Toolkit / Movement disorders

AIMS: Abnormal Involuntary Movement Scale

Clinician, 12 items, scored 0–28, about 10 minutes

Twelve-item clinician-rated examination for tardive dyskinesia. Seven body areas are rated 0–4 and summed; three global judgements and two dental questions are recorded alongside but do not count towards the total.

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Left blank, these print as lines to fill in by pen.

Observe the patient unobtrusively at rest, then complete the standard examination procedure (seated, hands on knees, mouth open, tongue out, finger tapping, arms extended, standing and walking). Rate the highest severity observed; rate movements that occur on activation one point less than those seen spontaneously.

  1. Facial and oral movements

  2. 1Muscles of facial expressione.g. movements of forehead, eyebrows, periorbital area, cheeks; include frowning, blinking, smiling, grimacing
  3. 2Lips and perioral areae.g. puckering, pouting, smacking
  4. 3Jawe.g. biting, clenching, chewing, mouth opening, lateral movement
  5. 4TongueRate only increases in movement both in and out of the mouth, not inability to sustain movement

  6. Extremity movements

  7. 5Upper (arms, wrists, hands, fingers)Include choreic movements (rapid, objectively purposeless, irregular, spontaneous) and athetoid movements (slow, irregular, complex, serpentine). Do not include tremor (repetitive, regular, rhythmic)
  8. 6Lower (legs, knees, ankles, toes)e.g. lateral knee movement, foot tapping, heel dropping, foot squirming, inversion and eversion of foot

  9. Trunk movements

  10. 7Neck, shoulders, hipse.g. rocking, twisting, squirming, pelvic gyrations

  11. Global judgements (not added to the total)

  12. 8Severity of abnormal movements overallnot in total
  13. 9Incapacitation due to abnormal movementsnot in total
  14. 10Patient’s awareness of abnormal movementsnot in totalRate only the patient’s report

  15. Dental status (not added to the total)

  16. 11Current problems with teeth and/or dentures?not in total
  17. 12Are dentures usually worn?not in total

Interpreting the total

0No abnormal movements rated
1–28Movements rated — see TD criteria

Notes

  • The total of items 1–7 (0–28) is useful for tracking change in the same patient. There are no official severity bands for the total.
  • Schooler–Kane research criteria for probable tardive dyskinesia: at least moderate (3) movements in one body area, or at least mild (2) movements in two or more areas, after at least 3 months of cumulative antipsychotic exposure, in the absence of another cause. (DSM-IV research criteria shorten the exposure to 1 month in people aged 60 or over.)
  • Repeat the AIMS at baseline and at regular intervals (commonly every 6–12 months) for anyone on long-term antipsychotics, and more often in older adults and those at higher risk.

References

  1. Guy W. ECDEU Assessment Manual for Psychopharmacology, revised. US Department of Health, Education and Welfare; 1976. Publication ADM 76-338: 534–537.
  2. Schooler NR, Kane JM. Research diagnoses for tardive dyskinesia. Arch Gen Psychiatry. 1982;39(4):486–487.

Developed by the US National Institute of Mental Health; in the public domain.

An educational aid for clinicians, not a substitute for clinical judgement. Scores support, but never replace, a full assessment. Your answers on this page are never stored or sent.

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