Sarah Wilkes-Gillan

Evaluating the psychometric quality of social skills measures: a systematic review

Introduction Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. Objective To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. Methods A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Results Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. Conclusions The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

Reliability and validity of the Pragmatics Observational Measure (POM): A new observational measure of pragmatic language for children

There is a need for a reliable and valid assessment of childhood pragmatic language skills during peer-peer interactions. This study aimed to evaluate the psychometric properties of a newly developed pragmatic assessment, the Pragmatic Observational Measure (POM). The psychometric properties of the POM were investigated from observational data of two studies - study 1 involved 342 children aged 5-11 years (108 children with ADHD; 108 typically developing playmates; 126 children in the control group), and study 2 involved 9 children with ADHD who attended a 7-week play-based intervention. The psychometric properties of the POM were determined based on the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) taxonomy of psychometric properties and definitions for health-related outcomes; the Pragmatic Protocol was used as the reference tool against which the POM was evaluated. The POM demonstrated sound psychometric properties in all the reliability, validity and interpretability criteria against which it was assessed. The findings showed that the POM is a reliable and valid measure of pragmatic language skills of children with ADHD between the age of 5 and 11 years and has clinical utility in identifying children with pragmatic language difficulty.

Piloting the use of experience sampling method to investigate the everyday social experiences of children with Asperger syndrome/high functioning autism

Abstract Objective: This pilot study explored the nature and quality of social experiences of children with Asperger Syndrome/High Functioning Autism (AS/HFA) through experience sampling method (ESM) while participating in everyday activities. Methods: ESM was used to identify the contexts and content of daily life experiences. Six children with AS/HFA (aged 8–12) wore an iPod Touch on seven consecutive days, while being signalled to complete a short survey. Results: Participants were in the company of others 88.3% of their waking time, spent 69.0% of their time with family and 3.8% with friends, but only conversed with others 26.8% of the time. Participants had more positive experiences and emotions when they were with friends compared with other company. Participating in leisure activities was associated with enjoyment, interest in the occasion, and having positive emotions. Conclusions: ESM was found to be helpful in identifying the nature and quality of social experiences of children with AS/HFA from their perspective.

The pragmatic language abilities of children with ADHD following a play-based intervention involving peer-to-peer interactions.

Abstract Children with Attention Deficit Hyperactivity Disorder (ADHD) commonly experience significant pragmatic language deficits which put them at risk of developing emotional and social difficulties. This study aimed to examine the pragmatic language exhibited in a peer-to-peer interaction between the children with ADHD and their playmates following a pilot play-based intervention. Participants were children (aged 5–11 years) diagnosed as having ADHD (n = 14) and their self-selected typically-developing playmate. Pragmatic language was measured using the Pragmatic Protocol (PP) and the Structured Multidimensional Assessment Profiles (S-MAPs). Childrens structural language was also screened and compared against their pragmatic language skills pre–post play-based intervention. The pragmatic language of children with ADHD improved significantly from pre–post intervention as measured by both the PP and S-MAPs. Both children with and without structural language difficulties improved significantly from pre- to post-intervention using S-MAPs; only children with structural language difficulties improved significantly using PP. The findings support the notion that pragmatic skills may improve following a play-based intervention that is characterized by didactic social interaction. As pragmatic language is a complex construct, it is proposed that clinicians and researchers reconsider the working definition of pragmatic language and the operationalization thereof in assessments.

Child outcomes of a pilot parent-delivered intervention for improving the social play skills of children with ADHD and their playmates

Abstract Objective: This pilot study examined the effectiveness of a parent-delivered intervention for improving: the social play skills of children with attention deficit hyperactivity disorder (ADHD) and their typically developing playmates and the empathy of children with ADHD. Methods: Participants were children with ADHD and their typically developing playmates (n = 9/group). The intervention was primarily parent-implemented and involved: parent-training, weekly home-modules, three clinic play-sessions, therapist-parent phone consultations and a one-month follow-up. The Test of Playfulness (ToP) was the primary outcome measure. Cohen’s-d and paired sample t-test calculations were used to measure effect. Results: Social play outcomes of children with ADHD improved significantly from: pre- to post-test (t = 3.2; p = 0.02; d = 1.0) and post-test to follow-up intervention (t = 2.7; p = 0.02; d = 1.1). Playmate’s improved significantly from pre- to post-intervention (t = 3.9; p = 0.03; d = 1.2). Children with ADHD improved significantly on 4/7 ToP empathy items (t = 2.31–3.16; p = 0.02). Conclusion: The intervention successfully improved the social play skills of children with ADHD and their playmates.

