Clinical Implications of the General Movement Optimality Score:Beyond the Classes of Rasch Analysis

This article explores the clinical implications of the three different classes drawn from a Rasch analysis of the general movements optimality scores (GMOS) of 383 infants. Parametric analysis of the class membership examines four variables: age of assessment, brain injury presence, general movement patterns, and 2-year-old outcomes. GMOS separated infants with typical (class 3) from atypical development, and further separated cerebral palsy (class 2) from other neurodevelopmental disorders (class 1). Each class is unique regarding its quantitative and qualitative representations on the four variables. The GMOS has strong psychometric properties and provides a quantitative measure of early motor functions. The GMOS can be confidently used to assist with early diagnosis and predict distinct classes of developmental outcomes, grade motor behaviors, and provide a solid base to study individual general movement developmental trajectories

Characterization of motor performance of infants at high risk for physical disability.

Characterization of motor performance of infants at high risk for physical disability

Cross-cultural validation of the Brazilian Little Developmental Coordination Disorder Questionnaire (LDCDQ-BR) for preschool children

Introduction: Motor difficulties associated with Developmental Coordination Disorder (DCD) are frequently apparent before the accepted diagnostic age of 5. Tools to support identification of DCD markers would allow provision of early intervention to reduce negative sequelae. Objective: Establish psychometric properties and define preliminary cut-off scores for the Brazilian Little Developmental Coordination Disorder Questionnaire - Brazil (LDCDQ-BR). Methods and procedures: Parents of 3- and 4-year-old children (n=312; 154 girls) from Belo Horizonte/MG, Brazil, completed the LDCDQ-BR, the Brazil Economic Classification Criterion and a demographic  questionnaire. One sub-set of children (n=119) was assessed with the Movement Assessment Battery for Children–2 nd Edition; another sub-set (n=77) completed the LDCDQ-BR a second time. Results: Rasch analysis indicated good item functioning with only one erratic item, suggesting unidimensionality. Item calibration reliability was excellent (0.97), children’s measures reliability was low (0.72), but implying separation of 2.46 motor ability levels. Significant, low correlations were found between the LDCDQ-BR and MABC-2 (r=0.30, p<0.01). Test-retest reliability was 0.77 (total score) and 0.44-0.78 (individual items). ROC curve analysis revealed sensitivity of 68% at a cut-off score of 64. Conclusion: The LDCDQ-BR shows promising psychometric properties to support early identification of DCD

Comparação das habilidades motoras de crianças prematuras e crianças nascidas a termo

Studies comparing the development of preterm and fullterm children provide relevant information to follow-up and early intervention programs. The objective of the present study was to compare the neuromotor development of preterm children with norms developed for fullterm children. The sample consisted of 162 children born before term (&lt;37 weeks), in the Hospital das Clínicas da Universidade Federal de Minas Gerais (Belo Horizonte, MG, Brazil). These children were longitudinally assessed in an outpatient follow-up programa, at the university hospital complex. The preterm group was assessed using the Denver Developmental Test at 12, 18 and 24 months corrected age. Data from these assessments were compared to norms described in the test´s manual, for the gross-motor and fine-motor, adaptive areas of function. Statistical analyses were conducted using Chi-square test (1). The results revealed that 16 (55%) out of the original 29 motor items showed significant difference between preterm and fullterm chidren. The observed difference indicated higher frequencies of positive scores (Pass) among the preterm group, especially among the fine-motor items. As the preterm group appoached the age of 24 months corrected age, an increasing number of itens showed significant group differences. The results were discussed considering the impact of extrauterine experience and correction of gestational age in the developmental outcome of preterm children, and suggesting a superestimation of these children´s developmental abilities compared to the term born children, at 24 months corected age.A investigação do desenvolvimento de crianças pretermo comparada com a de crianças nascidas a termo fornece informações importantes para programas de acompanhamento do desenvolvimento e intervenção precoce. Sendo assim, o objetivo deste trabalho foi comparar o desenvolvimento neuromotor de crianças pretermo com normas traçadas para crianças nascidas a termo. Foram analisados dados de uma amostragem de 162 crianças nascidas pretermo (antes de 37 semanas) na maternidade do Hospital das Clínicas da Universidade Federal de Minas Gerais e avaliadas sistematicamente pela equipe do Ambulatório de Acompanha-mernto do Recém Nascido de Alto Risco deste Hospital. O grupo de crianças pretermo foi avaliados pelo Teste de Desenvolvimento de Denver (TDD) aos 12,18 e 24 meses de idade corrigida e os dados obtidos foram comparados com os normativos, descritos no manual do teste, nos aspectos motor-fino adaptativo e motor grosso. O teste Qui-quadrado (1) foi utilizado pela análise estatística. Os resultados revelaram que, dos 29 itens motores analisados, 16 (55%) apresentaram diferença significativa entre pretermos e crianças nascidas a termo. O sentido da diferença observada indica que o grupo de crianças pretermo apresenta melhor desempenho, principalmente nos itens do apecto motor-fino. O melhor desempenho das crianças pretermo foi observado progressivamente em um maior número de itens, à medida que a idade da criança se aproxima dos 24 meses de idade corrigida. Os resultados são discutidos considerando-se o impacto da correção da idade gestacional e da experiência extra-uterina no desenvolvimento de crianças pretermo, apontando para uma superestimativa do desenvolvimento motor destas crianças em relação às nascidas a termo, aos 24 meses de idade corrigida

Psychometric Properties of the General Movement Optimality Score using Rasch Measurement

To explore the psychometric properties of the general movements optimality score (GMOS) by examining its dimensionality, rating scale functioning, and item hierarchies using Rasch measurement

Psychometric Properties of the General Movement Optimality Score using Rasch Measurement

AIM: To explore the psychometric properties of the general movements optimality score (GMOS) by examining its dimensionality, rating scale functioning, and item hierarchies using Rasch measurement. METHODS: Secondary data analysis of the GMOS data for video-recording of 383 infants with uni-, multidimensional, and mixed Rasch partial credit models. Videos were scored based on the global General Movement Assessment categories, and on the amplitude, speed, spatial range, proximal and distal rotations, onset and offset, tremulous and cramped components of the upper and lower extremities (21 items), resulting in the GMOS. RESULTS: The GMOS data fits best to a unidimensional mixed Rasch model with three different classes of infants, with all but two items contributing to the infants' separation. Rating scales functioned well for 19 items. Item difficulty hierarchies varied depending on infants' class. No floor effect and no substantive gaps between item difficulty estimates were found. CONCLUSION: The GMOS has strong psychometric properties to distinguish infants with different functional motor performance and provides a quantitative measure of quality of movement. INTERPRETATION: The GMOS can be confidently used to assist with early diagnosis, grade motor performance, and provide a solid base to study individual general movement developmental trajectories