INFANIB scale for UG students

1. - AKSHATHA NAYAK
INFANIB

2.  Infant Neurological International Battery.
 Neurological integrity of infants
 Evaluation of special children
 born premature
 Treated in NICU (high risk infants)
 Those who develop sickness during infancy
 Those who develop slowly.

3. Neurological assessment of infants is of key
importance for three reasons:
1) for identification of abnormalities that should
be referred for physical and occupational
therapy,
2) as a marker for problems during the early school
years,
3) for research about the causes and outcomes of
these abnormalities.

4. • Observational finding.
• At birth hands being closed is a normal finding
till 2-3 months of age.
• Clenching or fisting at any age is considered
abnormal and is scored as abnormal.
• If closed indicates increased tone.
• If abnormally loose  decreased tone.
HANDS OPEN/ CLOSED

5.  Changes occur in quarters of first year progresses
to lesser flexibility to greater flexibility.
 Examiner holds the arm near the elbow and
moves it across the chest as far as it will move
easily without excessive force.
 Angle measured between imaginary line drawn
from armpit and upper arm.
 Increased angle – Hypotonia
 Decreased angle – Hypertonia.
Scarf sign

6.  Measure of flexibility of hip and not lower spine.
 Examiner grasps the legs around the knees so that the
legs are extended.
 Buttocks should be kept close to examining table as
much as possible.
 Extensibility reduces as the age progresses.
 Excellent indicator of hypertonia.
 Appears before dorsiflexor tightness.
 Infants usually fail to attain feet to mouth milestone.
Heel to ear

7.  Increases with age.
 Another important predictor of spasticity.
 Grasp the legs near the knee flex and abduct the
hips with buttock near the examination table.
 Angle between the thigh and the leg.
 Popliteal angle is better indicator than heel to ear.
Popliteal angle

8.  Examiner holds the leg at the knee and proceeds
to abduct the lower limb.
 Angle formed between the legs with crotch as a
fulcrum.
 Flexibility Increases with age.
 Not so sensitive for hypertonia but very sensitive
for hypotonia.
Leg abduction

9.  Dorsiflexion of the foot.
 Pushing and not pulling.
 Flexibility decreases with age.
Dorsiflexion of the foot

10.  Examiner uses his/her thumb or finger to exert
pressure on the infants footpad, then observes
extent to which the toe curl downwards.
 Foot grasp present in neonate and the later
disappear in infancy.
 In children with increased tone the reflex is
exaggerated.
The foot grasp

11.  Examiner places one hand underneath the infant
and between the scapula and rubs the skin.
 Classical response is one of extension of either or
both arms and legs.
 Some might exhibit flexion which should also be
taken as abnormal.
Tonic labyrinthine Supine

12.  Examiner grasps the infant’s head with one hand
and turns the head to one side and watches for
posturing.
 Fencing position.
 Exaggerated when infant assumes the posture
when placed on a firm surface.
 Some infants might not exhibit the posture which
an be considered normal.
Asymmetric tonic neck reflex

13.  Grasping of infants hand and pulling the infant
up for sitting.
 Not necessary to reach sitting position if there is
marked reduction in the tone or delayed head
control.
 If there is discrepancy between the head position
and arm position, head position should be
considered for marking.

Pull to sitting

14.  Examiner initiates rolling over for the infant.
 If the child does not choose to exhibit roll from
back to front but the caretaker reports presence
of skill, it should be marked accordingly.
Body derotative

15.  Rolling over from back to front followed by a pull to
standing position.
 If pull to stand is not exhibited in front of the examiner
but the caretaker reports then the child can be marked
accordingly.
 Requires loss of any asymmetric tonic neck reflex, intact
vestibular function and maturation, sufficient truncal
tone and leg tone to support the body.
BODY ROTATIVE

16.  Examiner turns the infant over into prone
position.
 Observation is then made of the position of the
head, arms, and legs.
 If discrepancies are present in early infancy the
head should be the part of reference.
All-fours

17.  Examiner places his/her hand under the
baby’s chest with the baby in prone position.
Tonic labyrinthine prone

18.  Examiner places the infant in sitting position and
holds infant there unless he/she can maintain a
sitting position well independently.
 Observe the point at which the bend occurs.
Sitting

19.  Examiner places the infant in sitting position,
with his hand on lateral lower trunk.
 Then tips the baby off balance on either of sides
a bit and examines the hand and arm on the side
tipped to.
 The infant should extend the arm and use the
hand for balance.
 Excellent item to test hemiparesis.
SIDEWAYS PARACHUTE

20.  Examiner holds infant at trunk.
 Better done from side.
 Tipped backwards.
 Infant may turn to either of the side.
Backward parachute

21.  Examiner holds the infant under arms with legs in
standing position.
 Examiners should observe feet and legs.
Standing

22.  Is a double check for increased tone in ankle joint
and toe walking.
 Examiner observes infants feet as infant is placed
in standing position.
Positive support reaction

23.  Examiner holds on each side of the infant's trunk
and trusts the infant towards surface, head first.
 Normally infant extends both arm in anticipation,
toward the surface.
Forward parachute