A Randomised Controlled Trial of a Play-Based Intervention to Improve the Social Play Skills of Children with Attention Deficit Hyperactivity Disorder (ADHD)

There is a need for effective interventions to address the social difficulties of children with ADHD. This randomised controlled trial examined the effectiveness of a play-based intervention for improving the social play skills of children with ADHD in peer-to-peer interactions. Children with ADHD (5 to 11 years) were randomised to an intervention-first (n = 15) or waitlist control-first group (n = 14). Participants allocated to the control-first group received the intervention after a 10-week wait period. Children invited a typically-developing playmate and parents of children with ADHD participated. The intervention involved: six clinic play-sessions, weekly home-modules and a one-month home follow up. The Test of Playfulness (ToP) was scored by a blinded rater. Parent reported treatment adherence was used to assess treatment fidelity. Between group statistics were used to compare the change of the intervention-first (10-week intervention period) and control-first (10-week wait period) groups. Once all children had received the intervention, repeated measures ANOVA, post hoc Least Significance Difference tests and Cohen’s-d were used to measure effect. Changes in ToP social items were analysed using Friedman’s ANOVA. Linear regression analyses were used to identify variables that predicted change. The control-first group did not change during the wait period. The change in the intervention-first group was significantly greater than the change in the control-first group (during the wait period). When the data from the two groups were combined, the mean ToP scores of the children with ADHD (n = 29) improved significantly following the intervention, with a large effect from pre to post intervention and from pre intervention to follow up. Children maintained treatment gains at follow up. All ToP social items improved significantly following the intervention. The findings support the use of play involving parent and peer mediated components to enhance the social play skills of children with ADHD. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12614000973617

Parents' perspectives on the appropriateness of a parent-delivered intervention for improving the social play skills of children with ADHD

Introduction This study aimed to evaluate parents’ perspectives of the appropriateness of a parent-delivered play-based intervention, The Ultimate Guide to Making Friends. The intervention was designed to improve the social play skills of children with ADHD. Method One month post-intervention, seven parents of children with ADHD participated in individual semi-structured interviews. Interviews ranged from 40–60 minutes. Parents were asked about their perceptions of the intervention: experience, benefits, logistics that supported or hindered participation and satisfaction with the intervention for themselves and their children. Data were analysed thematically using constant comparative methods, whereby two researchers worked independently to analyse emergent themes. Findings Thematic analysis revealed a single core theme of reframing: a process whereby both parents and their children were assisted to develop new perspectives regarding their social skills and interactions. The core theme comprised three sub-themes: (1) connecting with the intervention; (2) parent and child benefits resulting from a new perspective; and (3) continued everyday use of the intervention materials and strategies. Conclusion The intervention was appropriate from parents’ perspectives. The core theme of reframing and sub-themes collectively related back to the following aspects of appropriateness: (a) a positive experience; (b) relevant and important to their/their child’s needs; (c) beneficial; (d) a socially and ecologically valid approach, fitting their everyday lives; and (e) promoting change that continued over time.

Evaluation of a Pilot Parent-Delivered Play-Based Intervention for Children With Attention Deficit Hyperactivity Disorder

OBJECTIVE. This study evaluated a parent-delivered intervention aiming to address the social difficulties of children with attention deficit hyperactivity disorder (ADHD). The intervention was evaluated from three perspectives: effectiveness, feasibility, and appropriateness. METHOD. This one-group pretest-posttest study included 5 children with ADHD and their parents, who had previously participated in a therapist-delivered play-based intervention. The 7-wk parent-delivered intervention involved home modules (including a DVD, manual, and play dates with a typically developing playmate) and three therapist-led clinic-based play sessions. The Test of Playfulness was used as a pre- and postintervention and follow-up measure. Parents were interviewed 1 mo following the intervention, and data were analyzed for recurring themes. RESULTS. Childrens social play outcomes improved significantly from pretest to 1-mo follow-up (Z = 2.02, p = .04, d = 1.0). Three themes emerged: the clinic play environment as a sanctuary, parental barriers to intervention delivery, and tools for repeating learned lessons. CONCLUSION. The parent-delivered intervention demonstrated preliminary evidence for feasibility and effectiveness. Further research is warranted regarding appropriateness.

Measurement of visual ability in children with cerebral palsy: a systematic review

To identify and evaluate measures of visual ability used with children with cerebral palsy (CP).

Peer-mediated intervention to improve play skills in children with autism spectrum disorder: A feasibility study

BACKGROUND/AIM Children with autism spectrum disorder (ASD) frequently demonstrate impaired play skills and poor quality social interactions compared to typically developing peers. Complex interventions to improve play skills should be investigated with randomised control trials (RCT) where possible to support evidence-based practice for occupational therapists. Prior to a RCT, multiple feasibility studies are recommended to identify barriers to the trial. The aim of this study is to adapt a complex intervention to improve play skills in children with ASD and investigate the feasibility of conducting a RCT. METHODS Participants were 10 children with ASD paired with typically developing playmates chosen by their families. Pairs attended 10 intervention sessions involving video modelling, therapist- and peer-mediation and free play. Participant numbers needed for future investigation of effectiveness were calculated and time and cost considerations were reviewed. The Test of Playfulness (ToP) was the primary outcome measure; both parent- and child-report outcome measures were evaluated for appropriateness. RESULTS To determine effectiveness of the intervention 34 pairs in both control and intervention groups will be needed to conduct a RCT over an 18-month timeframe. ToP scores showed a positive, but not statistically significant trend from pre- to post-intervention. These improvements were maintained at follow-up in both clinic and home environments. The Piers-Harris 2 and the Parent Relationship Questionnaire were identified as appropriate secondary outcome measures; additional parent- and teacher-report outcome measures are recommended for the RCT. CONCLUSION A RCT to investigate effectiveness of this intervention for improving play skills of children with ASD and their playmates are feasible.