# Agreement Between Tele- and Face-to-Face Assessment of Neuromotor Development in High-Risk Children
## 4 Discussion  
The objective of this study was to evaluate the level of agreement between the face-to-face assessment and tele-assessment of neuromotor development in a sample of infants between 0 and 18 months of age. Our results show excellent reliability when comparing the tele-assessment and face-to-face evaluation for both the total and subscales of the AIMS. Additionally, there is substantial to almost perfect reliability for most of the items of the \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Variable** & **Face-to-Face Assessment n** & **Tele-Assessment n (\%)** & **Kappa (p)** \\ \hline \multicolumn{4}{c}{Axis organization in supine position n (\%)} \\
1 Motor normality & 38 (84.4) & 42 (93.3) & \\
2 Mild difficulty & 7 (15.6) & 3 (6.7) & 0.338 (0.011) \\
3 Moderate difficulty & 0 & 0 & \\
4 Severe difficulty & 0 & 0 & \\ \hline \multicolumn{4}{c}{Eye–hand–mouth coordination (right/left) n (\%)} \\
1 Motor normality & 34 (75.6)/34 (75.6) & 37 (82.2)/36 (80) & \\
2 Mild difficulty & 8 (17.8)/8 (17.8) & 7 (15.6)/8 (17.8) & 0.682 (\(<\)0.001)/0.632 (\(<\)0.001) \\
3 Moderate difficulty & 3 (6.7)/3 (6.7) & 1 (2.2)/1 (2.2) & \\ \hline \multicolumn{4}{c}{Rolling supine to prone over right side/left side n (\%)} \\
0 Does not apply & 6 (13.3)/6 (13.3) & 6 (13.3) & \\
1 Motor normality & 16 (35.6)/16 (35.6) & 16 (35.6)/18 (40) & \\
2 Mild difficulty & 4 (8.9)/5 (11.1) & 4 (8.9)/7 (15.6) & 0.673 (\(<\)0.001)/0.673 (\(<\)0.001) \\
3 Moderate difficulty & 5 (11.1)/5 (11.1) & 5 (11.1)/4 (8.9) & \\
4 Severe difficulty & 14 (31.1)/14 (31.1) & 14 (31.1)/10 (22.2) & \\ \hline \multicolumn{4}{c}{Rolling prone to supine over right side/left side n (\%)} \\
0 Does not apply & 6 (13.3)/6 (13.3) & 6 (13.3)/6 (13.3) & \\
1 Motor normality & 25 (55.6)/25 (55.6) & 23 (51.1)/23 (51.1) & \\
2 Mild difficulty & 3 (6.7)/3 (6.7) & 5 (11.1)/5 (11.1) & 0.631 (\(<\)0.001)/0.631 (\(<\)0.001) \\
3 Moderate difficulty & 2 (4.4)/2 (4.4) & 6 (13.3)/6 (13.3) & \\
4 Severe difficulty & 9 (20)/9 (20) & 5 (11.1)/5 (11.1) & \\ \hline \multicolumn{4}{c}{Sitting with/without support n (\%)} \\
0 Does not apply & 8 (17.8) & 8 (17.8) & \\
1 With support & 19 (42.2) & 19 (42.2) & 1 (\(<\)0.001) \\
2 Without support & 18 (40) & 18 (40) & \\ \hline \multicolumn{4}{c}{Crawling n (\%)} \\
0 Does not apply & 39 (86.7\%) & 39 (86.7\%) & \\
1 Crawls & 3 (6.7\%) & 3 (6.7\%) & 1 (\(<\)0.001) \\
2 Does not crawl & 3 (6.7\%) & 3 (6.7\%) & \\ \hline \multicolumn{4}{c}{Standing without support n (\%)} \\
0 Does not apply & 42 (93.3\%) & 42 (93.3\%) & \\
1 Motor normality & 2 (4.4\%) & 2 (4.4\%) & \\
2 Mild difficulty & 0 & 0 & 1 (\(<\)0.001) \\
3 Moderate difficulty & 0 & 0 & \\
4 Severe difficulty & 1 (2.2\%) & 1 (2.2\%) & \\ \hline \multicolumn{4}{c}{Independent walking on regular ground/irregular ground n (\%)} \\
0 Does not apply & 43 (95.6\%)/43 (95.6\%) & 43 (95.6\%)/43 (95.6\%) & \\
1 Motor normality & 0/0 & 0/0 & \\
2 Mild difficulty & 0/0 & 0/0 & \\
3 Moderate difficulty & 0/0 & 1 (2.2\%)/0 & \\
4 Severe difficulty & 2 (4.4\%)/2 (4.4\%) & 1 (2.2\%)/2 (4.4\%) & \\ \hline \hline \end{tabular}
\end{table} 
Table 3: Descriptive values and interrater reliability of telerehabilitation and face-to-face clinical assessment of the levels of motor evolution (Niveaux d’Evolution Motrice, NEM). NEM assessed. The lowest correlation in the NEM evaluation was observed in the axis organization in the supine position (Kappa = 0.338). This may be attributed to difficulties in perceiving the axis organization through telematics. Additionally, the fair correlation found in the coordination between the two hands item (Kappa = 0.568) could be influenced by factors related to the telemabilitation method such as a lack of the child's cooperation, disinterest in the activity or the toy offered, irritability, or environmental distractions. Several studies support our findings regarding the validity of telematic assessment for gross motor skills' evaluation in children. The review conducted by [PERSON] et al.