Jessica M. Kramer

Accuracy and Precision of the Pediatric Evaluation of Disability Inventory Computer-Adaptive Tests (PEDI-CAT)

Aim  The aims of the study were to: (1) build new item banks for a revised version of the Pediatric Evaluation of Disability Inventory (PEDI) with four content domains: daily activities, mobility, social/cognitive, and responsibility; and (2) use post‐hoc simulations based on the combined normative and disability calibration samples to assess the accuracy and precision of the PEDI computer‐adaptive tests (PEDI‐CAT) compared with the administration of all items.

Lessons from use of the Pediatric Evaluation of Disability Inventory: where do we go from here?

Purpose: The purpose of this article is to review the innovations, applications, and effect of the original Pediatric Evaluation of Disability Inventory (PEDI) published in 1992 and to describe planned revisions. Summary of Key Points: During the past decade, the PEDI has helped to shift thinking from a developmental to a functional focus. Using the PEDI, researchers and clinicians worldwide have highlighted variations in functional skill acquisition in clinical populations, the importance of recognizing cultural differences, and the value of documenting functional progress in relation to interventions. Conclusions: The PEDI has had a rich tradition in helping to document functional development. New methods are proposed for the next generation of the PEDI by using item banks and computer adaptive testing. Recommendations for Clinical Practice: The computer adaptive testing feature and the revised and expanded content of the new PEDI will enable therapists to more efficiently assess childrens functioning to a broader age group of children.

Computer adaptive test performance in children with and without disabilities: prospective field study of the PEDI-CAT.

Purpose: To examine the discriminant validity, test–retest reliability, administration time and acceptability of the pediatric evaluation of disability inventory computer adaptive test (PEDI-CAT). Methods: A sample of 102 parents of children 3 through 20 years of age with (n = 50) and without (n = 52) disabilities was recruited for this prospective field study. A sub-sample (n = 25) also completed the PEDI-CAT a second time within one month. Parents completed 15 items in each of the four PEDI-CAT domains (daily activities, mobility, social/cognitive, responsibility) using a laptop computer. Following completion, parents answered a four-question user evaluation survey. Results: PEDI-CAT scores based on parent responses differentiated between groups of children with and without disabilities in all four domains. Test–retest reliability estimates were high (ICC = 0.96–0.99) for all four domains. The mean time to complete 60 items for the full sample (n = 102) was 12.66 minutes (SD = 4.47). Parents reported favorable reactions to the PEDI-CAT. Conclusions: The PEDI-CAT offers a valid and reliable assessment acceptable to parents. Implications for rehabilitation The pediatric evaluation of disability inventory computer adaptive test (PEDI-CAT) is a new measure for infants, children and youth from birth through 20 years of age in the functional areas of daily activities, mobility, social/cognitive and responsibility. PEDI-CAT scores based on parent responses differentiated functional skills between groups of children with and without disabilities in all four domains. The PEDI-CAT has high test–retest reliability and could be completed in about 12 minutes. Parent respondents indicated they provided meaningful information about their child with the PEDI-CAT.

Item Bank Development for a Revised Pediatric Evaluation of Disability Inventory (PEDI)

ABSTRACT The Pediatric Evaluation of Disability Inventory (PEDI) is a useful clinical and research assessment, but it has limitations in content, age range, and efficiency. The purpose of this article is to describe the development of the item bank for a new computer adaptive testing version of the PEDI (PEDI-CAT). An expanded item set and response options were reviewed by clinician experts and examined at parent and clinician focus groups. Eleven parents participated in 32 cognitive interviews to examine content, format, and comprehension of items and responses. A set of 76 self-care, 78 mobility, and 64 social function items with pictures and a four-point “Difficulty” scale were developed. The PEDIs Caregiver Assistance scale was replaced by a “Responsibility Scale” with 53 items. Content validity was established incorporating input from clinicians and parents. The new item bank covers a broad range of functional activities for children of all ages and abilities.

Developing the Occupational Self Assessment: the use of Rasch analysis to assure internal validity, sensitivity and reliability.

This paper reports the results of three studies that examined the internal validity, sensitivity and reliability of the Occupational Self Assessment (OSA), a self-report of Occupational Competence and Value for occupational performance and participation (Baron et al 2006). All three studies used a Rasch measurement approach to explore the psychometric properties of iterative versions of the OSA. The first study showed that the ‘Myself’ Occupational Competence and Values items constituted a unidimensional construct, but did not discriminate optimally between participants. The results also suggested that the two ‘My Environment’ scales did not contain enough items to exhibit adequate measurement properties. Next, the rating scales were changed from three-point to four-point categories. The second study examined these changes and provided evidence to support the use of a four-point Occupational Competence scale. The Values rating scale was further revised because sensitivity did not improve. The third study confirmed that the OSA items in combination have good internal validity and measure the unidimensional constructs of Occupational Competence and Values. Further, both four-point rating scales resulted in improved person separation, indicated increased sensitivity, and could be used in a consistent manner by 90% of participants with a range of disabilities from a variety of contexts.

