The intra- and inter-rater reliability of component analysis of rise from supine in the children with typical development and developmental delay.
Rising-from-supine coding is reliable, but always double-score leg actions, especially in kids with developmental delay.
01Research in Context
What this study did
Two therapists watched videos of babies rolling to stand. They scored how each child moved arms, legs, and trunk.
The team checked both kids with delays and kids who were on track. They wanted to know if two people would give the same score.
What they found
Agreement was high for most body parts. The same coder also scored the same way on two different days.
Scores for legs were shakier, especially for children with developmental delay.
How this fits with other research
dos Santos et al. (2013) say nonlinear math can spot delay, but warn that every lab uses different rules. Bih-Jen et al. give us one clear rule: watch the legs twice.
LeSage et al. (1996) saw the same drop in agreement when parents rated anxiety in kids with delay. Lower reliability in DD is not just a movement issue—it shows up across domains.
Matson et al. (2009) built a home tool for activity counts and also reached high inter-observer agreement. Both papers tell BCBAs: train two people, then check they still match.
Why it matters
If you track motor goals, videotape the rise-from-supine and have a second therapist score it. Count leg actions twice; they are the weak link. This quick double-check gives you solid data to show parents and payors that change is real.
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02At a glance
03Original abstract
The purpose of this study was to determine the intra- and inter-rater reliability of classifying the movement patterns of rising from supine to stand in the children with typical development (TD) and mild to moderate developmental delay (DD). Sixty-eight children with TD and 20 children with DD aged 2 through 6 years were videotaped during rising. Two trained pediatric physical therapists independently viewed each videotape and classified the movement patterns of upper extremities (UE), trunk/axial (AX) and lower extremities (LE) regions using descriptive categories developed by previous researchers. Kappa statistic and average percentage of agreement were calculated to determine reliability. The average agreement rate of intra-rater ranged from 90% to 97% in TD group for three regions, and 79% to 89% in DD group; the agreement rate between raters ranged from 82% to 95% in TD group for three regions, and 71% to 87% in DD group. Using kappa statistic guidelines, high intra- and inter-rater reliabilities (k>0.81) were found in TD group, except inter-rater reliability for LE. Substantial intra- and inter-reliabilities (0.61<k<0.81) were found in DD group. As comparing the reliabilities of three regions, the lowest intra- and inter-rater reliabilities were found at the LE region in both groups. As taking age into consideration and dividing each group into subgroups by 2-year interval, in DD group, the intra-rater reliabilities were higher in younger participants (aged 2-4 years), except for the LE region, but the results of inter-rater reliabilities were variable. For the children with TD, the levels of inter-rater reliability increased for the UE region and decreased for LE region in older age, but the results for these two regions were reverse for the children with DD. The findings of this study suggested that the complexities and difficulties affecting reliabilities in classifying the movement patterns of rising were related to developmental capability, age and body region. In order to improve intra- and inter-rater reliabilities, extra training is needed in examining the children with DD, particularly for the UE and LE regions.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2013.10.011