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Published on: November 3, 2016
Reproducibility of the Motor Optimality Score-Revised in infants with an increased risk of adverse neurodevelopmental
Carly Luke1,2, Arend F Bos3, Michelle Jackman4,5
1Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Australia.
Insights
The Motor Optimality Score-Revised (MOS-R) shows good reproducibility for assessing infants at high risk of neurodevelopmental disorders. Consensus agreement among experienced assessors enhances its reliability in clinical settings.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Clinical Assessment Tools
Background:
- Infants at high risk for adverse neurodevelopmental outcomes (ad-NDO) require reliable assessment tools.
- The Motor Optimality Score-Revised (MOS-R) is utilized to evaluate neurodevelopmental trajectories.
- Assessing the reproducibility of the MOS-R is crucial for its clinical application.
Purpose of the Study:
- To determine the reproducibility of the Motor Optimality Score-Revised (MOS-R).
- To assess the MOS-R's utility in identifying infants at high risk for cerebral palsy (CP), autism, and developmental delays.
- To evaluate the feasibility of MOS-R implementation in clinical settings.
Main Methods:
- Thirty infants (gestational age 23-41 weeks) with known 2-year outcomes were assessed.
- Six independent assessors, masked to infant history, scored MOS-R from two General Movements videos per infant.
- Interrater reliability was calculated using Intraclass Correlation Coefficient (ICC) and Gwet's agreement coefficient.
Main Results:
- Combined interassessor reliability for total MOS-R was 'fair' (ICC=0.56), improving to 'excellent' with consensus agreement (ICC=0.99).
- Reliability varied across subcategories, with 'movement patterns' showing highest agreement (Gwet's=0.73-1.00) and 'postural patterns' the lowest (0.45-0.73).
- Higher reproducibility was observed when assessors scored two videos per infant and for typically developing infants compared to those with CP or ad-NDO.
Conclusions:
- The MOS-R is a highly reproducible tool for assessing infants at high risk for ad-NDOs.
- The MOS-R is feasible for clinical implementation, particularly when used by experienced assessors aiming for consensus.
- Consensus agreement significantly enhances the reliability of MOS-R assessments.
Aim:
To determine reproducibility of the Motor Optimality Score-Revised (MOS-R) to assess infants at high risk of adverse neurodevelopmental outcomes, including cerebral palsy (CP), autism, and developmental delays.
Method:
Thirty infants (18 males, 12 females, gestational age mean [range] = 32.5 [23-41] weeks) were randomly selected, according to 2-year outcome (typically developing; CP; or adverse neurodevelopmental outcome [ad-NDO]) from a prospective cohort. Participants had two General Movements videos between 12 weeks and 15 + 6 weeks corrected age. Six assessors, masked to history and outcomes, independently scored the MOS-R from videos. Assessors scored either one (Group 1; n = 3) or two videos for each infant (Group 2; n = 3). Intraclass correlation coefficient (ICC), Gwet's agreement coefficient, and limits of agreement were calculated.
Results:
Combined interassessor reliability (IRR) over six assessors for total MOS-R was 'fair' (ICC = 0.56, 95% confidence interval [CI] 0.41-0.72), and 'excellent' with consensus agreement (ICC = 0.99, 95% CI 0.98-0.99). Analyses demonstrated a mean interrater difference of 0.316 (95% limits of agreement -11.51, 12.14) over 450 comparisons (15 pairs). IRR was 'moderate' to 'almost perfect' across subcategories, with the highest reliability 'movement patterns' (Gwet's agreement coefficient = 0.73-1.00) and the lowest 'postural patterns' (0.45-0.73). Assessors who scored two videos (Group 2) demonstrated higher reproducibility. IRR for total MOS-R was 'excellent' when infants were typically developing (ICC = 0.90), and 'good' for CP (0.74) and ad-NDO (0.68).
Interpretation:
The MOS-R is a highly reproducible tool for assessing infants at high risk of ad-NDOs and is feasible for implementation in clinical settings. Reproducibility is best when the tool is used by experienced assessors to gain consensus agreement.
