Sonja Mensch

79 Reliability of Movakic INTRODUCTION Motor abilities are of paramount importance to independent functioning, but are often severely compromised in children with severe multiple disabilities (SMD). Children with SMD suffer from profound intellectual disabilities (IQ <25) and have a level of motor abilities that is comparable to level IV/V on the Gross Motor Function Classification System (GMFCS) for children with cerebral palsy (Palisano et al., 1997) (Veugelers et al., 2005). In addition, children with SMD may have multiple sensory disorders and other comorbidity. Usually, physiotherapists are closely involved with stimulation and training of such children, because even subtle improvement of motor abilities can aid these children in developing some degree of control over their environment and may as such improve their quality of life. As in any healthcare profession, physical therapists desire to evaluate the effectiveness of their treatment methods, for which reliable instruments are needed. However, commonly used instruments for measuring motor abilities in children with disabilities (Mensch, Rameckers, Echteld, & Evenhuis., 2015a) review are considered unsuitable for children with SMD. They are unsuitable because of their inclusion of higher GMFCS levels, the requirement of perfect execution of themotor ability, the need for verbal instruction, the use of large-step grading, and the design of items without the application of manual support or use of devices in mind. Therefore, an instrument was needed that fulfills specific suitability criteria (Mensch, Rameckers, Echteld, Penning, & Evenhuis., 2015a). A new instrument named Movakic ( mo tor e va luation in ki ds with i ntellectual and c omplex disabilities) for measuring and evaluating motor abilities in children with SMD was developed by a Dutch expert focus group and was found to be feasible with good content validity (Mensch et al., 2015b). Before an instrument can be used in clinical or research settings, stability across time and raters should be assessed (Vet de, Terwee, Knol, & Bouter, 2006). Therefore, in this study the test-retest reliability and inter-rater reliability of Movakic were evaluated. METHODS Participants, selection Children younger than 18 years with SMD who received care in specialized day-care centers were included. Severemultiple disabilities were defined as profound intellectual disability (IQ<25) in combination with severely impaired motor abilities GMFCS level IV and V (Palisano et al., 1997).