The Early Neuropsychologic Optimality Rating Scale (ENORS-9): a new developmental follow-up technique

The development and application of the Early Neuropsychologic Optimality Rating Scale (ENORS-9) is described. This 24-item technique, scored in an optimal/nonoptimal fashion, enables assessment of posture, tone, and movement, as well as developmental delays. The ENORS-9 was compared with the Bayley Mental and Psychomotor Developmental indexes and a neurologic examination administered at 9 months, in terms of sensitivity and specificity of cognitive, motor, and neurologic outcome at 36 months. Using an ENORS-9 cut-off score of 85% for cognitive and motor, and 75% for neurologic outcome, sensitivity values were more than three times greater than more traditional assessment techniques. This instrument meets many needs in developmental follow-up because of straightforward scoring, decreased personnel requirements and cost, and flexibility in regard to missing data and cut-off scores. The implications of these findings are discussed.