Reproducibility of the Motor Optimality Score–Revised in infants with an increased risk of adverse neurodevelopmental outcomes
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.
