Risk Classification Instrument for Orofacial Myofunctional Disorders - ICR/DMO: Reliability (Part III)

To assess the reliability of the Risk Classification Instrument for Orofacial Myofunctional Disorders (ICR/DMO).

This reliability study was conducted as part of the broader validation process of the ICR/DMO. Ninety caregivers of infants and preschoolers participated and were allocated into three age groups: G1=30 infants aged 1-5 months; G2=30 infants aged 6-23 months; and G3=30 preschoolers aged 24-71 months. Participants were recruited from two public daycare centers and a university pediatric clinic. The ICR/DMO was administered in person by a single speech-language pathologist (A1) by means of individual interviews with the caregivers, with responses registered in real time and audio-recorded. The audio recordings were analyzed by three additional raters (A2a, A2b, and A2c). After calibration, each rater received 30 audio recordings according to the following group allocation: A2a (G1), A2b (G2), and A2c (G3). Inter-rater agreement (100% of the sample; n=90) and intra-rater reproducibility (20% of the sample; n=18) were assessed using Kendall's tau (Kendall's τ). The following interpretation was adopted: weak (<0.4), moderate (0.4-0.7), and strong (>0.7), with p<0.05.

Inter- and intra-rater agreement were observed both for the total scores and for individual instrument items. For the total scores, inter-rater agreement was moderate in G1 (τ=0.576; p=0.001); strong in G2 (τ=0.775; p<0.001), and moderate in G3 (τ=0.583; p<0.001). In all groups, the retest showed strong agreement (G1: τ=0.786; p=0.032; G2: τ=0.881; p=0.002; G3: τ=0.926; p=0.014). For the individual items, both inter-rater and intra-rater agreement showed satisfactory rates of observed agreement.

The ICR/DMO demonstrated evidence of reliability across the three age groups, with inter-rater agreement ranging from moderate to good and intra-rater agreement ranging from good to excellent.