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Updated: Oct 8, 2025

Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Functional Symmetry Observation Scale, Version 2: Development and Content Validation Using a Modified Delphi Method
Mary Rahlin1, Joyce Barnett, Bernadette Sarmiento
1Rosalind Franklin University of Medicine and Science (Dr Rahlin), North Chicago, Illinois; Ability Occupational Therapy Services, LLC (Ms Barnett), Anchorage, Alaska; Independent Practitioner (Ms Sarmiento), Skokie, Illinois.
Purpose:
To describe the development of the Functional Symmetry Observation Scale (FSOS) Version 2 and its content validation.
Methods:
The FSOS Version 2 is an observational assessment that quantifies symmetry in spontaneous movement and posture in infants with congenital muscular torticollis, age birth to 18 months. Twenty expert pediatric physical therapists were identified through purposive sampling and invited to participate in a modified Delphi study. Survey data were collected on Qualtrics. Consensus was evaluated using median ratings and percent agreement on Likert Scale items. Thematic analysis was performed for open-ended question responses.
Results:
Thirteen experts completed Round 1 and 2 surveys. In Round 1, consensus was achieved on all but 1 item. The scale was modified based on received feedback. In Round 2, consensus was achieved on all items (median rating of 4, agreement at 85%-100%).
Conclusions:
This study established the content validity of the FSOS Version 2.
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