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Baby Observational Selective Control AppRaisal (BabyOSCAR): Convergent and discriminant validity and reliability in
Theresa Sukal-Moulton1,2, Vanessa Maziero Barbosa3, Barbara Sargent4
1Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Insights
Reduced independent joint motion in infants indicates spastic cerebral palsy (CP). The Baby Observational Selective Control AppRaisal (BabyOSCAR) tool accurately identifies this early sign, correlating with later motor function.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Rehabilitation Medicine
Background:
- Spastic cerebral palsy (CP) affects infant motor development.
- Early identification of CP is crucial for timely intervention.
- Quantifying spontaneous independent joint motion is challenging in infants.
Purpose of the Study:
- To develop and validate the Baby Observational Selective Control AppRaisal (BabyOSCAR) measure.
- To assess the convergent validity and reliability of BabyOSCAR in infants.
- To determine if BabyOSCAR scores at 3 months predict later motor function in infants with and without CP.
Main Methods:
- Retrospective analysis of 75 infants (45 with spastic CP, 30 controls) at 3 months of age.
- BabyOSCAR scores compared with CP diagnosis, limb involvement, and Gross Motor Function Classification System (GMFCS) levels.
- Convergent validity assessed using t-tests, Kruskal-Wallis, and Spearman correlations.
- Interrater and test-retest reliability evaluated using intraclass correlation coefficients.
Main Results:
- Infants with spastic CP had significantly lower BabyOSCAR scores than controls (p < 0.001).
- BabyOSCAR scores significantly correlated with GMFCS levels (p < 0.001).
- Unilateral CP infants showed higher asymmetry scores than bilateral CP or control infants (p < 0.01).
- BabyOSCAR demonstrated good to excellent interrater and test-retest reliability.
Conclusions:
- Reduced independent joint control in infancy is a hallmark of spastic CP.
- BabyOSCAR is a reliable and valid observational tool for assessing infant motor control.
- Early BabyOSCAR scores predict later gross motor function, aiding in early CP diagnosis and management.
Aim:
To describe the development of an observational measure of spontaneous independent joint motion in infants with spastic cerebral palsy (CP), the Baby Observational Selective Control AppRaisal (BabyOSCAR), and to test its convergent validity and reliability.
Method:
A retrospective sample of 75 infants (45 with spastic CP and 30 without CP) at 3 months of age were scored with the BabyOSCAR and compared with diagnosis of spastic CP, limbs affected, and Gross Motor Function Classification level at 2 years of age or later for convergent validity using t-tests, Kruskal-Wallis tests, and Spearman's rank correlation coefficients. BabyOSCAR interrater and test-retest reliability was also evaluated using intraclass correlation coefficients.
Results:
Infants with spastic CP had significantly lower BabyOSCAR scores than children without CP (p < 0.001) and scores were significantly correlated with Gross Motor Function Classification System levels (p < 0.001). Children with unilateral CP had significantly higher asymmetry scores than children with bilateral CP or no CP (p < 0.01). Interrater and test-retest reliabilities were good to excellent.
Interpretation:
Reductions in independent joint control measured in infancy are a hallmark of eventual diagnosis of spastic CP, and influence gross motor function later in childhood (with or without a diagnosis of CP).
What This Paper Adds:
Early brain injury causing spastic cerebral palsy results in fewer independent joint movements in infants. Baby Observational Selective Control AppRaisal (BabyOSCAR) score at 3 months depends on limbs affected by early brain injury. BabyOSCAR scores at 3 months correlate with Gross Motor Function Classification System level at ≥2 years. BabyOSCAR has excellent interrater reliability. BabyOSCAR, scored with a 1-minute video recording, has good to excellent test-retest reliability.
