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Evaluating the validity, reliability and clinical utility of the Music therapy Sensory Instrument for Cognition,
Jonathan Wain Pool1,2, Richard John Siegert3, Steven Taylor4
1Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK jonathan.pool1@anglia.ac.uk.
Insights
This study introduces the Music therapy Sensory Instrument for Cognition, Consciousness and Awareness (MuSICCA) to improve diagnosis for children with disorders of consciousness (DOC). Validating MuSICCA aims to enhance care and rehabilitation for pediatric brain injury survivors.
Area of Science:
- Pediatric neurology
- Neurorehabilitation
- Music therapy
Background:
- Advances in healthcare increase survival rates for severe pediatric acquired brain injuries.
- Many pediatric survivors remain in disorders of consciousness (DOC), presenting significant diagnostic, clinical, and ethical challenges.
- Misdiagnosis in pediatric DOC can lead to inadequate care, limited rehabilitation, and reduced participation opportunities.
Purpose of the Study:
- To develop and validate a novel diagnostic measure, the Music therapy Sensory Instrument for Cognition, Consciousness and Awareness (MuSICCA).
- To support detailed goal-planning for children with disorders of consciousness.
- To improve diagnostic accuracy and subsequent care pathways for pediatric acquired brain injury survivors.
Main Methods:
- Initial assessment of face validity via questionnaire.
- Recruitment of 80 participants with suspected DOC across UK, USA, and Ireland.
- Validation against established scales (CRS-R, CNC, NCS), assessment of intra- and inter-rater reliability using video recordings, and evaluation of clinical utility via clinician and relative questionnaires.
Main Results:
- Face validity will be assessed and the instrument amended as needed.
- Reliability and validity will be established through rigorous comparison with external standards and blinded assessments.
- Clinical utility will be evaluated to gauge practical application in real-world settings.
Conclusions:
- The MuSICCA has the potential to significantly improve the diagnostic process for children with disorders of consciousness.
- Accurate diagnosis through MuSICCA can lead to more appropriate and effective care, rehabilitation, and support.
- This validated instrument aims to enhance the quality of life and participation for pediatric acquired brain injury survivors.
Introduction:
A growing number of children and young people are surviving severe acquired brain injuries due to advances in healthcare. However, many fail to emerge from coma and continue to live with disorders of consciousness (DOC). Diagnostic, clinical and ethical challenges are prominent in this group. Misdiagnosis can have severe consequences for children and their families, including inadequate care, insufficient access to rehabilitation and stimulation, reduced accessibility to services and inappropriately limited opportunities for participation. The proposed project will develop and validate a diagnostic measure that supports detailed goal-planning-the Music therapy Sensory Instrument for Cognition, Consciousness and Awareness (MuSICCA).
Methods And Analysis:
Face validity will be assessed using a short questionnaire and the MuSICCA will be amended if face validity is insufficient. Once face validity is sufficient, 80 participants with suspected DOC will be recruited from multiple sites around the UK, USA and Ireland.Validity will be assessed using external reference standards (Coma Recovery Scale-Revised, Coma Near-Coma Scale and Nociception Coma Scale). Intra-rater reliability will be established using repeated ratings of video recordings from the assessment sessions. Inter-rater reliability will be assessed through video ratings by a second blinded assessor. In addition to these analyses, the clinical utility of the MuSICCA will be evaluated using a questionnaire to be completed by clinicians and relatives of the participants following the completion of the MuSICCA assessment.
Ethics And Dissemination:
Ethical approval has been obtained for this study from the Research Ethics Committee and Health Research Authority of the National Health Service of the UK (ID: 167534). Results will be presented at national and international conferences, published in scientific journals and disseminated to participant representatives, clinicians, educators and care providers.
Trial Registration Details:
This study was registered at ClinicalTrials.gov Protocol Registration and Results System on 7th August 2019 (ID: NCT04050995); Pre-results.
