THE BRIEF ASSESSMENT OF MOTOR FUNCTION (BAMF): CONTENT VALIDITY AND RELIABILITY OF THE FINE MOTOR SCALE

Abstract

Purpose/Hypothesis: The BAMF consists of 5 hierarchical 0-10 scales designed for rapid assessment of motor performance, independent of age. BAMF items are structured to reliably assess demonstrated motor capability, not impairment or disability. The Lower Extremity Scale has been validated and published. Content validity is completed for the two Oral Motor Scales: Articulation and Deglutition, their reliability trials are in progress. This abstract reports content validity and reliability determinations for the Fine Motor Scale (FMS). A companion abstract for this meeting reports content validity and reliability for the Upper Extremity Gross Motor Scale. Number of Subjects: 28 Occupational Therapists participated as Expert Panel Members to evaluate the content of the FMS. All have PhD, DSc or ScD degrees; 90% have more than 25 years of experience. For reliability, a convenience sample of ten children (ages 19 mo to 15 years; 3 males, 7 females) with a range of diagnoses including Proteus, Sheldon-Freeman, Smith-Lemli-Opitz, and Smith-Magenis syndromes, was selected to represent a broad range of skill levels. Materials/Methods: After agreeing to participate, Expert Panel members were sent a questionnaire via email composed of 6 standard questions for each of the 0-10 FMS items. Response range was 1 = Disagree to 4 = Agree. Completion of the questionnaire was necessary for inclusion on the Expert Panel. Respondents were invited, not required, to provide additional written comments on the questionnaire. Means, medians and ranges were used to describe central tendency and range of responses. For reliability, 3 occupational and 2 physical therapists rated the videotaped motor performances of 10 children whose FMS scores ranged from 0-10. The Kappa Statistic was used to evaluate reliability. Results: Expert panel members agreed that all items should be included (means 3.43–3.89, range 1–4, medians 4.00); all items are functionally relevant (means 2.93–3.82, ranges 1–4, medians 2.5–4), and all items are easily discriminated (means 3.32–4.0; ranges 1–4, medians 4.00). Eighty-six written comments were used to modify the content of the FMS in addition to the quantitative data. Kappa values for interrater and intrarater reliability were 0.978 and 1.00, respectively. Conclusions: Twenty-eight experts in occupational therapy provided quantitative and qualitative feedback to establish content validity of the BAMF FMS. Kappa values for interrater and intrarater reliability indicate this is a highly reliable instrument for baseline and screening purposes when rapid motor performance assessment is desired. Clinical Relevance: Motor skill assessments normed to nondisabled children are valuable for obtaining intervention services. However, children with motor limitations are only described by these scales according to their relative deficits, using numbers which do not indicate what the child can actually do. The BAMF FMS was designed for very rapid screening and longitudinal assessment of children's capability, in a format that links immediately to a specific fine motor level.