AIM: The objectives of this study were (i) to develop two cerebral visual impairment motor questionnaires (CVI-MQ's) for children with cerebral palsy (CP): one for children with Gross Motor Function Classification System (GMFCS) levels I, II and III and one for children with GMFCS levels IV and V; (ii) to describe their face validity and usability; and (iii) to determine their sensitivity and specificity.BACKGROUNDS: The initial versions of the two CVI-MQ's were developed based on literature. Subsequently, the Delphi method was used in two groups of experts, one familiar with CVI and one not familiar with CVI, in order to gain consensus about face validity and usability. The sensitivity and specificity of the CVI-MQ's were subsequently assessed in 82 children with CP with (n = 39) and without CVI (n = 43). With the receiver operating curve the cut-off scores were determined to detect possible presence or absence of CVI in children with CP.RESULTS: Both questionnaires showed very good face validity (percentage agreement above 96%) and good usability (percentage agreement 95%) for practical use. The CVI-MQ version for GMFCS levels I, II and III had a sensitivity of 1.00 and specificity of 0.96, with a cut-off score of 12 points or higher, and the version for GMFCS levels IV and V had a sensitivity of 0.97 and a specificity of 0.98, with a cut-off score of eight points or higher.CONCLUSION: The CVI-MQ is able to identify at-risk children with CP for the probability of having CVI.
Poster presentatie op conferentie Background: Assessments of functional communication skills of children with cerebral palsy (CP), classified with the Communication Function Classification System (CFCS), often differ between the child's school teacher and the speech language therapist (SLT). Assessment by the SLT is usually based on observations in a clinical setting, which may not be representative of the functional communication skills in daily life. This study evaluated the inter-rater agreement of the CFCS assessed by the school teacher and SLT before and after observation of a communicative situation in the classroom. Methods: Functional communication of 35 children with CP (4 to 18 years; 26 with Alternative and Augmentative Communication, AAC) was classified by the own SLT and teacher using the CFCS. SLT's performed two assessments: the first without additional instructions and the second after observation of the child during a communicative situation in the classroom. For both assessments of the SLT inter-rater agreement on CFCS-level between SLT and teacher was determined using Cohen's weighted kappa statistics. Results: For the whole group, inter-rater reliability was 0.6 before observation in de classroom and 0.7 after observation. In the group without AAC weighted K was 0.67 for both assessments. In the group with AAC weighted K increased from 0.2 to 0.61. Interpretation The increased inter-rater agreement of CFCS classification between teacher and SLT after observation in the classroom, especially for children with AAC, emphasizes the need for professionals to base their CFCS assessment on observation of functional communication in everyday situations.
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Children with cerebral palsy must perform daily exercise which is a tedious and energy consuming task. Exergames can make this routine more engaging, which can increase the compliance of the patient. This research explores the feasibility of an exergame device called the Squid Monster. The device is the result of a research through design process, and it is designed to be played on smartphones in the home environment. It operates on the smartphone's integrated sensors and two external squeeze sensors, making it accessible and cost-effective. We conceptualize how the design can be supported using a machine learning adaptive difficulty system, aiming to increase flow and therapeutic adherence of the device. Ultimately, guidelines are provided to designers for future work in this field.
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