Beth S Slomine1,2, Stacy J Suskauer3,4, Rachel Nicholson3, Joseph T Giacino5,6. 1. Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA. 2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA. 3. Department ofPediatric Rehabilitation, Kennedy Krieger Institute, Baltimore, MD, USA. 4. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA. 6. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA.
Abstract
Objective: To examine the basic psychometric features of a modified version of the Coma Recovery Scale-Revised (CRS-R) for use in young children with disorders of consciousness (DoC).Method: The CRS-R was modified to create the Coma Recovery Scale for Pediatrics (CRS-P) and administered to 33 typically developing children (8-59 months). Total scores, subtest scores, and inter-rater reliability were evaluated. Performance on the two items representing emergence to conscious state (CS) - functional object use (FOU) and functional communication (FC) was examined across the age range. Results: Inter-rater reliability of CRS-P subscale scores was adequate (Kw = .87-1.00). All 4-year-olds, 75% of 3-year-olds, 10% of 2-year-olds, and 0% <2 years scored at the CRS-P ceiling. Total and subtest scores were strongly correlated with age as were the two behaviors representing emergence to CS (FOU, FC) - all children >12 months and none <12 months of age met criteria for FOU; all children ≥3 years, 20% between 2 and <3 years, and none <2 years met criteria for FC.Conclusions: The CRS-P is appropriate for use in children as young as 12 months of age, with a strong association between performance and age at administration. The CRS-P also captures emergence to CS, a key clinical milestone.
Objective: To examine the basic psychometric features of a modified version of the Coma Recovery Scale-Revised (CRS-R) for use in young children with disorders of consciousness (DoC).Method: The CRS-R was modified to create the Coma Recovery Scale for Pediatrics (CRS-P) and administered to 33 typically developing children (8-59 months). Total scores, subtest scores, and inter-rater reliability were evaluated. Performance on the two items representing emergence to conscious state (CS) - functional object use (FOU) and functional communication (FC) was examined across the age range. Results: Inter-rater reliability of CRS-P subscale scores was adequate (Kw = .87-1.00). All 4-year-olds, 75% of 3-year-olds, 10% of 2-year-olds, and 0% <2 years scored at the CRS-P ceiling. Total and subtest scores were strongly correlated with age as were the two behaviors representing emergence to CS (FOU, FC) - all children >12 months and none <12 months of age met criteria for FOU; all children ≥3 years, 20% between 2 and <3 years, and none <2 years met criteria for FC.Conclusions: The CRS-P is appropriate for use in children as young as 12 months of age, with a strong association between performance and age at administration. The CRS-P also captures emergence to CS, a key clinical milestone.
Entities:
Keywords:
Children; assessment; disorders of consciousness; minimally conscious state; unresponsive wakefulness syndrome; vegetative state
Authors: Matthew J McLaughlin; Eric Caliendo; Ryan Lowder; William D Watson; Brad Kurowski; Katherine T Baum; Laura S Blackwell; Christine H Koterba; Kristen R Hoskinson; Sarah J Tlustos; Kanecia O Zimmerman; Sudhin A Shah; Stacy J Suskauer Journal: J Head Trauma Rehabil Date: 2021-07-26 Impact factor: 3.117