Sonja Mensch

78 Chapter 4 ABSTRACT Aim: ‘ Mo tor e va luation in ki ds with intellectual and c omplex disabilities’ (Movakic) is a newly developed Dutch instrument for evaluating motor abilities in children with severe multiple disabilities. We have previously shown that its feasibility and content validity are satisfactory. The aim of this study is to investigate test-retest and inter-rater reliability. Methods: Children with severe multiple disabilities were scored six times by their own physical therapists at a three month interval, and at baseline by a second therapist familiar with the child in a subset of children. For the purposes of this study, the three- month period in which no event involving the child took place was selected. Results: Sixty children were recruited. The mean age of the children was 7.7 years (range 2-16), 45% had a cognitive development level <6 months (N=27) and 52% had Gross Motor Function Classification System level V (N=31). Test-retest reliability could be evaluated in 50 children and inter-rater reliability in 19 children. Intraclass correlations were all excellent or good (range .72-.98). Adequate absolute reliability is reflected in a small mean distance of Movakic scores and most respondents’ distances for test and retest were between one standard deviation and zero. Distribution is not related to the score level, although a ceiling effect might be present in score range 90-100. Conclusions: Movakic is a reliable instrument for measuring motor abilities in children with severe multiple disabilities. Key words Severe multiple disabilities; Motor abilities; Cerebral Palsy GMFCS V; Evaluative instrument; Movakic; Reliability Abbreviations Movakic; MOtor eVAluation of KIds with multiple and Complex disabilities SMD; Severe Multiple Disabilities GMFCS; Gross Motor Function Classification System COSMIN; COnsensus-based Standards for the selection of health Measurement INstruments IQ; Intelligent Quotient ICF-CY; International Classification of Functioning, Disability and Health for Children and Youth ICC; intraclass correlation coefficients