title: A computer adaptive testing approach for assessing physical functioning in children and adolescents.
abstract: The purpose of this article is to demonstrate: (1) the accuracy and (2) the reduction in amount of time and effort in assessing physical functioning (self-care and mobility domains) of children and adolescents using computer-adaptive testing (CAT). A CAT algorithm selects questions directly tailored to the child's ability level, based on previous responses. Using a CAT algorithm, a simulation study was used to determine the number of items necessary to approximate the score of a full-length assessment. We built simulated CAT (5-, 10-, 15-, and 20-item versions) for self-care and mobility domains and tested their accuracy in a normative sample (n=373; 190 males, 183 females; mean age 6y 11mo [SD 4y 2m], range 4mo to 14y 11mo) and a sample of children and adolescents with Pompe disease (n=26; 21 males, 5 females; mean age 6y 1mo [SD 3y 10mo], range 5mo to 14y 10mo). Results indicated that comparable score estimates (based on computer simulations) to the full-length tests can be achieved in a 20-item CAT version for all age ranges and for normative and clinical samples. No more than 13 to 16% of the items in the full-length tests were needed for any one administration. These results support further consideration of using CAT programs for accurate and efficient clinical assessments of physical functioning.
authors.affiliation: Health and Disability Research Institute, Boston University, Boston, MA 02215, USA. smhaley@bu.edu
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Haley
authors.forename: Pengsheng
authors.initials: P
authors.lastname: Ni
authors.forename: Maria A
authors.initials: MA
authors.lastname: Fragala-Pinkham
authors.forename: Alison M
authors.initials: AM
authors.lastname: Skrinar
authors.forename: Deyanira
authors.initials: D
authors.lastname: Corzo
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003198:Computer Simulation; D003199:Computer Systems; D016001:Confidence Intervals; D003710:Demography; D005260:Female; D006009:Glycogen Storage Disease Type II / Q000503:physiopathology; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D015203:Reproducibility of Results; D012648:Self Care; D012680:Sensitivity and Specificity