title: Can nurses be key players in assessing early motor development using a structured method in the child health setting?
abstract: OBJECTIVE
  Increasing evidence highlights the importance of early interventions for motor disorders in children. Given the key medical role of the nurse within the Swedish Child Health Service (CHS), we aimed to examine if nurses could apply a structured assessment of early motor development at the child health centre to enable early identification of children at risk.
  
  
  METHODS
  Structured Observation of Motor Performance in Infants (SOMP-I) assesses infant's level of motor development and quality of motor performance using subscales converted to total scores. The total score for both level and quality can then be plotted within the SOMP-I percentile distribution at the child's age for comparison with a reference population. Fifty-five infants (girls: 30) were assessed according to SOMP-I at three child health centres. Assessments were performed by nurses (n = 10) in a clinical setting; one nurse performed the assessment while another nurse and a physiotherapist observed.
  
  
  RESULTS
  Agreement for the assessment of level as a continuous variable was excellent [intraclass correlation coefficient (ICC) 0.97-0.98], but was lower for quality (ICC 0.02-0.46). When the children were categorized according to the percentile range categories, the assessors were in agreement for the majority of the children, with respect to both level (78-82%) and quality (78-87%).
  
  
  CONCLUSIONS
  Despite brief experience with SOMP-I, the agreement was excellent when assessing the level of motor development, but was less satisfactory for the assessment of quality of motor performance. More extensive education and training may be necessary to improve the nurses' ability to assess quality, as this domain was an entirely new concept to the nurses. Further research is warranted to determine the applicability of SOMP-I as a standardized method for nurses to assess motor development within the CHS.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Sweden.
authors.forename: Kine
authors.initials: K
authors.lastname: Johansen
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Persson
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Sarkadi
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Sonnander
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Sweden.
authors.forename: Margaretha
authors.initials: M
authors.lastname: Magnusson
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Sweden.
authors.forename: Steven
authors.initials: S
authors.lastname: Lucas
mesh_terms: D002657:Child Development; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009043:Motor Activity; D009048:Motor Skills; D009730:Nursing Assessment; D019370:Observation; D059825:Physical Therapists; D013548:Sweden
keywords: child public health; development; early assessment; infant; motor performance