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 (INFANIB) was not published in the September 1985 issue (Phys Ther 65:13261331, 1985) with the research article by Ellison et al entitled "Construction
of an Infant Neurological International Battery (INFANIB) for the Assessment 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

START
SCORE

INFANIB

ITEM

MAJOR
CHANGE

PRACTICE

Birth

SUPINE
Hands closed/open

Birth

Scarf sign

Date of Exam

NAME

Birth

Heel to ear

Birth

Popliteal angle

Sometimes
Closed

Closed
Less
Than

0 to
15

#1

15 to
45
2

60 to 90

40 to 60

Under
80

Dorsiflexion of foot

9
Birth mos.

Foot grasp

6
Tonic labyrinthine
Birth mos.
supine

Absent

6
Birth mos.

Asymmetric tonic
neck reflex

Absent

10

Birth

Pull to sitting

40 to 70

10 to 40

0to 10

Birth

15

Birth

130 to 150

Body rotative

Postures in,
can move out

Head
up
45

9
Tonic labyrinthine
mos.
prone

Forearms
only

Shoulder
retraction and
full leg extension
Persistent

Head up
Arms ext.

Head flexed
Arms flexed

Head flexed
Arms ext.

Absent or
markedly asymmetrical

Slow or mildly
asymmetrical
Poor

Present
Lifts
Head

Grasp

Shoulder retraction
or some extension
of trunk or legs

Present to
both sides

Body derotative

80 to 90

70 to 80

Barely
Grasp

No
Grasp

Head extended
Arms extended

14

100 to 130

Over
150

Birth

All fours

110 to 150

90 to 110
70 to 100

Under
40

Birth

Over
170

150 to 170

Leg abduction

13

4
10 to 40

Under
10

Birth

PRONE

Past
#4

Over
100

9 mos

60 to
85

45 to
60

80 to 90

12

Open

90 to 100

40 to 70

11 4 mos.

Corrected Gestational Age

CIRCLE ONE

Head
up
90

Absent
Assumes
all fours
unsteadily

Bears weight
on extended
arms

Assumes
all fours
well

Stands
up through
Plantigrade

With Head Flexion

Shoulder protraction
Shoulder protraction
or some flexion of legs
and arms, hips, or legs under trunk

Absent

SITTING
L3

Sitting position

L5

16

6 mos.

Sideways parachute

Present in
both arms

Slow or mildly
asymmetrical

Absent or
markedly
asymmetrical

17

9 mos.

Backwards parachute

Present in
both arms

Slow or mildly
asymmetrical

Absent or
markedly asymmetrical

STANDING
18

Birth

Weight bearing

19

3 mos.

Positive support
reaction

No
weight
bearing

Primitive
reflex

Feet flat

Poor weight
bearing
Breaks at
knees

Unequal
weight
bearing

5 to 30 sec. on toes
then drop to feet flat

>30 sec.
on toes

SUSPENDED
20 7 mos.

Forward parachute

Present

Slow or mildly
asymmetrical

Absent or
markedly asymmetrical

FACTOR SCORES
TOTAL SCORE
Volume 66 / Number 4, April 1986

549

ITEM

1.

1-1.9

0-.9

2.

3-3.9

2-2.9

4-4.9

Sometimes
closed

Closed

Overall: Normal = 5, Mildly abnormal = 3,

Markedly abnormal = 1

SCORING

Corrected gestational age

5-5.9

6-6.9

7-7.9

8-8.9

9-18 months

Open

Matches age = 5

15-45

0 - 15

45-60

5 = Picture
matches age

6 0 - 85

Comments
One stage delay = 3
Two stage delay = 1
One closed, one open = 1

3 = One stage
away or
1 = Two stages
away or

3.

100-90

90-60

60-40

40- 10

4.

80-90

90- 110

110- 150

150- 170

As above except definite

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

7.

Exaggerated Grasp = 1, Other = 5

8.

Exaggerated TLS = 1 , Other = 5

9.

Exaggerated ATNR = 1 , Other = 5

Absent = 5

Absent
= 5
Absent
= 5
Postures in
Can move out = 3

Present to
both sides = 5

11.

Grasp
= 1
Full
= 1

Persistent = 1
Picture matches age = 5
One stage delay = 3
Two stage delay = 1

Absent or
markedly asymmetrical = 1

Slow or mildly
asymmetrical = 3

Present = 5
Poor = 3
Absent = 1

12.

14.

Barely
Grasp = 3
Some
= 3

Full = 5
Partial head lag or not using arms = 3
Complete head lag and not using arms = 1

10.

13.

80-90 = 1

70-80 = 3

Head
up 4 5

Lifts
Head

Forearms
only

Head
up 9 0

Bears weight
on extended
forearms

All
fours
unsteadily

All
fours
well
Absent
= 5

Exaggerated TLP = 1, Other = 5

Picture matches age = 5

One stage delay = 3
Two stage delay = 1

Plantigrade

Some
= 3

Full
= 1
Picture matches age = 5
One stage delay = 3
Two stage delay = 1

15.
Present in
both arms = 5

16.

Slow or mildly
asymmetrical = 3

17.

18.

Absent or
markedly
asymmetrical = 1
As Above

Primitive
Reflex

No
Weightbearing

Poor weight
bearing
Breaks at knee

Picture matches age = 5

One stage delay = 3
Two stage delay = 1

Unequal
weight
bearing

Persistent weight-bearing
( > 6 0 sec) at 2.5 5 months = 1
Maintains weight
feet flat = 5

19.

5 - 30 sec. on toes
then drop to feet flat = 3

20.

Present = 5

> 30 sec
on toes = 1
Slow or mildly
Absent or
asymmetrical = 3 markedly asym. = 1

Degree of normality/abnormality based on total score

4 to 8 months
Abnormal 54
Transient 55-71
Normal 72

Less than 4 months

Abnormal 48
Transient 49 - 65
Normal 66

8 months or more
Abnormal 68
Transient 69-82
Normal 83

Category of abnormality

If abnormal, choose a category

D Spastic Tetraparesis/Dyskinesia

Spastic
Hemiparesis

Spastic
Diplegia

Hypotonia

1/85

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PHYSICAL THERAPY