higher neuromotor score (p = 0.001) compared to the control group. The french angle components of INFANIB including heel to ear (p = 0.016) and popliteal angle (p = 0.001) were statistically significant between the groups. CONCLUSIONS: Multisensory stimulation appears to have a beneficial effect on the tonal maturation in preterm infants. However, further studies are warranted to investigate the long-term effects of multisensory stimulation on neurodevelopmental outcome in preterm infants.
    The Indian Journal of Pediatrics 01/2013; · 0.72 Impact Factor

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