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

BACKGROUND

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.

METHODS

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.

CONCLUSION

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.