Abnormal Involuntary Movement Scale (AIMS)

Instructions: Complete examination procedure before making ratings.

Movement Ratings: Rate highest severity observed, rate movements that occur upon activation one less than those observed spontaneously.

Code: 0= None 1=Minimal, may be extreme normal 2= Mild

3= Moderate 4= Severe

Examination Procedure

Either before or after completing the examination procedure, observe the patient unobtrusively at rest. The chair to be used in this examination should be a hard, firm one without arms.

1. Ask patient whether there is anything in his/her mouth (i.e. gum, candy, etc) and if there is, to remove it.

2. Ask patient about the current condition of his/her teeth. Ask patient is he/she wears dentures. Do teeth/dentures bother patient now?

3. Ask patient whether he/she notices any movements in mouth, face, hands, or feet. If yes, ask to describe and to what extent they currently bother patient or interfere with his/her activities.

4. Have patient sit in chair with hands on knees, legs slightly apart, and feet flat on floor. (Look at entire body for movements while in this position)

5. Ask patient to sit with hands hanging unsupported. If male, between legs; If female and wearing a dress, hanging over knees (observe hands and other body areas)

6. Ask patient to open mouth. (Observe tongue at rest within mouth). Do this twice.

7. Ask patient to protrude tongue. Observe abnormalities of tongue movement. Do this twice.

8. Ask patient to tap thumb with each finger as rapidly as possible for 10-15 seconds; separately with right hand and then with left hand. (Observe facial and leg movements.)

9. Flex and extend patient's left and right arms, one at a time. (Note any rigidity and rate on dotes.)

10. Ask patient to stand up. (Observe in profile. Observe all body areas again, hips included)

11. Ask patient to extend both arms outstretched in front with palms down. (Observe trunk, legs, and mouth.)

12. Have patient walk a few paces, turn, and walk back to chair. (Observe hands and gait.) Do this twice.

Patient Name

First NameLast Name

Facial and Oral Movements

	0	1	2	3	4
1. Muscles of facial expression e.g Movements of forehead, eyebrows, periorbital area, cheeks; including frowning, blinking, smiling, grimacing
2. Lips and perioral area e.g. Puckering, pouting, smacking
3. Jaw e.g. 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.

Extremity Movements

	0	1	2	3	4
5. Upper- arms, wrists, hands, fingers. Include Chorea 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- legs, knees, angles, toes. (i.e. lateral knee movement, foot tapping, heel dropping, foot squirming, inversion and eversion of foot)

Trunk Movements

	0	1	2	3	4
7. Neck, Shoulders, Hips (i.e. rocking, twisting, squirming pelvic gyrations)

Global Judgments

	0	1	2	3	4
8. Severity of abnormal action
9. Incapacitation due to abnormal movements
10. Patient's awareness of abnormal movements

Dental Status

	0	1	2	3	4
11. Current Problems
12. Does patient usually wear dentures?

Not Applicable: Patient has no history of treatment with Neuroleptics for one month or more.

Examination Completed

Provider's Signature

Date of Examination

Date

Monitoring for all atypical antipsychotics: AIMS exam at baseline and ~Q6months due to risk of Tardive Dyskinesia. Warn of dystonia risk. Weight checks, fasting glucose/lipid panel ~Q6months at minimum.