BSN Tracker

Assessment Tool: AIMS

The AIMS is the standard monitoring instrument for tardive dyskinesia (TD) and other antipsychotic- induced movement disorders. Administer at baseline before starting antipsychotic therapy and repeat every 3–6 months. Observe the patient at rest and during activating maneuvers. Any progression requires immediate clinical review — TD may be irreversible once established.

AIMS — Abnormal Involuntary Movement Scale

A 12-item clinician-rated instrument developed by the National Institute of Mental Health (NIMH) to detect and monitor tardive dyskinesia (TD) and other involuntary movement disorders associated with antipsychotic medication use. Rate each body region during observation at rest and during activating maneuvers. Any item rated ≥ 2 in a body region, or two separate body regions rated ≥ 2, warrants clinical follow-up and consideration of medication modification.

Observation procedure: Ask patient to remove shoes and sit in a firm, armless chair. Observe gait, then have patient sit with hands on knees (or hanging unsupported), open mouth, protrude tongue, tap each finger to thumb, extend arms in front, and stand. Rate each region 0–4. Items 11–12 are dental/denture status items and are not scored.

Body Movement Ratings (Items 1–7)

1. Muscles of facial expression

Forehead, eyebrows, periorbital area, cheeks; include frowning, blinking, grimacing of upper face

2. Lips and perioral area

Puckering, pouting, smacking

3. Jaw

Biting, clenching, chewing, mouth opening, lateral movement

4. Tongue

Rate only increase in movement both in and out of mouth, NOT inability to sustain movement

5. Upper extremities (arms, wrists, hands, fingers)

Include choreic movements (i.e., rapid, objectively purposeless, irregular, spontaneous), athetoid movements (i.e., slow, irregular, complex, serpentine). Do NOT include tremor (i.e., repetitive, regular, rhythmic).

6. Lower extremities (legs, knees, ankles, toes)

Include choreic movements; foot tapping, heel dropping, foot squirming, inversion and eversion of foot

7. Neck, shoulders, hips

Include rocking, twisting, squirming, pelvic gyrations

Global Assessment (Items 8–10)

8. Severity of abnormal movements overall
9. Incapacitation due to abnormal movements
10. Patient's awareness of abnormal movements

Rate only patient's report

Items 11–12 — Dental Status (not scored)

11. Does the patient have current problems with teeth and/or dentures?

12. Does the patient usually wear dentures?

Document responses in clinical record; do not include in total score.