Strategies to address participant misrepresentation for eligibility in Web-based research.

Emerging methodological research suggests that the World Wide Web (“Web”) is an appropriate venue for survey data collection, and a promising area for delivering behavioral intervention. However, the use of the Web for research raises concerns regarding sample validity, particularly when the Web is used for recruitment and enrollment. The purpose of this paper is to describe the challenges experienced in two different Web‐based studies in which participant misrepresentation threatened sample validity: a survey study and an online intervention study. The lessons learned from these experiences generated three types of strategies researchers can use to reduce the likelihood of participant misrepresentation for eligibility in Web‐based research. Examples of procedural/design strategies, technical/software strategies and data analytic strategies are provided along with the methodological strengths and limitations of specific strategies. The discussion includes a series of considerations to guide researchers in the selection of strategies that may be most appropriate given the aims, resources and target population of their studies. Copyright

A New Approach to the Measurement of Adaptive Behavior: Development of the PEDI-CAT for Children and Youth with Autism Spectrum Disorders

ABSTRACT. The use of current adaptive behavior measures in practice and research is limited by their length and need for a professional interviewer. There is a need for alternative measures that more efficiently assess adaptive behavior in children and youth with autism spectrum disorders (ASDs). The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) is a computer-based assessment of a childs ability to perform activities required for personal self-sufficiency and engagement in the community. This study evaluated the applicability, representativeness, and comprehensiveness of the Daily Activity, Social/Cognitive, and Responsibility domains for children and youth with an ASD. Twenty professionals and 18 parents provided feedback via in-person or virtual focus groups and cognitive interviews. Items were perceived to represent relevant functional activities within each domain. Child factors and assessment characteristics influenced parents’ ratings. In response to feedback, 15 items and additional directions were added to ensure the PEDI-CAT is a meaningful measure when used with this population.

Worker Role Interview: Testing the psychometric properties of the Icelandic version

In Iceland, the worker role is one of the most enacted and valued roles, but the national disability rate is increasing and is often associated with the loss of the worker role. Resources in work rehabilitation in Iceland are disjointed, and the Ministry of Health and Social Security is calling for more focused and effective services in the field of work rehabilitation. One step towards reaching the goal of more effective services is having a reliable and theory-based assessment tool available to clinicians. The Worker Role Interview (WRI) is a psychometrically sound assessment tool based on the Model of Human Occupation. WRI assesses the psychosocial and environmental factors influencing injured and disabled workers’ ability to return to work. This article examines the psychometric properties of the Icelandic version of the WRI (WRI-IS) in order to determine whether therapists can use the instrument in a consistent and dependable manner. Fourteen Icelandic occupational therapists completed the WRI-IS with 146 clients who intended to return to work. Eleven of the interviewed clients were videotaped and rated by more than one therapist. Total ratings were 249. A many-faceted Rasch measurement (MFRM) approach was used to analyze the WRI-IS. Fifteen of the 17 WRI-IS items showed acceptable fit to the measurement model, and the items represented a meaningful continuum of psychosocial ability to return to work. The 14 therapists and over 95% of the clients showed acceptable fit to the model. The results indicate that the WRI-IS can generate reliable and valid measures of a clients psychosocial ability to return to work.

Comparing the Functional Performance of Children and Youths With Autism, Developmental Disabilities, and No Disability Using the Revised Pediatric Evaluation of Disability Inventory Item Banks

OBJECTIVE. We compared the functional performance of children with autism spectrum disorders (ASD), intellectual and developmental disabilities (IDD), and without disabilities using the revised Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) Social/Cognitive, Daily Activities, and Responsibility domains. METHOD. A nationally representative sample of parents of children ages 0-21 without disabilities (n = 2,205), with ASD (n = 108), or with IDD (n = 150) completed an online survey. We obtained predicted PEDI-CAT scaled scores for three reference ages (5, 10, 15) from a modified analysis of covariance model and compared each groups scores using contrasts of the regression parameters. RESULTS. We found no significant differences between the ASD and IDD groups. The group with ASD demonstrated significantly lower performance than the group without disabilities across the three domains at ages 10 and 15. CONCLUSION. Scores on the PEDI-CAT differentiated the group with ASD from the group without disabilities. Children with ASD and IDD did not demonstrate different performance profiles.

Using Mixed Methods to Establish the Social Validity of a Self-Report Assessment: An Illustration Using the Child Occupational Self-Assessment (COSA)

Social validity is the extent to which procedures, goals, and outcomes are acceptable and important to end users and is not commonly addressed during assessment development. This article pilots a process of triangulating multiple methods to evaluate the social validity of a self-report assessment. These procedures were piloted using the Child Occupational Self-Assessment (COSA), a self-report of everyday activities for children with disabilities. This study collected COSA responses from 502 children with disabilities and conducted observations and interviews with 5 additional children with cerebral palsy. Data were aligned with social validity benchmark statements and integrated using data displays. Social validity was evaluated by examining congruencies and discrepancies in the results. Implications and the legitimacy of design decisions are discussed.