Interrater and Intrarater Reliability Using Prechtl's Method of Qualitative Assessment of General Movements in Infants

Abstract

Purpose: To establish interrater and intrarater reliability of two novice raters (the two authors) with different educational background in assessing general movements (GM) of infants using Prechtl’s method. Methods: Forty-three infants under 20 weeks of post-term age were recruited from our Level III neonatal intensive care unit (NICU) and NICU follow-up clinics of our medical center. The infants were observed using the GM assessment either during the writhing movement or the fidgety movement age periods. Results: There was no significant difference (p > 0.05) between the two observers on interrater reliability and between Trials 1 and 2 for interrater reliability. Conclusion: Novice raters need to establish their interrater and intrarater reliabilities in order to correctly identify GM patterns. The ability to correctly identify GM patterns in infants may be influenced by the raters’ varying educational background. The infant’s GMs as gross motor movements are called writhing movements (WMs) which are preceded by variable preterm GMs before 36weeks. WMs can be observed after birth in both term and preterm infants. These GMs involve the whole body in variable sequence of the neck, trunk and extremities. They are described by Prechtl as “complex, elliptical, fluent, and are of moderate to large amplitude, with an intensity, force and speed that increases and decreases over time” [12]. The same GMs observed in preterm infants are frequently observed as WMs with faster speed and larger amplitude. If the GMs appear as monotonous and less complex, they are referred to as poor repertoire (PR) movements [12].