Poster #47 - Motor Performance Using the Movement ABC-2: The Absence of National Norms Affects the Clinical Report?

• In Event: 3-159 - Poster Session 12
  In Poster Session: PS 12 Section - Developmental Disabilities

Integrative Statement

BACKGROUND AND PURPOSE:
Very preterm birth is associated with poor motor and neurodevelopmental outcomes. The Screening to Improve Health in Very Preterm Infants in Europe (SHIPS) project aims to generate new knowledge about assessment tools and methods used to evaluate the neurodevelopment of 5 year old children born very preterm. One of those tools is the Movement Assessment Battery for Children 2nd edition (Movement ABC-2; Henderson et al., 2007). Although it is widely used, many countries, including Portugal, have not yet developed their own norms and must rely on other countries’ norms for the interpretation of test scores. The aim of this study is to investigate how the use of different norms affects the classification according to the motor ability of very preterm children at 5 years of age in Portugal.

METHODS:
As part of the SHIPs study, the Movement ABC-2 was administered to 353 Portuguese children who were born before 32 weeks GA between June 2011 and May 2012 (57.5% boys, mean GA 29.0 [range: 24-31]). The assessments were conducted by a group of clinical psychologists and took place between November 2016 and February 2018. The raw scores of the Movement ABC-2 for each child were transformed into standard scores according to the conversion tables of the UK norms, German norms, Italian norms and Dutch/Flemish norms. For comparison simplification only the percentiles of the total scores (mean total score: UK/German/Italian norms 31.0; Dutch/Fleming norms 24.4) and not the full test are displayed in table 1 and were compared for each child between the different norms.


RESULTS:
The percentiles of the Movement ABC-2 total scores were similar when using UK, German and Italian norms. However, in 64.3 % of the cases, using Dutch/Flemish norms yielded different percentiles. In 9.3% of the cases, the percentiles based on the Dutch/Fleming norms were higher than the UK/German/Italian norms, while in 55.0% of the cases the percentile was lower. A larger proportion of children had scores below the 15th percentile when using the Dutch/Flemish norms compared to the UK/German/Italian norms (n=143/40.5% vs n=98/27.8%). Proportions between the 16th and 25th percentile and above the 25th percentile when using the Dutch/Flemish norms were lower than when using UK/German/Italian norms (n=97/27.5% vs n=108/30.6% and n=113/32.0% vs n=147/41.6%, respectively).

CONCLUSIONS:
Three of the norms assessed in this study yielded almost identical percentile scores for very preterm children’s motor performance, but the Dutch/Flemish norms led to more children being classified as at risk of motor difficulty, although the direction of reclassification for each individual child was not consistent. The use of different country norms can position the child at different percentiles in terms of motor performance thus affecting clinical follow-up. The clinical interpretation of that positioning is discussed attending to each country definitions of those percentiles. Further investigation is needed to understand whether methods for generating the norms or cultural differences in motor development explain these large differences.

Group Authors

SHIPS Research Group

Authors

• Raquel Costa, EPIUnit - Instituto de Saúde Pública, Universidade do Porto
  Presenting Author

• Rym El Rafei, INSERM
  Non-Presenting Author

• Samantha Johnson, University of Leicester
  Non-Presenting Author

• Barros Henrique, EPIUnit - Instituto de Saúde Pública, Universidade do Porto
  Non-Presenting Author

• Jennifer Zeitlin, INSERM
  Non-Presenting Author

• SHIPS Research Group, INSERM
  Non-Presenting Author