Measuring functional change in children with acquired brain injury (ABI): comparison of generic and ABI-specific scales using the Pediatric Evaluation of Disability Inventory (PEDI).
OBJECTIVE
The Pediatric Evaluation of Disability Inventory (PEDI) subscales are hierarchic in nature, with item placements within each subscale reflecting the general order of skill attainment in children without disabilities. The purpose of this study was to determine whether a hierarchical subscale developed in this study for children with acquired brain injuries (ABIs) corresponds to the generic PEDI subscales, and, if not, whether condition-specific (ABI-specific) PEDI subscales are more sensitive for measuring change.


METHODS
Eighty-seven children and adolescents (mean age=9.2 years, SD=5.2, range=1-20) with ABI during inpatient rehabilitation admissions were included.


METHODS
Data were collected by retrospective chart review. Rasch one-parameter analyses were conducted to construct the ABI-specific PEDI scale focusing on the Mobility and Self-care domains (content areas) only. Each domain consists of a Functional Skills subscale and a Caregiver Assistance subscale. Thus, in all, 4 scales were constructed within the ABI-specific PEDI scale. Differences in item hierarchies and sensitivity between generic and ABI-specific PEDI subscales for each domain were then examined.


RESULTS
Both generic and ABI-specific PEDI scales were sensitive for measuring functional changes during inpatient rehabilitation hospitalization. Even though the generic and ABI-specific item hierarchies differed substantially, only one of the 4 ABI-specific PEDI subscales (Caregiver Assistance Self-care subscale) was more sensitive for measuring change than the generic PEDI scale.


CONCLUSIONS
The ABI-specific scales added relatively little improvement in sensitivity compared with the generic PEDI scales of the Mobility and Self-care domains. Thus, for group analyses, the authors recommend use of the generic PEDI subscales for children with ABI. Future work with ABI-specific subscales may improve the physical therapist's ability to describe an individual's pattern of functional recovery.
Kothari
Dhari H
DH
VA Rehabilitation Research and Development Center, Palo Alto, CA 94304, USA. dhara@rrdmail.stanford.edu
Haley
Stephen M
SM
Gill-Body
Kathleen M
KM
Dumas
Helene M
HM
D000203:Activities of Daily Living; D000293:Adolescent; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D019988:Children with Disabilities; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*