Grace Yao

Relationship between motor proficiency, attention, impulse, and activity in children with ADHD

The aim of this study was to investigate the relationship between motor performance, attention deficit, impulsiveness, and hyperactivity in children with attention‐deficit–hyperactivity disorder (ADHD). Participants were 42 school‐aged children with ADHD (36 males, 6 females; mean age 8 years 2 months, SD1 year 2 months; range 6 years to 11 years), and 42 age‐ and sex‐matched children without ADHD (mean age 8 years 3 months, SD 1 year 1 month; range 6 years to 11 years). Motor abilities were assessed with the Bruininks‐Oseretsky Test of Motor Proficiency. Attention and impulse control were measured with the Gordon Diagnostic System, and assessment of activity level was based on two Activity Level Rating Scales that were completed by parents and teachers. Analysis by t‐test revealed a significant difference between children with and without ADHD in fine and gross motor skills, impulse control, and attention. Stepwise regression indicated that attention, impulse control, and parent ratings of activity level were the three best predictors of gross motor skills for children with ADHD, accounting for 55.9% of the variance. Attention and impulse control were the two best predictors of fine motor skills, accounting for 45.7% of the variance. Attention and impulse control were consistently found to be important predictors of both fine and gross motor skills in children with ADHD. However, the fact that activity level was a predictor for gross motor proficiency but not for fine motor tasks suggests that different behavioral processes are involved in fine and gross motor performance to different extents.

Underachievement Among Spatially Gifted Students

High school students gifted in spatial ability were selected from a large national probability sample and compared to those gifted in mathematical ability. The groups were compared on multiple measures, including a range of cognitive tests, organizational participation, hobbies, extracurricular reading, coursework, study habits, grades, occupational and academic intentions, guidance received, and family/home environment. Results indicate that, relative to the students gifted in mathematics, the students high in spatial ability were not fully utilizing their academic capabilities, had interests that were less compatible with traditional coursework, received less college guidance from school personnel, were less motivated by the education experience, and aspired to, and achieved, lower levels of academic and occupational success.

Validating, Improving Reliability, and Estimating Correlation of the Four Subscales in the WHOQOL-BREF using Multidimensional Rasch Analysis

Objective: This study examined the construct validity, and improved the test reliability and the estimation accuracy for the correlation between domains of the WHOQOL-BREF using multidimensional Rasch analysis. Method: A total of 13,083 adults were administered the 28-item WHOQOL-BREF Taiwan version, which consists of 4 subscales (domains). The multidimensional form of the partial credit model was used to examine the fit of the 4 subscales. For comparison, each subscale individually was also fitted to the unidimensional partial credit model. Standard item fit statistics and analysis of differential item functioning (DIF) were used to check model-data fit. Results: After excluding 2 overall items and deleting 7 DIF items, the remaining items of each subscale in the WHOQOL-BREF constituted a single construct. The test reliabilities and correlations between domains obtained from the multidimensional approach, (0.82–0.86) and (0.79–0.89), respectively, were much higher than those obtained from the unidimensional approach, (0.67–0.75) and (0.53–0.65), respectively. Conclusion: The 19-item WHOQOL-BREF measures more succinct latent traits than the original design. The multidimensional approach yields not only more accurate estimates for the correlation between domains but also substantially higher reliabilities, than the standard unidimensional approach.

Factorial invariance of the WHOQOL-BREF among disease groups

To compare health-related quality of life (QOL) across groups, researchers have to assure that items of a QOL measure represent the same constructs across groups. This study investigated factorial invariance of the WHOQOL-BREF between a healthy population and populations with diseases using the data from the 2001 National Health Interview Survey (NHIS) in Taiwan. The NHIS was conducted by stratified multistage systematic sampling resulting in responses from 13,010 participants aged 20∼65 who completed the WHOQOL-BREF. The analysis was limited to 5 diseases where at least 200 individuals had that specific single condition; these were pulmonary disease, hypertension, peptic ulcer, sinusitis and liver disease. In this study, confirmatory factor analyses (CFA) on a four-factor model were conducted. Two-group analyses with unconstrained/constrained parameters were conducted to confirm the comparability of CFA factor structures between groups. Generally, the ξ2 discrepancy tests showed that different disease groups and their matched healthy groups shared the same first- and second-order factor loadings. Moreover, different disease groups shared the same first- and second-order factor loadings as well. In other words, after controlling age and gender, same perceptions on the WHOQOL-BREF questionnaire were found between disease and matched healthy groups and across disease groups.

Bayesian estimation of Thurstonian ranking models based on the Gibbs sampler

This paper presents a Gibbs sampler for the estimation of Thurstonian ranking models. This approach is useful for the analysis of ranking data with a large number of options. Approaches for assessing the goodness-of-fit of Thurstonian ranking models based on posterior predictive distributions are also discussed. Two simulation studies and two ranking studies are presented to illustrate that the Gibbs sampler is a promising solution to the numerical problems that previously plagued the estimation of Thurstonian ranking models.

