Elizabeth M. Hurrion

Aim To investigate the prevalence and prognostic value of ‘low‐normal’ motor skills in infants at high‐risk for poor developmental outcomes. Method Infants born extremely low‐birthweight and extremely preterm discharged from neonatal intensive care between 2015 and 2018 completed the Alberta Infant Motor Scale (AIMS), Neuro‐Sensory Motor Developmental Assessment (NSMDA) at corrected age 4, 8, and 12 months, and Griffiths Mental Development Scale at corrected age 12 months. Results Participating infants ( n = 191) with a mean gestational age (95% confidence interval [CI]) of 26.80 weeks (26.60, 27.1) and mean birthweight (95% CI) of 869 grams (843, 895) included 45 (23.80%) infants small for gestational age. AIMS rated 50.32%, 35.37%, and 14.86% of infants within the ‘low‐normal’ motor skills range (1–2 SD below the mean for age) at 4, 8, and 12 months respectively. Of the infants within the AIMS ‘low‐normal’ skills range, 55.70%, 88.46%, and 59.10% were classified as having impairment by NSMDA at 4, 8, and 12 months respectively. Griffiths assessment at 12 months identified only 7.33% of infants with ‘low‐normal’ skills and 3.33% with motor disability. Minimal motor impairment rating on the NSMDA at 4 or 8 months significantly predicted general development at 12 months. Interpretation High‐risk infants with ‘low‐normal’ motor skills may warrant referral to early intervention as associated impairment represents increased risk for poorer general development outcomes. What this paper adds High prevalence of ‘low‐normal’ motor skill exists in high‐risk infants. Clinical motor assessment validly identifies infants with motor impairment. Minimal motor impairment in high‐risk infants is prognostic of general development. High‐risk infants with ‘low‐normal’ motor skills may warrant early intervention. Griffiths Scales of Child Development, Third Edition assessment at 12‐months age may under‐identify motor difficulties.