Baby Observational Selective Control AppRaisal (BabyOSCAR): Scores at 3 months predict functional ability, spastic cerebral palsy distribution, and diagnosis at 2 years

• Published in: Developmental medicine and child neurology Vol. 66; no. 11; pp. 1521 - 1528
• Main Authors: Peyton, Colleen, Aaby, David, Barbosa, Vanessa Maziero, Boswell, Lynn, Regnier, Raye‐Ann, Bos, Arend F., Sukal Moulton, Theresa
• Format: Journal Article
• Language: English
• Published: England 01-11-2024
• ISSN: 0012-1622; 1469-8749; 1469-8749
• DOI: 10.1111/dmcn.15925

Aim
To assess the predictive capabilities of the Baby Observational Selective Control AppRaisal (BabyOSCAR) tool, administered at 3 months corrected age, in determining spastic cerebral palsy (CP) outcome, functional abilities, and body topography at 2 years of age or later.
Method
Independent joint motions were measured at age 10 to 16 weeks from video recordings of spontaneous movement using BabyOSCAR in a sample of 75 infants. All included infants had known 2‐year outcomes (45 with spastic CP and 30 without CP) including Gross Motor Functional Classification System (GMFCS) levels and CP body distribution. Receiver operating characteristic curves and cut points indicating greatest sensitivity and specificity were generated for predictive performance.
Results
Total BabyOSCAR score was a strong predictor of future outcome of spastic CP (cut score of 22.5, sensitivity = 98%, specificity = 100%, area under the curve = 0.99), and was able to distinguish children classified in GMFCS levels I and II from those in III to V (cut score of 13.5, sensitivity = 92%, specificity = 89%, area under the curve = 0.94). Having an (absolute) asymmetry score on the BabyOSCAR of more than 5 was a predictor of having unilateral CP at age 2 years (sensitivity = 56%, specificity = 100%, area under the curve = 0.86).
Interpretation
BabyOSCAR scores are predictors of diagnosis, body distribution, and future gross motor function in infants with spastic CP at 2 years of age or later.
What this paper adds
Decreased independent joint movement at 3 months predicts spastic cerebral palsy (CP) at 2 years.
Baby Observational Selective Control AppRaisal (BabyOSCAR) scores ≤13 are predictive of Gross Motor Function Classification System (GMFCS) levels III to V.
BabyOSCAR scores of 14 to 22 are predictive of GMFCS levels I and II.
A BabyOSCAR total asymmetry score >5 predicts unilateral CP.
Stereotyped movements are more prominent in those who will be diagnosed with spastic CP at 2 years.
What this paper adds
Decreased independent joint movement at 3 months predicts spastic cerebral palsy (CP) at 2 years.
Baby Observational Selective Control AppRaisal (BabyOSCAR) scores ≤13 are predictive of Gross Motor Function Classification System (GMFCS) levels III to V.
BabyOSCAR scores of 14 to 22 are predictive of GMFCS levels I and II.
A BabyOSCAR total asymmetry score >5 predicts unilateral CP.
Stereotyped movements are more prominent in those who will be diagnosed with spastic CP at 2 years.
Early assessment of infant movements using the total BabyOSCAR score at 3 months of age was predictive of spastic cerebral palsy diagnosis and gross motor function levels (GMFCS) at age two or above. Scores below 23 were predictive of a diagnosis of spastic CP and scores under 13 were predictive of the use of an assistive device for mobility. Additionally, BabyOSCAR asymmetry scores above 5 at 3 months were predictive of unilateral CP.
This original article is commented by Heathcock on pages 1406–1407 of this issue.