Concurrent Validity of the Comprehensive Developmental Inventory for Infants and Toddlers with the Bayley Scales of Infant Development-II in Preterm Infants

BACKGROUND AND PURPOSE The Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) is a new developmental test designed in Taiwan and lacks concurrent validity information. This study investigated the concurrent validity of the CDIIT with the Bayley Scales of Infant Development-II (BSID-II) in preterm infants aged 6-18 and 21-40 months, respectively. METHODS We recruited 160 preterm infants (84 boys, 76 girls) with a corrected age of 6-18 months and followed them up until 21-40 months of age. One tester administered the CDIIT and BSID-II to all infants. Developmental ages (DAs) and developmental quotients (DQs) from both tests were analyzed with Pearson correlation and kappa tests. RESULTS Correlation coefficients for DAs and DQs between the 2 cognitive and motor subtests and classification agreements were high at 6-18 months (r = 0.80-0.97; kappa = 0.80, 0.85) and moderate to high at 21-40 months (r = 0.60-0.77; kappa = 0.44, 0.57). DQ classification for the CDIIT motor subtests tended to be higher than for the BSID-II motor scales at 21-40 months. CONCLUSIONS In preterm infants, concurrent validity between the motor and cognitive subtests of the CDIIT and the BSID-II was acceptable. The CDIIT can be thus used in clinics for the early identification of developmental delay in infants and toddlers.

Dose–Response Relationship of Robot-Assisted Stroke Motor Rehabilitation The Impact of Initial Motor Status

Background and Purpose— The increasing availability of robot-assisted therapy (RT), which provides quantifiable, reproducible, interactive, and intensive practice, holds promise for stroke rehabilitation, but data on its dose–response relation are scanty. This study used 2 different intensities of RT to examine the treatment effects of RT and the effect on outcomes of the severity of initial motor deficits. Methods— Fifty-four patients with stroke were randomized to a 4-week intervention of higher-intensity RT, lower-intensity RT, or control treatment. The primary outcome, the Fugl-Meyer Assessment, was administered at baseline, midterm, and posttreatment. Secondary outcomes included the Medical Research Council scale, the Motor Activity Log, and the physical domains of the Stroke Impact Scale. Results— The higher-intensity RT group showed significantly greater improvements on the Fugl-Meyer Assessment than the lower-intensity RT and control treatment groups at midterm (P=0.003 and P=0.02) and at posttreatment (P=0.04 and P=0.02). Within-group gains on the secondary outcomes were significant, but the differences among the 3 groups did not reach significance. Recovery rates of the higher-intensity RT group were higher than those of the lower-intensity RT group, particularly on the Fugl-Meyer Assessment. Scatterplots with curve fitting showed that patients with moderate motor deficits gained more improvements than those with severe or mild deficits after the higher-intensity RT. Conclusions— This study demonstrated the higher treatment intensity provided by RT was associated with better motor outcome for patients with stroke, which may shape further stroke rehabilitation. Clinical Trial Registration— URL: http://clinicaltrials.gov. Unique identifier: NCT00917605.

Psychometric evaluation of the Taiwan version of the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire.

BACKGROUND AND PURPOSE To adapt the Taiwan version of the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and evaluate its psychometric properties. METHODS The DASH questionnaire was adapted through the process of translation, back-translation, and expert review. Eighty two subjects with upper extremity disorders were recruited in a medical center and 46 of these patients could be followed up to assess retest reliability in less than 10 days. Cronbach alpha and intraclass correlation coefficient were used to evaluate the internal consistency and test-retest reliability. Principal axis factor analysis was performed to assess the factor-construct validity, while concurrent validity was tested with the Medical Outcomes Study Short Form-36 (SF-36) Taiwan version questionnaire. RESULTS The internal consistency of the Taiwan version of the DASH questionnaire was high (Cronbach alpha = 0.96) and the test-retest reliability was satisfactory (intraclass correlation coefficient = 0.9). Principal axis factor analysis confirmed the 1-factor model. The Pearson correlation coefficients of the DASH questionnaire to the SF-36 showed a correlation with physical component summary scores rather than mental component summary scores. Bodily pain, physical function and role-physical scores among the SF-36 subscales were most significantly correlated with DASH disability/symptom scores. CONCLUSION The Taiwan version of the DASH questionnaire is a valid and reliable measure of health status for patients with upper-extremity disorders.

Concurrent validity in Taiwan of the Comprehensive Developmental Inventory for Infants and Toddlers who were full-term infants.

This study investigated the concurrent validity of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) with the Bayley Scales of Infant Development–II (BSID–II) in full-term infants. 106 full-term infants ages 6 to 18 months (63 boys, 43 girls) were recruited as a convenience sample. One tester administered the CDIIT and BSID–II to all children. The Developmental Ages and Developmental Quotients of the motor and the mental scales from both tests were analyzed with Pearson correlations and quadratic weighted kappa tests. The results showed that correlation coefficients for Developmental Ages between both tests on cognitive and motor subtests were high (r = .91–.95) and for Developmental Quotients were moderate (r = 57–.67). Moderate classification agreement was found in the two scales (quadratic weighted kappa = .50–53). Developmental Quotients classification for the CDIIT tended to be a little higher than for the BSID–II. It was concluded that although acceptable concurrent validity was found for the Motor and Cognitive subtests of the CDIIT, the tester should be cautious to compare Developmental Quotients obtained from the above two tests in clinical or in research settings.

Cultural Adaptation of the WHOQOL Questionnaire for Taiwan

This brief report describes cultural adaptation of the WHOQOL-100 questionnaire for Taiwan. The standard cultural adaptation procedure was used for questionnaire translation, response scale generation, and national items design. A field test was conducted on 1068 participants randomly selected from 17 hospitals all over Taiwan. Several psychometric criteria were used for selecting 12 out of the 20 national items previously proposed from three focus groups. In terms of reliability and validity, the psychometric properties of the culturally adapted WHOQOL questionnaire are good and the values are comparable with those in studies conducted in 15 countries.