Page last checked: 29th November 2022
Last updated: 15th February 2022

What is it and how is it scored?

The HINE score is only used in children up to the age of 2 years. It is a physiotherapy-based assessment designed to be as easy as possible to undertake and show meaningful measurement. Most items can be scored just by watching a baby or young child. HINE looks at developmental tasks a baby is expected to be able to do and scores them for each. There are eight parts to it:

• voluntary grasp
• head control
• ability to kick whilst lying on back
• rolling
• sitting
• crawling
• standing
• walking

Each of these parts is scored out of up to four. The total score for each varies as some tasks (such as crawling) may have more stages before successfully being able to complete them. The total score is out of 26.

For more information, see this simplified summary of what is measured and scored.

Usually, researchers are most interested in two things: the average score of infants at the end of the study, and how much the score may have changed. HINE is also used to look at other conditions such as cerebral palsy¹, Infants at risk of developmental problems², and premature babies³.

What has been reported as the usual score for an infant with SMA Type 1 without drug treatment over time?

A study by De Sanctis and colleagues looked at 34 infants with SMA (Type 1) using the HINE assessment⁴. They found a difference between infants who began with weakness at less than 6 months compared to infants who were older when symptoms began. The younger group scored 0 on all of the different parts and didn’t increase their score over the 12 months of the study. No infants improved in their score over time. Some of the infants affected at a later age may have achieved a score of one in head control, kick, and voluntary grasp. None improved their ability, and the majority had a lower score over the time of the study.

References

1. Romeo, D. M., Ricci, D. , Brogna, C. and Mercuri, E. (2016), Use of the Hammersmith Infant Neurological Examination in infants with cerebral palsy: a critical review of the literature. Dev Med Child Neurol, 58: 240-245. doi:10.1111/dmcn.12876

2. Maitre, Nathalie L. et al. Implementation of the Hammersmith Infant Neurological Examination in a High-Risk Infant Follow-Up Program. Pediatric Neurology, Volume 65, 31 – 38

3. Chin, E. Y., Baral, V. R., Ereno, I. L., Allen, J. C., Low, K. and Yeo, C. L. (2019), Evaluation of neurological behaviour in late‐preterm newborn infants using the Hammersmith Neonatal Neurological Examination. J Paediatr Child Health, 55: 349-357. doi:10.1111/jpc.14205

4. De Sanctis R, Coratti G, Pasternak A, et al. Developmental milestones in type I spinal muscular atrophy. Neuromuscul Disord. 2016;26(11):754–759. doi:10.1016/j.nmd.2016.10.002