Video and CD-ROM as a training tool for performing neurologic examinations of 1-year-old children in a multicenter epidemiologic study


Karl C.K. Kuban, Boston University
Michael A. O'Shea, University of Massachusetts Medical School
Elizabeth N. Allred, Children’s Boston Hospital
Alan Leviton, Children’s Boston Hospital
Herbert Gilmore, Tufts University School of Medicine
Adre DuPlessis, Harvard University
Kalpathy Krishnamoorthy, Massachusetts General Hospital
Cecil Hahn, Harvard University
Janet Soul, Harvard University
Sunila E. O'Connor, University of Chicago
Karen J. Miller, Tufts Medical Center
Paige T. Church, Tufts-New England Medical Center
Cecelia Keller, Tufts-New England Medical Center
Richard Bream, University of Massachusetts MedicalSchoolFollow
Robin Adair, University of Massachusetts Medical SchoolFollow
Alice Miller, University of Massachusetts Medical School
Elaine Romano, Yale University Medical Center
Haim Bassan, Harvard University
Kathy Kerkering, East Carolina University
Steve Engelke, East Carolina University
Diane Marshall, University of North Carolina
Kristy Milowic, University of North Carolina
Janice Wereszczak, University of North Carolina
Carol Hubbard, Maine Medical Center
Lisa Washburn, Wake Forest University
Robert Dillard, Wake Forest University
Cherrie Heller, Wake Forest University
Wendy Burdo-Hartman, DeVos Children’s Hospital
Lynn Fagerman, DeVos Children’s Hospital
Dinah Sutton, DeVos Children’s Hospital
Padu Karna, Michigan State University-Sparrow Medical Center
Nick Olomu, Michigan State University-Sparrow Medical Center
Leslie Caldarelli, University of Chicago
Melisa Oca, William Beaumont Hospital
Kim Lohr, DeVos Children’s Hospital
Albert Scheiner, University of Massachusetts Medical School

UMMS Affiliation

Department of Pediatrics

Publication Date


Document Type



*CD-ROM; Cerebral Palsy; Data Collection; Education; Epidemiologic Studies; Humans; Infant; Neurologic Examination; Observer Variation; Professional Competence; *Video Recording




In lieu of traditional training of examiners to identify cerebral palsy on a neurologic examination at age 1 year, we proposed an alternative approach using a multimedia training video and CD-ROM we developed after a two-step validation process. We hypothesized that use of CD-ROM interactive training will lead to reliable and valid performance of the neurologic examination by both pediatric neurologists and nonpediatric neurologists. All examiners were asked to take one of six interobserver variability tests found on the CD-ROM on two occasions. In the first interobserver variability evaluation, 89% (531 of 594) of the responses agreed with the gold standard responses. Following annotated feedback to the examiners about the two items that had a 60% correct rate, the correct response rate rose to 93% (114 of 123). In the second interobserver variability evaluation, 88% (493 of 560) of the responses agreed with the gold standard responses. Following annotated feedback to the examiners about the four items that had a 70% correct rate, the correct response rate rose to 96% (104 of 108). Interactive CD-ROM examination training is an efficient and cost-effective means of training both neurologists and non-neurologists to perform structured neurologic examinations in 1-year-old children. It provides an effective means to evaluate interobserver variability, offers a route for feedback, and creates an opportunity to reevaluate variability, both immediately and at periodic intervals.

DOI of Published Version



J Child Neurol. 2005 Oct;20(10):829-31. Link to article on publisher's website

Journal/Book/Conference Title

Journal of child neurology

Related Resources

Link to Article in PubMed

PubMed ID