The 18‐month early neuropsychologic optimality rating scale (ENORS‐18): A predictive assessment instrument

Abstract

The development and application of the 15‐item 18‐month Early Neuropsychologic Optimality Rating Scale (ENORS‐18) is described in a sample of 450 children. The ENORS‐18 is scored in an optimal‐nonoptimal fashion and enables assessment of tone, posture, movement, and developmental delay. Comparison of the ENORS‐18 and the 18‐month Bayley developmental indices and a neurologic examination in regard to 36‐month cognitive, motor, and neurologic outcome revealed that ENORS‐18 sensitivity values were 1½ to 10 times greater than the other techniques. Basic neurologic function/intactness items assumed less importance than in the previous 9‐month ENORS; receptive, fine‐motor/oral‐motor expressive, and processing items were more influential. Mental activity variables were equally important on both assessments. This instrument is useful in early assessment due to enhanced detection of dysfunction, decreased time and cost, and greater flexibility with missing data and cutoff scores. Implications of these findings are discussed.