Discipline of Paediatrics and Child Health, The University of Sydney, The Children's Hospital at Westmead, Clinical School, Locked Bag 4001, Westmead, NSW 2145, Australia.
BMC Pediatr. 2013 Sep 6;13:135. doi: 10.1186/1471-2431-13-135.
The Lililwan Project is the first population-based study to determine Fetal Alcohol Spectrum Disorders (FASD) prevalence in Australia and was conducted in the remote Fitzroy Valley in North Western Australia. The diagnostic process for FASD requires accurate assessment of gross and fine motor functioning using standardised cut-offs for impairment. The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) is a norm-referenced assessment of motor function used worldwide and in FASD clinics in North America. It is available in a Complete Form with 53 items or a Short Form with 14 items. Its reliability in measuring motor performance in children exposed to alcohol in utero or living in remote Australian Aboriginal communities is unknown.
A prospective inter-rater and test-retest reliability study was conducted using the BOT-2 Short Form. A convenience sample of children (n = 30) aged 7 to 9 years participating in the Lililwan Project cohort (n = 108) study, completed the reliability study. Over 50% of mothers of Lililwan Project children drank alcohol during pregnancy. Two raters simultaneously scoring each child determined inter-rater reliability. Test-retest reliability was determined by assessing each child on a second occasion using predominantly the same rater. Reliability was analysed by calculating Intra-Class correlation Coefficients, ICC(2,1), Percentage Exact Agreement (PEA) and Percentage Close Agreement (PCA) and measures of Minimal Detectable Change (MDC) were calculated.
Thirty Aboriginal children (18 male, 12 female: mean age 8.8 years) were assessed at eight remote Fitzroy Valley communities. The inter-rater reliability for the BOT-2 Short Form score sheet outcomes ranged from 0.88 (95%CI, 0.77 - 0.94) to 0.92 (95%CI, 0.84 - 0.96) indicating excellent reliability. The test-retest reliability (median interval between tests being 45.5 days) for the BOT-2 Short Form score sheet outcomes ranged from 0.62 (95%CI, 0.34 - 0.80) to 0.73 (95%CI, 0.50 - 0.86) indicating fair to good reliability. The raw score MDC was 6.12.
The BOT-2 Short Form has acceptable reliability for use in remote Australian Aboriginal communities and will be useful in determining motor deficits in children exposed to alcohol prenatally. This is the first known study evaluating the reliability of the BOT-2 Short Form, either in the context of assessment for FASD or in Aboriginal children.
Lililwan 项目是首个旨在确定澳大利亚胎儿酒精谱系障碍（FASD）患病率的基于人群的研究，该研究在澳大利亚西北部偏远的菲茨罗伊谷进行。FASD 的诊断过程需要使用标准化的损伤标准，对粗大运动和精细运动功能进行准确评估。Bruininks-Oseretsky 运动能力测验，第二版（BOT-2）是一种全球范围内使用的、用于评估运动功能的常模参照测试，也用于北美 FASD 诊所。它有完整形式（共 53 项）和简化形式（共 14 项）。其在测量子宫内暴露于酒精或生活在澳大利亚偏远的原住民社区的儿童的运动表现方面的可靠性尚不清楚。
采用 BOT-2 简化形式进行了前瞻性的评分者间和重测信度研究。参加 Lililwan 项目队列（共 108 名儿童）的 7 至 9 岁便利样本（n=30）的儿童完成了可靠性研究。Lililwan 项目儿童的母亲中，超过 50%在怀孕期间饮酒。两名评分者同时对每个孩子进行评分，以确定评分者间的信度。通过在第二次评估中主要使用相同的评分者来评估每个孩子，以确定重测信度。通过计算组内相关系数 ICC(2,1)、完全一致百分比（PEA）和接近一致百分比（PCA）以及最小可检测变化量（MDC）来分析可靠性。
在八个偏远的菲茨罗伊谷社区中，对 30 名原住民儿童（18 名男性，12 名女性：平均年龄 8.8 岁）进行了评估。BOT-2 简化形式成绩表结果的评分者间可靠性范围为 0.88（95%置信区间，0.77-0.94）至 0.92（95%置信区间，0.84-0.96），表明可靠性极好。BOT-2 简化形式成绩表结果的重测信度（两次测试之间的中位数间隔为 45.5 天）范围为 0.62（95%置信区间，0.34-0.80）至 0.73（95%置信区间，0.50-0.86），表明可靠性为一般至良好。原始分数 MDC 为 6.12。
BOT-2 简化形式在澳大利亚偏远的原住民社区中具有可接受的可靠性，将有助于确定子宫内暴露于酒精的儿童的运动缺陷。这是首个已知的评估 BOT-2 简化形式可靠性的研究，无论是在评估 FASD 还是在评估原住民儿童方面。
