Tests & Measures: A Resource for Pediatric Physical Therapy Practitioners

Pediatric Stroke Outcome Measure

Descriptive Information

1. Title, Edition, Dates of Publication and Revision*

Pediatric Stroke Outcome Measure, 2000

2. Author (s)

Gabrielle A. deVeber, MD; Duane MacGregor, MD; Rosalind Curtis, MD

3. Source (publisher or distributor, address)

Gabrielle A deVeber, MD

4. Costs (booklets, forms, kit)*

Only available by contacting Gabrielle A deVeber, MD

5. Purpose*

an objective disease-specific measure of neurological recovery after childhood stroke

6. Type of Test (eg, screening, evaluative; interview, observation,

checklist or inventory)*

The PSOM represents a structured, classical, pediatric neurological examination containing 115 test items encompassing cognition, language, cranial nerve, motor, sensory, cerebellar, and gait functions

7. Target Population and Ages*

Newborn – 18 years of age

8.Time Requirements – Administration and Scoring*

20 minutes

Test Administration

1.Administration

Test was administered by a profession that is qualified

2. Scoring

5 subscales: right sensorimotor, left sensorimotor (each with subcategories), language production, language comprehension, and cognitive/behavioral. Subscale scoring is 0 (no deficit), 0.5 (mild deficit, normal function), 1 (moderate deficit, decreased function), or 2 (severe deficit, missing function). The PSOM total score is the sum of the 5 subscale scores and ranges from 0 (no deficit) to 10 (maximum deficit).

3.Type of information, resulting from testing (e.g. standard scores, percentile ranks)

Deficit level of pediatric patient

4. Environment for Testing

In an examination room

5. Equipment and Materials Needed

Unknown

6.Examiner Qualifications

Unknown; Creators of test were neurologists

7. Psychometric Characteristics*

Unknown MCID

8. Standardization/normative data

Unknown

9. Evidence of Reliability

Kitchen et al. The Pediatric Stroke outcome Measure: A Validation and Reliability Study.Stroke. 2012; 43:1602-1608

The current study demonstrates, in a large cohort of children with pediatric stroke, that the PSOM is both valid and reliable.

Prospective IRR was excellent with the 2 raters’ prospective total scores in almost perfect agreement 0.93 and 95%. Retrospective IRR was also strong 0.77 and 95%.

10. Evidence of Validity

Kitchen et al. The Pediatric Stroke outcome Measure: A Validation and Reliability Study.Stroke. 2012; 43:1602-1608

The current study demonstrates, in a large cohort of children with pediatric stroke, that the PSOM is both valid and reliable

There was good construct validity ranging from 0.2-0.4 with a P < 0.05.

11. Discriminative

The PSOM discriminates pediatric patients within one of the 5 domains as either Normal (0), Mild(0.5), Moderate (1.0) or Severe (2.0).

12. Predictive

More research needs to be done in order for the PSOM to be considered predictive.

• Summary Comments*
  1. Strengths
     1. PSOM is the only disease-specific measure of neurological outcome for pediatric stroke. Plus, it is highly reliable and valid which are always good traits to have in an outcome measure.
  2.  Weaknesses
     1. Information on this outcome measure was very hard to find. There was no information on the costs for this outcome or any MCD/MCID given. I even looked for information on rehab measures online and there was no information on this outcome measure. It would be great if there was more information and an easier way to find this information since it is the only outcome measure for the pediatric stroke population.
  3. Clinical Applications
     1. This outcome measure would be great if you are working in a pediatric or neurological setting. The scoring is easily done and the criteria for this outcome measure is easily specified.

Article Summary

Kitchen et al. The Pediatric Stroke outcome Measure: A Validation and Reliability Study.Stroke. 2012; 43:1602-1608

This article was one in which they looked at the reliability and validity of the Pediatric Stroke Outcome Measure. The study consisted of 203 children age range from newborn to teens. This study found that the PSOM has a high reliability and validity. The prospective IRR was excellent with the 2 raters’ prospective total scores in almost perfect agreement 0.93 and 95%. Retrospective IRR was also strong 0.77 and 95%.  The results from this study indicate that PSOM is an effective screening tool for sensorimotor, language, and cognitive behavioral deficits from pediatric stroke. The PSOM is an easy and quick way to test sensorimotor, language, and cognition/behavior as that other more invasive neuropshycological testing would take longer and cost more. I would definitely use this outcome measure if I had any pediatric neurological patients one day. I would want more information on how to complete this outcome measure and the MCID in order to properly complete the outcome measure and its results.

References

Kitchen et al. The Pediatric Stroke outcome Measure: A Validation and Reliability Study.Stroke. 2012; 43:1602-1608