Scoring Sheet for the Infant Neurological International

Battery (INFANIB)
Suggestion from the Field
PATRICIA H. ELLISON

The scoring sheet for the Infant Neurological International Battery (IN-
FANIB) was not published in the September 1985 issue (Phys Ther 65:1326-
1331, 1985) with the research article by Ellison et al entitled "Construction
of an Infant Neurological International Battery (INFANIB) for the Assess-
ment of Neurological Integrity in Infancy." The sheet is printed here to permit
clinicians working with infants to use this method for a quantified evaluation
of tone and posture. Further details that describe each item and more
information about the use of the method are available from the author.

Dr. Ellison is Research Professor, Department of Psychology, University of Denver, 2030 S York St,
Denver, CO 80208 (USA).

548 PHYSICAL THERAPY

 PRACTICE

INFANIB
CHANGE
MAJOR
SCORE
START
Date of Exam
ITEM

NAME CIRCLE ONE Corrected Gestational Age

SUPINE Sometimes
1 Birth Open
Hands closed/open Closed Closed

Less 0° to 15° to 45° to 60° to Past

2 Birth Scarf sign Than 15° 45° 60° 85°
#4
#1
1 2 3 4
90° to 100° 60° to 90° 40° to 60° 10° to 40°
3 Birth Over Under
Heel to ear 100° 10°

4 Birth Popliteal angle Under Over

80° 150° to 170° 170°
80° to 90° 90° to 110° 110° to 150°
40° to 70° 70° to 100° 100° to 130° 130° to 150°

5 Birth Leg abduction Under Over

40° 150°

6 Birth Dorsiflexion of foot 10° to 40° 40° to 70° 70° to 80° 80° to 90°
0°to 10°

9 No Barely
7 Birth mos. Foot grasp Grasp Grasp
Grasp

6 Tonic labyrinthine Shoulder retraction Shoulder

8 Birth mos. supine Absent or some extension retraction and
of trunk or legs full leg extension

6 Asymmetric tonic Postures in,

9 Birth mos. Absent Persistent
neck reflex can move out

10 Birth Pull to sitting

Head extended Head up Head flexed Head flexed
Arms extended Arms ext. Arms ext. Arms flexed

11 4 mos. Present to Slow or mildly Absent or

Body derotative markedly asymmetrical
both sides asymmetrical

12 9 mos Body rotative Present Poor Absent

PRONE Head Head Bears weight Assumes Assumes Stands
Lifts Forearms
13 Birth up only up on extended all fours all fours up through
All fours Head unsteadily well
45° 90° arms Plantigrade
With Head Flexion
9 Tonic labyrinthine
14 Birth mos. Absent Shoulder protraction Shoulder protraction
prone
or some flexion of legs and arms, hips, or legs under trunk
SITTING
15 Birth
Sitting position L3
L5
Absent or
Present in Slow or mildly markedly
16 6 mos. Sideways parachute both arms asymmetrical asymmetrical

Backwards parachute Present in Slow or mildly Absent or

17 9 mos. both arms asymmetrical markedly asymmetrical
STANDING Poor weight
No Unequal
Primitive weight bearing weight
18 Birth Weight bearing reflex Breaks at
bearing bearing
knees

Positive support 5 to 30 sec. on toes >30 sec.

19 3 mos. Feet flat then drop to feet flat on toes
reaction

SUSPENDED
Present Slow or mildly Absent or
20 7 mos. Forward parachute markedly asymmetrical
asymmetrical

FACTOR SCORES
TOTAL SCORE

Volume 66 / Number 4, April 1986 549

 Overall: Normal = 5, Mildly abnormal = 3,
Corrected gestational age SCORING Markedly abnormal = 1
ITEM 0-.9 1-1.9 2-2.9 3-3.9 4-4.9 5-5.9 6-6.9 7-7.9 8-8.9 9-18 months Comments
One stage delay = 3
Closed Sometimes Open
1. closed
Matches age = 5 Two stage delay = 1
One closed, one open = 1

5 = Picture
2. matches age
0 - 15° 15-45° 45-60° 6 0 - 85°
1 2 3 4 3 = One stage
away ← or →
1 = Two stages
3. 100-90° 90-60° 60-40° 40- 10° away ← or →

4. 90- 110° As above except definite

80-90° 110- 150° 150- 170° asymmetry = 1

5. 40-70° 7 0 - 100° 100- 130° 130- 150° As for # 2 & 3

6. 0- 10° = 1 10-40° = 3 40-70° = 5 70-80° = 3 80-90° = 1

7. Exaggerated Grasp = 1, Other = 5 Absent Barely Grasp

= 5 Grasp = 3 = 1
8. Exaggerated TLS = 1 , Other = 5 Absent Some Full
= 5 = 3 = 1
9. Exaggerated ATNR = 1 , Other = 5 Absent = 5 Postures in Persistent = 1
Can move out = 3
Picture matches age = 5
Full = 5 One stage delay = 3
10. Partial head lag or not using arms = 3
Complete head lag and not using arms = 1 Two stage delay = 1

Present to Slow or mildly Absent or

11. both sides = 5 asymmetrical = 3 markedly asymmetrical = 1
Present = 5
12. Poor = 3
Absent = 1
Bears weight All All Picture matches age = 5
Lifts Head Forearms Head Plantigrade
13. on extended fours fours One stage delay = 3
Head up 4 5 ° only up 9 0 ° forearms unsteadily well Two stage delay = 1

14. Exaggerated TLP = 1, Other = 5 Absent Some Full

= 5 = 3 = 1
Picture matches age = 5
15. One stage delay = 3
Two stage delay = 1

Present in Slow or mildly Absent or

16. both arms = 5 asymmetrical = 3 markedly
asymmetrical = 1

17. As Above

No Poor weight Unequal Picture matches age = 5

Primitive Weight-
18. bearing weight One stage delay = 3
Reflex bearing Breaks at knee bearing Two stage delay = 1
Persistent weight-bearing
( > 6 0 sec) at 2.5 -
5 months = 1
Maintains weight 5 - 30 sec. on toes > 30 sec
19. feet flat = 5 then drop to feet flat = 3 on toes = 1

Slow or mildly Absent or

20. Present = 5
asymmetrical = 3 markedly asym. = 1

Degree of normality/abnormality based on total score

Less than 4 months 4 to 8 months 8 months or more

Abnormal ≤ 48 Abnormal ≤ 54 Abnormal ≤ 68
Transient 49 - 65 Transient 55-71 Transient 69-82
Normal ≥ 66 Normal ≥ 72 Normal ≥ 83

Category of abnormality

If abnormal, choose a category

D Spastic Tetraparesis/Dyskinesia □ Spastic □ Spastic □ Hypotonia
Hemiparesis Diplegia

1/85

550 PHYSICAL THERAPY