Inter-observer reliability using the General Movement Assessment is influenced by rater experience

C Peyton; A Pascal; L Boswell; R deRegnier; T Fjørtoft; R Støen; L Adde

doi:10.1016/j.earlhumdev.2021.105436

Inter-observer reliability using the General Movement Assessment is influenced by rater experience

Early Hum Dev. 2021 Oct:161:105436. doi: 10.1016/j.earlhumdev.2021.105436. Epub 2021 Aug 2.

Authors

C Peyton¹, A Pascal², L Boswell³, R deRegnier⁴, T Fjørtoft⁵, R Støen⁶, L Adde⁷

Affiliations

¹ Department of Physical Therapy and Human Movement Science, Northwestern University, Feinberg School of Medicine, 645 N. Michigan Ave, Chicago, IL 60611, USA; Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA. Electronic address: colleen.peyton1@northwestern.edu.
² Department of Rehabilitation Sciences, Ghent University, 9000 Gent, Belgium. Electronic address: aurelie.pascal@ugent.be.
³ Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA. Electronic address: lboswell@luriechildrens.org.
⁴ Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA; Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA. Electronic address: r-deregnier@northwestern.edu.
⁵ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Clinic of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway. Electronic address: toril.fjortoft@stolav.no.
⁶ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Department of Neonatology, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway. Electronic address: Ragnhild.stoen@ntnu.no.
⁷ Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway; Clinic of Clinical Services, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway. Electronic address: lars.adde@ntnu.no.

PMID: 34375936
DOI: 10.1016/j.earlhumdev.2021.105436

Abstract

Objective: To describe the inter-observer reliability of the General Movement Assessment (GMA) among a sample of infants at high-risk of cerebral palsy (CP) among raters with various levels of experience.

Methods: Video assessments of 150 high-risk infants at 10-15 weeks corrected age were rated by three Prechtl GMA-certified observers with varied experience using the assessment. Videos were scored based on temporal organization of fidgety movements (FMs), presence of abnormal FMs, or absence of FMs. Inter-observer agreements were analyzed with Gwet's AC1 statistic.

Results: We found fair to moderate agreement when subcategories of normal FMs (continuous and intermittent) were included (AC₁ = 0.32-0.57) and moderate to near perfect agreement when normal categories of FMs were combined (AC₁ = 0.60-0.95). Reliability was higher among observers with more experience using the GMA (AC₁ = 0.57-0.98) than the observer with less experience (AC₁ = 0.32-0.61).

Conclusions: Caution may be warranted when the GMA is used to differentiate "continuous and intermittent" FMs temporal organization. The GMA is highly reliable among experienced raters when comparing normal FMs to other FMs categorizations.

Keywords: General Movement Assessment; High-risk infants; Infant assessment; inter-observer reliability.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cerebral Palsy* / diagnosis
Dyskinesias*
Humans
Infant
Movement
Observer Variation
Reproducibility of Results