Acta Pædiatrica ISSN 0803–5253 REGULAR ARTICLE New reference values for the Alberta Infant Motor Scale need to be established K M W Fleuren(k.fleuren@erasmusmc.nl) 1 , L S Smit 2 , Th Stijnen 3 , A Hartman 1 1.Department of Pediatric Physiotherapy, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands 2.Department of Pediatric Neurology and Neonatology, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands 3.Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam, The Netherlands Keywords AIMS, Motor development, Reference values Correspondence K M W Fleuren, Department of Pediatric Physiotherapy, Sk-0327, Erasmus MC Sophia Children’s Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands. Tel.: + 31 10 463 6764 | Fax: +31 10 463 6200 | Email: k.fleuren@erasmusmc.nl Received 24 July 2006; revised 4 September 2006; accepted 14 September 2006. DOI:10.1111/j.1651-2227.2007.00111.x Abstract Aim: The Alberta Infant Motor Scale (AIMS) is an infant developmental test, which can be used to evaluate motor performance from birth to independent walking. Between 1990 and 1992 Piper and Darrah determined reference values in a cohort in Canada. To our knowledge no study has been carried out to determine whether the Canadian data are representative for other countries. In the present study we aimed to establish whether the AIMS test needs new reference values for Dutch children. Methods: Motor performance of 100 Dutch children, aged 0–12 months, was measured using the AIMS test. Results: The mean percentile score of the Dutch children was 28.8 (±22.9, range 1–85). The percentile scores of the group were significantly lower than scores of the Canadian norm population (p < 0.001), whereby 75% of the Dutch children scored below the 50th percentile. These lower scores were not be explained by sex, racial differences or congenital disorders and were seen in all age groups. Conclusion: We conclude that new reference values on the AIMS test for the age group of 0–12 months need to be established for Dutch children. It is recommended that the need for new normative data is also determined in all other European countries. INTRODUCTION In the first year of life motor development is an important manifestation of the integrity and functionality of the cen- tral nervous system. Deviations in motor development can be a first sign of disorders. Early diagnosis is important to start early intervention, as plasticity of the developing brain can be used to reach optimal outcome. During the last three decades neonatal care has improved resulting in survival of a greater number of premature and often very low birth weight children. However, these children are more likely to have developmental problems of the central nervous system and therefore the number of children at risk for motor develop- mental delay is also increasing (1). For this reason there is need for a reliable and valid test to assess motor develop- ment. The Alberta Infant Motor Scale (AIMS) is an infant devel- opmental test, which can be used to identify motor delay and to evaluate motor performance from birth to independent walking (2,3). The examiner encourages the child to demon- strate the skills he or she can accomplish spontaneously. A total number of 58 items in 4 positions (supine, prone, sitting and standing) can be scored. Each item contains three com- ponents of movement: weight-bearing, postural alignment and antigravity movement. The AIMS raw score is converted to an age-based percentile rank. This widely used observa- tional test is norm referenced. Between 1990 and 1992 Piper and Darrah determined reference values in a cohort of 2200 children aged 0–18 months in Alberta, Canada (2). Several studies have since demonstrated validity and reliability of the AIMS (4,5). Developmental characteristics may differ per country. In 2000 Jeng et al. stated that normative data had to be deter- mined for Taiwanese children to discriminate between nor- mally developing children and children with motor delay (4). This suggests that before using the AIMS in a non-Canadian population, a new study to determine norm values may be necessary. To our knowledge no study has been carried out to determine whether Canadian data are representative for other countries. In the present study we aimed to establish whether the AIMS test needs new reference values for Dutch children, or whether the Canadian values may be used. MATERIALS AND METHODS Participants During a 4-month period (June–September 2004) parents of all children aged 0–12 months, attending a health care centre in Gouda, the Netherlands, were invited to let their child participate in the study. During the first year of life, children are scheduled to visit their primary health care five times. Gouda is a medium sized town in the western urban part of the Netherlands and can be considered a representative of the average Dutch town. 424 C 2006 The Author(s)/Journal Compilation C 2006 Foundation Acta Pædiatrica/Acta Pædiatrica 2007 96, pp. 424–427