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Published on: June 20, 2020
Movement Disorders Rating Scale for Children Aged 0-3 years: A Revision Study Design
Roberta Battini1, Roberta Scalise2, Valentina Menici3
1Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Insights
The revised Movement Disorders - Childhood Rating Scale (MD-CRS 0-3 R) offers a more precise and reliable assessment of movement disorders in young children. This updated tool demonstrates improved psychometric properties for longitudinal evaluations.
Area of Science:
- Pediatrics
- Neurology
- Developmental Pediatrics
Background:
- The Movement Disorders - Childhood Rating Scale (MD-CRS 0-3) is used to evaluate movement disorders in children up to 3 years old.
- Clinical experience indicated a need for improved characterization, age-appropriate tasks, and a more detailed scoring system.
- The original scale required more quantitative specifications for precise scoring and psychometric definition.
Purpose of the Study:
- To revise the MD-CRS 0-3 scale to enhance its structure and items.
- To create the Movement Disorders - Childhood Rating Scale 0-3 Revised (MD-CRS 0-3 R).
- To promote wider adoption of the scale through improved usability and psychometric properties.
Main Methods:
- A measurement-focused study involving video sessions of children in inpatient and outpatient settings.
- Inclusion of 90 eligible participants (30 female, 60 male) aged 3 months to 3 years and 11 months.
- Independent and blind scoring of video sessions by five raters using both the original and revised scales with a minimum 6-month interval.
Main Results:
- The MD-CRS 0-3 R demonstrated high reliability, with Inter-rater and Intraclass Correlation Coefficient values exceeding 0.85 across all indexes.
- Standard Errors of Measurement and Minimally Detectable Differences were notably low, indicating precision.
- The revised scale exhibited superior psychometric properties compared to the original MD-CRS 0-3.
Conclusions:
- The revised MD-CRS 0-3 R is a trustworthy and sensitive tool for assessing movement disorder severity in children under 4 years.
- The scale is suitable for longitudinal assessments of movement disorder progression.
- The study supports the clinical utility and enhanced psychometric validation of the MD-CRS 0-3 R.
Background:
Movement Disorders - Childhood Rating Scale (MD-CRS 0-3) is a tool aimed to evaluate movement disorders in the first 3 years of life; however, with the experience gained in 10 years clinical practice, it has been possible, and necessary, to improve the characterization of the scale defining age-appropriate tasks according to age time windows and moving the MD severity from a three-point to a five-point scoring system. By using the scale in our clinical practice and in research, we realized that it was necessary to have more quantitative specifications, allowing a more precise scoring and a better definition of the psychometric properties. This study is a measurement-focused study of recorded video sessions and of video sessions which were carried out in in- and out-patient settings of IRCCS Fondazione Stella Maris aiming to revise the MD-CRS 0-3 and created the MD-CRS 0-3 R to promote and increase its use by improving its structure and items.
Methods:
A clinical sample of 90 eligible individuals-30 females and 60 males, mean age 2 years and 6 months, and age range 3 months - 3 years and 11 months-was included. Five raters independently and blindly scored the videotapes according to the MD-CRS 0-3 and the MD-CRS 0-3 R, with an interval of at least 6 months.
Results:
Inter-rater and Intraclass Correlation Coefficient values in all indexes of MD-CRS 0-3 R all exceeded 0.85. Standard Errors of the Measurement and Minimally Detectable Differences were very low. Overall, the MD-CRS 0-3 R exhibited improved psychometric properties compared to the original scale.
Conclusions:
The present study supports the use of the revised MD-CRS 0-3 in children under 4 years as a trustworthy, sensitive tool as for longitudinal assessments of movement disorder severity.
