Anne Passmore

The Case for Using the Repeatability Coefficient When Calculating Test-Retest Reliability

The use of standardised tools is an essential component of evidence-based practice. Reliance on standardised tools places demands on clinicians to understand their properties, strengths, and weaknesses, in order to interpret results and make clinical decisions. This paper makes a case for clinicians to consider measurement error (ME) indices Coefficient of Repeatability (CR) or the Smallest Real Difference (SRD) over relative reliability coefficients like the Pearson’s (r) and the Intraclass Correlation Coefficient (ICC), while selecting tools to measure change and inferring change as true. The authors present statistical methods that are part of the current approach to evaluate test–retest reliability of assessment tools and outcome measurements. Selected examples from a previous test–retest study are used to elucidate the added advantages of knowledge of the ME of an assessment tool in clinical decision making. The CR is computed in the same units as the assessment tool and sets the boundary of the minimal detectable true change that can be measured by the tool.

The effectiveness of a peer support camp for siblings of children with cancer

Siblings of children with cancer have higher levels of psychological stress and adaptational difficulties compared to siblings of healthy children and children with other chronic illness. This is the first study to report on the mental health of Australian siblings of children with cancer and examines the effects of a therapeutic peer support camp—Camp Onwards, as an intervention.

The relationship between stereotyped movements and self-injurious behavior in children with developmental or sensory disabilities

We assessed whether the stereotyped movements (SM) that are a defining characteristic of autism are discriminable from those observed in other disorders, and whether stereotyped self-injurious movements, which are excluded as exemplars of SM in DSM-IV, differ from other SM in severity or in kind. We used the Stereotyped and Self-Injurious Movement Interview to assess self-injurious and other SM in children with autism (n=56), intellectual disability (n=29), vision impairment (n=50), or hearing impairment (n=51) and in typical children (n=30). Cross-tabulation of scores indicated that self-injurious behavior is rarely performed in the absence of other SM. Reliability analyses indicated that patterns of covariation among SM items differ across groups so that different item sets are necessary to reliably measure SM in each group. Analyses of variance indicated the autism group exceeded one or more other groups in the frequency of 15 SM, the vision impaired group exceeded others on 5 SM, and the hearing impaired group exceeded others on 1 SM. Discriminant function analysis of SM items indicated that although only 66% of participants were accurately classified, it was rare for a child with a different disorder to be misclassified as having autism or visual impairment. We concluded that self-injurious behavior is a more severe form of SM, and there is a distinctive pattern of SM, including self-injurious behavior, that characterizes children with autism.

An investigation into parent perceptions of the needs of siblings of children with cancer.

Although more is understood about childhood cancer’s impact on the often forgotten siblings in the family, developing empirically tested interventions that support positive health outcomes is only just emerging. As family support is of key importance in sibling adjustment, further knowledge about their needs is crucial to the development of effective interventions. This investigation focused on examining parental perceptions regarding the concerns and issues for siblings of children with cancer and explored what support is helpful. Focus group methods were used to gather the data with probe questions developed from the literature and from clinical experience. Emergent topics generated were further analyzed using content analysis with 3 major topics identified: the universality of losses arising from the illness experience, behavioral challenges and adaptation, and parent-sibling communication. Parents also discussed helpful interventions. These are described and discussed in relation to the literature. The information obtained will contribute to developing interventions for siblings, specifically to produce a protocol for a therapeutic peer-support camp.

Effectiveness of an online fatigue self-management programme for people with chronic neurological conditions: a randomized controlled trial

Objective: To evaluate an online fatigue self-management programme in a sample of adults with chronic neurological conditions. Design: Randomized controlled trial. Setting: Online fatigue self-management programme delivered across Australia. Participants: Ninety-five people with fatigue secondary to multiple sclerosis, Parkinson’s disease or post-polio syndrome. Interventions: An online fatigue self-management programme, an information-only fatigue self-management programme and a control group. Main measures: Groups were compared at pre test, post test and at three months on primary outcomes using the Fatigue Impact Scale, Activity Card Sort and Personal Wellbeing Index. Results: With the exception of the Personal Wellbeing Index at post test (F = 3.519; P =0.034) and the Physical Subscale of the Fatigue Impact Scale at follow-up (F = 3.473; P =0.035) there were no significant differences between the three groups on primary outcomes. Post-hoc testing showed the differences to be between the information-only and control groups (P = 0.036 and P = 0.030 respectively). Improvement in the information-only group was unexpected but appears to be similar to results of other online interventions. The fatigue self-management and information-only groups performed better than the control on some secondary outcome measures. Low power in the analysis may have contributed to the findings. Repeated-measures ANCOVA showed that the fatigue self-management and the information-only groups improved over time on the Fatigue Impact Scale and the Activity Card Sort (P<0.05). The control group showed no improvements over time.

