Understanding the Hammersmith Infant Neurological Examination (HINE)
Parents always want to be sure their babies are growing, learning, and developing in the healthiest way possible. During your child’s first year of life, pediatricians, therapists, and specialists use a variety of tools to check in on how the brain and body are developing. One of the most trusted tools for this is the Hammersmith Infant Neurological Examination, often called the HINE.
What Is the HINE?
The Hammersmith Infant Neurological Examination is a simple, non-invasive developmental assessment for babies between 2 and 24 months old. It helps clinicians observe how your baby’s nervous system is developing by looking at posture, movement, muscle tone, reflexes, and early motor skills. Think of it as a structured, gentle way of watching how your baby moves and interacts with the world.
Why Is the HINE Used?
It’s widely trusted because it’s quick, baby‑friendly, and backed by strong research. The HINE helps providers:
- Identify early signs of motor delays
- Monitor a baby’s progress over time
- Guide therapy or early intervention recommendations
- Support infants born prematurely or with medical complications
What Happens During the Exam?
The exam takes 15-20 minutes and involves no machines or discomfort; just hands‑on, kid-friendly interaction. Your baby may be asked to:
- Track a toy with their eyes
- Show how they hold up their head
- Move their arms and legs
- Participate in gentle positioning or supported sitting
How Is the HINE Scored?
Each part of the exam gets a score. Higher scores generally mean development is on track, while lower scores simply signal that your baby may benefit from extra monitoring or early support. A lower score does not mean something is “wrong,” it just gives us helpful information to guide care.
When Should Parents Consider a HINE Assessment?
Babies develop at their own pace, but certain patterns can benefit from a closer look. You might consider a HINE if you notice any of the following:
Early Motor Differences
- Baby consistently keeps hands in tight fists after 3 months
- Limited kicking or one-sided movement patterns
- Baby seems “too floppy” or “too stiff”
Delayed Milestones
- Trouble holding their head up by 3–4 months
- Not rolling by 6–7 months
- Not sitting independently by 8–9 months
(Every baby is different, these are just guidelines.)
Asymmetry
- Baby always prefers turning head to one side
- One arm or leg is used much less than the other
- Uneven posture in lying, sitting, or supported standing
Movement or Posture Concerns
- Persistent arching of the back
- Difficulty opening hands or bringing hands to mouth
- Frequent scissoring or stiff leg patterns when held upright
Medical or Birth History
Even if your baby seems to be doing well, the HINE is commonly recommended for infants with:
- Prematurity
- NICU stay
- Low birth weight
- Birth complications
- Diagnoses that place them at higher risk for developmental delays
These signs do not mean something is wrong, they just mean your baby could benefit from a closer, supportive look.
Our Physical Therapists Are Trained in Administering the HINE
Because early development is so important, our Physical Therapists are specially trained in administering and interpreting the HINE. We use the HINE regularly as part of our infant developmental evaluations, especially for babies with motor delays, birth complications, or parental concerns. This ensures:
- Your baby is assessed by providers who deeply understand infant motor development
- You receive clear explanations in parent-friendly language
- Any next steps, whether reassurance or early therapy, are thoughtfully guided and personalized
The Hammersmith Infant Neurological Examination is a gentle, evidence-based tool that helps ensure your baby is developing in the best way possible. It offers early insight, supports early intervention when needed, and gives families peace of mind. To learn more, or to speak to one of our pediatric physical therapists, schedule a free phone consultation.
