Assessment & Research

Objective evaluation of muscle strength in infants with hypotonia and muscle weakness.

Reus et al. (2013) · Research in developmental disabilities 2013
★ The Verdict

A five-minute physiological test reliably spots severe weakness in hypotonic infants and charts progress over time.

✓ Read this if BCBAs in early-intervention or NICU follow-up programs who write motor goals for babies with Prader-Willi or Down syndrome.
✗ Skip if Clinicians working only with verbal school-age clients or purely behavioral targets.

01Research in Context

01

What this study did

Reus et al. (2013) built a quick, objective test of muscle strength for babies.

They tried it on typically developing infants and on infants with Prader-Willi syndrome who have very low tone.

The method uses simple equipment and gives a number you can track over time.

02

What they found

The new measure gave steady scores when different people used it.

It clearly split the two groups: Prader-Willi babies scored much lower.

The authors say the tool is ready for both clinic and research use.

03

How this fits with other research

Emerson et al. (2023) did the same kind of psychometric work, but for a working-memory game in toddlers with Down syndrome.

Both papers show you can build short, reliable tests for kids with developmental delays.

Boutot et al. (2018) looked at tummy-time in one hypotonic baby with Down syndrome.

Their case study proves that even weak infants can move more when you add a favorite toy.

Together, the three studies give you both a way to measure low tone and a way to treat it.

04

Why it matters

If you serve infants with genetic syndromes, you now have a fast strength metric that needs no big lab gear.

Use it at intake, then track progress every month.

Pair the numbers with simple motivation tricks like Boutot’s toy activation and you can show parents clear, data-based change.

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→ Action — try this Monday

Add the Linda strength check to your intake packet; score it before and after your tummy-time sessions.

02At a glance

Intervention
not applicable
Design
other
Sample size
98
Population
neurotypical, other
Finding
positive
Magnitude
large

03Original abstract

The clinical evaluation of an infant with motor delay, muscle weakness, and/or hypotonia would improve considerably if muscle strength could be measured objectively and normal reference values were available. The authors developed a method to measure muscle strength in infants and tested 81 typically developing infants, 6-36 months of age, and 17 infants with Prader-Willi Syndrome (PWS) aged 24 months. The inter-rater reliability of the measurement method was good (ICC=.84) and the convergent validity was confirmed by high Pearson's correlations between muscle strength, age, height, and weight (r=.79-.85). A multiple linear regression model was developed to predict muscle strength based on age, height, and weight, explaining 73% of the variance in muscle strength. In infants with PWS, muscle strength was significantly decreased. Pearson's correlations showed that infants with PWS in which muscle strength was more severely affected also had a larger motor developmental delay (r=.75).

Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2012.12.015