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Reliability of the Motor Optimality Score-Revised: A study of infants at elevated likelihood for adverse neurological
Maria Örtqvist1,2, Peter B Marschik3,4,5, Moreno Toldo6
1Department of Women's and Children's Health, Neonatal research unit, Karolinska Institutet, Stockholm, Sweden.
Insights
The Motor Optimality Score-Revised (MOS-R) demonstrates high reliability for assessing infants at risk of neurological issues. This tool is effective across diverse high-risk populations and age groups.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Neonatology
Background:
- Infants at elevated risk for adverse neurological outcomes require reliable assessment tools.
- The Motor Optimality Score-Revised (MOS-R) is utilized for evaluating infant motor development.
- Assessing the inter-assessor reliability of the MOS-R is crucial for its consistent application in clinical and research settings.
Purpose of the Study:
- To evaluate the inter-assessor reliability of the Motor Optimality Score-Revised (MOS-R).
- To determine the MOS-R's reliability in infants with an elevated likelihood for adverse neurological outcomes.
- To assess reliability across diverse infant populations and age spans.
Main Methods:
- The MOS-R was administered by two assessors to three distinct infant cohorts: extremely preterm infants (Sweden), infants from low-resource communities (India), and infants with prenatal SARS-CoV-2 exposure (USA).
- Intraclass correlation coefficients (ICC) and weighted kappa (κw) statistics were employed to quantify reliability.
- Reliability was analyzed for total MOS-R scores and subcategories across different age spans (9-12, 13-16, and 17-25 weeks post-term).
Main Results:
- High inter-assessor reliability was observed for the total MOS-R scores across all cohorts (ICC: 0.98-0.99) and age spans (ICC: 0.98-0.99).
- Substantial to perfect reliability was found for MOS-R subcategories (κw: 0.67-1.00).
- The postural patterns subcategory exhibited the lowest reliability (κw: 0.67).
Conclusions:
- The MOS-R demonstrates substantial to perfect inter-assessor reliability for use in high-risk infant populations.
- The MOS-R is reliable across different age groups and for both total and subcategory scores.
- Further investigation is warranted for the MOS-R subcategory 'postural patterns' and its overall clinical applicability.
Aim:
To assess the inter-assessor reliability of the Motor Optimality Score-Revised (MOS-R) when used in infants at elevated likelihood for adverse neurological outcome.
Methods:
MOS-R were assessed in three groups of infants by two assessors/cohort. Infants were recruited from longitudinal projects in Sweden (infants born extremely preterm), India (infants born in low-resource communities) and the USA (infants prenatally exposed to SARS-CoV-2). Intraclass correlation coefficients (ICC) and kappa (κw) were applied. ICC of MOS-R subcategories and total scores were presented for cohorts together and separately and for age-spans: 9-12, 13-16 and 17-25-weeks post-term age.
Results:
252 infants were included (born extremely preterm n = 97, born in low-resource communities n = 97, prenatally SARS-CoV-2 exposed n = 58). Reliability of the total MOS-R was almost perfect (ICC: 0.98-0.99) for all cohorts, together and separately. Similar result was found for age-spans (ICC: 0.98-0.99). Substantial to perfect reliability was shown for the MOS-R subcategories (κw: 0.67-1.00), with postural patterns showing the lowest value 0.67.
Conclusion:
The MOS-R can be used in high-risk populations with substantial to perfect reliability, both in regards of total/subcategory scores as well as in different age groups. However, the subcategory postural patterns as well as the clinical applicability of the MOS-R needs further study.
