Hammersmith Infant Neurological Examination (HINE)

The Hammersmith Infant Neurological Examination (HINE) is a standardized assessment tool used to evaluate neurological function in infants aged 2 to 24 months. It is particularly useful for detecting early signs of cerebral palsy and other neurodevelopmental disorders.

The HINE assesses:

  • Cranial nerve function (e.g., eye movements, facial expressions)
  • Posture and movements
  • Muscle tone and reflexes
  • Motor milestones

Scores range from 0 to 78, with lower scores indicating greater neurological impairment. The HINE is widely used in clinical and research settings to support early diagnosis and intervention planning.

Accessing the HINE:

You can download the official HINE proforma from the Queensland Cerebral Palsy and Rehabilitation Research Centre:

Additionally, detailed guidance notes are available from Mac Keith Press:

Pros of the HINE:

  • Comprehensive Assessment: The HINE evaluates 26 items across five domains: cranial nerve function, posture, movements, muscle tone, and reflexes.
  • Ease of Use: The examination is relatively short, easy to learn, and does not require expensive equipment, making it applicable in various clinical settings.
  • Early Detection: The HINE is effective in identifying infants at high risk for cerebral palsy and other neurological disorders, facilitating early intervention.
  • Standardized Scoring: Provides a structured scoring system, enhancing consistency and reliability in assessments.

Cons of the HINE:

  • Training Requirements: Accurate administration and interpretation require proper training to ensure reliability and consistency.
  • Age Limitations: Designed for infants between 3 to 24 months; its applicability beyond this age range is limited.
  • Sensitivity to Subtle Changes: While comprehensive, the HINE may not detect very subtle neurological abnormalities, necessitating supplementary assessments in some cases.