Investigation of the Turkish Validity and Reliability of Specific Test of Early Infant Motor Performance (STEP) in Follow-Up of Risk Infants

The aim of study was to evaluate the risk of premature and low birth weight babies with the Early Infant Motor Evaluation Test (STEP), to measure the correlation of the STEP test with Bayley Infant Development Scales (Bayley-III) and Hammersmith Infant Neurological Examination (HINE) evaluations, to investigate the validity and reliability of the STEP test in the evaluation and follow-up of babies at risk.

The Early Infant Motor Evaluation Test (STEP) provides a quantitative assessment of tone and movements that allows developmental monitoring with a short screening test in terms of practical patient flow. A standardized test provides an opportunity to recognize early abnormalities in tone and movement patterns and seek treatment before milestones are delayed or abnormal movements stabilized. STEP can be used to measure early movement problems in high-risk infants, refer these infants earlier, and then monitor response to targeted interventions. It is thought that STEP can identify infants at risk of delay, thus enabling earlier initiation of targeted therapy. The implementation and scoring of STEP takes approximately 10 minutes. It does not require special training, is easy to access, is a short and fast performing neuromotor examination. As a screening test for early intervention, it can be applied in neonatal intensive care units and follow-up clinics prior to discharge, potentially improving long-term outcomes.

Technological advances in neonatal-perinatal medicine have led to a steady increase in the survival rate of preterm infants. Although the increase in survival rate has been a remarkable achievement, children born prematurely are at high risk for brain damage and long-term neurodevelopmental deficits. Premature children may have abnormal muscle tone or movements, cognitive deficits, language disorders, and behavioral problems.

Babies born preterm (<37 weeks of gestation) are three to four times more at risk for a range of motor disorders than the general population due to various biological and environmental risk factors. This highlights the need for improved surveillance and intervention strategies in this group of children.

The main goal of developmental surveillance in infants with risk factors for cerebral palsy and other neuromotor disorders is to screen for signs of delayed motor development so that physical therapy can be started as early as possible. Neuroimaging is expensive and does not detect all infants at high risk. Parental reporting of motor milestones in the first trimester is unlikely to be as accurate as methods based on direct observation. Barriers to implementing highly sensitive assessments based on direct observation include the cost of training, lack of reliability in various professions, and the duration of assessment. Most of the screening tests used involve long-term use that may harm newborns.