Dual-informant clinical outcome assessment in the inclusive orchestra: measurement architecture for neurodevelopmental disorders prior to empirical evaluation.

Authors

Tommaso Liuzzi, Fiammetta D'Arienzo, Susanna Staccioli, Sarah Bompard, Martina Frascari Diotallevi, Roberto Giuliani, Donatella Lettori, Enrico Castelli

Published in

Frontiers in neurology. Volume 17. Pages 1834441. Epub Sep 29, 2026.

Abstract

Systematic behavioral observation in a group requires the rater to know when a target behavior could have occurred. In an inclusive orchestra the notated part and the conductor's cues generate that occasion outside the participant, before the session. This pre-implementation study builds a dual-informant clinical outcome assessment architecture on that property, for adolescents and adults with neurodevelopmental disorders.
The architecture comprises two context-specific candidate instruments, each of five seven-item domains. Working independently, two psychologists will score the same replayable 20-min orchestral segment within 24 h using the clinician-reported instrument (ClinRO-T), while a nominated caregiver completes the observer-reported instrument (ObsRO-P) for daily-life behavior directly observed during the subsequent 48 h. Paired items share an observable referent, and their correspondence is functional. An item-level grid predefines each behavioral referent, the event or window that creates a scoring opportunity, and the codes for structural inapplicability, unobservability and technical failure. A focal-participant rotation will yield 100 participant-session observations from 20 participants over 20 weeks, each independently double-coded in the clinician channel. A modified Delphi process and cognitive interviewing will precede form freeze. The first observational phase will report window adherence, coding burden, code distribution, inter-rater agreement at count, band and domain level, and the suitability of the Vineland Adaptive Behavior Scales as an external interpretive reference.
The design preserves separate orchestral-session and daily-life assessment channels. Both instruments remain candidate clinical outcome assessments. No participants have been enrolled, no psychometric data are reported, and no measurement property is claimed as established.

PMID:
42871593
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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