Abnormal Involuntary Movement Scale (AIMS)

Rates severity of orofacial, limb and trunk dyskinesia in patients on antipsychotics.

Facial and oral movements (frown, blink, smile, grimace)

Lips and perioral area (puckering, pouting, smacking)

Jaw (biting, clenching, chewing, mouth opening, lateral movement)

Tongue (movement in/out of mouth, not limited to eating)

Upper extremities (arms, wrists, hands, fingers)

Lower extremities (legs, knees, ankles, toes)

Neck, shoulders, hips (rocking, twisting, squirming)

Global severity of abnormal movements

Incapacitation due to abnormal movements

Patient's awareness of abnormal movements

Result0 points

Movement severity does not meet research criteria for probable tardive dyskinesia on items 1-7.

Global severity: 0
Incapacitation: 0
Awareness: 0
Meets Schooler-Kane research criteria for probable TD: No

When to use

Serial monitoring of orofacial and limb dyskinesia in patients on antipsychotics or other dopamine-blocking agents.
Screening for tardive dyskinesia and tracking change over time.

Formula

Sum of items 1-7 (facial/oral, extremity, trunk movements), each rated 0-4; range 0-28. Items 8-10 (global severity, incapacitation, awareness) are scored 0-4 but reported separately, not summed into the total.

Pearls and pitfalls

Rate the highest severity observed during activation procedures, not the average.
A rise of ≥2 points on any single item, or new appearance of movements, is generally considered a clinically meaningful change.

References

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