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Updated: Jun 28, 2025
Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
Baby Observational Selective Control AppRaisal (BabyOSCAR): Scores at 3 months predict functional ability, spastic
Colleen Peyton1,2, David Aaby3, Vanessa Maziero Barbosa4
1Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Insights
The Baby Observational Selective Control AppRaisal (BabyOSCAR) tool accurately predicts spastic cerebral palsy (CP) in infants. Early assessment of movement patterns using BabyOSCAR identifies children at risk for CP and its severity.
Area of Science:
- Neurology
- Developmental Pediatrics
- Movement Science
Background:
- Early detection of cerebral palsy (CP) is crucial for timely intervention.
- Assessing infant motor patterns can provide predictive insights into neurodevelopmental outcomes.
- The Baby Observational Selective Control AppRaisal (BabyOSCAR) tool evaluates spontaneous movements in infants.
Purpose of the Study:
- To evaluate the predictive accuracy of the BabyOSCAR tool administered at 3 months corrected age.
- To determine if BabyOSCAR can predict spastic CP diagnosis, functional abilities (GMFCS levels), and body topography at 2 years.
- To assess the tool's capability in distinguishing between different GMFCS levels.
Main Methods:
- 75 infants were assessed using BabyOSCAR by measuring independent joint motions from video recordings of spontaneous movements at 10-16 weeks.
- Infants had known 2-year outcomes, including CP diagnosis, GMFCS levels, and CP body distribution.
- Receiver operating characteristic (ROC) curves were used to determine predictive performance and optimal cut-off scores.
Main Results:
- A total BabyOSCAR score >22.5 strongly predicted spastic CP (98% sensitivity, 100% specificity, AUC=0.99).
- The tool differentiated GMFCS levels I-II from III-V (cut score 13.5, 92% sensitivity, 89% specificity, AUC=0.94).
- An asymmetry score >5 predicted unilateral CP (100% specificity, AUC=0.86).
Conclusions:
- BabyOSCAR scores effectively predict spastic CP diagnosis, body distribution, and gross motor function at 2 years.
- Decreased independent joint movement at 3 months is a significant predictor of spastic CP.
- Specific BabyOSCAR score ranges predict GMFCS levels, and asymmetry scores indicate unilateral CP.
Aim:
To assess the predictive capabilities of the Baby Observational Selective Control AppRaisal (BabyOSCAR) tool, administered at 3 months corrected age, in determining spastic cerebral palsy (CP) outcome, functional abilities, and body topography at 2 years of age or later.
Method:
Independent joint motions were measured at age 10 to 16 weeks from video recordings of spontaneous movement using BabyOSCAR in a sample of 75 infants. All included infants had known 2-year outcomes (45 with spastic CP and 30 without CP) including Gross Motor Functional Classification System (GMFCS) levels and CP body distribution. Receiver operating characteristic curves and cut points indicating greatest sensitivity and specificity were generated for predictive performance.
Results:
Total BabyOSCAR score was a strong predictor of future outcome of spastic CP (cut score of 22.5, sensitivity = 98%, specificity = 100%, area under the curve = 0.99), and was able to distinguish children classified in GMFCS levels I and II from those in III to V (cut score of 13.5, sensitivity = 92%, specificity = 89%, area under the curve = 0.94). Having an (absolute) asymmetry score on the BabyOSCAR of more than 5 was a predictor of having unilateral CP at age 2 years (sensitivity = 56%, specificity = 100%, area under the curve = 0.86).
Interpretation:
BabyOSCAR scores are predictors of diagnosis, body distribution, and future gross motor function in infants with spastic CP at 2 years of age or later.
What This Paper Adds:
Decreased independent joint movement at 3 months predicts spastic cerebral palsy (CP) at 2 years. Baby Observational Selective Control AppRaisal (BabyOSCAR) scores ≤13 are predictive of Gross Motor Function Classification System (GMFCS) levels III to V. BabyOSCAR scores of 14 to 22 are predictive of GMFCS levels I and II. A BabyOSCAR total asymmetry score >5 predicts unilateral CP. Stereotyped movements are more prominent in those who will be diagnosed with spastic CP at 2 years.