The impact of personal background and school contextual factors on academic competence and mental health functioning across the primary-secondary school transition

Students negotiate the transition to secondary school in different ways. While some thrive on the opportunity, others are challenged. A prospective longitudinal design was used to determine the contribution of personal background and school contextual factors on academic competence (AC) and mental health functioning (MHF) of 266 students, 6-months before and after the transition to secondary school. Data from 197 typically developing students and 69 students with a disability were analysed using hierarchical linear regression modelling. Both in primary and secondary school, students with a disability and from socially disadvantaged backgrounds gained poorer scores for AC and MHF than their typically developing and more affluent counterparts. Students who attended independent and mid-range sized primary schools had the highest concurrent AC. Those from independent primary schools had the lowest MHF. The primary school organisational model significantly influenced post-transition AC scores; with students from Kindergarten - Year 7 schools reporting the lowest scores, while those from the Kindergarten - Year 12 structure without middle school having the highest scores. Attending a school which used the Kindergarten - Year 12 with middle school structure was associated with a reduction in AC scores across the transition. Personal background factors accounted for the majority of the variability in post-transition AC and MHF. The contribution of school contextual factors was relatively minor. There is a potential opportunity for schools to provide support to disadvantaged students before the transition to secondary school, as they continue to be at a disadvantage after the transition.

Development, standardisation and pilot testing of an online fatigue self-management program

Purpose. Although an effective face-to-face fatigue program is available, people with transportation, time or geographic restrictions cannot access this intervention. Therefore, the aim of this study was to develop and to evaluate effectiveness of an online fatigue self-management program (online FSMP). Methods. Key features of the face-to-face program were captured and transferred to an online FSMP prototype. Subsequently, three pilot tests were conducted for formative evaluation of the program and necessary changes were made to improve the program. During the third pilot test, the effectiveness of the online FSMP was also tested using a pre-test post-test design on a sample of individuals with multiple sclerosis, Parkinsons disease or post-polio syndrome. Results. The study resulted in a standardised 7-week online FSMP mimicking its face-to-face version. Participants were offered fatigue self-management skills through structured activities, sharing information and experiences, expressing their ideas or feelings and offering advice and support to one another. The participants in the third pilot study improved significantly on the Fatigue Impact Scale (p <0.05) and a trend toward significance was shown on the Personal Wellbeing index (p = 0.08). Conclusions. The online FSMP is a viable treatment for people with neurological conditions and warrants further study.

Active citizens or passive recipients: How Australian young adults with cerebral palsy define citizenship

Abstract Background Citizenship participation by young adults has reciprocal benefits both for the individual and for society. This paper provides an insight into the ways young people with cerebral palsy (CP) perceive their citizenship experiences, and also examines factors which may influence citizenship participation for this group. Method Qualitative methodology was used to explore perceptions of citizenship experiences in young people with CP. Nine participants (aged 18–30 years), were interviewed using a semi‐structured interview format. Results Four themes emerged: (i) contribution, (ii) inclusion, (iii) equal opportunity, and (iv) a barrier‐free context. Conclusion The nine participants indicated that they aspired to make a contribution to society, play an active role, be accepted by others, and live with dignity and respect, as well as pursue their dreams and passions.

Adequacy of the Regular Early Education Classroom Environment for Students With Visual Impairment

This study describes the classroom environment that students with visual impairment typically experience in regular Australian early education. Adequacy of the classroom environment (teacher training and experience, teacher support, parent involvement, adult involvement, inclusive attitude, individualization of the curriculum, physical environment, and vision aids) for students with visual impairment in early regular education was assessed at the start and the end of one year. A total of 20 students with visual impairment (age M = 5.4 years) attending regular early education participated. In general, teacher-reported curriculum individualization and the physical environment were adequate. However, support provided for staff, teacher training, adult involvement, access to visual aids, and inclusive attitudes were less than adequate. More than 40% of students experienced fewer than four out of nine adequate environmental features. These results indicate that strategies to improve teacher training, support, attitudes, and access to vision aids are needed.

Does leisure support and underpin adolescents’ developing worker role?

Abstract The central theme of this paper is that an association exists between leisure and work, however this relationship is complex and multidimensional. A number of factors are proposed to impact upon this association, including the influences of both society and the self. Claims are made based upon the authors research, involving 1145 adolescents, of the positive contribution of leisure in personal development and in mental health outcomes, which subsequently has the potential to support and underpin the developing worker role.